Influenza
Conditions
Keywords
Influenza
Brief summary
The purpose of this study was to evaluate and compare the safety, reactogenicity, immunogenicity, relative efficacy and effectiveness of FluBlok to a licensed trivalent influenza vaccine (TIV)in healthy adults age 50-64 years.
Detailed description
Annual influenza epidemics are associated with serious excess morbidity and mortality, particularly among the elderly. Licensed trivalent inactivated influenza vaccines (TIVs) have been shown to reduce hospitalization and death following influenza in this vulnerable population, but their efficacy is lower than that observed in younger, healthy populations. In addition, recent studies have questioned the level of effectiveness of TIV in the elderly, suggesting that cohort studies have overestimated the benefits of immunization with current TIV formulations in this age group. In view of these considerations, it is widely accepted that improved and alternative vaccines are needed for control of seasonal and pandemic influenza. Currently available TIVs are prepared from viruses that are grown in embryonated hens' eggs. Alternative substrates for vaccine production are desirable in order to reduce the vulnerability of and to expand influenza vaccine supply. Recombinant DNA techniques allow for expression of the influenza hemagglutinin (rHA) by baculovirus vectors in insect cell cultures. Advantages of this technique include speed of production, absence of egg protein, and a highly purified product. Previous studies among healthy younger and older adults have confirmed that rHA vaccines are safe, well tolerated and immunogenic at dosages up to nine times higher than those contained in TIV. Dose-related increases in serum antibody levels after immunization also were observed.
Interventions
BIOLOGICALFluBlok Influenza Vaccination
0.5mL dose for intramuscular injection
BIOLOGICALTIV (Fluzone) Influenza Vaccination
0.5mL dose for intramuscular injection
Sponsors
Protein Sciences Corporation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
50 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
* Adults aged 50 to 64. * Females should be at least 2 years post-menopausal or sterile or practicing accepted form of birth control (including: condom with spermicidal, licensed hormonal contraceptive, abstinence, IUD or monogamous relationship with a vasectomized partner). * Healthy, as determined by oral temperature \<100.0°F, medical history, and medical assessment w/ brief physical evaluation by RN (if indicated) based on medical history. * Able to understand and comply with planned study procedures. * Provides written informed consent prior to initiation of any study procedure.
Exclusion criteria
* Known allergy to eggs or other vaccine components. * Immunosuppression as a result of an underlying illness or treatment, or used anticancer chemotherapy or radiation therapy within the preceding 36 months. * Any malignancy other than localized prostate cancer, diagnosed or treated actively during the past 5 years. Exceptions: Subjects with a history of lymphoproliferative disorder at any time in their life will be excluded, while subjects with a history of localized nonmelanotic skin cancer that has been completely removed during the past 5 years may be eligible. * Long-term use of oral steroids, parenteral steroids, or high-dose inhaled steroids (\>800 mcg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (Nasal and topical steroids are allowed). * Diagnosis of or treatment for bipolar disorder, severe major depression, schizophrenia or other major psychotic disorder in the past 3 months that is associated with severely impaired judgment or cognition. * History of receiving immunoglobulin or other blood product within the 3 months prior to enrollment in this study. * Receipt of any other licensed vaccines within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to enrollment in this study. * Use of experimental vaccines or any influenza vaccine other than FluBlOk after May 31st 2007 for the 2008 Southern Hemisphere or 2007 to 2008 Northern hemisphere epidemic seasons. * History of severe reactions following immunization with influenza virus vaccines. * Moderate to severe acute illness or febrile illness (oral temperature greater than 100degreesF) within 1 week prior to vaccination. * Receipt of an experimental agent (vaccine, drug, biologic, device, blood product or medication) within 1 month prior to enrollment in this study, or expects to receive an experimental agent during study period. * Known active human immunodeficiency virus, hepatitis B, or hepatitis C infection. * History of alcohol or drug abuse in the last 5 years. * History of Guillain-Barré Syndrome. * Subject is not available for three (3) or more consecutive weeks during active influenza season. * Any acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe, interfere with the evaluation of responses, or render the subject unable to meet the requirements of the protocol. These conditions include, but are not limited to: history of significant renal impairment (dialysis and treatment for kidney disease, including diabetic and hypertensive kidney disease); subjects with diabetes mellitus, well-controlled with oral agents may enroll as long there has been no dosage increase within the past 6 months; insulin-dependent diabetes is excluded; cardiac insufficiency, if heart failure is present (New York Heart Association Functional Class III or IV); an arteriosclerotic event during the 6 months prior to enrollment (e.g., history of myocardial infarction, stroke, recanalization of femoral arteries, or transient ischemic attack)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Reactogenicity days 0-7 following immunization; other AEs days 0-28 following immunization | Solicited reactogenicity events included injection site pain, bruising, erythema and swelling. Solicited systemic AEs included fatigue, chills, arthralgias, myalgias, headache and nausea. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | Day 0 and Day 28 | Immunogenicity was assessed by measuring the difference in values in Hemagglutination-Inhibition Assay (HAI) titers in participants from Day 0 to Day 28, using Geometric Mean Titers (GMTs). The GMTs from the FluBlok and TIV groups were then compared. |
| Percentage of Participants With Seroconversion | Day 28 following immunization at Day 0 | Percentage of participants with greater than or equal to a 4-fold rise in Hemagglutination-Inhibition Assay (HAI) titer over Day 0 at Day 28 following immunization |
| Percentage of Participants With Seroprotection | Day 28 following immunization at Day 0 | Percentage of participants with (HAI titer greater than or equal to 40) at Day 28 |
Countries
United States
Participant flow
Recruitment details
Subjects 50 - \<64 years of age were screened in participating outpatient clinics for eligibility within 30 days of randomization during the 2007 influenza season.
Pre-assignment details
Subjects whose laboratory values were exclusionary were not randomized. Women of child-bearing potential were required to have a negative pregnancy test.
Participants by arm
| Arm | Count |
|---|---|
| FluBlok Recombinant Trivalent Hemagglutinin Influenza Vaccine: 2007-2008 formulation containing 45μg of each hemagglutinin derived from A/Solomon Islands/03/2006 (H1N1), A/Wisconsin/67/2005 (H3N2), and B/Malaysia/2506/2004
135μg total | 300 |
| TIV (Fluzone) Licensed Trivalent Influenza Vaccine (TIV): 2007-2008 formulation containing 15μg of each hemagglutinin derived from A/Solomon Islands/03/2006 (H1N1), A/Wisconsin/67/2005 (H3N2), and B/Malaysia/2506/2004
45μg total
(Fluzone, sanofi pasteur) | 302 |
| Total | 602 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 0 | 1 |
| Overall Study | Withdrawal by Subject | 1 | 1 |
Baseline characteristics
| Characteristic | TIV (Fluzone) | FluBlok | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 302 Participants | 300 Participants | 602 Participants |
| Age Continuous | 55.7 years STANDARD_DEVIATION 3.64 | 55.9 years STANDARD_DEVIATION 3.71 | 55.8 years STANDARD_DEVIATION 3.67 |
| Region of Enrollment United States | 302 participants | 300 participants | 602 participants |
| Sex: Female, Male Female | 192 Participants | 187 Participants | 379 Participants |
| Sex: Female, Male Male | 110 Participants | 113 Participants | 223 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 4 / 300 | 9 / 302 |
| serious Total, serious adverse events | 1 / 300 | 0 / 302 |
Outcome results
Primary
Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs)
Solicited reactogenicity events included injection site pain, bruising, erythema and swelling. Solicited systemic AEs included fatigue, chills, arthralgias, myalgias, headache and nausea.
Time frame: Reactogenicity days 0-7 following immunization; other AEs days 0-28 following immunization
Population: Safety population included all randomized subjects who received a dose of study vaccine.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Nausea | 13 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Chills | 12 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Pain | 154 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Myalgia | 40 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Bruising | 16 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Fatigue | 40 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Erythema | 24 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Headache | 59 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Swelling | 25 participants |
| FluBlok | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Arthralgias | 15 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Swelling | 30 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Chills | 15 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Arthralgias | 19 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Myalgia | 63 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Headache | 63 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Nausea | 15 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Pain | 165 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Bruising | 14 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Injection Site Erythema | 25 participants |
| TIV (Fluzone) | Number of Participants With Reactogenicity (Solicited) Adverse Events (AEs) | Fatigue | 62 participants |
Secondary
Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age.
Immunogenicity was assessed by measuring the difference in values in Hemagglutination-Inhibition Assay (HAI) titers in participants from Day 0 to Day 28, using Geometric Mean Titers (GMTs). The GMTs from the FluBlok and TIV groups were then compared.
Time frame: Day 0 and Day 28
Population: All randomized subjects who received study vaccine and had Day 0 and Day 28 HAI titers
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) |
|---|---|---|---|
| FluBlok | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Solomon Islands (H1N1) - Day 0 | 28.71 HAI Titers |
| FluBlok | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Solomon Islands (H1N1) - Day 28 | 181.34 HAI Titers |
| FluBlok | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Wisconsin (H3N2) - Day 0 | 18.57 HAI Titers |
| FluBlok | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Wisconsin (H3N2) - Day 28 | 105.41 HAI Titers |
| FluBlok | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | B/Malaysia - Day 0 | 48.49 HAI Titers |
| FluBlok | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | B/Malaysia - Day 28 | 110.93 HAI Titers |
| TIV (Fluzone) | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | B/Malaysia - Day 0 | 49.18 HAI Titers |
| TIV (Fluzone) | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Solomon Islands (H1N1) - Day 0 | 27.77 HAI Titers |
| TIV (Fluzone) | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Wisconsin (H3N2) - Day 28 | 60.88 HAI Titers |
| TIV (Fluzone) | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Solomon Islands (H1N1) - Day 28 | 139.74 HAI Titers |
| TIV (Fluzone) | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | B/Malaysia - Day 28 | 116.03 HAI Titers |
| TIV (Fluzone) | Evaluation and Comparison of Immunogenicity of FluBlok and TIV in Healthy Adults 50-64 Years of Age. | A/Wisconsin (H3N2) - Day 0 | 18.20 HAI Titers |
Secondary
Percentage of Participants With Seroconversion
Percentage of participants with greater than or equal to a 4-fold rise in Hemagglutination-Inhibition Assay (HAI) titer over Day 0 at Day 28 following immunization
Time frame: Day 28 following immunization at Day 0
Population: All randomized subjects who received study vaccine and who had day 0 and day 28 HAI titers
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| FluBlok | Percentage of Participants With Seroconversion | A/Solomon Islands (H1N1) | 72 Percentage of participants |
| FluBlok | Percentage of Participants With Seroconversion | A/Wisconsin (H3N2) | 61 Percentage of participants |
| FluBlok | Percentage of Participants With Seroconversion | B/Malaysia | 41 Percentage of participants |
| TIV (Fluzone) | Percentage of Participants With Seroconversion | A/Solomon Islands (H1N1) | 66 Percentage of participants |
| TIV (Fluzone) | Percentage of Participants With Seroconversion | A/Wisconsin (H3N2) | 44 Percentage of participants |
| TIV (Fluzone) | Percentage of Participants With Seroconversion | B/Malaysia | 41 Percentage of participants |
Secondary
Percentage of Participants With Seroprotection
Percentage of participants with (HAI titer greater than or equal to 40) at Day 28
Time frame: Day 28 following immunization at Day 0
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| FluBlok | Percentage of Participants With Seroprotection | Influenza A/Solomon Islands (H1N1) | 96 Percentage of participants |
| FluBlok | Percentage of Participants With Seroprotection | Influenza A/Wisconsin (H3N2) | 85 Percentage of participants |
| FluBlok | Percentage of Participants With Seroprotection | Influenza B/Malaysia | 93 Percentage of participants |
| TIV (Fluzone) | Percentage of Participants With Seroprotection | Influenza B/Malaysia | 94 Percentage of participants |
| TIV (Fluzone) | Percentage of Participants With Seroprotection | Influenza A/Solomon Islands (H1N1) | 96 Percentage of participants |
| TIV (Fluzone) | Percentage of Participants With Seroprotection | Influenza A/Wisconsin (H3N2) | 75 Percentage of participants |