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For many years, oral vaccines have proven to be the quickest intervention for preventing, limiting, and controlling cholera outbreaks.

However, the supply of these vaccines was at an all-time low in 2024, especially in 23 countries, including Comoros, the Democratic Republic of the Congo, Ethiopia, Mozambique, Somalia, Zambia, and Zimbabwe.

To help relieve this inventory shortage, the World Health Organization (WHO) issued a new oral cholera vaccine (OCV) prequalification.

On April 12, 2024, EuBiologicals Co., Ltd.'s inactivated oral vaccine, Euvichol-S, which has similar efficacy to existing vaccines but a simplified formulation, was announced.

This authorization creates new opportunities to increase OCV production capacity rapidly.

"The new vaccine is the third product of the same family of cholera vaccines on our WHO prequalification list," said Dr Rogerio Gaspar, Director of the WHO Department for Regulation and Prequalification, in a press release on April 18, 2024.

The WHO's OCV prequalification list already includes Euvichol, Euvichol-Plus, Vaxchora®, Dukoral®, and Shanchol™.

When visiting countries with cholera outbreaks in 2024, the U.S. Centers for Disease Control and Prevention recommends OCV vaccination one month before traveling.

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Uromune MV140 Recurrent Urinary Tract Infections vaccine is an antibiotic alternative
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While measles outbreaks have been reported in dozens of countries in 2024, recent attention has focused on the cities of Chicago and London.

The U.K. Health Security Agency (UKHSA) published an updated epidemiological overview on April 18, 2024, stating that an additional 86 cases of measles were confirmed in England last week.

This data brings the total number of confirmed cases since October 2023 to 1,109.

About 39% of the U.K.'s measles cases (76 of 191) were in London during the last four weeks.

In a press release, Dr. Vanessa Saliba, UKHSA Consultant Epidemiologist, commented, "We know some communities in London have very low measles-mumps-rubella (MMR) vaccination rates. The MMR jab offers the best protection against measles."

The effective Priorx MMR vaccine is generally available at clinics and pharmacies in England. However, no measles-only vaccines are offered in England.

In the U.S., the Centers for Disease Control and Prevention (CDC) reported 121 measles cases in eighteen jurisdictions in 2024.

Most of these cases (61) have been reported by the Chicago Department of Public Health over the past two months.

The U.S. CDC republished a global Watch-Level 1, Practice Usual Precautions, Travel Health Notice in March 2024, alerting international travelers of potential health risks and identifying measles outbreaks in 49 countries.

The CDC recommends speaking with a travel vaccine consultant one month before traveling abroad to any outbreak countries.

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Euvichol-S oral cholera vaccine developed by EuBiologics and IVI in South Korea
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GSK plc today announced positive data from a long-term follow-up phase III clinical trial. The trial followed participants up to approximately 11 years following initial vaccination with Shingrix®, a non-live, recombinant subunit Herpes Zoster vaccine.

Announced on April 17, 2024, the final trial data demonstrate that Shingrix maintained efficacy against shingles for over a decade across all age groups.

The results from the ZOSTER-049 study, an extension from two phase III clinical trials in adults aged 50 and over (ZOE-50 and ZOE-70), include:

  • 79.7% vaccine efficacy (VE) in adults aged ≥50 cumulatively within the period from year six to year 11 after vaccination,
  • 82.0% VE in adults ≥50 at year 11, showing VE remains high each year after vaccination,
  • 73.1% VE in adults aged ≥70 cumulatively from six to 11 years after immunization, showing high VE rates.

In a press release, Dr. Javier Díez-Domingo, Principal Investigator, said, "These final data demonstrate continued protection over more than a decade with high efficacy maintained in both the 50+ and 70+ age groups."

"Infectious diseases like shingles pose a significant risk to adults due to the natural decline in our immune system, and these data represent a remarkable advancement in our understanding of what can be achieved long-term for effective protection against shingles."

Globally, shingles will affect about 30% of people in their lifetimes.

Up to 30% of people experience post-herpetic neuralgia following a shingles rash, a long-lasting nerve pain that can last weeks or months and occasionally persist for several years.

In the U.S., Shingrix was approved by the FDA on October 20, 2017, and is offered at most pharmacies.

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According to Quebec's National Institute of Excellence in Health and Social Services (INESSS), there will be an increasing demand for emergency services in 2024, which shows the need for all infants to be protected from Respiratory Syncytial Virus (RSV).

As of April 18, 2024, INESSS recommends BEYFORTUS® to prevent RSV lower respiratory tract disease (LRTD) in all neonates and infants aged eight months. 

BEYFORTUS (Nirsevimab-alip) is not a vaccine but is the first approved single-dose, extended half-life monoclonal antibody offering passive immunization in children.

Furthermore, the INESSS Standing Committee on Deliberation—Reimbursement and Access unanimously agrees that BEYFORTUS provides significant clinical benefits compared to placebo in reducing lower respiratory tract infections that require medical assistance and hospitalization due to RSV infection in the healthy, full-term, or premature pediatric population during the first RSV season.

The Committee also recognizes the therapeutic value of BEYFORTUS in the population for whom the risk of developing a serious infection persists for a second RSV season.

Sanofi Canada confirmed it is working with Quebec provincial authorities to make BEYFORTUS available to a broad cohort of infants for the 2024-25 RSV season.

Delphine Lansac, General Manager, Vaccines Canada, Sanofi, stated in a press release, "Parents and physicians who experience the impacts of RSV annually have been waiting for a preventative option that can cover the entire infant population and protect our most vulnerable."

"I believe every baby deserves to be protected against RSV and this recommendation for BEYFORTUS marks an important milestone towards achieving that goal in Quebec. Now is the time to protect all infants against this devastating illness."

Health Canada issued a Notice of Compliance for BEYFORTUS in April 2023. Additionally, it was approved by the U.S. FDA, China, Japan, the European Union, and Great Britain.

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GSK today announced positive results from the pivotal phase III trial for gepotidacin, a potential first-in-class oral antibiotic with a novel mechanism of action for uncomplicated urogenital gonorrhea in adolescents and adults.

The study's results showed that gepotidacin (oral, two doses of 3,000mg) was non-inferior, with 92.6% success rates, compared to 91.2% success rates for intramuscular (IM) ceftriaxone (500mg) plus oral azithromycin (1,000mg) combined therapy, a leading combination gonorrhea treatment regimen.

Chris Corsico, SVP of Development, GSK, said in a press release on April 17, 2024, "We are committed to working with health regulators globally to introduce this potential new antibiotic, focusing on solutions that meet critical patient needs."

This announcement is important since the U.S. CDC previously reported that approximately half of the gonorrhea cases each year in the US are resistant to one antibiotic.

Gonorrhea is a sexually transmitted infection caused by bacteria called Neisseria gonorrhoeae, which the World Health Organisation has recognized as a priority pathogen. If inadequately treated, it can lead to infertility and other sexual and reproductive health complications.

Additionally, GSK is developing gepotidacin to potentially treat uncomplicated urinary tract infections (uUTs). If approved, Gepotidacin could be the first uUTI oral antibiotic in over twenty years.

The development of gepotidacin has been funded in whole or in part with U.S. federal funds.

From a prevention perspective, there are no approved gonorrhea vaccines., but a repurposed meningococcal vaccine has been reported effective.

And the is an oral spray UTI vaccine (Uromune™, MV140) being evaluated in 26 countries in 2024.

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A vaccine to prevent chlamydia infections is considered an important measure to control sexually transmitted and ocular infections.

Chlamydia trachomatis is the most common sexually transmitted bacterial infection worldwide, says the U.S. CDC.

As of April 2024, there is no vaccine against the major global pathogen Chlamydia trachomatis; its different serovars cause trachoma in the eye or chlamydia in the genital tract. 

However, significant research and investment have been made towards developing a chlamydial vaccine, but it has been quite some time since a successful phase 1 trial, commented Wilhelmina Huston, with the School of Life Sciences, University of Technology, Sydney, Australia, in an editorial published by The Lancet.

According to results from a phase 1 study (CHLM-02), Statens Serum Institut's CTH522, adjuvanted with CAF01 or CAF09b, is safe and immunogenic. 85 μg CTH522-CAF01 induces robust serum IgG binding titers.

Intradermal vaccination conferred systemic IgG neutralization breadth, and topical ocular administration increased ocular IgA formation. By day 42, the active groups had a 100% four-fold seroconversion rate, while the placebo group had no seroconversion.

The participants were healthy men and non-pregnant women aged 18–45 years without pre-existing C trachomatis genital infection.

Participants were randomly assigned (1:1:1:1:1) to each of the groups A–E, which received an investigational medicinal product, and group F received a placebo only.

Two liposomal adjuvants, CAF01 and CAF09b, were compared.

Serum IgG anti-CTH522 titers were higher after 85 μg CTH522-CAF01 than 15 μg, although not significantly, with no difference after three injections of 85 μg CTH522-CAF01 compared with CTH522-CAF09b (group E).

Intradermal CTH522 (group C) induced high titers of serum IgG anti-CTH522 neutralizing antibodies against serovars B (trachoma) and D (urogenital).

Topical ocular CTH522 (group B) at days 28 and 112 induced higher total ocular IgA compared with baseline (p<0·001).

Participants in all active vaccine groups, particularly groups B and E, developed cell-mediated immune responses against CTH522.

These findings published by The Lancet indicate the CTH522 vaccine candidate's regimens against ocular trachoma and urogenital chlamydia for testing in phase 2 clinical trials.

This phase 1, double-blind, randomized, placebo-controlled trial was conducted at the National Institute for Health Research Imperial Clinical Research Facility in the U.K.

As of April 17, 2024, the U.S. FDA, the U.K., and the European Medicines Agency have not approved a vaccine to prevent chlamydia infections.

However, Sanofi's multi-antigen chlamydia vaccine candidate is planning a Phase 1/2 study in 2024.

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CTH522 Chlamydia Vaccine

CTH522 Chlamydia Vaccine

Statens Serum Institut (SSI) CTH522 Chlamydia vaccine candidate is a multi-component prime-boost Chlamydia trachomatis vaccination regime. The vaccine antigen CTH522 is a recombinant, engineered version of the C. trachomatis major outer membrane protein (MOMP), comprising heterologous immunorepeats from four genital C. trachomatis serovars (D, E, F, and G). Preclinical research on the CTH522 vaccine led to the selection of the liposome-based cationic adjuvant formulation CAF®01, designed to induce a strong cell-mediated immune response combined with antibody induction. 

On February 23, 2024, Nature Communications published a report on a comparative immunological characterization of CTH522/CAF®01 in female mice and humans was published. We find a range of immune signatures that translate from mouse to human, including a Th1/Th17 cytokine profile and antibody functionality. We identify vac ine-induced T cell epitopes conserved among Chlamydia serovars and previously found in infected individuals. Using the mouse model, we show that the common immune signature protected against ascending infection in mice, and vaccine-induced antibodies could delay bacterial ascension to the oviduct and the development of pathology in a T cell-depleted mouse model. Finally, we demonstrate long-lasting immunity and protection of mice one year after vaccination.

A study funded by The EU Horizon Program TRACVAC at the National Institute for Health Research Imperial Clinical Research Facility, London, UK, reported on April 11, 2024, CTH522, adjuvanted with CAF01 or CAF09b, is safe and immunogenic, with 85 μg CTH522-CAF01 inducing robust serum IgG binding titers. Intradermal vaccination conferred systemic IgG neutralization breadth, and topical ocular administration increased ocular IgA formation. These findings indicate CTH522 vaccine regimens against ocular trachoma and urogenital chlamydia for testing in phase 2 clinical trials.

Statens Serum Institut (SSI) was inaugurated in September 1902 and is under the auspices of the Danish Ministry of Health. SSI has developed a unique vaccine strategy to combat this challenging infection. SSI envisions a vaccine that elicits cell-mediated and humoral immunity, with neutralizing antibodies as the primary role in reducing the initial infectious load. On the other hand, the bacteria are intracellular so that a bactericidal cell-mediated immune response will target them. 

CTH522 Chlamydia Vaccine Dosage

During the recent phase 1 study, participants were randomly assigned (1:1:1:1:1) to each of the group's A–E (12 participants each), and six were randomly assigned to group F. Investigators were masked to treatment allocation. GGrupsA–E received an investigational medicinal product, and Group F received a placebo only. Tw liposomal adjuvants, CAF01, and CAF09b, were comp red. Th groups were intramuscular 85 μg CTH522-CAF01, or placebo on day 0 and two boosters or placebo at days 28 and 112, and a mucosal recall with either placebo or CTH522 topical ocularly at day 140 (A); intramuscular 85 μg CTH522-CAF01, two boosters at day 28 and 112 with additional topical ocular administration of CTH522, and a mucosal recall with either placebo or CTH522 topical ocularly at day 140 (B); intramuscular 85 μg CTH522-CAF01, two boosters at day 28 and 112 with additional intradermal administration of CTH522, and a mucosal recall with either placebo or CTH522 topical ocularly at day 140 (C); intramuscular 15 μg CTH522-CAF01, two boosters at day 28 and 112, and a mucosal recall with either placebo or CTH522 topical ocularly at day 140 (D); intramuscular 85 μg CTH522-CAF09b, two boosters at day 28 and 112, and a mucosal recall with either placebo or CTH522 topical ocularly at day 140 (E); intramuscular placebo (F).

CTH522 Chlamydia Vaccine Indication

Chlamydia trachomatis is the most common sexually transmitted bacterial infection worldwide. An infection with the bacteria C. trachomatis causes chlamydia. The bacteria is like a virus, which relies on its host to survive and reply. Ate. C. trachoma tis has two developmental forms: a small (0.3 microns) non-replicating infectious form which, after attachment, is internalized into the host cell and instantly reorganized into a metabolically active and replicating form of almost triple the size. After completing a replicative cycle, it reorganizes into the infectious form and is released from the host cell. If the immune system does not control the bacteria, it may ascend to infect the fallopian tubes and cause significant damage, leading to pelvic inflammatory disease, scarring, and occlusion.

CTH522 Chlamydia Vaccine News

April 11, 2024 - Editorial: Immunological responses in a Chlamydia trachomatis vaccine trial.

November 22, 2022 - The Frontiers Immunology published an ORIGINAL RESEARCH article - This study evaluated the immunogenicity and protective efficacy of combined multi-component immunization strategies with both protein vaccines (CTH522, Con E), DNA vaccine and recombinant viral vector (MVA-MOMP), and adeno vector-based vaccines, in a non-human primate (NHP) model.

August 12, 2019 - The Lancet Infectious Diseases - Safety and immunogenicity of the chlamydia vaccine candidate CTH522 adjuvanted with CAF01 liposomes or aluminum hydroxide: a first-in-human, randomized, double-blind, placebo-controlled, phase 1 trial.

CTH522 Chlamydia Vaccine Clinical Trials

NCT03926728: A Phase I, Double-blind, Parallel, Randomised and Placebo-controlled Trial (CHLM-02) Investigating the Safety and Immunogenicity of a Chlamydia Vaccine, CTH522, in Healthy Ad ts. Biologica  CTH522-CAF01 IM; CTH522-CAF09b IM; CTH52  ID. Findings: Between February 17, 2020 and February 22, 2022, of 154 participants screened, 65 were randomly assigned, and 60 completed the trial (34 [52%] of 65 women, 46 [71%] of 65 White, mean age 26·8 ye rs). No serious adverse events occurred, but one participant in group A2 discontinued dosing after having self-limiting adverse events after both placebo and investigational medicinal products did. Study procedures were otherwise well tolerated; most adverse events were mild to moderate, with only seven (1%) of 865 reported as grade 3 (sev re). There was a 100% four-fold seroconversion rate by day 42 in the active groups (A–E) and no seroconversion in the placebo group. Serum IgG-CTH522 titers were higher after 85 μg CTH522-CAF01 than 15 μg, although not significantly (intention-to-treat median IgG titer ratio groups A–C: D=5·6; p=0·062), with no difference after three injections of 85 μg CTH522-CAF01 compared with CTH522-CAF09b (group E). IIntradermal TH522 (group C) induced high titers of serum IgG anti-CTH522 neutralizing antibodies against serovars B (trachoma) and D (urogeni al). Topical ooclarCTH522 (group B) at days 28 and 112 induced higher total ocular IgA compared with baseline (p<0· 01). Participants in all active vaccine groups, particularly groups B and E, developed cell-mediated immune responses against CTH522.

NCT02787109: Findings: Between August 15, 2016, and February 13, 2017, 35 women were randomly assigned (15 to CTH522:CAF01, 15 to CTH522:AH, and five to plac bo). 32 (91%) received all five vaccinations, and all participants were included in the intention-to-treat anal sex. No related serious adverse reactions were reported, and the most frequent adverse events were mild local injection-site reactions, which were reported in all (15 [100%] of 15) participants in the two vaccine groups and three (60%) of five participants in the placebo group (p=0·0526 for both companies ns). Intranasal vaccination was not associated with a higher frequency of related local reactions (reported in seven [47%] of 15 participants in the active treatment groups vs three [60%] of five in the placebo group; p=1· 00). CTH522:CAF 1 and CTH522:AH induced anti-CTH522 IgG seroconversion in 15 (100%) of 15 participants after five immunizations, whereas no participants in the placebo group were seroconve ted. CTH522:CAF 1 showed accelerated seroconversion, increased IgG titers, an enhanced mucosal antibody profile, and a more consistent cell-mediated immune response profile than CTH522:AH.

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CTH522
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