Entwicklung neuer Reiseimpfstoffe – Was ist bereits zugelassen, was ist in der Pipeline?

Pamela Perona; Thomas Löscher

doi:10.1055/s-0028-1098012

Flugmedizin · Tropenmedizin · Reisemedizin - FTR, Inhaltsverzeichnis

Flugmedizin · Tropenmedizin · Reisemedizin - FTR 2008; 15(3): 126-133
DOI: 10.1055/s-0028-1098012

Reisemedizin

Entwicklung neuer Reiseimpfstoffe – Was ist bereits zugelassen, was ist in der Pipeline?

Developing new vaccines for travels abroad – Which vaccines have been approved and which are under way?Pamela Perona¹ , Thomas Löscher¹

¹Abteilung für Infektions– und Tropenmedizin, Ludwig–Maximilians–Universität München(Leitung: Prof. Dr. Thomas Löscher)

Abstract

In den letzten Jahren wurden verschiedene reisemedizinisch relevante Impfstoffe neu zugelassen. Dazu zählen neue und verbesserte Vakzine gegen Cholera, enterotoxinbildende Escherichia coli, Rotaviren, Meningokokken und Influenza. Hoffnungsvolle Impfstoffkandidaten sind die in fortgeschrittener klinischer Erprobung stehenden Impfstoffe gegen die Japanische Enzephalitis, Hepatitis E, präpandemische H5N1–Impfstoffe, ein Vierfach–Impfstoff gegen Meningokokken, eine Konjugat–Vakzine gegen den Typhus–Erreger, einige wenige Impfstoffe gegen Malaria sowie ein Impfstoff gegen den Erreger des Chikungunya–Fiebers. Dringender Bedarf an Impfstoffen besteht noch bei so bedeutenden Infektionskrankheiten wie HIV/AIDS oder Tuberkulose.

In recent years a variety of vaccines for travels abroad have been officially approved. This includes many new and improved vaccines against cholera, Escherichia coli producing enterotoxins, rotaviruses, meningococci and influenza. Promising vaccines are still being clinically tested against Japanese encephalitis, hepatitis E, pre–pandemic H5N1 vaccines, a quadruple vaccine against meningococci, a conjugate vaccine against typhoid, a few antimalarial vaccines and a vaccine against chikungunya. However, there is an urgent need for vaccines against prominent diseases such as HIV/AIDS and tuberculosis.

Key words

vaccination - travel vaccines - infectious diseases - approval - clinical testing

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Referenzen

Literatur

1 Steffen R, Boppart I.. Travellers' diarrhoea. Baillieres Clin Gastroenterol. 1987; 1 361-376
2 Markwalder K.. Travelers' diarrhea. Ther Umsch. 2001; 58 367-371
3 Clemens JD. et al. . Field trial of oral cholera vaccines in Bangladesh: results from three–year follow–up. Lancet. 1990; 335 270-273
4 Peltola H. et al. . Prevention of travellers' diarrhoea by oral B–subunit/whole–cell cholera vaccine. Lancet. 1991; 338 1285-1289
5 Scerpella EG. et al. . Safety, immunogenicity, and protective efficacy of the whole–cell/recombinant B subunit (WC/rBS) oral cholera vaccine against travelers' diarrhea. J Travel Med. 1995; 2 22-27
6 Wiedermann G. et al. . Double–blind, randomized, placebo controlled pilot study evaluating efficacy and reactogenicity of an oral ETEC B–subunit–inactivated whole cell vaccine against travelers' diarrhea (preliminary report). J Travel Med. 2000; 7 27-29
7 Sack DA. et al. . Randomised, double–blind, safety and efficacy of a killed oral vaccine for enterotoxigenic E. Coli diarrhoea of travellers to Guatemala and Mexico. Vaccine. 2007; 25 4392-4400
8 Vesikari T. et al. . Efficacy of human rotavirus vaccine against rotavirus gastroenteritis during the first 2 years of life in European infants: randomised, double–blind controlled study. Lancet. 2007; 370 1757-6317
9 Ruiz Jr. LP. Rotavirus vaccines. N Engl J Med. 2006; 354 1747-1751
10 Trotter CL. et al. . Effectiveness of meningococcal serogroup C conjugate vaccine 4 years after introduction. Lancet. 2004; 364 365-367
11 Offit PA, Peter G.. Meningococcal conjugate vaccine in the UK: an update. Lancet. 2004; 364 309-310
12 Lagos R. et al. . Safety and immunogenicity of a meningococcal (Groups A, C, Y, W–135) polysaccharide diphtheria toxoid conjugate vaccine in healthy children aged 2 to 10 years in Chile. Hum Vaccin. 2005; 1 228-231
13 Update: Guillain–Barre syndrome among recipients of Menactra meningococcal conjugate vaccine – United States, June 2005–September 2006. MMWR Morb Mortal Wkly Rep. 2006; 55 1120-1124
14 Report from the Advisory Committee on Immunization Practices (ACIP): decision not to recommend routine vaccination of all children aged 2–10 years with quadrivalent meningococcal conjugate vaccine (MCV4). MMWR Morb Mortal Wkly Rep. 2008; 57 462-465
15 Wedege E. et al. . Functional and specific antibody responses in adult volunteers in new zealand who were given one of two different meningococcal serogroup B outer membrane vesicle vaccines. Clin Vaccine Immunol. 2007; 14 830-838
16 Hosking J. et al. . Immunogenicity, reactogenicity, and safety of a P1.7b,4 strain–specific serogroup B meningococcal vaccine given to preteens. Clin Vaccine Immunol. 2007; 14 1393-1399
17 Morley SL. et al. . Immunogenicity of a serogroup B meningococcal vaccine against multiple Neisseria meningitidis strains in infants. Pediatr Infect Dis J. 2001; 20 1054-1061
18 Camaraza MA. et al. . (Immunogenecity induced by the VA–MENGOC–BC antimeningococcal vaccine against the ATCC C11. N. meningitidis strain in adolescents 12 years after being vaccinated). Rev Cubana Med Trop. 2004; 56 26-30
19 Halperin SA. et al. . Safety and immunogenicity of a trivalent, inactivated, mammalian cell culture–derived influenza vaccine in healthy adults, seniors, and children. Vaccine. 2002; 20 1240-1247
20 Piedra PA. et al. . Live attenuated influenza vaccine, trivalent, is safe in healthy children 18 months to 4 years, 5 to 9 years, and 10 to 18 years of age in a community–based, nonrandomized, open–label trial. Pediatrics. 2005; 116
21 Piedra PA. et al. . Trivalent live attenuated intranasal influenza vaccine administered during the 2003–2004 influenza type A (H3N2) outbreak provided immediate, direct, and indirect protection in children. Pediatrics. 2007; 120
22 Belshe RB. et al. . Live attenuated versus inactivated influenza vaccine in infants and young children. N Engl J Med. 2007; 356
23 Treanor JJ. et al. . Safety and immunogenicity of an inactivated subvirion influenza A (H5N1) vaccine. N Engl J Med. 2006; 354 1343-1351
24 Leroux–Roels I. et al. . Antigen sparing and cross–reactive immunity with an adjuvanted rH5N1 prototype pandemic influenza vaccine: a randomised controlled trial. Lancet. 2007; 370 580-589
25 Defraites RF. et al. . Japanese encephalitis vaccine (inactivated, BIKEN) in U.S. soldiers: immunogenicity and safety of vaccine administered in two dosing regimens. Am J Trop Med Hyg. 1999; 61 288-293
26 Lyons A. et al. . A Phase 2 study of a purified, inactivated virus vaccine to prevent Japanese encephalitis. Vaccine. 2007; 25 3445-3453
27 Tauber E. et al. . Safety and immunogenicity of a Vero–cell–derived, inactivated Japanese encephalitis vaccine: a non–inferiority, phase III, randomised controlled trial. Lancet. 2007; 370 1847-1853
28 Gerolami R, Moal V, Colson P.. Chronic hepatitis E with cirrhosis in a kidney–transplant recipient. N Engl J Med. 2008; 358
29 Peron JM. et al. . Liver histology in patients with sporadic acute hepatitis E: a study of 11 patients from South–West France. Virchows Arch. 2007; 450 405-410
30 Kamar N. et al. . Hepatitis E virus and chronic hepatitis in organ–transplant recipients. N Engl J Med. 2008; 358 811-817
31 Shrestha MP. et al. . Safety and efficacy of a recombinant hepatitis E vaccine. N Engl J Med. 2007; 356 895-903
32 Snape MD. et al. . Immunogenicity of a tetravalent meningococcal glycoconjugate vaccine in infants: a randomized controlled trial. Jama. 2008; 299 173-184
33 Lin FY. et al. . The efficacy of a Salmonella typhi Vi conjugate vaccine in two–to–five–year–old children. N Engl J Med. 2001; 344 1263-1269
34 Aponte JJ. et al. . Safety of the RTS,S/AS02D candidate malaria vaccine in infants living in a highly endemic area of Mozambique: a double blind randomised controlled phase I/IIb trial. Lancet. 2007; 370 1543-1551
35 Levitt NH. et al. . Development of an attenuated strain of chikungunya virus for use in vaccine production. Vaccine. 1986; 4 157-162
36 Edelman R. et al. . Phase II safety and immunogenicity study of live chikungunya virus vaccine TSI–GSD–218. Am J Trop Med Hyg. 2000; 62 681-685
37 Whitehead SS. et al. . Prospects for a dengue virus vaccine. Nat Rev Microbiol. 2007; 5 518-528
38 Kanesa–thasan N. et al. . Safety and immunogenicity of attenuated dengue virus vaccines (Aventis Pasteur) in human volunteers. Vaccine. 2001; 19 3179-3188
39 Arroyo J. et al. . ChimeriVax–West Nile virus live–attenuated vaccine: preclinical evaluation of safety, immunogenicity, and efficacy. J Virol. 2004; 78 12497-12507
40 Hall RA, Khromykh AA.. ChimeriVax–West Nile vaccine. Curr Opin Mol Ther. 2007; 9 498-504
41 Yates J.. Traveler's diarrhea. Am Fam Physician. 2005; 71 2095-2100

Korrespondenz

Pamela Perona

Abteilung für Infektions– und Tropenmedizin der Ludwig–Maximilians–Universität

Leopoldstraße 5

80802 München

eMail: perona@lrz.uni-muenchen.de