Document Type

Capstone Experience

Graduation Date

5-2021

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

Abraham Mengist, PhD

Second Committee Member

Shinobu Watanabe-Galloway, PhD

Third Committee Member

David Brett-Major, MD MPH

Abstract

There have been previous reviews looking into the efficacy of vaccine candidates against Zika infection in non-humans primates, but there hasn’t been a review looking into the efficacy against Congenital Zika Syndrome (CZS).The aim of this project was to systematically review literature on efficacy of vaccine candidates against Zika infection and CZS. A protocol was developed following PRISMA guidelines. English articles published since 2015 were included. Clinical trials (CCTs) that compared the efficacy of four Zika virus vaccine candidates' (PIV, DNA, mRNA, and Adenovirus) against zika infection and CZS in human and non-human primate models were included. Grey literature and studies with mice models were excluded. Literature was searched from PubMed, Scopus, CINAHL and Cochrane Library and screened against predetermined inclusion and exclusion criteria. Bias and quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Efficacy of the vaccine candidates was evaluated using two outcomes: protection against Zika infection and whether CZS occurred. Studies were combined using a meta-analysis technique to determine the summary estimates of the efficacy of the vaccine candidates against Zika infection. All seven studies showed that the four vaccine types were protective against Zika infection, and one study showed that a DNA vaccine was protective against CZS. The meta-analysis found that the summary risk of Zika infection was 0.08 (0.01, 0.15) in vaccinated nonhuman primates versus unvaccinated. The development of a vaccine aganst Zika infection has progressed quickly into clinical trials, but authorization of a vaccine could falter because efficacy field trials are not currently possible. There still needs to be more research into the disease mechanism of CZS before more vaccine efficacy studies occur.

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