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Vaccination uptake trends vary in 2024
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Transgene and NEC Corporation today announced the signing of a further development collaboration agreement to continue the clinical evaluation of the individualized neoantigen cancer vaccine TG4050.

TG4050 is currently being evaluated in a randomized multicenter Phase I trial as a single agent in the adjuvant treatment of HPV-negative head and neck cancers. Based on promising data obtained in this Phase I trial, Transgene and NEC are preparing a randomized Phase I/II extension of this trial slated to start in 2024.

This new trial builds on compelling first signs of efficacy and induction of specific T-cell responses to generate a comprehensive set of immunological and clinical data to demonstrate the potential of TG4050 further.

Additional immunological and clinical data from the Phase I trial is expected at a scientific conference in the first half of 2024.

Alessandro Riva, Chairman and CEO of Transgene, commented in a press release, "We are pleased to announce the extension of our agreement with NEC, which marks a significant milestone in our collaboration."

"We look forward to continuing to treat patients with our individualized cancer vaccine TG4050. The compelling initial Phase I data presented with NEC at ASCO 2023 showed that all evaluable patients treated with TG4050 monotherapy developed a specific immune response and remained disease-free."

"Our joint clinical development plan builds on these promising data in a setting where there is no approved treatment to prevent patient relapse after adjuvant chemoradiotherapy."

"We believe that TG4050, by combining a powerful and immunogenic viral vector with an extremely sophisticated neoantigen selection tool, has the potential to address major medical needs in the adjuvant treatment of solid tumors."

TG4050 is based on Transgene's viral vector-based myvac® platform and powered by NEC's cutting-edge AI capabilities for identifying and predicting the most immunogenic neoantigens.

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A U.S. CDC-funded Original Research study concluded that two doses of recombinant zoster vaccine (RZV) were highly effective, although less effective against Herpes Zoster (shingles) than in the previous clinical trials.

Published by the Annals of Internal Medicine on January 9, 2024, this Real-World Setting study included nearly 2 million persons who contributed 7.6 million person-years of follow-up.

After adjustment, the vaccine efficacy (VE) of 1 dose was 64%, and VE of 2 doses was 76%.

After one dose only, VE was 70% during the first year, 45% during the second year, 48% during the third year, and 52% after the third year.

After two doses, VE was 79% during the first year, 75% during the second year, and 73% during the third and fourth years.

These findings underscore the importance of the second vaccine dose, wrote these researchers.

Currently, the CDC recommends the Shingrix® vaccine to prevent herpes zoster and related complications for most adults aged 50 and older. 

There is no specific time you need to wait before administering Shingrix to patients who have had herpes zoster.

However, it would be best if you did not give Shingrix to patients who are experiencing an acute episode of herpes zoster or a pregnant woman.

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by Gerd Altmann
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According to a Medical News Brief by Emily Harris with The JAMA Network, observational data from more than 1.6 million people in the United States suggests that a high-dose vaccine may also be more effective than standard-dose vaccines for certain adults.

Reported in the New England Journal of Medicine in December 2023, the Original Article evaluated a recombinant vaccine that contains more than triple the amount of influenza hemagglutinin protein compared with standard-dose vaccines.

Flu cases were about 15% lower for people aged 50 to 64 who received the recombinant vaccine.

Because standard-dose vaccines only prevent up to 40% to 60% of influenza cases, decreasing the number of cases by an additional 15% would still “provide a substantial public health benefit, especially during more severe influenza seasons,” the researchers wrote.

As of December 31, 2023, the U.S. CDC reported that over 155 million egg, cell, and nasal-based influenza vaccines, which are generally available at local pharmacies, had been distributed this flu season.

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Influenza Vaccine Candidates 2024

Influenza Vaccine Candidates 2024

report indicates over 110 influenza vaccine candidates are under development in 2024.

A mosaic influenza nanoparticle vaccine (FluMos-v1) is unique in that it is designed to co-display four recently circulating haemagglutinin (HA) strains. A phase 1 clinical study demonstrates that FluMos-v1 nanoparticles are predominantly quadrivalent. Imaging by TIRFM allowed direct visualization of the co-localization of HA trimers from multiple strains, and imaging of more than 10 thousand nanoparticles revealed individual nanoparticles with four, three, two, and one color.

CSL sa-mRNA bicistronic influenza vaccine candidates produced a potent, cross-reactive immune response against pandemic and seasonal influenza strains A(H5N1) and A(H1N1). In addition, the mRNA platform recently reported results from a significant Phase III vaccine study, meeting its primary and secondary endpoints of infection prevention and severe disease with a favorable safety and tolerability profile.

Cidara Therapeutics's CD388 is a highly potent long-acting antiviral immunotherapy in phase 1 study, designed to deliver universal seasonal and pandemic influenza prevention.

CureVac's second-generation mRNA influenza vaccine candidate, CVSQIV, was developed with GSK. An extended preliminary phase 1 data from Joint COVID-19 and Flu mRNA Vaccine Development Programs was launched on May 8, 2023. The Phase 1 study's best-performing candidate providing broad antigen coverage against WHO-recommended flu strains selected for Phase 2, following positive data from Phase 1 interim analysis. Dosing of the first Phase 2 participant is anticipated in Q4 2023.

The Emergex universal influenza vaccine candidate is designed to induce CD8+ T cells specific to highly conserved parts of the influenza virus from both the positive and negative sense reading frames. 

Flu-v Influenza Vaccine is a synthetic universal flu vaccine candidate that offers protection across a broad influenza spectrum forcing 1+NP forcing vaccine candidate consisting of MVA, a replication-deficient pox viral vector safely tested in thousands of patients, generates strong immune reaction against Matrix 1 Nucleoprotein influenza antigens. 

NasoVAX is a recombinant intranasal vaccine developed for both seasonal and pandemic use.

NanoFlu is a quadrivalent recombinant hemagglutinin (H.A.) protein nanoparticle influenza vaccine produced by Novavax in its SF9 insect cell baculovirus system. NanoFlu uses H.A. amino acid protein sequences similar to the recommended wild-type circulating virus H.A. sequences. In addition, NanoFlu contains Novavax's patented saponin-based Matrix-M™ adjuvant. CD388 (drug-Fc conjugate) is a highly potent, long-acting antiviral immunotherapy designed to deliver universal prevention and treatment of seasonal and pandemic influenza. Cidara Therapeutics intends to initiate a Phase 1 study in healthy volunteers in 2022.

The U.S. NIH's BPL-1357 is a whole-virus vaccine candidate comprising four non-infectious, chemically inactivated, low-pathogenicity avian flu viruses conducting a phase 1 study.

Novavax investigational influenza (qNIV) vaccine is our quadrivalent nanoparticle vaccine candidate, targeting seasonal flu. qNIV is designed using our recombinant technology, with four forms of wild-type hemagglutinin (H.A.) protein from the influenza virus as antigens. Antigens are organized into distinct nanoparticle complexes recognized by the immune system, working in concert with our Matrix-M™ adjuvant.

Osivax' OVX836 targets the nucleoprotein (N.P.), a highly conserved internal antigen. Unlike surface antigens, the N.P. is much less likely to mutate, alleviating the need for annual vaccination updates. The latest results from the Phase 2a dose-optimization study (OVX836-003) found that OVX836 maintained an excellent safety profile at all doses and provided protective efficacy in reducing PCR-confirmed influenza-like illnesses by 78%. Topline results from both studies are anticipated in the first half of 2023. 

Sinovac Biotech Ltd.'s two-dose inactivated quadrivalent influenza vaccine is conducting a phase 3 study with children in Chile.

Revelation Biosciences Inc. intranasal REVTx-99a is for the preventive treatment of H3N2 influenza (influenza A and B) infection in healthy humans, parainfluenza, rhinovirus, respiratory syncytial virus, and SARS-CoV-2 including its variants.

Redeeflu (M2SR) is a nasal vaccine candidate utilizing a proprietary M2 deleted, single replication influenza virus.

Vaxess Technologies, Inc. MIMIX-Flu Vaccine Patch is conducting Phase I Clinical Trial, a first-in-man trial of VX-103. On June 5, 2023, the Company stated the MIMIX-Flu vaccine patch elicited robust, durable, and broadly protective immune responses. And titers did not differ significantly for the two dose levels, indicating a fractional dose can be delivered without substantially impacting immunogenicity.

PDS Biotechnology Corporation's investigational universal influenza vaccine PDS0202 demonstrated active neutralization across multiple influenza viruses. 

The universal influenza vaccine candidate FluMos-v2 (VRC- FLUMOS0116-00-VP, start date: 2023-08-09) was designed by researchers at NIAID's Vaccine Research Center (VRC) and is conducting a phase 1 clinical trial. FluMos-v2 is intended to induce antibodies against various influenza virus strains by displaying part of the influenza virus hemagglutinin (H.A.) protein in repeating patterns on self-assembling nanoparticle scaffolds (SAPNs). Exposure to these harmless fragments of virus proteins prepares the immune system to recognize and fight the virus. When tested in animals, the experimental vaccine resulted in robust antibody responses. It is an adaptation of an earlier U.S. NIH universal flu vaccine candidate, FluMos-v1, which began first-in-human testing in 2021 and is still undergoing clinical trials.

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Influenza Vaccine Candidates under development in 2024
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Curevo Vaccine today announced positive data from a Phase 2 trial of amezosvatein (a non-mRNA, adjuvanted subunit vaccine also known as CRV-101) head-to-head versus the U.S. FDA-approved Shingrix® vaccine.

According to the Company's press release on January 7, 2024, Amezosvatein met all primary endpoints in the randomized, controlled, observer-blind Phase 2 trial, including demonstrating non-inferiority to Shingrix as measured by humoral immune response.

Amezosvatein also exhibited lower rates of solicited local and systemic adverse events. Amezosvatein was engineered to have a best-in-class safety profile.

Like Shingrix, amezosvatein uses a subunit protein antigen called glycoprotein 'E' (gE).

Targeting the gE antigen is proven to elicit a long-term, protective immune response to prevent shingles.

Also, like Shingrix, amezosvatein uses an adjuvant targeting the TLR4 pathway to boost the immune response to the gE antigen.

"Fewer than 5% of eligible adults in most European countries and China have received both doses of Shingrix," noted George Simeon, Curevo's Chief Executive Officer, "and two-thirds of adults in the USA still need to be immunized against shingles.

As of January 8, 2024, various shingles vaccines are available in over 30 countries.

Based upon these clinical study results, Curevo will advance amezosvatein into global Phase 3 trials in 2024 to address a market for shingles vaccination currently exceeding $4 billion. 

Virtually all adults have been exposed to the varicella-zoster virus, and around 30% will develop shingles at least once in their lifetime. 

Also called 'herpes zoster,' shingles occur when the varicella-zoster virus causing childhood chickenpox re-emerges from sensory ganglion nervous system cells where the virus lies dormant after initial exposure.

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RSV antibody 2024
Updated CDC Guidance regarding using Nirsevimab Beyfortus to protect young children from RSV
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The Philadelphia Department of Public Health reported today that there is a cluster of measles among unvaccinated residents.

As of January 4, 2024, in addition to an index case, three locally acquired cases have been confirmed, with two of those cases being hospitalized and released.

Furthermore, there are at least two more possible cases that have been hospitalized.

If you visited any of these sites on the days listed at this link, you may have been exposed to measles.

These measles cases are connected with the notice issued on December 23, 2023.

Health Commissioner Dr. Cheryl Bettigole commented in a press release, “Unfortunately, we are seeing cases of measles that have spread to vulnerable individuals, including young children, due to people declining vaccination and also failing to adhere to quarantine recommendations."

The Health Department is strongly recommending that anyone who may have been exposed to measles should quarantine themselves by staying home and away from others.

Additionally, people who have not received both doses of a Measles, Mumps, and Rubella (MMR) vaccine should talk with their healthcare provider about getting caught up.

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Dengue cases 2023
Qdenga dengue vaccine has limited availability in 2024
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AstraZeneca and Sanofi recently announced China's National Medical Products Administration approved Beyfortus™ (Nirsevimab-alip) for the prevention of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI).

Beyfortus is the first approved single-dose (50mg) preventive option to protect infants born healthy at term, preterm, or with specific health conditions that make them vulnerable to severe RSV disease entering or during their first RSV season.

Beyfortus is anticipated to be available in China during the upcoming 2024-2025 RSV season. Its administration can be timed to the start of the local RSV season.

RSV is the most common cause of LRTD in infants, including bronchiolitis and pneumonia, and is also a leading cause of hospitalisation in all infants. China ranks among countries with a high prevalence of RSV infections.

Iskra Reic, Executive Vice President, Vaccines and Immune Therapies, AstraZeneca, commented in a press release on January 2, 2024, "Beyfortus  represents the first opportunity to prevent serious respiratory disease due to RSV for all infants in China."

"We look forward to making Beyfortus available for the 2024/25 season."

While Beyfortus was approved in the United States in 2023, its availability has been limited. As of December 14, 2023, the manufacturers committed 1.4 million doses for delivery in the U.S. before February 2024.

Canada, the European Union, and the United Kingdom have also approved Beyfortus.

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