Preview

Biological Products. Prevention, Diagnosis, Treatment

Advanced search

Current regulatory requirements for clinical trials of viral vaccines

https://doi.org/10.30895/2221-996X-2023-23-4-513-529

Abstract

Scientific relevance. In recent years, the development of various vaccines based on novel platforms has underscored the significance of updating regulatory requirements for vaccines. Consequently, clinical trials of viral vaccines need harmonised approaches within national guidelines and the Eurasian Economic Union (EAEU) regulatory framework.

Aim. This study aimed to analyse national and international requirements for clinical trials of the efficacy and safety of preventive viral vaccines.

Discussion. This article presents an analysis of the guidelines issued by the WHO and leading regulatory authorities on different aspects of clinical trials of viral vaccines. These guidelines place particular emphasis on the immunogenicity of vaccines. The lack of well-established immune correlates of protection for most infections presents a significant problem for assessing the effectiveness of vaccines. Immunobridging studies may be conducted to expand vaccine indications to different populations (such as a new age group). The size of the prelicensure safety database should include data on at least 3,000 vaccinated study participants. For some vaccines, safety studies must assess the risk of disease onset or enhancement due to vaccination.

Conclusions. The clinical trial requirements for viral vaccines have been substantially aligned by the WHO and major international regulatory authorities, thereby facilitating the development of harmonised national or EAEU guidelines.

About the Authors

A. A. Soldatov
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation

Aleksandr A. Soldatov, Dr. Sci. (Med.)

8/2 Petrovsky Blvd, Moscow 127051



D. V. Gorenkov
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation

Dmitry V. Gorenkov

8/2 Petrovsky Blvd, Moscow 127051



Zh. I. Avdeeva
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation

Zhanna I. Avdeeva, Dr. Sci. (Med.), Professor

8/2 Petrovsky Blvd, Moscow 127051



V. A. Merkulov
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation

Vadim A. Merkulov, Dr. Sci. (Med.), Professor

8/2 Petrovsky Blvd, Moscow 127051



References

1. Plotkin SA, Gilbert PB. Nomenclature for immune correlates of protection after vaccination. Clin Infect Dis. 2012;54(11):1615–7. https://doi.org/10.1093/cid/cis238

2. Arora M, Lakshmi R. Vaccines — safety in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2021;76:23–40. https://doi.org/10.1016/j.bpobgyn.2021.02.002

3. Sebghati M, Khalil A. Uptake of vaccination in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2021;76:53–65. https://doi.org/10.1016%2Fj.bpobgyn.2021.03.007

4. Cohen-Abbo A, Culley BS, Reed GW, Sannella EC, Mace RL, Robertson SE, Wright PF. Seroresponse to trivalent oral poliovirus vaccine as a function of dosage interval. Pediatr Infect Dis J. 1995;14(2):100–6. https://doi.org/10.1097/00006454-199502000-00004

5. Nathanson N. David Bodian’s contribution to the development of poliovirus vaccine. Am J Epidemiol. 2005;161(3):207–12. https://doi.org/10.1093/aje/kwi033

6. Salk J, Salk D. Control of influenza and poliomyelitis with killed virus vaccines. Science. 1977;195(4281):834–47. https://doi.org/10.1126/science.320661

7. Mason RA, Tauraso NM, Spertzel RO, Ginn RK. Yellow fever vaccine: direct challenge of monkeys given graded doses of 17D vaccine. Appl Microbiol. 1973;25(4):539–44. https://doi.org/10.1128/am.25.4.539-544.1973

8. Gaucher D, Therrien R, Kettaf N, Angermann BR, Boucher G, Filali-Mouhim A, et al. Yellow fever vaccine induces integrated multilineage and polyfunctional immune responses. J Exp Med. 2008;205(13):3119–31. https://doi.org/10.1084/jem.20082292

9. Zhu FC, Zhang J, Zhang XF, Zhou C, Wang ZZ, Huang SJ, et al. Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large-scale, randomised, double-blind placebo-controlled, phase 3 trial. Lancet. 2010;376(9744):895–902. https://doi.org/10.1016/s0140-6736(10)61030-6

10. Zhang H, An D, Liu W, Mao Q, Jin J, Xu L, et al. Analysis of cross-reactive neutralizing antibodies in human HFMD serum with an EV71 pseudovirus-based assay. PLoS One. 2014;9(6):e100545. https://doi.org/10.1371/journal.pone.0100545

11. Darmostukova MA, Snegireva II, Velts NYu, Kazakov AS, Alyautdin RN. Vaccine safety international monitoring. Safety and Risk of Pharmacotherapy. 2019;7(1):6–14 (In Russ.). https://doi.org/10.30895/2312-7821-2019-7-1-6-14

12. Simonsen L, Viboud C, Elixhauser A, Taylor RJ, Kapikian AZ. More on RotaShield and intussusception: the role of age at the time of vaccination. J Infect Dis. 2005;192(Suppl 1):S36–43. https://doi.org/10.1086/431512

13. Gershman MD, Staples JE, Bentsi-Enchill AD, Breugelmans JG, Brito GS, Camacho LA, et al. Viscerotropic disease: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2012;30(33):5038–58. https://doi.org/10.1016/j.vaccine.2012.04.067

14. Bardina SV, Bunduc P, Tripathi S, Duehr J, Frere JJ, Brown JA, et al. Enhancement of Zika virus pathogenesis by preexisting antiflavivirus immunity. Science. 2017;356(6334):175–180. https://doi.org/10.1126/science.aal4365

15. Shukla R, Ramasamy V, Shanmugam RK, Ahuja R, Khanna N. Antibody-dependent enhancement: a challenge for developing a safe dengue vaccine. Front Cell Infect Microbiol. 2020;10:572681. https://doi.org/10.3389/fcimb.2020.572681


Supplementary files

Review

For citations:


Soldatov A.A., Gorenkov D.V., Avdeeva Zh.I., Merkulov V.A. Current regulatory requirements for clinical trials of viral vaccines. Biological Products. Prevention, Diagnosis, Treatment. 2023;23(4):513-529. (In Russ.) https://doi.org/10.30895/2221-996X-2023-23-4-513-529

Views: 870


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2221-996X (Print)
ISSN 2619-1156 (Online)