Using a Human Challenge Model of Infection to Measure Vaccine Efficacy: A Randomised, Controlled Trial Comparing the Typhoid Vaccines M01ZH09 with Placebo and Ty21a

使用人类感染模型来衡量疫苗效力:一项比较伤寒疫苗 M01ZH09 与安慰剂和 Ty21a 的随机对照试验

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作者:Thomas C Darton, Claire Jones, Christoph J Blohmke, Claire S Waddington, Liqing Zhou, Anna Peters, Kathryn Haworth, Rebecca Sie, Christopher A Green, Catherine A Jeppesen, Maria Moore, Ben A V Thompson, Tessa John, Robert A Kingsley, Ly-Mee Yu, Merryn Voysey, Zoe Hindle, Stephen Lockhart, Marcelo B

Background

Typhoid persists as a major cause of global morbidity. While several licensed vaccines to prevent typhoid are available, they are of only moderate efficacy and unsuitable for use in children less than two years of age. Development of new efficacious vaccines is complicated by the human host-restriction of Salmonella enterica serovar Typhi (S. Typhi) and lack of clear correlates of protection. In this study, we aimed to evaluate the protective efficacy of a single dose of the oral vaccine candidate, M01ZH09, in susceptible volunteers by direct typhoid challenge.

Conclusions

Despite successfully demonstrating the use of a human challenge study to directly evaluate vaccine efficacy, a single-dose M01ZH09 failed to demonstrate significant protection after challenge with virulent Salmonella Typhi in this model. Anti-Vi antibody detected prior to vaccination played a major role in outcome after challenge.

Trial registration

ClinicalTrials.gov (NCT01405521) and EudraCT (number 2011-000381-35).

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