ABSTRACT
Introduction: Zika virus disease received little attention until its recent explosive emergence around the globe. The devastating consequences of this pandemic include congenital Zika syndrome (CZS) and the neurological autoimmune disorder Guillain-Barré syndrome. These potential outcomes prompted massive efforts to understand the course of Zika infection and to develop therapeutic and prophylactic strategies for treatment and prevention of disease.
Area covered: Preclinical and clinical data demonstrate that a safe and efficacious vaccine for protection against Zika virus infection is possible in the near future. Nevertheless, significant knowledge gaps regarding the outcome of a mass vaccination strategy exist and must be addressed. Zika virus circulates in flavivirus-endemic regions, an ideal Zika vaccine should avoid the potential of antibody-dependent enhancement from exposure to dengue virus. Prevention of CZS is the primary goal for immunization, and the vaccine must provide protection against intrauterine transmission for use during pregnancy and in women of childbearing age. Ideally, a vaccine should also prevent sexual transmission of the virus through mucosal protection.
Expert opinion: This review describes current vaccine approaches against Zika virus with particular attention to the application of virus-like particle (VLP) technology as a strategy for solving the challenges of Zika virus immunization.
Article highlights
Zika virus (ZIKV) is a mosquito-borne flavivirus associated with congenital Zika syndrome (CZS) and with the neurological autoimmune disorder Guillain-Barré syndrome (GBS). Currently, no vaccines or antiviral strategies are licensed for ZIKV.
A successful, safe, and efficacious Zika vaccine must elicit a robust and sustained immunity and protect fetal development during pregnancy to prevent CZS.
ZIKV circulates in flaviviruses-endemic areas with the serologically related dengue virus (DENV) and yellow fever virus (YFV). Hence, a safe immunization strategy should prevent the risk of antibody-dependent enhancement (ADE) of disease between flavivirus infections.
To date, multiple virus-like particle (VLP)-based vaccine candidates have been created against ZIKV and have demonstrated excellent efficacy and avoidance of ADE between ZIKV and DENV.
The VLP technology offers a promising immunization strategy against ZIKV for mass vaccination of the affected population, including childbearing women.
Acknowledgments
We thank the ATCC colleagues: Drs. Randy Vines and Heather Couch for the helpful discussions and critical review of the manuscript; Jeb Suphankij for graphical design; Dr. Joseph Leonelli for his support.
Declaration of interest
VC, SR, and TTS are employees of ATCC, a nonprofit organization involved in vaccine research. JMG is an employee of TechnoVax, Inc, a company focused on vaccine research and development, including a vaccine for Zika virus. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Reviewer disclosures
Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.