Immunogenicity of a Live-Attenuated Dengue Vaccine Using a Heterologous Prime-Boost Strategy in a Phase 1 Randomized Clinical Trial

Leyi Lin, Michael A. Koren, Kristopher M. Paolino, Kenneth H. Eckels, Rafael De La Barrera, Heather Friberg, Jeffrey R. Currier, Gregory D. Gromowski, Naomi E. Aronson, Paul B. Keiser, Marvin J. Sklar, Erica L. Sondergaard, Louis E. Jasper, Timothy P. Endy, Richard G. Jarman, Stephen J. Thomas

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Dengue is a global health problem and the development of a tetravalent dengue vaccine with durable protection is a high priority. A heterologous prime-boost strategy has the advantage of eliciting immune responses through different mechanisms and therefore may be superior to homologous prime-boost strategies for generating durable tetravalent immunity. Methods: In this phase 1 first-in-human heterologous prime-boost study, 80 volunteers were assigned to 4 groups and received a tetravalent dengue virus (DENV-1-4) purified inactivated vaccine (TDENV-PIV) with alum adjuvant and a tetravalent dengue virus (DENV-1-4) live attenuated vaccine (TDENV-LAV) in different orders and dosing schedules (28 or 180 days apart). Results: All vaccination regimens had acceptable safety profiles and there were no vaccine-related serious adverse events. TDEN-PIV followed by TDEN-LAV induced higher neutralizing antibody titers and a higher rate of tetravalent seroconversions compared to TDEN-LAV followed by TDEN-PIV. Both TDEN-PIV followed by TDEN-LAV groups demonstrated 100% tetravalent seroconversion 28 days following the booster dose, which was maintained for most of these subjects through the day 180 measurement. Conclusions: A heterologous prime-boost vaccination strategy for dengue merits additional evaluation for safety, immunogenicity, and potential for clinical benefit. Clinical Trials Registration: NCT02239614.

Original languageEnglish
Pages (from-to)1707-1716
Number of pages10
JournalJournal of Infectious Diseases
Volume223
Issue number10
DOIs
StatePublished - 15 May 2021
Externally publishedYes

Keywords

  • dengue vaccine
  • dengue virus
  • immunogenicity

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