开发新一代 COVID-19 疫苗:生物医学高级研究与开发局(BARDA)支持的 2b 期研究设计。

Development of Next-Generation COVID-19 Vaccines: Biomedical Advanced Research and Development Authority (BARDA-)-Supported Phase 2b Study Designs.

机构信息

Biomedical Advanced Research and Development Authority, Administration for Strategic Preparedness and Response, Department of Health and Human Services, Washington, DC, USA.

Rho, Incorporated, Federal Research Operations, Durham, NC, USA.

出版信息

Clin Infect Dis. 2024 Oct 15;79(4):928-935. doi: 10.1093/cid/ciae286.

Abstract

In response to the coronavirus disease 2019 (COVID-19) pandemic, vaccines were quickly and successfully developed and deployed, saving millions of lives globally. While first-generation vaccines are safe and effective in preventing disease caused by SARS-CoV-2, next-generation vaccines have the potential to improve efficacy and safety. Vaccines delivered by a mucosal route may elicit greater protective immunity at respiratory surfaces, thereby reducing transmission. Inclusion of viral antigens in addition to the spike protein may enhance protection against emerging variants of concern. Next-generation vaccine platforms with a new mechanism of action may necessitate efficacy trials to fulfill regulatory requirements. The Biomedical Advanced Research and Development Authority (BARDA) will be supporting Phase 2b clinical trials of candidate next-generation vaccines. The primary endpoint will be improved efficacy in terms of symptomatic disease relative to a currently approved COVID-19 vaccine. In this paper, we discuss the planned endpoints and potential challenges to this complex program.

摘要

针对 2019 年冠状病毒病(COVID-19)大流行,疫苗被迅速成功开发并部署,在全球范围内挽救了数百万人的生命。虽然第一代疫苗在预防由 SARS-CoV-2 引起的疾病方面是安全有效的,但下一代疫苗有可能提高疗效和安全性。通过黏膜途径递送的疫苗可能在呼吸道表面引发更强的保护性免疫,从而减少传播。除了刺突蛋白之外,包含病毒抗原可能会增强对新出现的令人关注的变异体的保护作用。具有新作用机制的下一代疫苗平台可能需要进行疗效试验以满足监管要求。生物医学高级研究与开发局(BARDA)将支持候选下一代疫苗的 2b 期临床试验。主要终点将是相对于目前批准的 COVID-19 疫苗,在有症状疾病方面提高疗效。在本文中,我们讨论了该复杂计划的计划终点和潜在挑战。

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