Summary

Gj, Galasso; Mj, Mattheis; Jd, Cherry; Jd, Connor; McIntosh, Kenneth; As, Benenson; Dw, Alling

doi:10.1093/infdis/135.1.183

Cited by 22 publications

(1 citation statement)

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“…The three aforementioned strains of vaccinia virus were considered equivalent in protecting against smallpox during outbreaks, and provided some protection when administered within 3–4 days of exposure [3] . Although highly effective immunizing agents, each of these vaccines produced significant adverse events [4–8] . The smallpox vaccines in current global stockpiles are derived from these historical vaccinia strains.…”

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confidence: 99%

IMVAMUNE^®: modified vaccinia Ankara strain as an attenuated smallpox vaccine

Kennedy

Greenberg

2009

Expert Review of Vaccines

118

106

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Smallpox vaccines based on replicating vaccinia virus are known to elicit rare yet serious adverse events, particularly in human populations with immune deficiency, atopic dermatitis and at the extremes of age. A vaccine that induces protective immune responses equivalent to first-generation smallpox vaccines while reducing the risk for severe adverse events is critical for a national stockpile of smallpox vaccines. Modified vaccinia Ankara (MVA) has been proposed as an immediate solution for vaccination of high-risk individuals. Bavarian Nordic's vaccine MVA-BN (IMVAMUNE) is a MVA strain that is replication incompetent in mammalian cell lines. IMVAMUNE has been administered to more than 1900 human subjects to date, including high-risk populations (e.g., people diagnosed with atopic dermatitis or infected with HIV) in which standard replicating vaccines are contraindicated. We review the Phase I clinical trial safety profile and immune responses and compare them with other smallpox vaccines, including ACAM2000 and Dryvax.

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mentioning

confidence: 99%

IMVAMUNE^®: modified vaccinia Ankara strain as an attenuated smallpox vaccine

Kennedy

Greenberg

2009

Expert Review of Vaccines

118

106

View full text Add to dashboard Cite

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Vaccines for preventing smallpox

Metzger

Mordmueller²

2007

Cochrane Database of Systematic Reviews

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Background Smallpox was eradicated by 1980, but its possible use as a bioweapon has rekindled interest in the development of protective vaccines. Therefore, stockpiled calf lymph-derived vaccines and recently developed cell-cultured vaccines have been investigated to contribute information to smallpox emergency response plans, while newer (non-replication competent) vaccines are developed. Objectives To assess the e ects of smallpox vaccines in preventing the disease, in inducing immunity, and in regard to adverse events. Search methods In December 2006, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2006, Issue 4), MEDLINE, EMBASE, LILACS, and Current Controlled Trials, and handsearched Index Medicus. We also searched three databases of vaccine safety in December 2005. Selection criteria Randomized controlled trials of smallpox vaccines versus placebo, other smallpox or non-smallpox vaccine, no intervention, or di erent dose of the same vaccine in people receiving smallpox vaccination irrespective of age. Data collection and analysis Both authors independently assessed trial quality and extracted data. We combined dichotomous data using risk ratio with a randome ects model. Main results Ten trials involving 2412 participants were included. The vaccines investigated were calf-lymph derived first-generation vaccines (Dryvax, APVS, Lancy-vaxina, Lister), and cell-cultured second-generation vaccines (ACAM, CCSV). Vaccines were investigated in di erent dilutions. All undiluted vaccines induced a reaction in 95% of people vaccinated in terms of pustule and immunogenicity. Also 1:10 dilutions were fully e icient when the starting concentration was defined. Serious adverse events were reported in 1% to 2% of the volunteers. Fever was observed in 11% to 22% of participants, and headache in roughly half of the participants. Fever was less frequent when new vaccines were administered, but rates of headache were similar in new and old vaccines.

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