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Immunogenicity and Safety Study of ZOSTAVAX Administered by Intramuscular or Subcutaneous Route to Participants Aged From 50 Years Old (V211-045)

An Open-label, Randomised, Comparative, Multicentre Study of the Immunogenicity and Safety of ZOSTAVAX When Administered by Intramuscular Route or Subcutaneous Route to Subjects of 50 Years of Age and Older

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01391546
Enrollment
354
Registered
2011-07-12
Start date
2011-06-20
Completion date
2012-10-15
Last updated
2019-01-09

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

Conditions

Herpes Zoster

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

BIOLOGICALZOSTAVAX

1 dose 0.65 mL

Sponsors

Merck Sharp & Dohme LLC
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
Yes

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

MeasureTime frameDescription
Geometric Mean Titre (GMT) of Varicella Zoster Virus (VZV) Antibodies 4 Weeks Post-vaccination4 week post-vaccinationBlood 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 RoutePre-vaccination (Day 0) and 4 week post-vaccinationBlood 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

MeasureTime frameDescription
Geometric Mean Fold Rise (GMFR) of IFN-γ ELISPOT AntibodiesPre-vaccination (Day 0) and 4 week post-vaccinationBlood 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 Reactionup to 28 days after vaccinationParticipants 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 RoutePre-vaccination (Day 0) and 4 week post-vaccinationBlood 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 Eventup to 35 days after vaccinationA 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 Eventup to Day 28 after vaccinationAn 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) Antibodies4 week post-vaccinationBlood 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

ArmCount
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
Total354

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyHistory of Herpes Zoster (HZ)10

Baseline characteristics

CharacteristicTotalZOSTAVAX Subcutaneous (SC) RouteZOSTAVAX Intramuscular (IM) Route
Age at Vaccination62.6 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 Participants82 Participants81 Participants
Age, Customized
60-69 years of age
111 Participants55 Participants56 Participants
Age, Customized
≥70 years of age
80 Participants40 Participants40 Participants
Sex: Female, Male
Female
195 Participants97 Participants98 Participants
Sex: Female, Male
Male
159 Participants80 Participants79 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
59 / 176112 / 177
serious
Total, serious adverse events
1 / 1762 / 177

Outcome results

Primary

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.

ArmMeasureValue (GEOMETRIC_MEAN)
ZOSTAVAX Intramuscular (IM) RouteGeometric Mean Fold Rise (GMFR) in VZV Antibody Titre: IM Route2.7 Ratio
Comparison: Acceptability was demonstrated if the lower bound of the two-sided 95% CI was \>1.495% CI: [2.4, 3]
Primary

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.

ArmMeasureValue (GEOMETRIC_MEAN)
ZOSTAVAX Intramuscular (IM) RouteGeometric Mean Titre (GMT) of Varicella Zoster Virus (VZV) Antibodies 4 Weeks Post-vaccination395.3 gpELISA units/mL
ZOSTAVAX Subcutaneous (SC) RouteGeometric Mean Titre (GMT) of Varicella Zoster Virus (VZV) Antibodies 4 Weeks Post-vaccination391.7 gpELISA units/mL
p-value: <0.00195% CI: [0.93, 1.18]longitudinal regression model
Secondary

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.

ArmMeasureValue (GEOMETRIC_MEAN)
ZOSTAVAX Intramuscular (IM) RouteGeometric Mean Count (GMCs) of VZV Interferon Gamma ((IFN-γ) Enzyme-Linked ImmunoSpot (ELISPOT) Antibodies209.8 ELISPOT count/10^6 PBMC
ZOSTAVAX Subcutaneous (SC) RouteGeometric Mean Count (GMCs) of VZV Interferon Gamma ((IFN-γ) Enzyme-Linked ImmunoSpot (ELISPOT) Antibodies195.7 ELISPOT count/10^6 PBMC
Secondary

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.

ArmMeasureValue (GEOMETRIC_MEAN)
ZOSTAVAX Intramuscular (IM) RouteGeometric Mean Fold Rise (GMFR) in VZV Antibody Titre: SC Route2.5 Ratio
Secondary

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.

ArmMeasureValue (GEOMETRIC_MEAN)
ZOSTAVAX Intramuscular (IM) RouteGeometric Mean Fold Rise (GMFR) of IFN-γ ELISPOT Antibodies3.3 Ratio
ZOSTAVAX Subcutaneous (SC) RouteGeometric Mean Fold Rise (GMFR) of IFN-γ ELISPOT Antibodies3.4 Ratio
Secondary

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.

ArmMeasureValue (NUMBER)
ZOSTAVAX Intramuscular (IM) RoutePercentage of Participants Who Report at Least 1 Injection-site Adverse Reaction34.1 Percentage of Participants
ZOSTAVAX Subcutaneous (SC) RoutePercentage of Participants Who Report at Least 1 Injection-site Adverse Reaction64.4 Percentage of Participants
Secondary

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

ArmMeasureValue (NUMBER)
ZOSTAVAX Intramuscular (IM) RoutePercentage of Participants Who Report at Least 1 Serious Adverse Event0.6 Percentage of Participants
ZOSTAVAX Subcutaneous (SC) RoutePercentage of Participants Who Report at Least 1 Serious Adverse Event1.1 Percentage of Participants
Secondary

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.

ArmMeasureValue (NUMBER)
ZOSTAVAX Intramuscular (IM) RoutePercentage of Participants Who Report at Least 1 Systemic Adverse Event23.3 Percentage of Participants
ZOSTAVAX Subcutaneous (SC) RoutePercentage of Participants Who Report at Least 1 Systemic Adverse Event22.6 Percentage of Participants

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