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Using a Human Challenge Model of Infection to Measure Vaccine Efficacy: A Randomised,Controlled Trial Comparing the Typhoid Vaccines M01ZH09 with Placebo and Ty21a
Authors:Thomas C. Darton  Claire Jones  Christoph J. Blohmke  Claire S. Waddington  Liqing Zhou  Anna Peters  Kathryn Haworth  Rebecca Sie  Christopher A. Green  Catherine A. Jeppesen  Maria Moore  Ben A. V. Thompson  Tessa John  Robert A. Kingsley  Ly-Mee Yu  Merryn Voysey  Zoe Hindle  Stephen Lockhart  Marcelo B. Sztein  Gordon Dougan  Brian Angus  Myron M. Levine  Andrew J. Pollard
Abstract:BackgroundTyphoid persists as a major cause of global morbidity. While several licensed vaccines to prevent typhoid are available, they are of only moderate efficacy and unsuitable for use in children less than two years of age. Development of new efficacious vaccines is complicated by the human host-restriction of Salmonella enterica serovar Typhi (S. Typhi) and lack of clear correlates of protection. In this study, we aimed to evaluate the protective efficacy of a single dose of the oral vaccine candidate, M01ZH09, in susceptible volunteers by direct typhoid challenge.ConclusionsDespite successfully demonstrating the use of a human challenge study to directly evaluate vaccine efficacy, a single-dose M01ZH09 failed to demonstrate significant protection after challenge with virulent Salmonella Typhi in this model. Anti-Vi antibody detected prior to vaccination played a major role in outcome after challenge.

Trial registration

ClinicalTrials.gov (NCT01405521) and EudraCT (number 2011-000381-35).
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