Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children

David Ishola; Osman Mohamed Bah; Foday Suma Bangalie; Agnes Bangura; Ifeolu David; Gibrilla Fadlu Deen; Augustin Fombah; Abdulai Berber Jalloh; Abu Bakarr Kamara; Ibrahim Franklyn Kamara; Michael Kamara; Bailah Leigh; Foday Morovia; Baimba Rogers; Mohamed Samai; Alimamy Serry-Bangura; Mahmud Sheku; Ibrahim Swaray; Dickson Anumendem; Auguste Gaddah; Viki Bockstal; Babajide Keshinro; Cynthia Robinson; Muhammed Afolabi; Pauline Akoo; Philip Ayieko; Frank Baiden; Katherine Gallagher; Brian Greenwood; David Ishola; Brian Kohn; Dickens Kowuor; Bolarinde Lawal; Brett Lowe; Daniela Manno; Lazarus Odeny; Tuda Otieno; Kwabena Owusu-Kyei; Elizabeth Smout; Daniel Tindanbil; Deborah Watson-Jones

doi:10.1093/cid/ciac209

Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children

David Ishola, Osman Mohamed Bah, Foday Suma Bangalie, Agnes Bangura, Ifeolu David, Gibrilla Fadlu Deen, Augustin Fombah, Abdulai Berber Jalloh, Abu Bakarr Kamara, Ibrahim Franklyn Kamara, Michael Kamara, Bailah Leigh, Foday Morovia, Baimba Rogers, Mohamed Samai, Alimamy Serry-Bangura, Mahmud Sheku, Ibrahim Swaray, Dickson Anumendem, Auguste GaddahViki Bockstal, Babajide Keshinro, Cynthia Robinson, Muhammed Afolabi, Pauline Akoo, Philip Ayieko, Frank Baiden, Katherine Gallagher, Brian Greenwood, David Ishola, Brian Kohn, Dickens Kowuor, Bolarinde Lawal, Brett Lowe, Daniela Manno, Lazarus Odeny, Tuda Otieno, Kwabena Owusu-Kyei, Elizabeth Smout, Daniel Tindanbil, Deborah Watson-Jones

London School of Hygiene and Tropical Medicine

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Background

Malaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen.

Methods

In this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95% confidence intervals (CIs).

Results

A total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12–17, 4–11, and 1–3 years). Asymptomatic malaria was observed in 47.5% of adults and 51.5% of children on day 1. Post-dose 1, GMCs were lower in 1–3-year-old malaria-positive compared with malaria-negative children (age group–specific GMR, .56; 95% CI, .39–.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95% CI, .67–1.02).

Conclusions

The Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.

Original language	English
Pages (from-to)	1585-1593
Number of pages	9
Journal	Clinical Infectious Diseases
Volume	75
Issue number	9
Early online date	30 May 2022
DOIs	https://doi.org/10.1093/cid/ciac209
Publication status	E-pub ahead of print - 30 May 2022
Externally published	Yes

Keywords

Ebola vaccination
immune suppression
malaria

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/cid/ciac209Licence: CC BY-NC-ND

3Final published version, 11.4 MBLicence: CC BY-NC-ND

Cite this

Ishola, D., Bah, O. M., Bangalie, F. S., Bangura, A., David, I., Deen, G. F., Fombah, A., Jalloh, A. B., Kamara, A. B., Kamara, I. F., Kamara, M., Leigh, B., Morovia, F., Rogers, B., Samai, M., Serry-Bangura, A., Sheku, M., Swaray, I., Anumendem, D., ... Watson-Jones, D. (2022). Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children. Clinical Infectious Diseases, 75(9), 1585-1593. Advance online publication. https://doi.org/10.1093/cid/ciac209

@article{6871872e780742f8805ee375796e467a,

title = "Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children",

abstract = "BackgroundMalaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen.MethodsIn this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95\% confidence intervals (CIs).ResultsA total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12–17, 4–11, and 1–3 years). Asymptomatic malaria was observed in 47.5\% of adults and 51.5\% of children on day 1. Post-dose 1, GMCs were lower in 1–3-year-old malaria-positive compared with malaria-negative children (age group–specific GMR, .56; 95\% CI, .39–.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95\% CI, .67–1.02).ConclusionsThe Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.",

keywords = "Ebola vaccination, immune suppression, malaria",

author = "David Ishola and Bah, \{Osman Mohamed\} and Bangalie, \{Foday Suma\} and Agnes Bangura and Ifeolu David and Deen, \{Gibrilla Fadlu\} and Augustin Fombah and Jalloh, \{Abdulai Berber\} and Kamara, \{Abu Bakarr\} and Kamara, \{Ibrahim Franklyn\} and Michael Kamara and Bailah Leigh and Foday Morovia and Baimba Rogers and Mohamed Samai and Alimamy Serry-Bangura and Mahmud Sheku and Ibrahim Swaray and Dickson Anumendem and Auguste Gaddah and Viki Bockstal and Babajide Keshinro and Cynthia Robinson and Muhammed Afolabi and Pauline Akoo and Philip Ayieko and Frank Baiden and Katherine Gallagher and Brian Greenwood and David Ishola and Brian Kohn and Dickens Kowuor and Bolarinde Lawal and Brett Lowe and Daniela Manno and Lazarus Odeny and Tuda Otieno and Kwabena Owusu-Kyei and Elizabeth Smout and Daniel Tindanbil and Deborah Watson-Jones",

year = "2022",

month = may,

day = "30",

doi = "10.1093/cid/ciac209",

language = "English",

volume = "75",

pages = "1585--1593",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "9",

}

Ishola, D, Bah, OM, Bangalie, FS, Bangura, A, David, I, Deen, GF, Fombah, A, Jalloh, AB, Kamara, AB, Kamara, IF, Kamara, M, Leigh, B, Morovia, F, Rogers, B, Samai, M, Serry-Bangura, A, Sheku, M, Swaray, I, Anumendem, D, Gaddah, A, Bockstal, V, Keshinro, B, Robinson, C, Afolabi, M, Akoo, P, Ayieko, P, Baiden, F, Gallagher, K, Greenwood, B, Ishola, D, Kohn, B, Kowuor, D, Lawal, B, Lowe, B, Manno, D, Odeny, L, Otieno, T, Owusu-Kyei, K, Smout, E, Tindanbil, D & Watson-Jones, D 2022, 'Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children', Clinical Infectious Diseases, vol. 75, no. 9, pp. 1585-1593. https://doi.org/10.1093/cid/ciac209

TY - JOUR

T1 - Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children

AU - Ishola, David

AU - Bah, Osman Mohamed

AU - Bangalie, Foday Suma

AU - Bangura, Agnes

AU - David, Ifeolu

AU - Deen, Gibrilla Fadlu

AU - Fombah, Augustin

AU - Jalloh, Abdulai Berber

AU - Kamara, Abu Bakarr

AU - Kamara, Ibrahim Franklyn

AU - Kamara, Michael

AU - Leigh, Bailah

AU - Morovia, Foday

AU - Rogers, Baimba

AU - Samai, Mohamed

AU - Serry-Bangura, Alimamy

AU - Sheku, Mahmud

AU - Swaray, Ibrahim

AU - Anumendem, Dickson

AU - Gaddah, Auguste

AU - Bockstal, Viki

AU - Keshinro, Babajide

AU - Robinson, Cynthia

AU - Afolabi, Muhammed

AU - Akoo, Pauline

AU - Ayieko, Philip

AU - Baiden, Frank

AU - Gallagher, Katherine

AU - Greenwood, Brian

AU - Ishola, David

AU - Kohn, Brian

AU - Kowuor, Dickens

AU - Lawal, Bolarinde

AU - Lowe, Brett

AU - Manno, Daniela

AU - Odeny, Lazarus

AU - Otieno, Tuda

AU - Owusu-Kyei, Kwabena

AU - Smout, Elizabeth

AU - Tindanbil, Daniel

AU - Watson-Jones, Deborah

PY - 2022/5/30

Y1 - 2022/5/30

N2 - BackgroundMalaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen.MethodsIn this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95% confidence intervals (CIs).ResultsA total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12–17, 4–11, and 1–3 years). Asymptomatic malaria was observed in 47.5% of adults and 51.5% of children on day 1. Post-dose 1, GMCs were lower in 1–3-year-old malaria-positive compared with malaria-negative children (age group–specific GMR, .56; 95% CI, .39–.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95% CI, .67–1.02).ConclusionsThe Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.

AB - BackgroundMalaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen.MethodsIn this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95% confidence intervals (CIs).ResultsA total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12–17, 4–11, and 1–3 years). Asymptomatic malaria was observed in 47.5% of adults and 51.5% of children on day 1. Post-dose 1, GMCs were lower in 1–3-year-old malaria-positive compared with malaria-negative children (age group–specific GMR, .56; 95% CI, .39–.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95% CI, .67–1.02).ConclusionsThe Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.

KW - Ebola vaccination

KW - immune suppression

KW - malaria

U2 - 10.1093/cid/ciac209

DO - 10.1093/cid/ciac209

M3 - Article

SN - 1058-4838

VL - 75

SP - 1585

EP - 1593

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 9

ER -

Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children

Abstract

Keywords

UN SDGs

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