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Immune Responses to H5N1 Vaccine With and Without AS03 Adjuvant

Characterization of Innate Immune Responses to AS03 Adjuvanted H5N1 Vaccine Compared to Non-adjuvanted H5N1 Vaccine

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01578317
Enrollment
43
Registered
2012-04-16
Start date
2012-03-20
Completion date
2016-01-31
Last updated
2019-02-26

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

Conditions

Influenza

Keywords

H5N1 Vaccine, H5N1 Immunization, AS03 Adjuvant, Biologic Sample Collection, Laboratory Research Specimens, Healthy Volunteer, HV

Brief summary

Background: \- Adjuvants are substances included in vaccines that stimulate the immune system and increase the body's response to the vaccine. The AS03 adjuvant is used in seasonal flu vaccines in Europe. However, it has not been fully tested in the United States. Researchers want to test the immune responses of people who receive a bird flu vaccine with or without AS03 to better understand how the adjuvant works. This information may help develop better flu vaccines. Objectives: \- To compare the healthy immune system responses to bird flu vaccine with or without the AS03 adjuvant. Eligibility: \- Healthy volunteers between 18 and 45 years of age. Design: * Participants will be screened with a physical exam and medical history. * Participants will be assigned to one of two groups. Each group will have an initial vaccine, followed by a booster vaccine 21 days later. Both vaccinations will use the same type of vaccine. One group will have the vaccine with AS03; the other group will have the vaccine without it. * All participants will have two 36-hour inpatient stays to receive the vaccine. Each stay will involve the vaccination, followed by regular and frequent blood draws. Participants will be monitored for any signs or symptoms that may be caused by the vaccine. * Additional blood samples will be collected 7, 28, 42, and 100 days after the initial vaccination.

Detailed description

Adjuvants have been in use for many decades to enhance the effects of vaccines on the host immune system, yet we know very little on how they actually work. Better understanding of the mechanism by which adjuvants activate the immune system will enable us to develop better and safer vaccines as well as a broad range of immune interventions to a wide spectrum of diseases including cancer and autoimmunity. In the current study we propose to study the effect of AS03 adjuvant on the innate/early immune response to H5N1, avian flu, a potentially lethal disease that most subjects are assumed to be naive to AS03 is an adjuvant oil in water emulsion containing DL-alpha-tocopherol, squalene and the non-ionic detergent Tween 80 that has been widely used as an adjuvant to flu vaccines produced by GlaxoSmithKline(GSK). We therefore propose to randomize up to 60 healthy volunteers into two intervention arms (25 volunteers in each arm with up to 10 total replacements in the event a volunteer does not return for the first vaccine). The first arm will receive a vaccine containing H5N1 with AS03 adjuvant, the second arm will receive H5N1 without AS03 adjuvant. Both arms will receive primary and booster vaccination followed by repeated blood sampling to evaluate the immune responses. We will apply high throughput analytic techniques and use systems biology methods to integrate the collected data and draw a description of the immune system response with and without the adjuvant. The primary objective is to compare multiplex immune response signatures following two (primary and a boost) vaccinations with the GSK AS03 adjuvanted H5N1 influenza vaccine, or the non-adjuvanted form of the H5N1 influenza vaccine, at the 3.75 mcg dose and given 21 days apart and identify differences in very early innate immune responses. These immune signatures will also be correlated with the clinical observations especially safety related local and systemic events.

Interventions

H5N1 influenza vaccine with AS03 at the 3.75 mcg dose level given 21 days apart.

H5N1 influenza vaccine non- adjuvanted form at the 3.75 mcg dose level given 21 days apart.

Sponsors

National Institute of Allergy and Infectious Diseases (NIAID)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes

Inclusion criteria

* INCLUSION CRITERIA: 1. Healthy status confirmed by History, Physical Exam and blood work through the CHI Screening Protocol. 2. Age 21 years to 45 years 3. Able to comprehend the investigational nature of the protocol and provide informed consent 4. Must be willing to use effective birth control for one month before, during and for two months after the last vaccination.

Exclusion criteria

1. Severe allergies to eggs or their products, chicken proteins or to any component of the influenza antigen preparation. 2. Recipient of AS03 vaccine at any time in the past 3. Recipient of the seasonal influenza vaccine within the past 3 months. 4. Prior severe reactions to vaccines, including influenza vaccines (e.g. anaphylaxis, angioedema or urticaria) 5. Participation on any blood collection or blood donation procedure during study that will bring the total blood draw \>550ml over 8 weeks 6. Current pregnancy (women of child bearing potential must have a negative serum pregnancy test done on screening within 1 week of protocol accrual) 7. Currently breast-feeding 8. History of Guillain Barre syndrome 9. Acute illness with patient reported temperature of 38 (Infinite)C or greater within 3 days prior to the proposed time of administration. 10. Any history or presence of serious illness, bleeding disorders or autoimmune disorders, or planned surgeries. 11. Weight less than 50 kg (110 pounds) 12. History of hepatitis or liver disease. 13. Subjects receiving immunosuppressive therapy. 14. Presence of HLA DQB1\*06:02, the narcolepsy risk associated allele.

Design outcomes

Primary

MeasureTime frameDescription
Flu Antibody TitersDays 0, 21, 42, and 100Flu Antibody titers at days 0, 21, 42, 100. Antibody-neutralization titers by microneutralization were measured against five different H5N1 virus strains (i.e., A/Vietnam/1194/2004 (clade 1), A/Indonesia/5/2005 (clade 2.1), A/Turkey/15/2006 (clade 2.2), A/Egypt/3072/2010 (clade 2.2), and A/Anhui/1/2005 (clade 2.3.4)) at day 0 (prevaccination), day 21 (post first vaccination), day 42 (post second vaccination) and day 100 postvaccination for AS03-adjuvanted group and unadjuvanted group. Sera were tested at an initial dilution of 1:20, and those that were negative (\<1:20) were assigned a titer of 10.

Countries

United States

Participant flow

Participants by arm

ArmCount
AS03 Adjuvanted
Adminsitered day 1, booster at Day 21 H5N1 vaccine plus AS03 adjuvant: H5N1 influenza vaccine with AS03 at the 3.75 mcg dose level given 21 days apart.
22
Unadjuvanted
Administer day 1 and booster at Day 21 H5N1 vaccine without adjuvant: H5N1 influenza vaccine non- adjuvanted form at the 3.75 mcg dose level given 21 days apart.
20
Total42

Baseline characteristics

CharacteristicAS03 AdjuvantedTotalUnadjuvanted
Age, Continuous33.59 years
STANDARD_DEVIATION 6.64
32.28 years
STANDARD_DEVIATION 6.25
30.85 years
STANDARD_DEVIATION 5.62
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants3 Participants2 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
21 Participants39 Participants18 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants3 Participants3 Participants
Race (NIH/OMB)
Black or African American
6 Participants10 Participants4 Participants
Race (NIH/OMB)
More than one race
2 Participants3 Participants1 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
13 Participants25 Participants12 Participants
Region of Enrollment
United States
22 Participants42 Participants20 Participants
Sex: Female, Male
Female
13 Participants25 Participants12 Participants
Sex: Female, Male
Male
9 Participants17 Participants8 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 220 / 20
other
Total, other adverse events
17 / 2213 / 20
serious
Total, serious adverse events
0 / 220 / 20

Outcome results

Primary

Flu Antibody Titers

Flu Antibody titers at days 0, 21, 42, 100. Antibody-neutralization titers by microneutralization were measured against five different H5N1 virus strains (i.e., A/Vietnam/1194/2004 (clade 1), A/Indonesia/5/2005 (clade 2.1), A/Turkey/15/2006 (clade 2.2), A/Egypt/3072/2010 (clade 2.2), and A/Anhui/1/2005 (clade 2.3.4)) at day 0 (prevaccination), day 21 (post first vaccination), day 42 (post second vaccination) and day 100 postvaccination for AS03-adjuvanted group and unadjuvanted group. Sera were tested at an initial dilution of 1:20, and those that were negative (\<1:20) were assigned a titer of 10.

Time frame: Days 0, 21, 42, and 100

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
AS03 AdjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 42136.68 TitersStandard Deviation 291.7
AS03 AdjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 42600.92 TitersStandard Deviation 487.05
AS03 AdjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 10040 TitersStandard Deviation 35.02
AS03 AdjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 2110.99 TitersStandard Deviation 15.95
AS03 AdjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 010.65 TitersStandard Deviation 6.4
AS03 AdjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 2131.09 TitersStandard Deviation 60.53
AS03 AdjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 2112.87 TitersStandard Deviation 16.77
AS03 AdjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 4293.65 TitersStandard Deviation 313.55
AS03 AdjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 42106.23 TitersStandard Deviation 173.42
AS03 AdjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 100218.57 TitersStandard Deviation 133.05
AS03 AdjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 10045.95 TitersStandard Deviation 33.78
AS03 AdjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 10034.82 TitersStandard Deviation 20.12
AS03 AdjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 010.65 TitersStandard Deviation 6.4
AS03 AdjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 010.65 TitersStandard Deviation 6.4
AS03 AdjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 2110.99 TitersStandard Deviation 14.92
AS03 AdjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 010.65 TitersStandard Deviation 6.4
AS03 AdjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 4220 TitersStandard Deviation 66.76
AS03 AdjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 010.32 TitersStandard Deviation 2.13
AS03 AdjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 10011.49 TitersStandard Deviation 15.69
AS03 AdjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 2114.59 TitersStandard Deviation 34.83
UnadjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 10010 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 010.35 TitersStandard Deviation 2.24
UnadjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 2110.35 TitersStandard Deviation 2.24
UnadjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 4220 TitersStandard Deviation 74.64
UnadjuvantedFlu Antibody TitersA/Indonesia/5/05 Day 10018.59 TitersStandard Deviation 49.14
UnadjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 010 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 2110 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 4210.72 TitersStandard Deviation 6.71
UnadjuvantedFlu Antibody TitersA/Turkey/15/2006 Day 10011.16 TitersStandard Deviation 3.75
UnadjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 010 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 4211.89 TitersStandard Deviation 16.7
UnadjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 10011.57 TitersStandard Deviation 9.46
UnadjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 010 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 2110 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 4210.72 TitersStandard Deviation 6.71
UnadjuvantedFlu Antibody TitersA/Anhui/1/2005 Day 10012 TitersStandard Deviation 9.55
UnadjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 010 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 2110 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Vietnam/1203/2004 Day 4210 TitersStandard Deviation 0
UnadjuvantedFlu Antibody TitersA/Egypt/3072/2010 Day 2110 TitersStandard Deviation 0

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