Clin Infect Dis. 2022 Oct 29;75(9):1585-1593. doi: 10.1093/cid/ciac209.
Malaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen.
In this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95% confidence intervals (CIs).
A total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12-17, 4-11, and 1-3 years). Asymptomatic malaria was observed in 47.5% of adults and 51.5% of children on day 1. Post-dose 1, GMCs were lower in 1-3-year-old malaria-positive compared with malaria-negative children (age group-specific GMR, .56; 95% CI, .39-.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95% CI, .67-1.02).
The Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.
疟疾感染会影响某些疫苗的免疫反应。由于埃博拉病毒（EBOV）的爆发主要发生在疟疾流行的国家，我们评估了无症状疟疾是否会影响两剂 Ad26.ZEBOV、MVA-BN-Filo 埃博拉疫苗方案的免疫反应。
在塞拉利昂的 EBOVAC-Salone 埃博拉疫苗试验的子研究中，在埃博拉疫苗接种时进行疟疾显微镜检查。有症状疟疾的参与者在接种疫苗前接受治疗。在接种疫苗后第 1 天（第 57 天）和第 2 天（第 78 天）通过 EBOV 糖蛋白 FANG 酶联免疫吸附试验（ELISA）评估埃博拉疫苗反应，并以几何平均浓度（GMC）表示。从疟疾阳性与疟疾阴性参与者的 GMC 中得出几何平均比值（GMR）及其 95%置信区间（CI）。
共研究了 587 名参与者，包括 188 名成年人（≥18 岁）和 399 名儿童（年龄组为 12-17 岁、4-11 岁和 1-3 岁）。第 1 天，成年人无症状疟疾的发生率为 47.5%，儿童为 51.5%。接种疫苗后第 1 天，1-3 岁疟疾阳性儿童的 GMC 低于疟疾阴性儿童（年龄组特异性 GMR，0.56；95%CI，0.39-0.81），但在年龄较大的组中没有一致的影响。接种疫苗后第 2 天，不同年龄组的疟疾感染没有一致的影响，但反应呈下降趋势（GMR，0.82；95%CI，0.67-1.02）。
Ad26.ZEBOV、MVA-BN-Filo 埃博拉疫苗方案在无症状疟疾感染的参与者中具有免疫原性。因此，在使用该方案进行疫苗接种之前，无需筛查无症状疟疾感染。
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