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    Zika vaccines and therapeutics: landscape analysis and challenges ahead

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    Author
    Wilder-Smith, A; Vannice, K; Durbin, A; Hombach, J; Thomas, SJ; Thevarjan, I; Simmons, CP
    Date
    2018-06-06
    Source Title
    BMC Medicine
    Publisher
    BMC
    University of Melbourne Author/s
    Simmons, Cameron
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Wilder-Smith, A., Vannice, K., Durbin, A., Hombach, J., Thomas, S. J., Thevarjan, I. & Simmons, C. P. (2018). Zika vaccines and therapeutics: landscape analysis and challenges ahead. BMC MEDICINE, 16 (1), https://doi.org/10.1186/s12916-018-1067-x.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255276
    DOI
    10.1186/s12916-018-1067-x
    Abstract
    BACKGROUND: Various Zika virus (ZIKV) vaccine candidates are currently in development. Nevertheless, unique challenges in clinical development and regulatory pathways may hinder the licensure of high-quality, safe, and effective ZIKV vaccines. DISCUSSION: Implementing phase 3 efficacy trials will be difficult given the challenges of the spatio-temporal heterogeneity of ZIKV transmission, the unpredictability of ZIKV epidemics, the broad spectrum of clinical manifestations making a single definite endpoint difficult, a lack of sensitive and specific diagnostic assays, and the need for inclusion of vulnerable target populations. In addition to a vaccine, drugs for primary prophylaxis, post-exposure prophylaxis, or treatment should also be developed to prevent or mitigate the severity of congenital Zika syndrome. CONCLUSION: Establishing the feasibility of immune correlates and/or surrogates are a priority. Given the challenges in conducting phase 3 trials at a time of waning incidence, human challenge trials should be considered to evaluate efficacy. Continued financial support and engagement of industry partners will be essential to the successful development, licensure, and accessibility of Zika vaccines or therapeutics.

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