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Concomitant Use of Hepatitis A Vaccine, Inactivated With Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) and Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed Given to Healthy Children 15 Months of Age (V251-068)

An Open, Randomized, Multicenter Study of the Safety, Tolerability, and Immunogenicity of VAQTA™ Given Concomitantly With PedvaxHIB™ and Infanrix™ in Healthy Children 15 Months of Age

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00289913
Enrollment
1274
Registered
2006-02-10
Start date
2006-04-30
Completion date
2010-06-30
Last updated
2017-04-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hepatitis A Virus

Keywords

Hepatitis A virus

Brief summary

This two-stage study evaluates the immunogenicity, safety, and tolerability of the administration of VAQTA™ (Hepatitis A Vaccine, Inactivated) concomitantly with PedvaxHIB™ (Haemophilus B Conjugate Vaccine \[Meningococcal Protein Conjugate\]) and Infanrix™ (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed, GlaxoSmithKline) versus the administration of VAQTA™ in healthy children 15 months of age at study entry.

Detailed description

In stage I, VAQTA™ given concomitantly with Infanrix™ and/or PedvaxHIB™ was evaluated. In stage 2: Two (2) doses of the VAQTA™ vaccine were administered at least 6 months apart. Safety data was collected after each dose.

Interventions

BIOLOGICALComparator: VAQTA™

VAQTA™ (Hepatitis A Vaccine, Inactivated). Two intramuscular 0.5-mL doses of VAQTA™ were administered 24 weeks apart, with the second dose being administered prior to 24 months of age.

BIOLOGICALComparator: Infanrix™

Infanrix™ (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed, GlaxoSmithKline). One intramuscular 0.5-mL injection of Infanrix™ was administered at the first study visit.

BIOLOGICALComparator: PedvaxHIB™

PedvaxHIB™ (Haemophilus B Conjugate Vaccine \[Meningococcal Protein Conjugate\]). One intramuscular 0.5-mL injection of PedvaxHIB™ was administered at the first study visit.

Sponsors

Merck Sharp & Dohme LLC
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
12 Months to 17 Months
Healthy volunteers
Yes

Inclusion criteria

* Stage 1) Healthy males and females 15 months of age with no active liver disease and a negative history of hepatitis A who have been vaccinated against Haemophilus influenzae type b (Hib), diphtheria, tetanus, and pertussis diseases * Stage 2) Healthy males and females 12 to 17 months of age with no active liver disease and a negative history of hepatitis A

Exclusion criteria

* Stage 1) Males and females previously vaccinated with hepatitis A vaccine, any immune deficiency, a history of allergy to any of the vaccine components, a history of seizure disorder or a neurologic disorder that would contraindicate pertussis vaccine, or a bleeding disorder * Stage 2) Males and females previously vaccinated with hepatitis A vaccine, any immune deficiency, a history of allergy to any of the vaccine components, or a history of bleeding disorder

Design outcomes

Primary

MeasureTime frameDescription
Seropositivity Rate (SPR) to Hepatitis A4 weeks after dose 2 of VAQTA™SPR is the percent of participants with Hepatitis A antibody titers \>= 10 milli-International Units/milliliter (mIU/mL), 4 weeks after dose 2 of VAQTA™ regardless of their initial serostatus. Antibody titers to Hepatitis A virus (HAV) were detected in participants' serum samples using an Enzyme Immunoassay (EIA).
Antibody Response Rate to Haemophilus Influenzae Type b (Hib)4 weeks postvaccination with PedvaxHIB™Antibodies to the Hib capsular polysaccharide (polyribosylribitol phosphate \[PRP\]) are assessed in participants serum using radioimmunoassay (RIA). The limit of detection (LOD) for the RIA is 6.60 ng/mL. The antibody response rate is defined as the percentage of participants with anti-PRP titers \>1.0 mcg/mL, 4 weeks postvaccination with PedvaxHIB™.
Number of Participants With Adverse Events (AE)Days 1 to 14 after any dose of VAQTA™ for systemic AEs, and Days 1 to 5 after any dose of VAQTA™ for injection-site AEsSystemic and injection site AEs were collected from participants receiving * VAQTA™ concomitantly with Infanrix™ and PedvaxHIB™ or PedvaxHIB™ (Stage I) * VAQTA™ non-concomitantly with Infanrix™ and PedvaxHIB™ or PedvaxHIB™ (Stage I) * VAQTA™ administered alone (Stage II) Safety data was collected on a standardized Vaccination Report Card (VRC) following each dose. Participants returned the VRC after the safety follow-up period for each dose of VAQTA™. AEs determined by the investigator to be possibly, probably or definitely related to the vaccine are reported as Vaccine-related AE.
Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™4 weeks postvaccination with Infanrix™GMTs for antibodies to PT, FHA, and PRN were measured in serum samples of participants vaccinated with Infanrix™. IgG antibodies to PT were assessed using the anti-pertussis toxin enzyme-linked immunosorbent assay (anti-PT ELISA), with the LOD of 2.4 ELU/mL. IgG antibodies to FHA were assessed using the anti-pertussis filamentous hemagglutinin enzyme-linked immunosorbent assay (anti-FHA ELISA), with the LOD of 2.0 ELU/mL. IgG antibodies to PRN were assessed using the anti-pertussis pertactin enzyme-linked immunosorbent assay (anti-PRN ELISA), with the LOD of 3.3 ELU/mL.

Participant flow

Recruitment details

In Stage I, a total of 620 participants were randomized to receive study vaccinations. However for 3 participants, the Health Insurance Portability and Accountability Act (HIPAA) and/or Informed Consent Form was not signed by the parents in error. Therefore a total of 617 participants were included in Stage I. 654 participants started Stage II.

Pre-assignment details

For this study: Visit 1 was on Day 1 (for Stage I and Stage II). Visit 2 was at Week 4 (Stage I) and Week 2 (Stage II). Visit 3 was at Week 24/Week 28 (Stage I) and Week 24 (Stage II). Visit 4 was at Week 28/Week 32 (Stage I) and Week 26 (Stage II). For safety, participants were followed for 14 days after each vaccination (safety follow-up \[F/U\]).

Participants by arm

ArmCount
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)
Day 1: VAQTA™ (first dose), PedvaxHIB™ and Infanrix™ were administered concomitantly at different injection sites. Week 24: The second dose of VAQTA™ was administered.
155
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)
Day 1: PedvaxHIB™ and Infanrix™ were administered concomitantly at different injection sites. Week 4: The first dose of VAQTA™ was administered. Week 28: The second dose of VAQTA™ was administered.
151
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)
Day 1: VAQTA™ (first dose) and PedvaxHIB™ were administered concomitantly at different injection sites. Week 24: The second dose of VAQTA™ was administered.
159
PedvaxHIB™/ VAQTA™/ VAQTA™ (Stage 1)
Day 1: PedvaxHIB™ was administered. Week 4: The first dose of VAQTA™ was administered. Week 28: The second dose of VAQTA™ was administered.
152
VAQTA™/ VAQTA™ (Stage 2)
Day 1: The first dose of VAQTA™ was administered. Week 24: The second dose of VAQTA™ was administered.
654
Total1,271

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004
Visit 1 (Stage I and Stage II)Lost after safety F/U21005
Visit 1 (Stage I and Stage II)Lost during safety F/U32221
Visit 1 (Stage I and Stage II)Moved during safety F/U00001
Visit 1 (Stage I and Stage II)Other reasons after safety F/U10200
Visit 1 (Stage I and Stage II)Other reasons during safety F/U00010
Visit 1 (Stage I and Stage II)Protocol deviation after safety F/U12000
Visit 1 (Stage I and Stage II)Protocol deviation during safety F/U01000
Visit 1 (Stage I and Stage II)Withdrew consent after safety F/U]08560
Visit 1 (Stage I and Stage II)Withdrew consent during safety F/U22022
Visit 2 (Stage I and Stage II)Lost after safety F/U25030
Visit 2 (Stage I and Stage II)Lost during safety F/U811220
Visit 2 (Stage I and Stage II)Lost (Stage II)000011
Visit 2 (Stage I and Stage II)Moved (Stage II)00006
Visit 2 (Stage I and Stage II)Other reasons after safety F/U]10000
Visit 2 (Stage I and Stage II)Other reasons during safety F/U10100
Visit 2 (Stage I and Stage II)Other reasons (Stage II)00009
Visit 2 (Stage I and Stage II)Protocol deviation after safety F/U01310
Visit 2 (Stage I and Stage II)Protocol deviation during safety F/U00100
Visit 2 (Stage I and Stage II)Protocol deviation (Stage II)00007
Visit 2 (Stage I and Stage II)Subject moved during safety F/U01000
Visit 2 (Stage I and Stage II)Withdrew consent after safety F/U01200
Visit 2 (Stage I and Stage II)Withdrew consent during safety F/U32100
Visit 2 (Stage I and Stage II)Withdrew consent (Stage II)00007
Visit 3 (Stage I and Stage II)Lost after safety F/U12014
Visit 3 (Stage I and Stage II)Lost during safety F/U83122
Visit 3 (Stage I and Stage II)Moved after safety F/U00001
Visit 3 (Stage I and Stage II)Other reasons after safety F/U01000
Visit 3 (Stage I and Stage II)Other reasons during safety F/U00001
Visit 3 (Stage I and Stage II)Protocol deviation during safety F/U01000
Visit 3 (Stage I and Stage II)Withdrew consent after safety F/U]01100
Visit 3 (Stage I and Stage II)Withdrew consent during safety F/U00010

Baseline characteristics

CharacteristicVAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)PedvaxHIB™/ VAQTA™/ VAQTA™ (Stage 1)VAQTA™/ VAQTA™ (Stage 2)Total
Age, Customized
Between 12 and 18 months
155 participants151 participants159 participants152 participants654 participants1271 participants
Sex: Female, Male
Female
74 Participants67 Participants70 Participants73 Participants319 Participants603 Participants
Sex: Female, Male
Male
81 Participants84 Participants89 Participants79 Participants335 Participants668 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —
other
Total, other adverse events
116 / 15074 / 145123 / 15288 / 146426 / 641
serious
Total, serious adverse events
0 / 1502 / 1450 / 1522 / 1462 / 641

Outcome results

Primary

Antibody Response Rate to Haemophilus Influenzae Type b (Hib)

Antibodies to the Hib capsular polysaccharide (polyribosylribitol phosphate \[PRP\]) are assessed in participants serum using radioimmunoassay (RIA). The limit of detection (LOD) for the RIA is 6.60 ng/mL. The antibody response rate is defined as the percentage of participants with anti-PRP titers \>1.0 mcg/mL, 4 weeks postvaccination with PedvaxHIB™.

Time frame: 4 weeks postvaccination with PedvaxHIB™

Population: The per-protocol population, which consisted of all Stage I participants who received vaccinations within the specified day ranges, completed appropriate follow-up, and were without any pre-specified protocol violations.

ArmMeasureValue (NUMBER)
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Antibody Response Rate to Haemophilus Influenzae Type b (Hib)98.1 Percentage of participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Antibody Response Rate to Haemophilus Influenzae Type b (Hib)97.0 Percentage of participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Antibody Response Rate to Haemophilus Influenzae Type b (Hib)97.3 Percentage of participants
PedvaxHIB™/ VAQTA™/ VAQTA™ (Stage 1)Antibody Response Rate to Haemophilus Influenzae Type b (Hib)97.2 Percentage of participants
Primary

Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™

GMTs for antibodies to PT, FHA, and PRN were measured in serum samples of participants vaccinated with Infanrix™. IgG antibodies to PT were assessed using the anti-pertussis toxin enzyme-linked immunosorbent assay (anti-PT ELISA), with the LOD of 2.4 ELU/mL. IgG antibodies to FHA were assessed using the anti-pertussis filamentous hemagglutinin enzyme-linked immunosorbent assay (anti-FHA ELISA), with the LOD of 2.0 ELU/mL. IgG antibodies to PRN were assessed using the anti-pertussis pertactin enzyme-linked immunosorbent assay (anti-PRN ELISA), with the LOD of 3.3 ELU/mL.

Time frame: 4 weeks postvaccination with Infanrix™

Population: The per-protocol population, which consisted of all Stage I participants who received vaccinations within the specified day ranges, completed appropriate follow-up, and were without any pre-specified protocol violations.

ArmMeasureGroupValue (GEOMETRIC_MEAN)
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™Pertussis PT69.2 ELISA units per mL (ELU/mL)
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™Pertussis FHA253.8 ELISA units per mL (ELU/mL)
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™PRN333.5 ELISA units per mL (ELU/mL)
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™Pertussis PT51.7 ELISA units per mL (ELU/mL)
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™Pertussis FHA249.2 ELISA units per mL (ELU/mL)
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Geometric Mean Titers (GMTs) to Antibodies for the Pertussis Toxin (PT), Pertussis Filamentous Hemagglutinin Antibody (FHA), and Pertactin (PRN) Components of Infanrix™PRN358.5 ELISA units per mL (ELU/mL)
Primary

Number of Participants With Adverse Events (AE)

Systemic and injection site AEs were collected from participants receiving * VAQTA™ concomitantly with Infanrix™ and PedvaxHIB™ or PedvaxHIB™ (Stage I) * VAQTA™ non-concomitantly with Infanrix™ and PedvaxHIB™ or PedvaxHIB™ (Stage I) * VAQTA™ administered alone (Stage II) Safety data was collected on a standardized Vaccination Report Card (VRC) following each dose. Participants returned the VRC after the safety follow-up period for each dose of VAQTA™. AEs determined by the investigator to be possibly, probably or definitely related to the vaccine are reported as Vaccine-related AE.

Time frame: Days 1 to 14 after any dose of VAQTA™ for systemic AEs, and Days 1 to 5 after any dose of VAQTA™ for injection-site AEs

Population: Participants administered at least one dose of vaccine, for whom follow-up was available.

ArmMeasureGroupValue (NUMBER)
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With vaccine-related (VR) AE192 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---injection-site AE (VR)164 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---sytemic AE (VR)91 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With serious AE0 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With serious AE (VR)0 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who died0 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who discontinued due to AE0 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who discontinued due to serious AE0 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With no AE63 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With one or more AE239 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---injection-site AE167 Participants
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---sytemic AE183 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---sytemic AE119 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With vaccine-related (VR) AE129 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who discontinued due to AE0 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With no AE86 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---injection-site AE (VR)116 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who died0 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---injection-site AE116 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---sytemic AE (VR)42 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who discontinued due to serious AE0 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With serious AE (VR)0 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With serious AE1 Participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With one or more AE170 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With serious AE2 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With serious AE (VR)0 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With one or more AE466 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who died0 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who discontinued due to AE0 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)Who discontinued due to serious AE0 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---injection-site AE249 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With vaccine-related (VR) AE328 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---injection-site AE (VR)249 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)With no AE181 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---sytemic AE (VR)147 Participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Number of Participants With Adverse Events (AE)---sytemic AE395 Participants
Primary

Seropositivity Rate (SPR) to Hepatitis A

SPR is the percent of participants with Hepatitis A antibody titers \>= 10 milli-International Units/milliliter (mIU/mL), 4 weeks after dose 2 of VAQTA™ regardless of their initial serostatus. Antibody titers to Hepatitis A virus (HAV) were detected in participants' serum samples using an Enzyme Immunoassay (EIA).

Time frame: 4 weeks after dose 2 of VAQTA™

Population: The per-protocol population, which consisted of all Stage I participants who received vaccinations within the specified day ranges, completed appropriate follow-up, and were without any pre-specified protocol violations.

ArmMeasureValue (NUMBER)
VAQTA™, PedvaxHIB™ and Infanrix™/ VAQTA™ (Stage 1)Seropositivity Rate (SPR) to Hepatitis A100 Percentage of participants
PedvaxHIB™ and Infanrix™/ VAQTA™/ VAQTA™ (Stage 1)Seropositivity Rate (SPR) to Hepatitis A100 Percentage of participants
VAQTA™, PedvaxHIB™/ VAQTA™ (Stage 1)Seropositivity Rate (SPR) to Hepatitis A100 Percentage of participants
PedvaxHIB™/ VAQTA™/ VAQTA™ (Stage 1)Seropositivity Rate (SPR) to Hepatitis A100 Percentage of participants

Source: ClinicalTrials.gov · Data processed: Mar 4, 2026