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Humoral immune responses during a malaria vaccine trial in Tanzanian infants
C M Galindo1, C J Acosta, D Schellenberg
1Unidad de Epidemiología y Bioestadística and Department of Microbiology, Hospital Clinic/IDIBAPS, Universidad de Barcelona, Barcelona, Spain.
Insights
The SPf66 malaria vaccine trial in Tanzanian infants showed it stimulated an immune response but didn't protect against malaria. It did not interfere with routine Expanded Programme of Immunization (EPI) vaccines.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Malaria vaccine development is crucial for disease control in Africa.
- Integration into the Expanded Programme of Immunization (EPI) is key for optimal vaccine delivery.
- The SPf66 peptide vaccine was tested in Tanzanian infants alongside EPI vaccines.
Purpose of the Study:
- To evaluate the safety, immunogenicity, and efficacy of the SPf66 malaria vaccine in infants.
- To assess the interaction between SPf66 and EPI vaccines.
- To describe humoral immune responses to both SPf66 and EPI vaccines.
Main Methods:
- A two-arm, double-blind, randomized placebo-controlled trial involving 1207 infants.
- Cross-sectional surveys to assess seroconversion rates to EPI vaccines.
- Measurement of antibody responses to SPf66 and Plasmodium falciparum antigens.
Main Results:
- High seroconversion rates to EPI vaccines were observed, unaffected by SPf66 co-administration.
- SPf66 induced a detectable anti-SPf66 IgG response in infants, which waned by age two.
- No significant protection against clinical malaria was associated with SPf66 vaccination, nor were antibodies generated against P. falciparum antigens.
Conclusions:
- SPf66 vaccination in very young infants elicits a humoral response but does not confer protection against clinical malaria.
- The immune response to SPf66 in infants differs from that in older children, raising concerns for infant immunization strategies.
- SPf66 can be safely co-administered with EPI vaccines without compromising infant immunization schedules.
Abstract:
The development of a malaria vaccine is a priority for improved and sustained malaria control. Optimal use of a vaccine in Africa will only be achieved if it can be delivered through the Expanded Programme of Immunization (EPI). We have completed a trial of the peptide vaccine SPf66 in Tanzanian infants, given alongside the EPI vaccines. This paper describes the humoral responses to SPf66 and the EPI vaccines. A total of 1207 infants were recruited into a two-arm, double-blind, individually randomized placebo-controlled trial of SPf66. The objectives of the trial were to determine the safety, immunogenicity and efficacy of SPf66 and to assess interactions with EPI vaccines when three doses of SPf66 were delivered alongside the EPI vaccines. Cross-sectional surveys were carried out to asses seroconversion rates to the EPI vaccines and the antibody response to SPf66 (NANP)50 and Plasmodium falciparum lysates. Seroconversion rates to EPI vaccines were high and no statistically significant differences in prevalence or titres were found between SPf66 and placebo recipients. IgG antibodies against SPf66 (NANP)50 and whole P. falciparum lysate were present in high titres in mothers of recruited children at the time of birth. Vaccination with SPf66 stimulated a good anti-SPf66 IgG response which declined to preimmunization levels by 2 years of age and which was not associated with protection against clinical malaria. The vaccine induced no IgG antibodies against (NANP)50 or P. falciparum lysates. SPf66 stimulated a humoral immune response when given to very young infants and did not interfere with seroconversion to EPI vaccines. The response to SPf66 was qualitatively different from that seen in older children, in whom SPf66 has been shown to be moderately efficacious. This difference raises concerns about the difficulties of immunizing very young infants who need to be targeted by antimalarial vaccination programs.