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rVSV-ZEBOV 疫苗在几内亚一线工作人员中对扎伊尔型埃博拉的安全性。

Safety of the rVSV ZEBOV vaccine against Ebola Zaire among frontline workers in Guinea.

机构信息

Epicentre, 8 rue Saint Sabin, 75011 Paris, France.

Médecins Sans Frontières-Operational Center, Belgium.

出版信息

Vaccine. 2019 Nov 15;37(48):7171-7177. doi: 10.1016/j.vaccine.2018.09.009. Epub 2018 Sep 25.

Abstract

BACKGROUND

As part of the ring vaccination trial in Guinea, Front Line Workers were invited to participate in a sub-study to provide additional information on the immunogenicity and safety of rVSVΔG/ZEBOV-GP. Here we summarize the information on the safety follow-up.

METHODS

An open-label, non-randomized, immunogenicity evaluation of one dose of rVSVΔG/ZEBOV-GP was conducted in Conakry, Guinea between March 2015 and July 2016. Front-line workers refusing vaccination were invited to participate as a control group. Participants were followed for 3 months with a subset followed-up for 6 months after vaccination. Women becoming pregnant during the follow-up were followed until pregnancy outcome. Solicited and unsolicited adverse events were monitored at each contact with participants using standardized study forms.

RESULTS

2016 vaccinated participants and 99 controls were included in the safety cohort. On the 3 days post-vaccination visit adverse events were very common, with over 70% of participants reporting at least one adverse event. The most frequently reported symptoms were headache, fatigue, arthralgia, subjective fever and myalgia. Among participants that completed fever diaries (n = 887), post-vaccination fever was reported by 15.22%. Comparing to the unvaccinated group, local reaction, fatigue, headache, arthralgia, myalgia and subjective fever occurring within the first 3 days post-vaccination were statistically significantly different in the vaccinated group compared to the unvaccinated. A total of 8 Serious Adverse Events were identified during follow-up. 2 SAEs were related to pregnancy.

CONCLUSIONS

Results confirm that adverse events 3 days after vaccination with the rVSV candidate vaccine are common. The occurrence of fever is of particular concern in the context of ongoing Ebola transmission. Additional studies should address important data gaps regarding the use of the vaccine in pregnancy and other vulnerable populations.

摘要

背景

作为几内亚环状疫苗接种试验的一部分,一线工作人员应邀参加一项子研究,以提供关于 rVSVΔG/ZEBOV-GP 的免疫原性和安全性的更多信息。在此,我们总结了安全性随访信息。

方法

2015 年 3 月至 2016 年 7 月在几内亚科纳克里进行了 rVSVΔG/ZEBOV-GP 单剂的开放性、非随机、免疫原性评估。拒绝接种疫苗的一线工作人员应邀作为对照组参加。对参与者进行了 3 个月的随访,其中一部分在接种疫苗后随访 6 个月。在随访期间怀孕的女性一直随访到妊娠结局。使用标准化研究表格在每次与参与者接触时监测有针对性和非针对性的不良事件。

结果

共有 2016 名接种疫苗的参与者和 99 名对照者纳入安全性队列。在接种后 3 天就诊时,不良事件非常常见,超过 70%的参与者报告至少有一种不良事件。最常报告的症状是头痛、疲劳、关节痛、主观发热和肌痛。在完成发热日记的参与者中(n=887),接种后报告发热的有 15.22%。与未接种组相比,接种组在接种后 3 天内出现的局部反应、疲劳、头痛、关节痛、肌痛和主观发热的发生率明显高于未接种组。在随访期间共发现 8 例严重不良事件。2 例严重不良事件与妊娠有关。

结论

结果证实,接种 rVSV 候选疫苗后 3 天出现的不良事件很常见。在埃博拉病毒持续传播的情况下,发热的发生尤其令人关注。应开展更多研究,以解决有关该疫苗在妊娠和其他弱势群体中使用的重要数据空白。

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