Herpes Zoster
Conditions
Brief summary
PRIMARY OBJECTIVES Two co-primary objectives are: * To demonstrate that the immunogenicity of ZOSTAVAX administered by intramuscular route (IM) is non-inferior to ZOSTAVAX administered by subcutaneous route (SC) * To demonstrate that ZOSTAVAX administered by IM route induces an acceptable fold-rise of varicella zoster virus (VZV) antibody titre from pre to 4-week post-vaccination SECONDARY OBJECTIVES Immunogenicity objectives * To evaluate the immunogenicity as measured by VZV antibody titre at 4 weeks following ZOSTAVAX administered by IM or SC route * To evaluate the immune response as measured by a second assay, the VZV Interferon gamma Enzyme-linked immunospot (ELISPOT) at 4 weeks following ZOSTAVAX administered by IM or SC route Safety objective \- To describe the safety profile of ZOSTAVAX administered by IM or SC route
Interventions
1 dose 0.65 mL
Sponsors
Study design
Eligibility
Inclusion criteria
* Adults aged \>=50 years * Varicella history-positive or residence for \>30 years in a country with endemic VZV infection
Exclusion criteria
* Febrile illness * History of hypersensitivity or anaphylactoid reaction to any of the vaccine components * Prior herpes zoster episode clinically diagnosed or exposure to varicella or herpes zoster within the 4 weeks prior to vaccination * Prior receipt of varicella or zoster vaccine * Active untreated tuberculosis * Thrombocytopenia, any other coagulation disorder contraindicating intramuscular injection * Receipt of medication / vaccine that may interfere with study assessments * Known or suspected immune dysfunction * User of recreational / illicit drugs or subject with alcohol abuse or dependence within the last year * Any condition that might interfere with the interpretation of the study,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Geometric Mean Titre (GMT) of Varicella Zoster Virus (VZV) Antibodies 4 Weeks Post-vaccination | 4 week post-vaccination | Blood samples taken at 4 weeks post vaccination to determine the geometric mean titre (GMT) of VZV antibodies via Glycoprotein Enzyme Linked Immunosorbent Assay (gpELISA). |
| Geometric Mean Fold Rise (GMFR) in VZV Antibody Titre: IM Route | Pre-vaccination (Day 0) and 4 week post-vaccination | Blood sample taken at predose (Day 0) and 4 weeks post vaccination to determine the geometric mean titre (GMT) of VZV antibodies via gpELISA. The GMFR was calculated as GMT Post-dose/GMT Pre-vaccination |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Geometric Mean Fold Rise (GMFR) of IFN-γ ELISPOT Antibodies | Pre-vaccination (Day 0) and 4 week post-vaccination | Blood samples taken pre-vaccination and 4 weeks post-vaccination to determine the IFN-γ ELISPOT GMFR. |
| Percentage of Participants Who Report at Least 1 Injection-site Adverse Reaction | up to 28 days after vaccination | Participants entered data into daily diary card regarding previously identified possible injection site reactions of erythema, injection site swelling or injection site pain for 1st 4 days post-vaccination. Additionally, injection site reactions not prompted on diary card (unsolicited) were collected up 28 days post-vaccination. All injection site reactions (solicited or unsolicited) were recorded. |
| Geometric Mean Fold Rise (GMFR) in VZV Antibody Titre: SC Route | Pre-vaccination (Day 0) and 4 week post-vaccination | Blood sample taken at predose (Day 0) and 4 weeks post vaccination to determine the geometric mean titre (GMT) of VZV antibodies via gpELISA. The GMFR was calculated as GMT Post-vaccination/GMT Pre-vaccination |
| Percentage of Participants Who Report at Least 1 Serious Adverse Event | up to 35 days after vaccination | A serious adverse event (SAE) is any adverse event that results in death, is life threatening, results in a persistent or significant disability/incapacity, results in hospitalization or prolongs an existing hospitalization, is a congenital anomaly/birth defect, is a cancer, is an overdose, or is considered an other important medical event based on medical judgement. The percentage of participants who reported an SAE within 35 days of vaccination were recorded. |
| Percentage of Participants Who Report at Least 1 Systemic Adverse Event | up to Day 28 after vaccination | An adverse event (AE) was defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. Adverse events that were considered systemic (not localized) were summarized. These events included rashes of interest: i.e. Varicella, Varicella-like rashes, Herpes zoster or shingles and Herpes zoster-like rashes and other systemic adverse events. |
| Geometric Mean Count (GMCs) of VZV Interferon Gamma ((IFN-γ) Enzyme-Linked ImmunoSpot (ELISPOT) Antibodies | 4 week post-vaccination | Blood samples taken 4 weeks post-vaccination to determine the IFN-γ ELISPOT GMC's. Results were reported as ELISPOT count/10\^6 Peripheral Blood Mononuclear Cells (PBMC) |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| ZOSTAVAX Intramuscular (IM) Route Single dose of 0.65 mL via IM injection | 177 |
| ZOSTAVAX Subcutaneous (SC) Route Single dose of 0.65 mL via SC injection | 177 |
| Total | 354 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | History of Herpes Zoster (HZ) | 1 | 0 |
Baseline characteristics
| Characteristic | Total | ZOSTAVAX Subcutaneous (SC) Route | ZOSTAVAX Intramuscular (IM) Route |
|---|---|---|---|
| Age at Vaccination | 62.6 Years of Age STANDARD_DEVIATION 8.4 | 62.6 Years of Age STANDARD_DEVIATION 8.5 | 62.6 Years of Age STANDARD_DEVIATION 8.3 |
| Age, Customized 50-59 years of age | 163 Participants | 82 Participants | 81 Participants |
| Age, Customized 60-69 years of age | 111 Participants | 55 Participants | 56 Participants |
| Age, Customized ≥70 years of age | 80 Participants | 40 Participants | 40 Participants |
| Sex: Female, Male Female | 195 Participants | 97 Participants | 98 Participants |
| Sex: Female, Male Male | 159 Participants | 80 Participants | 79 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 59 / 176 | 112 / 177 |
| serious Total, serious adverse events | 1 / 176 | 2 / 177 |
Outcome results
Geometric Mean Fold Rise (GMFR) in VZV Antibody Titre: IM Route
Blood sample taken at predose (Day 0) and 4 weeks post vaccination to determine the geometric mean titre (GMT) of VZV antibodies via gpELISA. The GMFR was calculated as GMT Post-dose/GMT Pre-vaccination
Time frame: Pre-vaccination (Day 0) and 4 week post-vaccination
Population: All randomised participants who had received the study vaccine via IM route, had at least one valid immunogenicity evaluation for VZV antibody and had post-vaccination data available for endpoint.
| Arm | Measure | Value (GEOMETRIC_MEAN) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Geometric Mean Fold Rise (GMFR) in VZV Antibody Titre: IM Route | 2.7 Ratio |
Geometric Mean Titre (GMT) of Varicella Zoster Virus (VZV) Antibodies 4 Weeks Post-vaccination
Blood samples taken at 4 weeks post vaccination to determine the geometric mean titre (GMT) of VZV antibodies via Glycoprotein Enzyme Linked Immunosorbent Assay (gpELISA).
Time frame: 4 week post-vaccination
Population: All randomised participants who had received the study vaccine, had at least one valid immunogenicity evaluation for VZV antibody and had post-vaccination data available for endpoint.
| Arm | Measure | Value (GEOMETRIC_MEAN) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Geometric Mean Titre (GMT) of Varicella Zoster Virus (VZV) Antibodies 4 Weeks Post-vaccination | 395.3 gpELISA units/mL |
| ZOSTAVAX Subcutaneous (SC) Route | Geometric Mean Titre (GMT) of Varicella Zoster Virus (VZV) Antibodies 4 Weeks Post-vaccination | 391.7 gpELISA units/mL |
Geometric Mean Count (GMCs) of VZV Interferon Gamma ((IFN-γ) Enzyme-Linked ImmunoSpot (ELISPOT) Antibodies
Blood samples taken 4 weeks post-vaccination to determine the IFN-γ ELISPOT GMC's. Results were reported as ELISPOT count/10\^6 Peripheral Blood Mononuclear Cells (PBMC)
Time frame: 4 week post-vaccination
Population: All randomised participants in the ELISPOT subset (predetermined protocol-defined sites) who had received the study vaccine and had valid post-vaccination data for endpoint.
| Arm | Measure | Value (GEOMETRIC_MEAN) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Geometric Mean Count (GMCs) of VZV Interferon Gamma ((IFN-γ) Enzyme-Linked ImmunoSpot (ELISPOT) Antibodies | 209.8 ELISPOT count/10^6 PBMC |
| ZOSTAVAX Subcutaneous (SC) Route | Geometric Mean Count (GMCs) of VZV Interferon Gamma ((IFN-γ) Enzyme-Linked ImmunoSpot (ELISPOT) Antibodies | 195.7 ELISPOT count/10^6 PBMC |
Geometric Mean Fold Rise (GMFR) in VZV Antibody Titre: SC Route
Blood sample taken at predose (Day 0) and 4 weeks post vaccination to determine the geometric mean titre (GMT) of VZV antibodies via gpELISA. The GMFR was calculated as GMT Post-vaccination/GMT Pre-vaccination
Time frame: Pre-vaccination (Day 0) and 4 week post-vaccination
Population: All randomised participants who had received the study vaccine via SC route, had at least one valid immunogenicity evaluation for VZV antibody and had post-vaccination data available for endpoint.
| Arm | Measure | Value (GEOMETRIC_MEAN) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Geometric Mean Fold Rise (GMFR) in VZV Antibody Titre: SC Route | 2.5 Ratio |
Geometric Mean Fold Rise (GMFR) of IFN-γ ELISPOT Antibodies
Blood samples taken pre-vaccination and 4 weeks post-vaccination to determine the IFN-γ ELISPOT GMFR.
Time frame: Pre-vaccination (Day 0) and 4 week post-vaccination
Population: All randomised participants in the ELISPOT subset (predetermined protocol-defined sites) who had received the study vaccine and had valid pre- and post-vaccination data for endpoint.
| Arm | Measure | Value (GEOMETRIC_MEAN) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Geometric Mean Fold Rise (GMFR) of IFN-γ ELISPOT Antibodies | 3.3 Ratio |
| ZOSTAVAX Subcutaneous (SC) Route | Geometric Mean Fold Rise (GMFR) of IFN-γ ELISPOT Antibodies | 3.4 Ratio |
Percentage of Participants Who Report at Least 1 Injection-site Adverse Reaction
Participants entered data into daily diary card regarding previously identified possible injection site reactions of erythema, injection site swelling or injection site pain for 1st 4 days post-vaccination. Additionally, injection site reactions not prompted on diary card (unsolicited) were collected up 28 days post-vaccination. All injection site reactions (solicited or unsolicited) were recorded.
Time frame: up to 28 days after vaccination
Population: All vaccinated participants who had follow-up safety data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Percentage of Participants Who Report at Least 1 Injection-site Adverse Reaction | 34.1 Percentage of Participants |
| ZOSTAVAX Subcutaneous (SC) Route | Percentage of Participants Who Report at Least 1 Injection-site Adverse Reaction | 64.4 Percentage of Participants |
Percentage of Participants Who Report at Least 1 Serious Adverse Event
A serious adverse event (SAE) is any adverse event that results in death, is life threatening, results in a persistent or significant disability/incapacity, results in hospitalization or prolongs an existing hospitalization, is a congenital anomaly/birth defect, is a cancer, is an overdose, or is considered an other important medical event based on medical judgement. The percentage of participants who reported an SAE within 35 days of vaccination were recorded.
Time frame: up to 35 days after vaccination
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Percentage of Participants Who Report at Least 1 Serious Adverse Event | 0.6 Percentage of Participants |
| ZOSTAVAX Subcutaneous (SC) Route | Percentage of Participants Who Report at Least 1 Serious Adverse Event | 1.1 Percentage of Participants |
Percentage of Participants Who Report at Least 1 Systemic Adverse Event
An adverse event (AE) was defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. Adverse events that were considered systemic (not localized) were summarized. These events included rashes of interest: i.e. Varicella, Varicella-like rashes, Herpes zoster or shingles and Herpes zoster-like rashes and other systemic adverse events.
Time frame: up to Day 28 after vaccination
Population: All vaccinated participants who had follow-up safety data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| ZOSTAVAX Intramuscular (IM) Route | Percentage of Participants Who Report at Least 1 Systemic Adverse Event | 23.3 Percentage of Participants |
| ZOSTAVAX Subcutaneous (SC) Route | Percentage of Participants Who Report at Least 1 Systemic Adverse Event | 22.6 Percentage of Participants |