Avian Influenza
Conditions
Keywords
Influenza, H7N9, Elderly, Vaccine, MF59 Adjuvant
Brief summary
This is a Phase II randomized, partially-blinded, controlled trial in 360 (up to 600) males and females, 65 years of age and older, who are in good health and meet all eligibility criteria. This clinical trial is designed to assess the safety, reactogenicity, and immunogenicity of a monovalent inactivated influenza A/H7N9 virus vaccine manufactured by Sanofi Pasteur administered intramuscularly at different intervals and dosages (3.75, 7.5, or 15 mcg of HA/0.5 mL dose) given with MF59 adjuvant manufactured by Novartis Vaccines and Diagnostics. Subjects will receive three doses of the vaccine. Safety, reactogenicity, and immunogenicity data will be collected at standard time points with safety follow-up to continue through one year post dose 2. Study Duration is approximately 30 months and Subject Participation is approximately 18 months. The primary objectives are to (1) assess the safety and reactogenicity of different dosages (3.75, 7.5, and 15 mcg of HA/0.5 mL dose) of an MF59-adjuv
Detailed description
This is a Phase II randomized, partially-blinded, controlled trial in males and females, 65 years of age and older, who are in good health and meet all eligibility criteria. This clinical trial is designed to assess the safety, reactogenicity, and immunogenicity of a monovalent inactivated influenza A/H7N9 virus vaccine, derived from the influenza A/Shanghai/2/2013 virus, manufactured by Sanofi Pasteur administered intramuscularly at different intervals and dosages (3.75, 7.5, or 15 mcg of HA/0.5 mL dose) given with MF59 adjuvant manufactured by Novartis Vaccines and Diagnostics. Subjects will be assigned randomly to 1 of 6 groups (60 to 100 subjects per group) to receive three doses intramuscularly of the inactivated A/H7N9 vaccine at dosages (3.75, 7.5, or 15 mcg of HA/0.5 mL dose) given with MF59 adjuvant using two different study vaccination schedules. The first and third study vaccinations will be administered to all subjects on Day 1 and approximately Day 169. The second study vaccination will be administered either on approximately Day 29 for Groups 1, 3, and 5 or approximately Day 57 for Groups 2, 4, and 6. Reactogenicity will be measured from the time of each study vaccination through 8 days after each study vaccination by the occurrence of solicited injection site and systemic reactions. Unsolicited non-serious adverse events (AEs) will be collected from the time of each study vaccination through approximately 28 days after each study vaccination. Serious adverse events (SAEs) and new-onset chronic medical conditions will be collected from the time of the first study vaccination through approximately 12 months after the last study vaccination. Immunogenicity testing will include performing hemagglutination inhibition (HAI) and neutralizing (Neut) antibody assays on serum obtained immediately prior to the first study vaccination (Day 1), approximately 28 days after the second study vaccination (approximately Day 57 for Groups 1, 3, and 5; approximately Day 85 for Groups 2, 4, and 6), immediately prior to the third study vaccination (approximately Day 169), and approximately 28 days after the third study vaccination (approximately Day 197). Subjects in Groups 1, 3, and 5 will also have immunogenicity testing for HAI and Neut antibody assays performed on serum obtained at approximately 56 days after the second study vaccination (approximately Day 85). Between 360 and 600 subjects will be enrolled in this trial. Study Duration is approximately 30 months and Subject Participation is approximately 18 months. The primary objectives are to (1) assess the safety and reactogenicity of different dosages (3.75, 7.5, and 15 mcg of HA/0.5 mL dose) of an MF59-adjuvanted, monovalent inactivated influenza A/H7N9 virus vaccine using two different study vaccination schedules and (2) assess the serum hemagglutination inhibition (HAI) antibody responses to different dosages (3.75, 7.5, and 15 mcg of HA/0.5 mL dose) of an MF59-adjuvanted, monovalent inactivated influenza A/H7N9 virus vaccine using two different study vaccination schedules following receipt of the second study vaccination. The secondary obectives are to (1) assess study vaccine-related unsolicited non-serious adverse events following receipt of different dosages (3.75, 7.5, and 15 mcg of HA/0.5 mL dose) of an MF59-adjuvanted, monovalent inactivated influenza A/H7N9 virus vaccine using two different study vaccination schedules, (2) assess new-onset chronic medical conditions following receipt of different dosages (3.75, 7.5, and 15 mcg of HA/0.5 mL dose) of an MF59-adjuvanted, monovalent inactivated influenza A/H7N9 virus vaccine using two different study vaccination sched
Interventions
DRUGMF59
Microfluoridized adjuvant 59 (MF59) is an oil-in-water emulsion. Group 1-6 receive 3.75 mcg, 7.5 mcg and 15 mcg.
Monovalent inactivated split influenza virus vaccine made with HA antigen derived from the influenza A/Shanghai/2/2013 virus. Monovalent influenza A/H7N9 virus vaccine. Group 1-6 receive 3.75 mcg, 7.5 mcg and 15 mcg.
Sponsors
National Institute of Allergy and Infectious Diseases (NIAID)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
65 Years to 99 Years
Healthy volunteers
Yes
Inclusion criteria
1. Provide written informed consent prior to initiation of any study procedures. 2. Are able to understand and comply with planned study procedures and be available for all study visits. 3. Are males or females, 65 years of age and older. 4. Are in good health1. 1As determined by medical history and targeted physical examination, if indicated based on medical history, to evaluate acute or currently ongoing chronic medical diagnoses or conditions that would affect the assessment of eligibility and safety of subjects. Chronic medical diagnoses or conditions being actively managed must be within acceptable limits in the last 180 days. Good health in the elderly is also defined as no change in chronic prescription medication, dose, or frequency of medication in the 90 days prior to enrollment. Any prescription change that is due to change of health care provider, insurance company, etc., or that is done for financial reasons, as long as in the same class of medication, will not be considered a deviation of this inclusion criterion. Any change in prescription medication due to improvement of a disease outcome, as determined by the site principal investigator or appropriate sub-investigator, will not be considered a deviation of this inclusion criterion. Subjects may be on chronic or as needed (prn) medications if, in the opinion of the site principal investigator or appropriate sub-investigator, they pose no additional risk to subject safety or assessment of reactogenicity and immunogenicity and does not indicate a worsening of medical diagnosis or condition. Similarly, medication changes subsequent to enrollment and first study vaccination are acceptable provided the subject is asymptomatic, condition stable, and there is no additional risk to the subject or interference with the evaluation of responses to study vaccination. Note: Topical, nasal, and inhaled medications (with the exception of steroids as outlined in the Subject
Exclusion criteria
(see Section 5.2)), herbals, vitamins, and supplements are permitted 5. Oral temperature is less than 100.0 degrees F. 6. Pulse is 50 to 115 bpm, inclusive. 7. Systolic blood pressure is 85 to 160 mm Hg, inclusive. 8. Diastolic blood pressure is 55 to 95 mm Hg, inclusive
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the A/H7N9 antigen contained in the study vaccine | 28 days after the second study vaccination |
| Percent of subjects achieving HAI seroconversion against the A/H7N9 antigen contained in the study vaccine (either a pre-vaccine HAI titer < 1:10 and a post-vaccine HAI titer > /= 1:40 or a pre-vaccine HAI titer > /=1:10 and a min 4-fold rise in post-vac | 28 days after the second study vaccination |
| Occurrence of study vaccine-related serious adverse events | Through Day 1 to 12 months after the last study vaccination |
| Occurrence of solicited injection site and systemic reactogenicity events | Through 8 days after each study vaccination |
Secondary
| Measure | Time frame |
|---|---|
| Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the A/H7N9 antigen contained in the study vaccine | Baseline and 28 days after the third study vaccination |
| Occurrence of study vaccine-related unsolicited non-serious adverse events | 28 days after each study vaccination |
| Percentage of subjects achieving HAI seroconversion against the A/H7N9 antigen | 28 days after the third study vaccination |
| Percentage of subjects achieving a serum Neut antibody titer of 1:40 or greater against the A/H7N9 antigen contained in the study vaccine | Baseline and 28 days after the second and third study vaccinations |
| Occurrence of new-onset chronic medical conditions | Through Day 1 to 12 months after the last study vaccination |
| Percentage of subjects achieving Neut seroconversion against A/H7N9 antigen (either prevaccination Neut titer < 1:10 and postvaccination Neut titer > /=1:40 or prevaccination Neut titer > /=1:10 and minimum fourfold rise in post-vaccination Neut | 28 days after the second and third study vaccinations |
| Geometric Mean Titers of serum HAI and Neut antibodies against the A/H7N9 antigen | Baseline and 28 days after the second and third study vaccinations |
Countries
United States
Outcome results
None listed