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Marcia A. Blackman. 1 Trudeau Institute, Saranac Lake, New York.

In-Jeong Kim. 1 Trudeau Institute, Saranac Lake, New York.

Jr-Shiuan Lin. 1 Trudeau Institute, Saranac Lake, New York.

Stephen J. Thomas. 2 Infectious Disease Division, Upstate Medical University, State University of New York, Syracuse, New York.

Address correspondence to: Dr. Marcia A. Blackman, Trudeau Institute, 154 Algonquin Avenue, Saranac Lake, NY 12983, E-mail: [email protected]

Introduction

Zika virus (ZIKV) is a mosquito-borne flavivirus, first identified in 1947. Until recently, the virus posed little concern, as infection is largely asymptomatic or associated with a mild rash and febrile illness (22), although it had occasionally been accompanied by the development of Guillain-Barre syndrome in adults (10). Public attention was drawn to an outbreak of ZIKV that emerged in Brazil in 2015 and that was associated with devastating fetal microcephaly and other neurological defects in the developing fetus as a consequence of infection during pregnancy (19,78). The WHO declared a state of public health emergency from February 1, 2016 to November 18, 2016 (95). It is now emerging that microcephaly may be the tip of the iceberg in terms of ZIKV damage to the developing fetus (16,17,68,101), as babies who appear normal at birth may manifest neurological defects later in development. ZIKV has been shown to target both neural progenitor cells and more mature neural cells (89), and can persist long-term in neurological sites (2). ZIKV has also been shown to persist in bodily fluids, including semen, consistent with its ability to be sexually transmitted, calling into question the potential for sustained transmission when mosquito vector populations may be low (64,67,97). This dramatic impact on human health and the rapid spread of the virus [now reported in at least 84 countries (95)] make the development of a vaccine against ZIKV an urgent public health priority.

Progress in ZIKV Vaccine Development

A global effort is underway to develop vaccines against ZIKV, and more than 40 candidates are currently under development, employing a wide variety of vaccine platforms. Here, we will review general approaches and challenges to ZIKV vaccine development, as detailed progress in the development of individual candidates and preclinical testing have been recently reviewed by others (5,6,26,59,90,91). An increasing number of Zika vaccine candidates are in phase I clinical...

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