Human Papilloma Virus
Conditions
Keywords
Gardasil 9, Immunogenicity, Children
Brief summary
This study is an open-label nonrandomized exploratory proof of concept and descriptive 4-year immunogenicity study to assess immunogenicity after administration of a 2-dose regimen of 9-valent human papillomavirus vaccine (9vHPV) vaccine separated by 12 months (months 0, 12).
Detailed description
Study participants will include 150 boys and girls aged 4-8 years (total, 75 boys and 75 girls) to receive 2 doses of the 9vHPV vaccine at 0 and 12 months. Patients will be recruited by age-group to achieve balanced enrollment of 15 girls and 15 boys per year of age. The investigators will examine the immunogenicity profile in this cohort, for which titers will be analyzed one month after dose 2 (Month 13). Though clinical efficacy cannot be assessed in young children because of limited exposure to human papillomavirus (HPV), this descriptive study will allow the investigators to understand whether the 9vHPV vaccine in younger patients provides immunogenicity similar to that shown for the 9-14 and 16-26 age groups who have received the 9vHPV vaccine. This study will require an IND for the use of the HPV vaccine in children younger than 9 years. Immunogenicity will be measured by examining serum antibodies of all participants using a competitive Luminex immunoassay (cLIA). The antibody response testing will be performed at Merck Research Laboratory. The goal of this study is to explore whether a 2-dose 9vHPV vaccine regimen with dosage separated by 12 months is immunogenic among children aged 4-8 years. The primary outcome will be geometric mean titers (GMT) for HPV6, HPV11, HPV16, HPV18, HPV31, HPV33, HPV45, HPV52, and HPV58 antibodies at month 13. Results will allow the investigators to qualitatively compare immunogenicity in individuals vaccinated at age 4-8 years to known immunogenicity in 9vHPV recipients vaccinated at ages 9-14. Knowledge of whether vaccination in this age group is sufficient to induce high-level protective antibody titers after the second dose will support further efficacy studies in a larger randomized trial of a 2-dose 9vHPV regimen for children aged 4-8 years.
Interventions
DRUGGardasil9
The Gardasil 9 vaccine is a recombinant L 1 VLP vaccine containing HPV types 6, 11,16,18, 31, 33, 45, 52 and 58 VLP. The vaccine is not currently licensed for children under 9 years of age but it is licensed in the USA for males and females ages 9 to 45 years old.
Sponsors
Boston Medical Center
Merck Sharp & Dohme LLC
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
4 Years to 8 Years
Healthy volunteers
Yes
Inclusion criteria
1. Children aged 4-8 years old 2. Receives care at the Boston Medical Center or one of the affiliated Community heath centers 3. Naïve to HPV Vaccine
Exclusion criteria
1. A history of severe allergic reaction, including known allergy to any vaccine component, specially severe allergic reaction to yeast 2. Immunocompromised/previous immunosuppressive therapy 3. Thrombocytopenia or other coagulation disorder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HPV6 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV6 if it is \>30mMu. |
| HPV11 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV11 if it is \>16mMu. |
| HPV16 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV16 if it is \>20mMu. |
| HPV18 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV18 if it is \>24 mMU. |
| HPV31 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV31 if it is \>10 mMU. |
| HPV33 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV33 if it is \>8 mMU. |
| HPV45 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV45 if it is \>8 mMU. |
| HPV52 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV52 if it is \>8 mMU. |
| HPV58 antibodies at 13 months | 13 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV58 if it is \>8 mMU. |
| HPV6 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV6 if it is \>30mMU. |
| HPV11 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV11 if it is \>16 mMU. |
| HPV16 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV16 if it is \>20 mMU. |
| HPV18 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV18 if it is \>24mMU. |
| HPV31 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV31 if it is \>10 mMU. |
| HPV33 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV33 if it is \>8 mMU. |
| HPV45 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV45 if it is \>8 mMU. |
| HPV52 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV52 if it is \>8 mMU. |
| HPV58 antibodies at 60 months | 60 months | A serum sample will be analyzed using 9-valent Luminex immunoassay (cLIA, mMU/mL) to assess the geometric mean for HPV antibodies. The results will be considered positive for HPV58 if it is \>8 mMU. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Injection site swelling after first injection | day 3 after injection | Solicited local swelling will be graded from 0-4 where 0 is no swelling and 4 is severe swelling. |
| Injection site swelling after second injection | day 3 after injection | Solicited local swelling will be graded from 0-4 where 0 is no swelling and 4 is severe swelling. |
| Injection site redness after first injection | day 3 after injection | Solicited local redness will be graded from 0-4 where 0 is no redness and 4 is severe redness. |
| Injection site redness after second injection | day 3 after injection | Solicited local redness will be graded from 0-4 where 0 is no redness and 4 is severe redness. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORElisha Wachman, MD
Boston Medical Center
Outcome results
None listed