Avian Influenza, Influenza Immunisation
Conditions
Keywords
Healthy Young Adults, Immunogenicity, Inactivated Influenza A/H5N1 Vaccine, Phase I Clinical Trial, Reactogenicity, Safety, Topical Aldara(R)
Brief summary
Phase I randomized, double-blind, placebo-controlled trial in 50 males and non-pregnant females, 18 to 49 years old, who are in good health and meet all eligibility criteria. This clinical trial is designed to assess the safety, reactogenicity, and immunogenicity of inactivated A/H5N1 influenza vaccine administered intradermally (ID) with topical Aldara or control cream as a 2-dose regimen. The vaccine will be administered using the MicronJet600(TM) device. Subjects will be assigned to 2 treatment arms (25 subjects per treatment arm). Group A will receive two doses of A/H5N1 IIV ID with pre-application of topical Aldara on Days 1 and 22. Group B will receive two doses of A/H5N1 IIV ID with pre-application of topical control cream on Days 1 and 22. The duration of this study will be approximately 20 months with patient participation duration approximately 7 months. The primary objectives of this study are: 1) to assess the safety and reactogenicity after 2 doses of A/H5N1 IIV vaccine containing 9 mcg HA per dose administered ID approximately 21 days apart with topical Aldara or control cream; 2) to assess the serum HAI antibody responses 21 days after receipt of the 2nd dose of A/H5N1 IIV administered ID at 9 mcg HA per dose with topical Aldara or control cream.
Detailed description
This is a Phase I randomized, double-blind, placebo-controlled trial in 50 males and non-pregnant females, 18 to 49 years old, inclusive, who are in good health and meet all eligibility criteria. This clinical trial is designed to assess the safety, reactogenicity, and immunogenicity of inactivated A/H5N1 influenza vaccine administered intradermally (ID) with topical Aldara or control cream as a 2-dose regimen. The vaccine will be administered using the MicronJet600(TM) device. Subjects will be assigned randomly to 1 of 2 treatment arms (25 subjects per treatment arm) to receive 2 doses of A/H5N1 IIV administered ID with topical Aldara or control cream. Group A will receive two doses of A/H5N1 IIV (9 mcg HA/dose) ID with pre-application of topical Aldara on Days 1 and 22. Group B will receive two doses of A/H5N1 IIV (9 mcg HA/dose) ID with pre-application of topical control cream on Days 1 and 22. The duration of this study will be approximately 20 months with patient participation duration approximately 7 months. The primary objectives of this study are: 1) to assess the safety and reactogenicity after 2 doses of A/H5N1 IIV vaccine containing 9 mcg HA per dose administered ID approximately 21 days apart with topical Aldara or control cream; 2) to assess the serum HAI antibody responses 21 days after receipt of the 2nd dose of A/H5N1 IIV administered ID at 9 mcg HA per dose with topical Aldara or control cream. The secondary objectives are: 1) to assess unsolicited non-serious adverse events (AEs) following receipt of 2 doses of A/H5N1 IIV administered ID approximately 21 days apart with topical Aldara or control cream; 2) to assess medically-attended adverse events (MAAEs) including new-onset chronic medical conditions (NOCMCs), and potentially immune mediated medical conditions (PIMMCs) following receipt of two doses of A/H5N1 IIV administered ID approximately 21 days apart with topical Aldara or control cream for six months after last vaccination; 3) to assess the serum neutralizing (Neut) antibody responses 21 days following receipt of the 1st and 2nd dose of A/H5N1 IIV administered ID with topical Aldara or control cream; 4) to assess the serum HAI antibody responses 21 days following receipt of the 1st dose of A/H5N1 IIV administered ID with topical Aldara or control cream; 5) to assess the serum HAI and Neut antibody responses 7 days following receipt of the 2nd dose of A/H5N1 IIV administered ID with topical Aldara or control cream.
Interventions
Aqueous Cream B.P. will be used as the control cream. An equivalent of 250mg of the cream will be applied and rubbed into the skin until it vanishes, on the deltoid area 5-15 minutes prior to vaccine administration.
Aldara (imiquimod 5%) cream is an immune response modifier for topical administration. 250 mg of the cream, equivalent to 12.5 mg of imiquimod will be applied and rubbed into the skin until it vanishes, on the deltoid area 5-15 minutes prior to vaccine administration.
Inactivated monovalent subvirion H5N1 vaccine containing hemagglutinin (HA) of A/Vietnam/1203/04
Sponsors
Study design
Eligibility
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 non-pregnant females, 18 to 49 years old, inclusive. 4. Are in good health, as determined by vital signs (oral temperature, pulse, and blood pressure), medical history, and physical examination to ensure any existing medical diagnoses or conditions (except those exclusionary) are stable. \- Stable chronic medical condition - no change in prescription medication, dose, or frequency of medication in the last 2 months (defined as 60 days) and health outcomes of the specific disease are considered to be within acceptable limits in the last 6 months (defined as 180 days). Any 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 violation 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 violation 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. Note: Topical, nasal, and inhaled medications (with the exception of steroids as outlined in the Subject
Exclusion criteria
), vitamins, and contraceptives are permitted. 5. Oral temperature is less than 100.0 degrees F. 6. Pulse is 47 to 100 bpm, inclusive. 7. Systolic blood pressure is 85 to 150 mm Hg, inclusive. 8. Diastolic blood pressure is 55 to 95 mmHg, inclusive. 9. Women of childbearing potential must use an acceptable method of contraception from 30 days prior to vaccination until 60 days after the last study vaccination. \- Not sterilized via tubal ligation, bilateral oophorectomy, hysterectomy, or successful Essure(R) placement (permanent, non-surgical, non-hormonal sterilization) with documented radiological confirmation test at least 90 days after the procedure, and still menstruating or \< 1 year of the last menses if menopausal). \-- Includes non-male sexual relationships, abstinence from sexual intercourse with a male partner, monogamous relationship with a vasectomized partner, male condoms with the use of applied spermicide, intrauterine devices, NuvaRing(R), and licensed hormonal methods such as implants, injectables or oral contraceptives (the pill). Method of contraception will be captured on the appropriate data collection form. 10. Female subjects of childbearing potential must have a negative urine pregnancy test within 24 hours prior to study vaccination.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Occurrence of study vaccine-related SAEs | Day 1 through Day 202 |
| Occurrence of solicited systemic AEs | Day 1 through Day 8 |
| Geometric mean titers (GMTs) of serum HAI antibodies | Day 1 |
| Occurrence of all SAEs | Day 1 through Day 202 |
| Occurrence of solicited injection site AEs | Day 1 through Day 8 |
| Percentage of subjects achieving a serum HAI antibody titer of 40 or greater against the A/H5N1 antigen contained in the study vaccine | Day 43 |
| Percentage of subjects achieving HAI seroconversion against study vaccine (pre-vaccination HAI titer <10 and post-vaccination HAI titer > / = 40 or pre-vaccination HAI titer > / =10 and a min 4-fold rise in post-vaccination HAI antibody titer | Day 43 |
Secondary
| Measure | Time frame |
|---|---|
| Percentage of subjects achieving a serum Neut antibody titer of 40 or greater against the A/H5N1 antigen contained in the study vaccine | Day 1 |
| Percentage of subjects achieving HAI seroconversion against the A/H5N1 antigen contained in the study vaccine | Day 22 |
| Percentage of subjects achieving Neut seroconversion (pre-vaccination Neut titer < 10 and post-vaccination Neut titer > / = 40 or pre-vaccination Neut titer > / = 10 and a min 4-fold rise in post-vaccination Neut antibody titer) | Day 22 |
| Proportion of subjects with GMT of serum Neut antibody against the A/H5N1 antigen contained in the study vaccine | Day 29 |
| Proportion of subjects with seroconversion against the A/H5N1 antigen contained in the study vaccine | Day 29 |
| Proportion of subjects with titer of 40 or greater of serum HAI antibody against the A/H5N1 antigen contained in the study vaccine | Day 29 |
| Proportion of subjects with titer of 40 or greater of serum Neut antibody against the A/H5N1 antigen contained in the study vaccine | Day 29 |
| Secondary Proportion of subjects with GMT of serum HAI antibody against the A/H5N1 antigen contained in the study vaccine | Day 29 |
| GMT of serum HAI antibody against the A/H5N1 antigen contained in the study vaccine | Day 22 |
| GMT of serum Neut antibody against the A/H5N1 antigen contained in the study vaccine | Day 1 |
| Occurrence of all unsolicited non-SAEs | Day 1 through Day 43 |
| Occurrence of Medically-Attended Adverse Events (MAAEs), including New-Onset Chronic Medical Conditions (NOCMCs) and Potentially Immune-Mediated Medical Conditions (PIMMCs) | Day 1 through Day 202 |
| Occurrence of study vaccine-related unsolicited non-serious AEs | Day 1 through Day 43 |
| Percentage of subjects achieving a serum HAI antibody titer of 40 or greater against the A/H5N1 antigen contained in the study vaccine | Day 22 |
Countries
United States