Progress on the research and development of plague vaccines with a call to action

Abstract

There is a compelling demand for approved plague vaccines due to the endemicity of Yersinia pestis and its potential for pandemic spread. Whilst substantial progress has been made, we recommend that the global funding and health security systems should work urgently to translate some of the efficacious vaccines reviewed herein to expedite clinical development and to prevent future disastrous plague outbreaks, particularly caused by antimicrobial resistant Y. pestis strains.Content includes material subject to Crown Copyright © 2024.This is an open access article under the Open Government License ( http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/ ).

Fig. 1. Flea-vectored transmission of plague.

The figure depicts various routes for the flea-vectored transmission of plague to man. The figure is reproduced from Williamson and Westlake (2019) with permission (License 5753521304382, Oxford University Press).

Fig. 2. Plague vaccines in clinical trials.

*Adjuvant not specified. Ages of study participants ranges from 18 to 55 years. All vaccines were given in 2–3 doses intramuscularly over a range of 6 months. The EV 76 NIIEG vaccine was given 1–4 times at intervals of 1–3 months. ?data not published; !data not conclusive.

Fig. 3. Immunobridging to predict vaccine efficacy in man.

The figure depicts the use of percentage survival in vaccinated animals, which correlates with an immunological readout(s), to compare with the same immunological readout determined in a clinical trial, to predict vaccine efficacy in human.