Successful Immunization of Infants With and Without Maternal Antibody by Aerosolized Measles Vaccine

Sabin, Albert B.; Aréchiga, Amador Flores; Castro, J Fernández de; Albrecht, Paul; Sever, John L.; Shekarchi, Isabel C.

doi:10.1001/jama.1984.03340420029022

Cited by 69 publications

(6 citation statements)

References 5 publications

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“… 9 Initially, clinical trials using aerosolized measles vaccine were performed in Mexico and these demonstrated the feasibility of this vaccination route. 10 Recent studies confirmed that aerosol measles vaccination was equivalent or superior to injection as booster vaccine. 11 However, when used for primary immunization of infants, aerosol vaccination resulted in lower seroconversion levels than standard injection.…”

Section: Introductionmentioning

confidence: 98%

Needle-free delivery of measles virus vaccine to the lower respiratory tract of non-human primates elicits optimal immunity and protection

et al. 2017

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Needle-free measles virus vaccination by aerosol inhalation has many potential benefits. The current standard route of vaccination is subcutaneous injection, whereas measles virus is an airborne pathogen. However, the target cells that support replication of live-attenuated measles virus vaccines in the respiratory tract are largely unknown. The aims of this study were to assess the in vivo tropism of live-attenuated measles virus and determine whether respiratory measles virus vaccination should target the upper or lower respiratory tract. Four groups of twelve cynomolgus macaques were immunized with 104 TCID50 of recombinant measles virus vaccine strain Edmonston-Zagreb expressing enhanced green fluorescent protein. The vaccine virus was grown in MRC-5 cells and formulated with identical stabilizers and excipients as used in the commercial MVEZ vaccine produced by the Serum Institute of India. Animals were immunized by hypodermic injection, intra-tracheal inoculation, intra-nasal instillation, or aerosol inhalation. In each group six animals were euthanized at early time points post-vaccination, whereas the other six were followed for 14 months to assess immunogenicity and protection from challenge infection with wild-type measles virus. At early time-points, enhanced green fluorescent protein-positive measles virus-infected cells were detected locally in the muscle, nasal tissues, lungs, and draining lymph nodes. Systemic vaccine virus replication and viremia were virtually absent. Infected macrophages, dendritic cells and tissue-resident lymphocytes predominated. Exclusive delivery of vaccine virus to the lower respiratory tract resulted in highest immunogenicity and protection. This study sheds light on the tropism of a live-attenuated measles virus vaccine and identifies the alveolar spaces as the optimal site for respiratory delivery of measles virus vaccine.

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Section: Introductionmentioning

confidence: 98%

Needle-free delivery of measles virus vaccine to the lower respiratory tract of non-human primates elicits optimal immunity and protection

et al. 2017

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“…Over three decades ago, Dr. Albert Sabin and colleagues proved the feasibility of vaccination by aerosolized measles vaccine [70, 71]. Since then, other trials have demonstrated that measles vaccine administered by aerosol provides a superior boosting response compared to vaccination by injection in school-age children [72, 73].…”

Section: Reviewmentioning

confidence: 99%

“…The WHO decided to aerosolize the liquid formulation that was licensed for injection therapy and had proven effective by inhalation in earlier studies in Mexico [70, 71]. This was the Edmonston-Zagreb (EZ) live-attenuated measles vaccine.…”

Section: Reviewmentioning

confidence: 99%

The expanding role of aerosols in systemic drug delivery, gene therapy and vaccination: an update

Laube

2014

Transl Respir Med

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Until the late 1990s, aerosol therapy consisted of beta2-adrenergic agonists, anti-cholinergics, steroidal and non-steroidal agents, mucolytics and antibiotics that were used to treat patients with asthma, COPD and cystic fibrosis. Since then, inhalation therapy has matured to include drugs that: (1) are designed to treat diseases outside the lung and whose target is the systemic circulation (systemic drug delivery); (2) deliver nucleic acids that lead to permanent expression of a gene construct, or protein coding sequence, in a population of cells (gene therapy); and (3) provide needle-free immunization against disease (aerosolized vaccination). During the evolution of these advanced applications, it was also necessary to develop new devices that provided increased dosing efficiency and less loss during delivery. This review will present an update on the success of each of these new applications and their devices. The early promise of aerosolized systemic drug delivery and its outlook for future success will be highlighted. In addition, the challenges to aerosolized gene therapy and the need for appropriate gene vectors will be discussed. Finally, progress in the development of aerosolized vaccination will be presented. The continued expansion of the role of aerosol therapy in the future will depend on: (1) improving the bioavailability of systemically delivered drugs; (2) developing gene therapy vectors that can efficiently penetrate the mucus barrier and cell membrane, navigate the cell cytoplasm and efficiently transfer DNA material to the cell nucleus; (3) improving delivery of gene vectors and vaccines to infants; and (4) developing formulations that are safe for acute and chronic administrations.

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“…12 This phenomena was described by Sabin as a delayed seroconversion. 13 The use of a standard dose of E-Z at 6 months of age was included in a two-dose vaccination policy as part of a measles elimination strategy, where the measles-mumps-rubella (MMR) vaccine was given at the age of 12 months. This policy was implemented in 1991.…”

Section: Control Phasementioning

confidence: 99%

Measles in Saudi Arabia: from control to elimination

Khalil

Al-Mazrou

Al-Howasi

et al. 2005

Annals of Saudi Medicine

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This article describes the tremendous efforts made in the field of measles immunization in Saudi Arabia in the past 20 years, from the control phase to the elimination phase. Mandatory measles vaccination with one-dose Schwartz vaccine was introduced in 1982 by a royal decree, a step aimed at increasing vaccine coverage. In 1991, a two-dose schedule was implemented using Edmonston-Zagreb measles vaccine, with a first dose at 6 months to protect children younger than 9 months and a second dose of MMR at 12 months of age to protect those who did not respond to the first dose. A marked reduction in the epidemic peak and a shift of infection to older age were noticed. But the same data showed that 50% of measles cases in the 1- to 4-year age group occurred in vaccinated children. In 1998, with the start of elimination phase, an MMR campaign was launched in two phases, targeting school children in 1998 (secondary schools) and in 2000 (primary and intermediate schools). Evaluation of the MMR campaign and surveillance data was reflected in the measles immunization policy by shifting the age of measles immunization to 12 months and to preschool using the two-dose MMR schedule.

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Successful Immunization of Infants With and Without Maternal Antibody by Aerosolized Measles Vaccine

Cited by 69 publications

References 5 publications

Needle-free delivery of measles virus vaccine to the lower respiratory tract of non-human primates elicits optimal immunity and protection

Needle-free delivery of measles virus vaccine to the lower respiratory tract of non-human primates elicits optimal immunity and protection

The expanding role of aerosols in systemic drug delivery, gene therapy and vaccination: an update

Measles in Saudi Arabia: from control to elimination

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