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Norovirus Vaccines

Norovirus Vaccine Candidate October 2025

While vaccines against Human norovirus (HuNoVs) disease are in demand, developing a broadly effective vaccine remains challenging in 2025, owing to the vast genetic and antigenic diversity of noroviruses, which have multiple co-circulating variants of different genotypes. As of October 2025, the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the U.K. had not approved a norovirus vaccine, and the World Health Organization (WHO) has not pre-qualified any norovirus vaccine.

Norovirus Vaccine Candidates

JAMA published a news article on a norovirus vaccine on July 25, 2025, summarizing current development efforts.

Research Article published in March 2025; Broadly neutralizing antibodies targeting pandemic GII.4 variants or seven GII genotypes of human norovirus demonstrate that norovirus human monoclonal antibodies with broad GII.4 potency and cross-GII breadth can be boosted in serum after immunization with an adenoviral vector–based vaccine, findings that may guide the design of immunogens for broadly protective norovirus vaccines.

Vaxart Inc.'s orally administered bivalent GI.1/GII.4 norovirus oral vaccine candidate showed robust, antigen-specific responses in the nasal cavity following oral administration in a phase 1b study in 2025. In May 2025, a phase 2b randomized, placebo-controlled vaccination and challenge study to assess the safety, efficacy, immunogenicity, and correlates of protection of VXA-G1.1-NN, an oral tablet norovirus vaccine. VXA-G1.1-NN was found to be safe and well-tolerated, conferred protection against norovirus GI.1 challenge, and reduced viral shedding in stool and emesis. The vaccine candidate was immunogenic and protected against norovirus infection, with a 30% relative reduction in the vaccine group compared with the placebo group (p = 0.003).

Moderna Inc. is developing two multivalent virus-like particle vaccines, mRNA-1403 (trivalent) and mRNA-1405 (pentavalent), to prevent norovirus infections. The Nova 301 Phase 3 trial is a randomized, observer-blind, placebo-controlled trial evaluating the efficacy, safety, and immunogenicity of mRNA-1403. In 2025, Moderna announced the US FDA placed a clinical hold following a single adverse event report of a case of Guillain-Barré syndrome, which is currently under investigation. The Company does not expect an impact on the study's efficacy readout timeline, as enrollment in the Northern Hemisphere has already been completed. The timing of the Phase 3 readout will be dependent on case accruals.

HilleVax HIL-214 was a bivalent vaccine candidate in development for preventing moderate to severe acute gastroenteritis. HilleVax's HIL-216 hexavalent virus-like particle (VLP) vaccine candidate for norovirus includes VLPs for six of the most common norovirus genotypes, including GI.1, GII.2, GII.3, GII.4, GII.6, and GII.17. The U.S. Food and Drug Administration (FDA) cleared an Investigational New Drug application for HIL-216 in September 2023. Vaccine development was discontinued in 2024.

Anhui Zhifei Longcom Biologic Pharmacy Co., Ltd. is conducting a Phase 1/2a clinical trial to evaluate the safety and tolerability of a tetravalent recombinant Norovirus vaccine at various doses. This candidate utilizes the Pichia pastoris expression system, which enables the production of virus-like particles (VLPs) recombinant engineered bacteria for expressing norovirus epidemic strains, which are then cultured.

Cocrystal Pharma, Inc. has dosed the first subjects in a Phase 1 clinical trial of its oral, first-in-class pan-norovirus and pan-coronavirus 3CL protease inhibitor, CDI-988, on September 29, 2023. Recent CDI-988 in vitro studies have demonstrated potent, broad-spectrum antiviral activity against a panel of pandemic GII.4 norovirus proteases, along with a favorable pharmacokinetic profile that targets the gastrointestinal tract. 

Norovirus Treatment 2025

Cocrystal Pharma, Inc. announced on January 8, 2025, favorable safety and tolerability results at doses of up to 800 mg per day for 10 consecutive days from the multiple-ascending dose portion of its ongoing Phase 1 study with its oral protease inhibitor, CDI-988. CDI-988 is the first pan-viral drug candidate in development for the orally administered treatment of norovirus and coronavirus infections. 

Travelan® is an orally administered passive immunotherapy that prophylactically reduces the likelihood of contracting travelers' diarrhea. In Australia, Travelan® is a listed medicine on the Australian Register for Therapeutic Goods. It is antimicrobial and indicated to reduce the risk of Travelers' Diarrhea and minor gastrointestinal disorders. In Canada, Travelan® is a licensed natural health product that reduces the risk of Travelers' Diarrhea. In the U.S., Travelan® is sold as a dietary supplement for digestive tract protection.

Norovirus Outbreaks

Based on CaliciNet Data, the U.S. Centers for Disease Control and Prevention CDC published the Norovirus Outbreak Map in 2025. The Wastewater SCAN Norovirus map is updated in 2025. The CDC also posts national trends for Norovirus. Approximately 2,500 reported norovirus outbreaks occur in the United States each year. In 2019, norovirus infections resulted in approximately 5.5 million illnesses and 22,400 hospitalizations.

Norovirus Cruise Ship Outbreaks

The U.S. CDC and the U.K. identified norovirus outbreaks and issued ts for the cruise ship industry in 2025. Eighteen potential norovirus outbreaks were reported in 2025; twelve occurred on cruise ships in 2024 and 2023. A University of Surrey–led research team identified cruise ship dining areas as priorities for preventing disease outbreaks.

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Norovirus vaccine candidates are conducting clinical studies.
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ENA Respiratory today announced that INNA-051, a first-in-class, broad-spectrum, innate immunomodulator in development for the prevention of respiratory viral infections, was found to significantly impact the course of viral infection in a Phase 2a flu challenge study.

The study's post hoc analyses, excluding those with pre-existing immunity, showed that INNA-051-treated participants with PCR laboratory-confirmed infection had a statistically significant shorter duration of infection.

"This study further supports the concept that boosting the local innate immune response to common respiratory viruses has potential clinical benefit. In this study, INNA-051 was found to be safe and to significantly impact the course of infection. We are eager to investigate INNA-051's clinical benefit in the context of natural viral respiratory tract infections in individuals at increased risk of more severe illness," said Christophe Demaison, Ph.D., Managing Director and CEO of ENA Respiratory, in a press release on February 14, 2023.

These Phase 2a study results mirror those seen in animal respiratory infection models and are consistent with the INNA-051 mechanism of action. INNA-051 accelerates virus clearance and reduces virus spread to other body parts.

It is anticipated that INNA-051 prophylaxis will reduce illness severity and healthcare utilization in individuals exposed to respiratory viral infections, especially those at high risk of complications. 

Earlier research in humans and animals has shown that INNA-051 activates the innate immune system in the nose, a common site of infection.

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Jiangsu Recbio Technology Co., Ltd. today announced it has recently completed the first batch of subject enrollment for its novel adjuvanted recombinant vaccine, REC610, that prevents shingles caused by varicella zoster virus (VZV).

The study is a randomized, observer-blinded, active-controlled phase I clinical trial to evaluate the safety and immunogenicity of REC610 in healthy adult subjects aged 40 and above.

According to research data on shingles vaccines that have been marketed worldwide, the novel adjuvanted vaccine can provide stronger cellular immunity and protective efficacy compared to live attenuated vaccines.

This announcement is essential since about 2.5 million adults in China suffer from herpes zoster yearly, and most seniors in China carry the dormant herpes zoster virus.

REC610 is equipped with a novel adjuvant BFA01 independently developed by the Company, which can promote the production of high levels of VZV glycoprotein E (gE)-specific CD4+ T cells and antibodies.

Preclinical studies have shown that REC610 has favorable immunogenicity and can induce high levels of gE-specific CD4+ T cell responses and IgG antibodies.

Its immune response is non-inferior to the controlled vaccine, Shingrix® says the Company.

Shingrix® is a non-live, adjuvanted recombinant vaccine consisting of the VZV glycoprotein E antigen and the AS01B adjuvant system, a proprietary adjuvant containing QS-21 and MPL with liposomes. 

Shingrix has been commercially available in the U.S. since 2017.

Additional shingles vaccine development is posted at PrecisionVaccinations.

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A United Nations (UN) team led by Beatrice Mutali, the Resident Coordinator in Zambia, recently confirmed it is supporting the Republic of Zambia's response to a cholera outbreak.

Zambia's Ministry of Health declared the cholera outbreak on January 26, 2023.

Cholera outbreaks in three districts have been reported, with 90 cases and three related fatalities confirmed.

As of February 10, 2023, the UN team is providing technical support to authorities while mobilizing funding to bridge a gap of $32 million for risk communication, water and sanitation, food, and other items.

Since December 2022, UNICEF has provided 4.5 tonnes of granular chlorine, 20,000 bottles of liquid chlorine for household water treatment, 250 containers of disinfectant, and other critical supplies to keep the water safe.

For its part, the World Health Organization (WHO) is working with Zambian authorities to strengthen assessment capacities along with surveillance, contact tracing, and lab preparations for cholera vaccination. 

As of February 12, 2023, extensive cholera outbreaks have been reported in Haiti, Malawi, and Syria.

The WHO has approved various cholera vaccines for use in 2023.

Unfortunately, these cholera vaccines are not currently available in the U.S.

In addition to cholera, the U.S. CDC suggests various vaccinations before visiting Zambia.

These travel vaccines are offered in the U.S. at certified clinics and pharmacies.

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U.S. CDC Zambia map 2023
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Nepal children
Measles outbreaks in India and Nepal in 2023
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In his opening address to the Executive Board, WHO Director-General Dr. Tedros Adhanom Ghebreyesus recently noted that no wild poliovirus cases had been reported anywhere since September 2022.

"We are in a much better situation now than we were previously. But the last mile is the hardest."

"There can be no room for complacency. Now is actually the moment to double down on our efforts. So let's continue to push on."

Experts noted the unique window of opportunity to succeed in 2023, the target year for stopping all remaining poliovirus transmission globally. 

The WHO also provided guidance to develop a new vision for the polio transition that will go beyond 2023, supported by tailored regional action plans to drive country progress.

AN updated list of At-Risk Countries was posted.

Following that WHO meeting, the Global Polio Eradication Initiative reported on February 8, 2023, a summary of new polioviruses detections and polio cases this week:

  • Afghanistan: two WPV1-positive environmental samples
  • Algeria: one cVDPV2 case
  • Chad: two cVDPV2 cases
  • DRC: eight cVDPV1 cases, 22 cVDPV2 cases and one cVDPV2 positive environmental sample
  • Mali: one cVDPV2 case
  • Nigeria: two cVDPV2-positive environmental samples

To alert international travelers of their potential health risk, the U.S. CDC updated its Alert - Level 2, Practice Enhanced Precautions notice regarding polio outbreaks in 2023.

Other polio outbreak news is posted at Vax-Before-Travel.

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WPV1 and cVDPV cases in country Feb. 2023
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The Florida Health Department reported on February 4, 2023, sixteen travel-associated and one locally acquired dengue cases have been confirmed this year.

In 2022, Florida reported 869 travel-associated and 68 locally-acquired dengue cases.

To alert residents of their potential health risks, the Florida Department of Health in Miami-Dade County issued a mosquito-borne illness advisory in mid-2022.

Additionally, Broward County, which is located north of Miami, issued its mosquito-borne illness alert in 2022.

In the Region of the Americas, 46 countries and territories reported dengue cases in 2022.

Four different viruses cause dengue fever, and a person can be infected with each serotype during their lifetime.

Dengue viruses are spread to people through the bite of an infected Aedes mosquito.

Most symptoms of dengue are mild and typically last 2–7 days. But, infections can turn severe.

The U.S. CDC says no specific treatment for dengue/severe dengue exists.

However, one approved vaccine (Dengvaxia) is available in the U.S. on a limited basis.

And the U.K., Europe, and Indonesia have recently authorized the newer, less restrictive Qdenga® vaccine.

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U.S. CDC Dengue map Feb. 4, 2023
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Since no U.S. Food and Drug Administration (FDA) vaccines are available to prevent Alzheimer's Disease (AD), can other vaccines reduce the risk of this old-age disease?

The Conversation published an article written by neurodegenerative disease experts on January 18, 2023, highlighting the potential value of existing FDA-approved vaccines to reduce AD aggravating factors from viral infections.

In previous studies, researchers identified that infections by varicella zoster (chickenpox and shingles) and influenza viruses could lead to a higher risk of AD.

However, researchers have been unable to consistently detect these suspect viruses in the brains of people who died of Alzheimer's. 

In other words, when researchers analyze AD patient brains, detectable viral components may have disappeared, and causation is difficult to establish.

The full unedited article published by The Conversation is posted at this link.

As of February 12, 2023, the FDA has not authorized any of the current Alzheimer's vaccine candidates.

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Cholera outbreaks 2023
Cholera is a vaccine preventable disease
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An outbreak of an undefined disease that has killed several people in Equatorial Guinea was reported on February 8, 2023, according to a Health Alert issued by the U.S. Embassy in Malabo.

The Government of Equatorial Guinea (EG) announced that over the past month, there had been an epidemiological outbreak of an unidentified disease in the Nsok Nsomo district of the Kie-Ntem province in the mainland region.

In a statement, EG said that travel restrictions had been imposed in "view of the high risk of importation of this disease.

According to preliminary investigations, these fatalities were linked to a funeral ceremony.

In reaction, the neighboring country of Cameroon has restricted movement along its border with Equatorial Guinea.

This area of Africa has been involved with numerous Ebolavirus outbreaks over the past decade.

The Republic of EG is located on Africa's west coast, consisting of Río Muni and five islands.

The local U.S. Embassy website has not posted an alert regarding this situation as of February 11, 2023, but does say in case of emergency, American citizens have access to an after-hours help line: (+240) 555-516 008.

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Republic of Equatorial Guinea 2023
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