PHASE 1 STUDIES OF WALTER REED ARMY INSTITUTE OF RESEARCH CANDIDATE ATTENUATED DENGUE VACCINES: SELECTION OF SAFE AND IMMUNOGENIC MONOVALENT VACCINES

N. KANESA-THASAN Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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R. EDELMAN Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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C. O. TACKET Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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S. S. WASSERMAN Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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D.W. VAUGHN Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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T. S. COSTER Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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G. J. KIM-AHN Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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D. R. DUBOIS Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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J. R. PUTNAK Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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A. KING Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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P. L. SUMMERS Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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B. L. INNIS Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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K. H. ECKELS Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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C. H. HOKE JR. Walter Reed Army Institute of Research, Washington, District of Columbia; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland

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We describe the results of initial safety testing of 10 live-attenuated dengue virus (DENV) vaccine candidates modified by serial passage in primary dog kidney (PDK) cells at the Walter Reed Army Institute of Research. The Phase 1 studies, conducted in 65 volunteers, were designed to select an attenuated vaccine candidate for each DENV serotype. No recipient of the DENV candidate vaccines sustained serious injury or required treatment. Three vaccine candidates were associated with transient idiosyncratic reactions in one volunteer each, resulting in their withdrawal from further clinical development. Increasing PDK cell passage of DENV-1, DENV-2, and DENV-3 candidate vaccines increased attenuation for volunteers, yet also decreased infectivity and immunogenicity. This effect was less clear for DENV-4 candidate vaccines following 15 and 20 PDK cell passages. Only one passage level each of the tested DENV-2, -3, and -4 vaccine candidates was judged acceptably reactogenic and suitable for expanded clinical study. Subsequent studies with more recipients will further establish safety and immunogenicity of the four selected vaccine candidates: DENV-1 45AZ5 PDK 20, DENV-2 S16803 PDK 50, DENV-3 CH53489 PDK 20, and DENV-4 341750 PDK 20.

Author Notes

  • 1

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    Eckels KH, Scott RM, Bancroft WH, Brown J, Dubois DR, Summers PL, Russell PK, Halstead SB, 1984. Selection of attenuated dengue 4 viruses by serial passage in primary kidney cells. V. Human response to immunization with a candidate vaccine prepared in fetal rhesus lung cells. Am J Trop Med Hyg 33 :684–689.

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    Eckels KH, Dubois DR, Putnak JR, Vaughn DW, Innis BL, Henchal EA, Hoke CH Jr, 2003. Modification of dengue virus strains by passage in primary dog kidney cells: preparation of candidate vaccines and immunization of monkeys. Am J Trop Med Hyg 69 (suppl): (in press).

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  • 21

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