Potent immunogenicity and protective efficacy of a multi-pathogen vaccination targeting Zaire ebolavirus, Sudan ebolavirus, Marburg and Lassa viruses
Authors: Flaxman Amy , Sebastian Sarah , Appelberg Sofia , Cha Kuan M , Ulaszewska Marta , Purushotham Jyothi , Gilbride Ciaran , Sharpe Hannah , Spencer Alexandra J , Bibi Sagida , Wright Daniel , Dowall Stuart , Easterbrook Linda , Findlay-Wilson Stephen , Gilbert Sarah , Mirazimi Ali , Lambe Teresa 
Published: November 2023

AbstractViral 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 ebolavirus resulted in 164 cases with 55 deaths. In February 2023, a Marburg disease outbreak was confirmed in Equatorial Guinea resulting in 15 confirmed and 23 suspected cases to date, with a second outbreak occurring concurrently in Tanzania. There are no clearly defined correlates of protection against these VHF, impeding targeted subunit 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 (Zaire ebolavirus, Sudan ebolavirus, Marburg) and an arenavirus (Lassa). 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 Zaire ebolavirus, Sudan ebolavirus and Marburg virus challenges in a small animal model.Author summaryOutbreaks caused by Ebola and Lassa viruses have made headlines worldwide in recent years. Most recently, in 2023 a Marburg virus outbreak has claimed tens of lives with a high case fatality rate. As yet, no licensed vaccine exists to protect against this and other viral haemorrhagic fevers. An ideal vaccine would induce long-lasting immunity to, and protection from, viruses causing viral haemorrhagic fevers. We developed vaccines which can target multiple strains of Ebolavirus, 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 these vaccines could protect small animals against challenge with Zaire ebolavirus, Sudan ebolavirus and Marburg virus.