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mRNA vaccines against H10N8 and H7N9 influenza viruses of pandemic potential are immunogenic and well tolerated in healthy adults in phase 1 randomized clinical trials
Open accessAbstract
BACKGROUND: We evaluated safety and immunogenicity of the first mRNA vaccines against potentially pandemic avian H10N8 and H7N9 influenza viruses. METHODS: Two randomized, placebo-controlled, double-blind, phase 1 clinical trials enrolled participants between December 2015 and August 2017 at single centers in Germany (H10N8) and USA (H7N9). Healthy adults (ages 18-64 years for H10N8 study; 18-49 years for H7N9 study) participated. Participants received vaccine or placebo in a 2-dose vaccination series 3 weeks apart. H10N8 intramuscular (IM) dose levels of 25, 50, 75, 100, and 400 µg and intradermal dose levels of 25 and 50 µg were evaluated. H7N9 IM 10-, 25-, and 50-µg dose levels were evaluated; 2-dose series 6 months apart was also evaluated. Primary endpoints were safety (adverse events) and tolerability. Secondary immunogenicity outcomes included humoral (hemagglutination inhibition [HAI], microneutralization [MN] assays) and cell-mediated responses (ELISPOT assay). RESULTS: H10N8 and H7N9 mRNA IM vaccines demonstrated favorable safety and reactogenicity profiles. No vaccine-related serious adverse event was reported. For H10N8 (N = 201), 100-µg IM dose induced HAI titers ≥ 1:40 in 100% and MN titers ≥ 1:20 in 87.0% of participants. The 25-µg intradermal dose induced HAI titers > 1:40 in 64.7% of participants compared to 34.5% of participants receiving the IM dose. For H7N9 (N = 156), IM doses of 10, 25, and 50 µg achieved HAI titers ≥ 1:40 in 36.0%, 96.3%, and 89.7% of participants, respectively. MN titers ≥ 1:20 were achieved by 100% in the 10- and 25-µg groups and 96.6% in the 50-µg group. Seroconversion rates were 78.3% (HAI) and 87.0% (MN) for H10N8 (100 µg IM) and 96.3% (HAI) and 100% (MN) in H7N9 (50 µg). Significant cell-mediated responses were not detected in either study. CONCLUSIONS: The first mRNA vaccines against H10N8 and H7N9 influenza viruses were well tolerated and elicited robust humoral immune responses. ClinicalTrials.gov NCT03076385 and NCT03345043.
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“Those studies showed that solicited systemic adverse events tended to be more frequent and more severe with higher doses and after the second vaccination.”
From An mRNA Vaccine against SARS-CoV-2 — Preliminary Report (2020) · cites this paper as [11]
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In the citing paper
“This descriptive safety profile is similar to that described in a report of two trials of avian influenza mRNA vaccines (influenza A/H10N8 and influenza A/H7N9) that were manufactured by Moderna with the use of an earlier lipid nanoparticle capsule formulation11 and is consistent with an interim report of a phase 1–2 evaluation of a Covid-19 mRNA vaccine encoding the S receptor-binding domain.6”
From An mRNA Vaccine against SARS-CoV-2 — Preliminary Report (2020) · cites this paper as [11]
In the citing paper
“Two RNA vaccine studies encoding other antigens did not see durable antibody titers in humans or non-human primates”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Feldman et al., 2019
In the citing paper
“Current clinical trials showed that the mRNA-1440 vaccine against H10N8 and the mRNA-1851 vaccine against H7N9 influenza viruses were well tolerated and elicited robust humoral immune responses when tested separately (Table 4).360”
From Advances in COVID-19 mRNA vaccine development (2022) · cites this paper as [360]
In the citing paper
“Adverse effects were limited to pain at the injection site, redness, muscle pain, joint pain, headache, fatigue and chills/common-cold-like symptoms, indicating that the vaccine is safe and well tolerated150.”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [150]
In the citing paper
“in phase I trials of the Moderna influenza H10N8 vaccine, severe adverse events from the 400 μg dose stopped further evaluation of that dose150.”
From mRNA vaccines for infectious diseases: principles, delivery and clinical translation (2021) · cites this paper as [150]
In the citing paper
“Moderna already reported on the good tolerability of an intramuscular/intradermal nucleoside-modified mRNA vaccine against two Influenza viruses (H10N8 and H7N9). Typical adverse events related to immune activation such as myalgia, fatigue and headache were reported which were mostly mild to moderate in severity and short-lived, not requiring medical interventions [16]”
From The dawn of mRNA vaccines: the COVID-19 case (2021) · cites this paper as [16]
In the citing paper
“Indeed, both i.m. and i.d. administration of lipid nanoparticle–mRNA vaccines produce robust immune responses at a well-tolerated dose in human trials156,157.”
From Lipid nanoparticles for mRNA delivery (2021) · cites this paper as [157]
In the citing paper
“Haemagglutinin is an essential surface antigen of influenza viruses156,157.”
From Lipid nanoparticles for mRNA delivery (2021) · cites this paper as [157]
In the citing paper
“Lipid nanoparticle–mRNA vaccines are also being investigated as influenza vaccines29,41,156,157,159,184,189–191, with some formulations in clinical trials (Table 1).”
From Lipid nanoparticles for mRNA delivery (2021) · cites this paper as [157]
In the citing paper
“A 100-μg dose level induced 78.3% (HAI) and 87.0% (MN) seroconversion for H10N8 (refs156,157) and a 50-μg dose level resulted in 96.3% (HAI) and 100% (MN) seroconversion for H7N9 (refs156,157).”
From Lipid nanoparticles for mRNA delivery (2021) · cites this paper as [157]
In the citing paper
“A 100-μg dose level induced 78.3% (HAI) and 87.0% (MN) seroconversion for H10N8 (refs156,157) and a 50-μg dose level resulted in 96.3% (HAI) and 100% (MN) seroconversion for H7N9 (refs156,157).”
From Lipid nanoparticles for mRNA delivery (2021) · cites this paper as [157]
In the citing paper
“The mRNA-1440 and mRNA-1851 vaccines, which are composed of lipid nanoparticles and mRNA encoding haemagglutinin from H10N8 and H7N9 influenza viruses, respectively, have completed phase I clinical studies (NCT03076385 and NCT03345043)156,157.”
From Lipid nanoparticles for mRNA delivery (2021) · cites this paper as [157]
In the citing paper
“Initial results with lipid-nanoparticle-formulated mRNA vaccines against H10N8 and H7N9 influenza viruses and SARS-CoV-2 indicate that these vaccines are well tolerated and that they produce a robust humoral response 76,77 .”
From Nanotechnology approaches for global infectious diseases (2021) · cites this paper as [77]
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Banerjee, S., Bose, S., Shukla, A. C., & Baig, M. R. (2024) · Interdisciplinary biotechnological advances · doi:10.1007/978-981-97-1148-2_15 · Cited by 3
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Kwetkat, A., Heppner, H. J., Endres, A., & Leischker, A. H. (2021) · Der Internist · doi:10.1007/s00108-021-01101-1 · Cited by 3
mRNA-based COVID-19 vaccines: a new age
Martínez-Espinosa, R. R., & Ramírez-Vélez, G. (2021) · Proceedings of Scientific Research Universidad Anáhuac Multidisciplinary Journal of Healthcare · doi:10.36105/psrua.2021v1n2.03 · Cited by 2
Review of SARS-CoV-2 Antigen and Antibody Testing in Diagnosis and Community Surveillance
Nerenz, R. D., Hubbard, J. A., & Cervinski, M. A. (2022) · Clinics in Laboratory Medicine · doi:10.1016/j.cll.2022.09.018 · Cited by 5
A Historical Overview on mRNA Vaccine Development
Verbeke, R., Cheng, M. H. Y., & Cullis, P. R. (2024) · Wiley eBooks · doi:10.1002/9783527838394.ch1 · Cited by 5
Huddleston, J., & Bedford, T. (2025) · eLife · doi:10.7554/elife.104282.1 · Cited by 3
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The persistence of COVID-19 vaccine artifacts in bodily fluids and tissues: a systematic review
Selem, E., Raszek, M., Varón, J., & Halma, M. T. J. (2026) · Future Journal of Pharmaceutical Sciences · doi:10.1186/s43094-026-00939-2 · Cited by 3
“A phase I trial of influenza vaccines tracked antibody in two vaccines for 183 and 205 days, respectively [3].”
Future Pneumococcal Vaccines: Shifting from Capsular Polysaccharides to Protein-Based Immunogens
Zheng, R., Shu, J., Xie, X., Zhao, C., Zhang, S., Zhang, X., & Xu, J. (2026) · Vaccines · doi:10.3390/vaccines14030208 · Cited by 2
“Prior to COVID-19, groups had already advanced mRNA platforms in oncology and viral vaccines (e.g., influenza), providing a foundation for broader infectious-disease applications [116–118].”
Unlocking the potential of mRNA nanomedicines for comprehensive fibrosis therapy
Yang, Y., Li, C., Xiong, W., Li, C., & Xiao, J. (2026) · Molecular Therapy — Nucleic Acids · doi:10.1016/j.omtn.2026.102917 · Cited by 2
Recent advances in LNP-mRNA vaccines
Redenti, B. J., Zhong, Y., Yu, C., & Dong, Y. (2026) · Colloids and Surfaces B Biointerfaces · doi:10.1016/j.colsurfb.2026.115675 · Cited by 3
mRNA Vaccines for Influenza: Hope for a Universal Vaccine?
Omotara, P., Zhu, W., & Wang, B. (2026) · BioDrugs · doi:10.1007/s40259-026-00791-z · Cited by 2
Saisonale Influenza – Aktuelles zu Epidemiologie, Prävention und Therapie
Brehm, T. T., & Hennigs, A. (2022) · DMW - Deutsche Medizinische Wochenschrift · doi:10.1055/a-1838-9223 · Cited by 2
Inactivated and Recombinant Influenza Vaccines
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Technologies for Making New Vaccines
Pecetta, S., Ahmed, S., Ellis, R. W., & Rappuoli, R. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-79058-1.00067-0 · Cited by 2
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Fan, C., Wang, S.-W., & Wong, C. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.12.26.572282 · Cited by 2
A 10-valent composite mRNA vaccine against both influenza and COVID-19Preprint
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Harnessing mRNA vaccines for viral diseases: bottleneck and breakthrough
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“However, most AEs experienced by mRNA-treated participants were transient and graded as grade 1 or 2 [50,51].”
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“Since the onset of the COVID-19 pandemic in 2019, mRNA-based vaccine platforms have emerged as promising candidate vaccines due to flexible antigen design and the possibility for rapid production (Blakney et al., 2019; Feldman et al., 2019).”
Ionizable lipids as a promising platform for creating mRNA vaccines
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mRNA Based Vaccine Studies in Infectious Diseases and Current Developments
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mRNA Vaccine Review against COVID-19 with Potential Applications to Improve Efficacy and Targeting
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“The H10N8 (Germany) and H7N9 (USA) vaccines were mRNAbased vaccines against influenza [68].”
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“…rates for 100 m g of H10N8 mRNA vaccine were 78.3% (hemagglutination inhibition) and 87.0% (micro-neutralization), while those for 50 m g of H7N9 mRNA vaccine were 96.3% (hemagglutination inhibition) and 100% (micro-neutralization), without cell-mediated immunity observed (Feldman et al., 2019).”
InfluentialIntegrating Context of Tumor Biology and Vaccine Design to Shape Multidimensional Immunotherapies
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“In a Stage I trial of this approach against two strains of influenza, this study showed seroconversion to protective titers in 80-100% of subjects (49).”
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Metadata
- Authors
- Feldman, R. A., Fuhr, R., Smolenov, I., (Mick) Ribeiro, A., Panther, L., Watson, M., Senn, J. J., Smith, M., Almarsson, Ӧ., Pujar, H. S., Laska, M. E., Thompson, J., Zaks, T., & Ciaramella, G.
- Affiliations
- Moderna Therapeutics (United States) (US)
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2019-05
- Volume
- 37
- Issue
- 25
- Pages
- 3326-3334
- ISSN
- 0264-410X (ISSN-L)
- OpenAlex
- W2944588091
- Cited by
- 454
- References
- 36
- Citations by year
- 2026: 27 · 2025: 41 · 2024: 66 · 2023: 60 · 2022: 87 · 2021: 114 · 2020: 53 · 2019: 6
- FWCI
- 49.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Vaccine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Moderna
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- mRNA vaccines, H7N9 influenza virus, pandemic influenza preparedness, vaccine safety, vaccine immunogenicity, intradermal vaccination, intramuscular vaccination, dose escalation, hemagglutination inhibition, microneutralization, cell-mediated immunity, healthy adults, reactogenicity, healthy volunteers, vaccine tolerability
- MeSH terms
- Immunogenicity, Vaccine, Adolescent, Adult, Antibodies, Viral, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Influenza, Human, Influenza Vaccines, Male, Middle Aged, RNA, Viral, Young Adult, Healthy Volunteers, Influenza A Virus, H7N9 Subtype, Influenza A Virus, H10N8 Subtype
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