Flaxman, Amy, Sebastian, Sarah, Appelberg, Sofia, Cha, Kuan M., Ulaszewska, Marta, Purushotham, Jyothi, Gilbride, Ciaran, Sharpe, Hannah, Spencer, Alexandra J., Bibi, Sagida, Wright, Daniel, Schmidt, Isabel, Dowall, Stuart, Easterbrook, Linda, Findlay-Wilson, Stephen, Gilbert, Sarah, Mirazimi, Ali, and Lambe, Teresa
Viral haemorrhagic fevers (VHF) pose a significant threat to human health. In recent years, VHF outbreaks caused by Ebola, Marburg and Lassa viruses have caused substantial morbidity and mortality in West and Central Africa. In 2022, an Ebola disease outbreak in Uganda caused by Sudan virus resulted in 164 cases with 55 deaths. In 2023, a Marburg disease outbreak was confirmed in Equatorial Guinea and Tanzania resulting in over 49 confirmed or suspected cases; 41 of which were fatal. There are no clearly defined correlates of protection against these VHF, impeding targeted vaccine development. Any vaccine developed should therefore induce strong and preferably long-lasting humoral and cellular immunity against these viruses. Ideally this immunity should also cross-protect against viral variants, which are known to circulate in animal reservoirs and cause human disease. We have utilized two viral vectored vaccine platforms, an adenovirus (ChAdOx1) and Modified Vaccinia Ankara (MVA), to develop a multi-pathogen vaccine regime against three filoviruses (Ebola virus, Sudan virus, Marburg virus) and an arenavirus (Lassa virus). These platform technologies have consistently demonstrated the capability to induce robust cellular and humoral antigen-specific immunity in humans, most recently in the rollout of the licensed ChAdOx1-nCoV19/AZD1222. Here, we show that our multi-pathogen vaccines elicit strong cellular and humoral immunity, induce a diverse range of chemokines and cytokines, and most importantly, confers protection after lethal Ebola virus, Sudan virus and Marburg virus challenges in a small animal model. Author summary: Outbreaks caused by ebolaviruses and Lassa virus have made headlines worldwide in recent years. Most recently, in 2023 a Marburg virus outbreak resulted in 49 confirmed or probable cases, 41 of which were fatal. Apart from vaccines against Ebola virus, no licensed vaccine exists to protect against viral haemorrhagic fevers caused by filoviruses. An ideal vaccine against viral haemorrhagic fevers would induce long-lasting immunity to, and protection from, viruses causing disease and concomitant fatalities. We developed vaccines which can target multiple orthoebolaviruses, the closely related Marburg virus and Lassa virus. The geographical ranges of these viruses overlap in West and Central Africa. We used viral vector platform technologies to generate these vaccines; ChAdOx1 has now been administered worldwide as part of COVID-19 vaccine rollouts, and MVA has been used in numerous clinical trials thus far. We found that both long lasting, antigen specific T cell and antibody responses were induced after vaccination. Lastly, we demonstrated that these vaccines could protect small animals against challenge with Ebola virus, Sudan virus and Marburg virus. [ABSTRACT FROM AUTHOR]