Abstract

Zika virus is an emergent pathogen that gained significant importance during the epidemic in South and Central America as unusual and alarming complications of infection were recognized. Although initially considered a self-limited benign infection, a panoply of neurologic complications were recognized including a Guillain–Barré-like syndrome and in-utero fetal infection causing microcephaly, blindness, and other congenital neurologic complications. Numerous Zika virus vaccines were developed, with nine different vaccines representing five different platforms entered into clinical trials, one progressing to Phase II. Here we review the current landscape and challenges confronting Zika virus vaccine development.

Highlights

  • The Zika virus, discovered in Uganda in 1947 [1], was shown to be endemic through Sub-Saharan Africa and tropical areas of Southeastern Asia in studies through the second half of the 20th century [2]

  • It was soon recognized that Zika virus infection occurring during pregnancy caused microcephaly and other congenital disorders in the developing fetus, the latter being the primary reason for the World Health Organization (WHO) labelling Zika as an international threat in early 2016

  • We provide a brief update of current progress in Zika virus vaccine development and explore the challenges to vaccine assessment and eventual licensure

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Summary

Introduction

The Zika virus, discovered in Uganda in 1947 [1], was shown to be endemic through Sub-Saharan Africa and tropical areas of Southeastern Asia in studies through the second half of the 20th century [2]. Starting in mid-2015, Zika virus infection achieved epidemic status, spreading rapidly through South America, Central America, and the Caribbean Islands [5]. It was soon recognized that Zika virus infection occurring during pregnancy caused microcephaly and other congenital disorders in the developing fetus, the latter being the primary reason for the World Health Organization (WHO) labelling Zika as an international threat in early 2016. Beginning in late 2015, numerous academic labs and pharmaceutical companies initiated work to develop a vaccine against Zika, by the time the first vaccines entered clinical trials, the Zika epidemic had started to wane creating significant challenges to vaccine assessment [6] that has engendered discussion of other regulatory pathways to licensure [7]. We provide a brief update of current progress in Zika virus vaccine development and explore the challenges to vaccine assessment and eventual licensure

Zika Vaccine Target Population
Changing Epidemiology of the Zika Virus Outbreak
Zika Vaccine Candidates in Development
Potential Animal Models for Vaccine Evaluation
Challenge Human Infection Models
Findings
Summary
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