VACCINATION OF HUMAN VOLUNTEERS WITH MONOVALENT AND TETRAVALENT LIVE-ATTENUATED DENGUE VACCINE CANDIDATES

WELLINGTON SUN Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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ROBERT EDELMAN Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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NIRANJAN KANESA-THASAN Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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KENNETH H. ECKELS Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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J. ROBERT PUTNAK Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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ALAN D. KING Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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HUO-SHU HOUNG Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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DOUGLAS TANG Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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JOHN M. SCHERER Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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CHARLES H. HOKE JR. Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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BRUCE L. INNIS Department of Virus Diseases, Department of Biologics Research, and Division of Biometrics, Walter Reed Army Institute of Research, Silver Spring, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Military Infectious Disease Research Program, United States Army Medical Research and Materiels Command, Fort Detrick, Frederick, Maryland

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Four serotypes of monovalent live attenuated dengue virus vaccine candidates were tested for reactogenicity and immunogenicity in 49 flavivirus non-immune adult human volunteers. The four monovalent candidates were then combined into a tetravalent formulation and given to another 10 volunteers. Neutralizing antibody seroconversion rates after a single-dose monovalent vaccination ranged from 53% to 100%. Solicited reactogenicity was scored by each volunteer. A composite index, the Reactogenicity Index, was derived by these self-reported scores. Reactogenicity differed among the four serotype candidates with serotype-1 associated with the most vaccine related side effects. A second dose of monovalent vaccines at either 30 days or 90 days was much less reactogenic but did not significantly increase seroconversion rates. Seroconversion rates in the 10 volunteers who received a single dose of tetravalent vaccine ranged from 30% to 70% among the four serotypes. Similar to the monovalent vaccines, a second dose of the tetravalent vaccine at one month was less reactogenic and did not increase seroconversion. A third dose of the tetravalent vaccine at four months resulted in three of four volunteers with trivalent or tetravalent high-titer neutralizing antibody responses.

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