Two severe cases of tick-borne encephalitis despite complete active vaccination?the significance of neutralizing antibodies

Bender, Ana Lígia; Jäger, Gundula; Scheuerer, W.; Feddersen, Berend; Kaiser, Reinhard; Pfister, H.-W.

doi:10.1007/s00415-004-0329-z

Cited by 42 publications

(41 citation statements)

References 6 publications

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“…A case of TBE disease has been reported in a subject with positive ELISA, but negative NT titres after vaccination. 23 Natural infection by TBE provides life-long protection against the disease. A GMT-NT of 19 (95% CI: 11-34) was observed in a group of 19 subjects with natural acquired immunity, 24 NT-titres of individuals were equal or greater to 4 (unpublished data).…”

Section: Resultsmentioning

confidence: 99%

Tick-Borne Encephalitis (TBE) Vaccination in Children: Advantage of the Rapid Immunization Schedule (i.e., days 0, 7, 21)

Schoendorf¹,

Ternák²,

Oroszlán³

et al. 2007

Human Vaccines

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Section: Resultsmentioning

confidence: 99%

Tick-Borne Encephalitis (TBE) Vaccination in Children: Advantage of the Rapid Immunization Schedule (i.e., days 0, 7, 21)

Schoendorf¹,

Ternák²,

Oroszlán³

et al. 2007

Human Vaccines

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“…Despite the effectiveness of TBE vaccination in Austria, the inactivated vaccines have several limitations, including the long schedule of primary immunization, the need for repeated booster vaccinations due to the short duration of immunity, the rare occurrence of severe TBE disease in vaccinees in TBEV endemic areas [4,24], and the high cost of manufacture. These disadvantages and difficulties associated with the current inactivated TBEV vaccines have encouraged research to develop new improved vaccines.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Langat/dengue 4 chimeric virus as a live attenuated tick-borne encephalitis vaccine for safety and immunogenicity in healthy adult volunteers

Wright

Ankrah

Henderson

et al. 2008

Vaccine

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With the steady rise in tick-borne encephalitis virus (TBEV) infections in Europe, development of a live attenuated vaccine that will generate long-lasting immunity would be of considerable benefit. A chimeric flavivirus, designated LGT/DEN4, was previously constructed to have a genome containing the prM and E protein genes of Langat virus (LGT), a naturally attenuated member of the TBEV complex, and the remaining genetic sequences derived from dengue 4 virus (DEN4).LGT/ DEN4 was highly attenuated in rodents and non-human primates, and clinical trials in humans were initiated. Twenty-eight healthy seronegative adult volunteers were randomly assigned in a 4:1 ratio to receive 10 3 PFU of LGT/DEN4 or placebo. Volunteers were closely monitored for clinical responses and for blood chemistry and hematological changes, and the level of viremia and the magnitude and duration of the neutralizing antibody response were determined. The LGT/DEN4 vaccine was safe and viremia was seen in only one vaccinee. Infection induced a neutralizing antibody response to wild-type LGT in 80% of volunteers with a geometric mean titer (GMT) of 1:63 present on day 42 post-immunization; however the antibody response against TBEV was both much less frequent (35%) and lower in magnitude (GMT = 1:9). To assess the response to a booster dose, 21 of the original 28 volunteers were re-randomized to receive a second dose of either 10 3 PFU of vaccine or placebo given 6 to 18 months after the first dose. The immunogenicity against either LGT or TBEV was not significantly enhanced after the second dose of vaccine. Thus, chimerization of LGT with DEN4 yielded a vaccine virus that was highly attenuated yet infectious in humans. The level of replication was sufficiently restricted to induce only a weak cross-reactive antibody response to TBEV. To provide a sufficient level of immunity to widely prevalent, highly neurovirulent strains of TBEV in humans, vaccine candidates will likely need to be based on the TBEV structural protein genes.

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“…Using a rapid schedule with the Encepur vaccine (days 0, 7, 21) in children has been shown to provide fast protection and stable antibody levels for at least 1 year [209]. The antibody response to TBEV vaccination declines with age [210][211][212][213][214][215][216], and older individuals are at higher risk of vaccine failures [189,200,217]. Both the European vaccines are considered safe to use and efficacious for individuals ≥1 years old by the WHO [201].…”

Section: Vaccinementioning

confidence: 99%

Epidemiological and Ecological Studies of Tick-borne Encephalitis Virus

Lindblom¹

2014

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Two severe cases of tick-borne encephalitis despite complete active vaccination?the significance of neutralizing antibodies

Cited by 42 publications

References 6 publications

Tick-Borne Encephalitis (TBE) Vaccination in Children: Advantage of the Rapid Immunization Schedule (i.e., days 0, 7, 21)

Tick-Borne Encephalitis (TBE) Vaccination in Children: Advantage of the Rapid Immunization Schedule (i.e., days 0, 7, 21)

Evaluation of the Langat/dengue 4 chimeric virus as a live attenuated tick-borne encephalitis vaccine for safety and immunogenicity in healthy adult volunteers

Epidemiological and Ecological Studies of Tick-borne Encephalitis Virus

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