First-in-Human Clinical Trial of a Mosaic Quadrivalent Influenza Vaccine Compared With a Licensed Inactivated Seasonal QIV in Healthy Adults

Participants recorded the occurrence of solicited local symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for Any Local Symptom is the number of participants reporting any local symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials, modified from FDA Guidance - September 2007.

Time frame: 7 days after product administration

Population: Population included all enrolled participants who received study product and provided safety data (via diary card and/or laboratory results) following vaccine administration (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw.

Participants recorded the occurrence of solicited systemic symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for Any Systemic Symptom is the number of participants reporting any systemic symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials, modified from FDA Guidance - September 2007.

Time frame: 7 days after product administration

Population: Population included all enrolled participants who received study product and provided safety data (via diary card and/or laboratory results) following vaccine administration (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw.

Abnormal lab results recorded as unsolicited adverse events (AEs) are summarized. Safety lab parameters included hematology (hemoglobin, hematocrit, platelets, and white blood cell (WBC), red blood cell (RBC), neutrophil, lymphocyte, monocyte, eosinophil and basophil percents/counts) and chemistry (alanine aminotransferase (ALT), alanine aspartate (AST), alkaline phosphate (ALP), creatinine and total bilirubin). Complete Blood Count (CBC) with differential, total bilirubin, AST, ALT, and ALP results were collected at Baseline, Day 0, Day 14, and 28. Creatinine results were collected at Baseline, Day 0 and Day 14. Institutional lab normal ranges as well as Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventative Vaccine Clinical Trials FDA Guidance, September 2007 were used.

Time frame: Day 0 through 28 days post product administration, up to Week 4

Population: Population included all enrolled participants who received study product (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw.

Influenza or influenza-like illness (ILI) were recorded in the study database from receipt of the study product administration through the last study visit. ILI was defined as fever (temperature of 100 degrees F \[37.8 degrees C\] or greater) and a cough and/or sore throat in the absence of a known cause other than influenza. Collection of nasopharyngeal swabs were used for laboratory confirmation of influenza by polymerase chain reaction (PCR) in participants who met criteria for ILI. Subsequently, results of any reported laboratory testing for identification of pathogens were included for cases meeting initial criteria for ILI. The severity of illness in participants with laboratory confirmed influenza illness were captured on a case report form rather than on an Adverse Event (AE) form.

Time frame: Day 0 after product administration through Day 280, up to Week 40

Population: Population included all enrolled participants who received study product (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw.

New chronic medical conditions that required ongoing medical management were recorded from receipt of study product administration through the last expected study visit at Week 40. The relationship between a new chronic medical condition and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.

Time frame: Day 0 after product administration through Day 280, up to Week 40

Population: Population included all enrolled participants who received study product (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw.

Unsolicited AEs and attribution assessments were recorded in the study database from receipt of study product administration through the visit scheduled for 4 weeks after study product administration. At other time periods greater than 4 weeks after the study product administration, only serious AEs (SAEs reported as a separate outcome and in the AE module), influenza-like illness (ILI) or influenza and new chronic medical conditions that required ongoing medical management (reported as separate outcomes) were recorded through the last study visit. The relationship between an AE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.

Time frame: Day 0 through 28 days post product administration, up to Week 4

Population: Population included all enrolled participants who received study product (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw.

SAEs were recorded from receipt of product administration through the last study visit at Week 40. The relationship between a SAE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.

Time frame: Day 0 after product administration through Day 280, up to Week 40

Population: Population included all enrolled participants who received study product (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw.

FluMos-v1-specific antibody titers were measured by Electrochemiluminescence Immunoassay (ECLIA) using a Meso Scale Discovery (MSD) platform. FluMos-v1 was biotinylated at an AviTag site located proximal to the C-terminus from the trimer foldon and bound to MSD streptavidin-coated plates. Serum samples collected at 2 weeks after product administration were assayed alongside healthy pooled human sera (not from this trial) as a reference standard. Binding of the reference standard to FluMos-v1 was assigned a stock concentration of 54000 arbitrary units per milliliter (AU/mL). Serial dilutions of sample within the dynamic range of the standard curve were interpolated to assign a sample concentration in AU/mL. Group geometric mean AU/mL values and 95% confidence intervals are reported.

Time frame: Baseline to 2 weeks after product administration

Population: Population included all enrolled participants who received study product (N=61). Two participants in Group 4B did not receive study product: for 1 participant, difficulties were experienced with vein access for blood sample collection, and 1 participant had a syncopal event during a blood draw. Twelve (12) out of 13 participants were analyzed in Group 4 at Week 2 post administration, as serum was not collected for one Group 4 participant at Week 2.