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      Meeting report: Convening on the influenza human viral challenge model for universal influenza vaccines, Part 1: Value; challenge virus selection; regulatory, industry and ethical considerations; increasing standardization, access and capacity

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          Abstract

          In response to global interest in the development of a universal influenza vaccine, the Bill & Melinda Gates Foundation, PATH, and the Global Funders Consortium for Universal Influenza Vaccine Development convened a meeting of experts (London, UK, May 2018) to assess the role of a standardized controlled human influenza virus infection model (CHIVIM) towards the development of novel influenza vaccine candidates. This report (in two parts) summarizes those discussions and offers consensus recommendations. This article (Part 1) covers challenge virus selection, regulatory and ethical considerations, and issues concerning standardization, access, and capacity. Part 2 covers specific methodologic considerations.

          Current methods for influenza vaccine development and licensure require large costly field trials. The CHIVIM requires fewer subjects and the controlled setting allows for better understanding of influenza transmission and host immunogenicity. The CHIVIM can be used to identify immune predictors of disease for at-risk populations and to measure efficacy of potential vaccines for further development.

          Limitations to the CHIVIM include lack of standardization, limited access to challenge viruses and assays, lack of consensus regarding role of the CHIVIM in vaccine development pathway, and concerns regarding risk to study participants and community. To address these issues, the panel of experts recommended that WHO and other key stakeholders provide guidance on standardization, challenge virus selection, and risk management. A common repository of well-characterized challenge viruses, harmonized protocols, and standardized assays should be made available to researchers. A network of research institutions performing CHIVIM trials should be created, and more study sites are needed to increase capacity.

          Experts agreed that a research network of institutions working with a standardized CHIVIM could contribute important data to support more rapid development and licensure of novel vaccines capable of providing long-lasting protection against seasonal and pandemic influenza strains.

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          Author and article information

          Contributors
          Journal
          Vaccine
          Vaccine
          Vaccine
          Elsevier Science
          0264-410X
          1873-2518
          14 August 2019
          14 August 2019
          : 37
          : 35
          : 4823-4829
          Affiliations
          [a ]Center for Vaccine Innovation and Access, PATH, 455 Massachusetts Avenue NW, Suite 1000, Washington, DC 20001, USA
          [b ]Bill & Melinda Gates Foundation, PO Box 23350, Seattle, WA 98102, USA
          [c ]Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-9826, USA
          [d ]Influenza Division, Centers for Disease Control and Prevention, and Task Force for Global Health, Atlanta, USA
          Author notes
          Article
          S0264-410X(19)30857-6
          10.1016/j.vaccine.2019.06.080
          6677912
          31362819
          8040603f-fdea-41ca-ab8c-22ac5774fe73
          © 2019 Elsevier Ltd. All rights reserved.

          This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

          History
          : 23 April 2019
          : 18 June 2019
          : 21 June 2019
          Categories
          Article

          Infectious disease & Microbiology
          influenza,influenza vaccine,universal vaccine,human challenge trial,vaccine development

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