PDF(Pubmed)
Abstract：
The Modified Vaccinia Ankara vaccine developed by Bavarian Nordic (MVA-BN) was widely deployed to prevent mpox during the 2022 global outbreak. This vaccine was initially approved for mpox based on its reported immunogenicity (from phase I/II trials) and effectiveness in animal models, rather than evidence of clinical efficacy. However, no validated correlate of protection after vaccination has been identified. Here we performed a systematic search and meta-analysis of the available data to test whether vaccinia-binding ELISA endpoint titer is predictive of vaccine effectiveness against mpox. We observe a significant correlation between vaccine effectiveness and vaccinia-binding antibody titers, consistent with the existing assumption that antibody levels may be a correlate of protection. Combining this data with analysis of antibody kinetics after vaccination, we predict the durability of protection after vaccination and the impact of dose spacing. We find that delaying the second dose of MVA-BN vaccination will provide more durable protection and may be optimal in an outbreak with limited vaccine stock. Although further work is required to validate this correlate, this study provides a quantitative evidence-based approach for using antibody measurements to predict the effectiveness of mpox vaccination.
摘要：
巴伐利亚北欧（MVA-BN）开发的改良安卡拉牛痘疫苗在2022年全球爆发期间被广泛用于预防水痘。该疫苗最初基于其报道的免疫原性（来自I/II期试验）和在动物模型中的有效性而被批准用于水痘。而不是临床疗效的证据。然而,尚未确定疫苗接种后的保护相关因素。在这里，我们对可用数据进行了系统搜索和荟萃分析，以测试牛痘结合ELISA终点滴度是否可以预测疫苗对水痘的有效性。我们观察到疫苗有效性和牛痘结合抗体滴度之间的显着相关性，与现有的抗体水平可能与保护相关的假设一致。将这些数据与疫苗接种后的抗体动力学分析相结合，我们预测疫苗接种后保护的持久性和剂量间隔的影响。我们发现，延迟第二剂MVA-BN疫苗接种将提供更持久的保护，并且在疫苗库存有限的疫情中可能是最佳的。尽管需要进一步的工作来验证这种关联，这项研究提供了一种基于定量证据的方法,用于使用抗体测量来预测水痘疫苗接种的有效性.
