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Safety and Immunogenicity of RTS,S/AS02D Malaria Vaccine in Infants

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dc.contributor.author Abdulla, S.
dc.contributor.author Oberholzer, R.
dc.contributor.author Juma, O.
dc.contributor.author Kubhoja, S.
dc.contributor.author Machera, F.
dc.contributor.author Membi, C.
dc.contributor.author Omari, S.
dc.contributor.author Urassa, A.
dc.contributor.author Mshinda, H.
dc.contributor.author Jumanne, A.
dc.contributor.author Salim, N.
dc.contributor.author Shomari, M.
dc.contributor.author Aebi, T.
dc.contributor.author Schellenberg, D.M.
dc.contributor.author Carter, T.
dc.contributor.author Villafana, T.
dc.contributor.author Demoitié, M-A.
dc.contributor.author Dubois, M-C.
dc.contributor.author Leach, A.
dc.contributor.author Lievens, M.
dc.contributor.author Tanner, M.
dc.date.accessioned 2013-02-13T08:04:31Z
dc.date.available 2013-02-13T08:04:31Z
dc.date.issued 2008
dc.identifier.issn 0807773
dc.identifier.uri http://hdl.handle.net/123456789/376
dc.description.abstract Background The RTS,S/AS malaria vaccine is being developed for delivery through the World Health Organization’s Expanded Program on Immunization (EPI). We assessed the feasibility of integrating RTS,S/AS02D into a standard EPI schedule for infants. Methods In this phase 2B, single-center, double-blind, controlled trial involving 340 infants in Bagamoyo, Tanzania, we randomly assigned 340 infants to receive three doses of either the RTS,S/AS02D vaccine or the hepatitis B vaccine at 8, 12, and 16 weeks of age. All infants also received a vaccine containing diphtheria and tetanus toxoids, whole-cell pertussis vaccine, and conjugated Haemophilus influenzae type b vaccine (DTPw/Hib). The primary objectives were the occurrence of serious adverse events during a 9-month surveillance period and a demonstration of noninferiority of the responses to the EPI vaccines (DTPw/Hib and hepatitis B surface antigen) with coadministration of the RTS,S/AS02D vaccine, as compared with the hepatitis B vaccine. The detection of antibodies against Plasmodium falciparum circumsporozoite and efficacy against malaria infection were secondary objectives. Results At least one serious adverse event was reported in 31 of 170 infants who received the RTS,S/AS02D vaccine (18.2%; 95% confidence interval [CI], 12.7 to 24.9) and in 42 of 170 infants who received the hepatitis B vaccine (24.7%; 95% CI, 18.4 to 31.9). The results showed the noninferiority of the RTS,S/AS02D vaccine in terms of antibody responses to EPI antigens. One month after vaccination, 98.6% of infants receiving the RTS,S/AS02D vaccine had seropositive titers for anticircumsporozoite antibodies on enzyme-linked immunosorbent assay (ELISA). During the 6-month period after the third dose of vaccine, the efficacy of the RTS,S/AS02D vaccine against first infection with P. falciparum malaria was 65.2% (95% CI, 20.7 to 84.7; P = 0.01). Conclusions The use of the RTS,S/AS02D vaccine in infants had a promising safety profile, did not interfere with the immunologic responses to coadministered EPI antigens, and reduced the incidence of malaria infection. (ClinicalTrials.gov number, NCT00289185.) en_GB
dc.language.iso en en_GB
dc.publisher The New England Journal of Medicine en_GB
dc.relation.ispartofseries New England Journal of Medicine;359:2533-44.
dc.subject Immunogenicity en_GB
dc.subject RTS en_GB
dc.subject S/AS02D en_GB
dc.subject Malaria en_GB
dc.subject Vaccine en_GB
dc.subject Infants en_GB
dc.title Safety and Immunogenicity of RTS,S/AS02D Malaria Vaccine in Infants en_GB
dc.type Article en_GB


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