Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children

Ishola, David, Bah, Osman Mohamed, Bangalie, Foday Suma, Bangura, Agnes, David, Ifeolu, Deen, Gibrilla Fadlu, Fombah, Augustin, Jalloh, Abdulai Berber, Kamara, Abu Bakarr, Kamara, Ibrahim Franklyn, Kamara, Michael, Leigh, Bailah, Morovia, Foday, Rogers, Baimba, Samai, Mohamed, Serry-Bangura, Alimamy, Sheku, Mahmud, Swaray, Ibrahim, Anumendem, Dickson, Gaddah, Auguste, Bockstal, Viki, Keshinro, Babajide, Robinson, Cynthia, Afolabi, Muhammed, Akoo, Pauline, Ayieko, Philip, Baiden, Frank, Gallagher, Katherine, Greenwood, Brian, Ishola, David, Kohn, Brian, Kowuor, Dickens, Lawal, Bolarinde, Lowe, Brett, Manno, Daniela, Odeny, Lazarus, Otieno, Tuda, Owusu-Kyei, Kwabena, Smout, Elizabeth, Tindanbil, Daniel and Watson-Jones, Deborah (2022) 'Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children'. Clinical Infectious Diseases, Vol 75, Issue 9, pp. 1585-1593.

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Abstract

Background
Malaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen.

Methods
In this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95% confidence intervals (CIs).

Results
A total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12–17, 4–11, and 1–3 years). Asymptomatic malaria was observed in 47.5% of adults and 51.5% of children on day 1. Post-dose 1, GMCs were lower in 1–3-year-old malaria-positive compared with malaria-negative children (age group–specific GMR, .56; 95% CI, .39–.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95% CI, .67–1.02).

Conclusions
The Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.

Item Type:	Article
Uncontrolled Keywords:	NOT_LSTM
Subjects:	WC Communicable Diseases > Virus Diseases > General Virus Diseases > WC 500 Virus diseases (General or not elsewhere classified) WC Communicable Diseases > Tropical and Parasitic Diseases > WC 695 Parasitic diseases (General) WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1093/cid/ciac209
Depositing User:	Rachel Dominguez
Date Deposited:	15 Jun 2023 07:59
Last Modified:	15 Jun 2023 07:59
URI:	https://archive.lstmed.ac.uk/id/eprint/22627

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