Division of Infectious Diseases, University of Kentucky School of Medicine, Lexington, KY, USA.
Clinical Testing, Quality Control Munich, Bavarian Nordic GmbH, Martinsried, Germany.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2384189. doi: 10.1080/21645515.2024.2384189. Epub 2024 Aug 22.
Modified Vaccinia Ankara Bavarian Nordic (MVA-BN) as a smallpox and mpox vaccine has been approved in its liquid-frozen (LF) formulation in the US, Canada, and EU. A freeze-dried (FD) formulation may offer additional benefits, such as a longer shelf life and reduced dependence on cold chain storage and transport. In a phase 2 clinical trial, 651 vaccinia-naïve participants were vaccinated with two doses of MVA-BN LF or FD, 4 weeks apart. The objectives were to compare MVA-BN FD with LF in terms of vaccine-induced immune responses, safety, and reactogenicity. Non-inferiority of the immune response was assessed by the 95% CI of the geometric mean ratios. Both formulations induced robust vaccinia-specific humoral and cellular immune responses. At peak humoral responses (Week 6), geometric means of total antibody titers were 1096 (95% CI 1013, 1186) from the FD group and 877 (95% CI 804, 956) from the LF group, achieving the primary endpoint of non-inferiority of MVA-BN FD compared to MVA-BN LF. At peak cellular responses (Week 2), geometric means of T cell spot forming units were 449 (95% CI 341, 590) from the FD group and 316 (95% CI 234, 427) from the LF group. Both formulations of MVA-BN were well tolerated, with similar unsolicited AEs and solicited systemic reactions in both groups but slightly more local reactions in the FD group. No vaccine-related serious adverse events (SAEs) or vaccine-related AE of special interest were reported. The FD formulation of MVA-BN was shown to be equivalent to MVA-BN LF.
改良安卡拉牛痘病毒巴伐利亚北欧株(MVA-BN)作为天花和猴痘疫苗,其液态冷冻(LF)剂型已分别在美国、加拿大和欧盟获得批准。冻干(FD)剂型可能具有一些额外的优势,例如更长的保质期以及减少对冷链储存和运输的依赖。在一项 2 期临床试验中,651 名未曾接种过牛痘疫苗的参与者接受了 2 剂 MVA-BN LF 或 FD 疫苗的接种,间隔 4 周。目的是比较 MVA-BN FD 与 LF 在疫苗诱导的免疫反应、安全性和不良反应方面的差异。免疫反应的非劣效性通过几何均数比的 95%置信区间(CI)来评估。两种剂型均能诱导出强大的牛痘特异性体液和细胞免疫反应。在体液反应峰值(第 6 周)时,FD 组的总抗体滴度几何均数为 1096(95%CI:1013,1186),LF 组为 877(95%CI:804,956),达到 MVA-BN FD 与 MVA-BN LF 相比非劣效性的主要终点。在细胞反应峰值(第 2 周)时,FD 组的 T 细胞斑点形成单位几何均数为 449(95%CI:341,590),LF 组为 316(95%CI:234,427)。两种 MVA-BN 剂型均具有良好的耐受性,两组的不良反应发生率和全身反应发生率相似,但 FD 组的局部反应略多。未报告与疫苗相关的严重不良事件(SAE)或疫苗相关的特殊关注的不良反应。MVA-BN 的 FD 剂型与 MVA-BN LF 剂型相当。
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