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Implementation of a randomized, placebo-controlled trial of live attenuated malaria sporozoite vaccines in an Indonesian military study population

Abstract:
Malaria eradication efforts prioritize safe and efficient vaccination strategies, although none with high-level efficacy against malaria infection are yet available. Among several vaccine candidates, Sanaria® PfSPZ Vaccine and Sanaria PfSPZ-CVac are, respectively, live radiation- and chemo-attenuated sporozoite vaccines designed to prevent infection with Plasmodium falciparum, the leading cause of malaria-related morbidity and mortality. We are conducting a randomized normal saline placebo-controlled trial called IDSPZV1 that will analyze the safety, tolerability, immunogenicity, and efficacy of PfSPZ Vaccine and PfSPZ-CVac administered pre-deployment to malaria-naive Indonesian soldiers assigned to temporary duties in a high malaria transmission area. We describe the manifold challenges of enrolling and immunizing 345 soldier participants at their home base in western Indonesia before their nearly 6,000-km voyage to eastern Indonesia, where they are being monitored for incident P. falciparum and Plasmodium vivax malaria cases during 9 months of exposure. The unique regulatory, ethical, and operational complexities of this trial demonstrate the importance of thorough planning, frequent communication, and close follow-up with stakeholders. Effective engagement with the military community and the ability to adapt to unanticipated events have proven key to the success of this trial.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.4269/ajtmh.23-0597

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Publisher:
American Society of Tropical Medicine and Hygiene
Journal:
American Journal of Tropical Medicine and Hygiene More from this journal
Volume:
110
Issue:
5
Pages:
892-901
Place of publication:
United States
Publication date:
2024-03-26
Acceptance date:
2023-11-24
DOI:
EISSN:
1476-1645
ISSN:
0002-9637
Pmid:
38531102


Language:
English
Pubs id:
1940989
Local pid:
pubs:1940989
Deposit date:
2025-01-14
ARK identifier:

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