The Oxford Vaccine Group within the Department for Paediatrics in Oxford announced in January 2024 that a first-in-human trial of the ChAdOx1 NipahB vaccine has been launched. The vaccine is being developed by researchers at the University’s Pandemic Sciences Institute, and the trial will be led by the Oxford Vaccine Group with funding from CEPI. The trial will involve 51 people between the ages of 18 and 55.
ChAdOx1
ChAdOx1 was “born” in 2012; it is a viral vector vaccine based on a modified simian adenovirus, which is intended to evade the problem of pre-existing immunity. Dame Sarah Gilbert, Professor of Vaccinology at Oxford, told Nature that this is a “true platform technology”, which can be modified for the expression of different viral proteins without manufacturing or safety compromises. Dr Ahmed Salman, senior vaccinologist and immunologist, added that the technology allows easy vaccine production “at a really low cost in a short amount of time”.
Priority targets
The teams at Oxford are investigating ChAdOx1’s applications to a range of targets, including Nipah virus. Nipah is one of WHO’s priority pathogens; it was identified in 1998 but there are no approved vaccines or treatments. It is in the paramyxovirus family and is carried by fruit bats. In around 75% of cases, infection is fatal. The project will take place over the next 18 months before further trials follow in a country affected by Nipah.
Professor Brian Angus is the Principal Investigator for the trial and reflected that the “devastating disease” is a priority pandemic pathogen due to its “high mortality rate” and transmission nature.
“This vaccine trial is an important milestone in identifying a solution that could prevent local outbreaks occurring, while also helping the world prepare for a future global pandemic.”
Dr In-Kyu Yoon, Acting Executive Director of Vaccine Research and Development at CEPI, agreed that the trial is a “step forward” towards the development of a “suite of tools to protect against this killer virus”.
“Knowledge gained could also inform development of other paramyxovirus countermeasures.”
Ethical concerns
As countermeasure momentum grows against Nipah, Oxford is taking the ethical frontier forward as well. A paper in Journal of Medical Ethics reflects this, with the authors arguing that the virus demands specific ethical considerations.
“There has been almost no bioethical work examining ethical considerations surrounding the epidemiology, prevention, and treatment of Nipah virus or research that has already begun.”
The authors highlight the distinctive characteristics of Nipah, such as high case fatality rate versus low transmission rate.
“Measures used in response to other viruses may not be effective or ethical, or in some cases may be unnecessary despite the potential for the virus to be a major threat.”
Postdoctoral Research Fellow at Oxford Population health, Dr Euzebiusz Jamrozik, states that the paper raises key questions from the 2023 Nipah virus outbreak in Kerala, India, and looks forward to future ethical questions.
“We also argue that the design of future vaccine trials should also be informed by ethical considerations, including the results of local community engagement activities.”
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