Potent immunogenicity and protective efficacy of a multi-pathogen vaccination targeting Zaire ebolavirus, Sudan ebolavirus, Marburg and Lassa viruses

Viral haemorrhagic fevers (VHF) pose a significant threat to human health. In recent years, VHF outbreaks caused by Ebola, Marburg and Lassa viruses have caused substantial morbidity and mortality in West and Central Africa. In 2022, an Ebola disease outbreak in Uganda caused by Sudan ebolavirus resulted in 164 cases with 55 deaths. In February 2023, a Marburg disease outbreak was confirmed in Equatorial Guinea resulting in 15 confirmed and 23 suspected cases to date, with a second outbreak occurring concurrently in Tanzania. There are no clearly defined correlates of protection against these VHF, impeding targeted subunit vaccine development. Any vaccine developed should therefore induce strong and preferably long-lasting humoral and cellular immunity against these viruses. Ideally this immunity should also cross-protect against viral variants, which are known to circulate in animal reservoirs and cause human disease. We have utilized two viral vectored vaccine platforms, an adenovirus (ChAdOx1) and Modified Vaccinia Ankara (MVA), to develop a multi-pathogen vaccine regime against three filoviruses (Zaire ebolavirus, Sudan ebolavirus, Marburg) and an arenavirus (Lassa). These platform technologies have consistently demonstrated the capability to induce robust cellular and humoral antigen-specific immunity in humans, most recently in the rollout of the licensed ChAdOx1-nCoV19 /AZD1222. Here, we show that our multi-pathogen vaccines elicit strong cellular and humoral immunity, induce a diverse range of chemokines and cytokines, and most importantly, confers protection after lethal Zaire ebolavirus, Sudan ebolavirus and Marburg virus challenges in a small animal model. ### Competing Interest Statement TL reports consulting fees from Vaccitech on an unrelated project, an honorarium from Seqirus, grant support from the Vaccine Taskforce for this trial, work-related investments, and is named as an inventor on a patent application for a vaccine against SARS-CoV-2.