Dengue Disease, Dengue Virus
Conditions
Brief summary
The primary objective of this study is to compare the dengue virus-neutralizing antibody geometric mean titers (GMTs) for each of the 4 dengue serotypes (DENV1, DENV2, DENV3, and DENV4) at Day 28 post-vaccination for participants administered the V181 Low-Potency Level vaccine versus the V181 Mid-Potency Level vaccine. This study will also evaluate the safety and tolerability of 3 different V181 potency level vaccines. The primary hypothesis of the study is that the V181 Low-Potency Level vaccine is non-inferior to the V181 Mid-Potency Level vaccine for each of the 4 dengue serotypes based on GMTs at Day 28 post-vaccination.
Interventions
BIOLOGICALV181 High-Potency Level
0.5 mL SC dose of V181 High-Potency vaccine
BIOLOGICALV181 Mid-Potency Level
0.5 mL SC dose of V181 Mid-Potency vaccine
BIOLOGICALV181 Low-Potency Level
0.5 mL SC dose of V181 Low-Potency vaccine
BIOLOGICALPlacebo
0.5 mL SC dose of placebo
Sponsors
Merck Sharp & Dohme LLC
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Male participants are eligible to participate if they agree to the following for at least 90 days after administration of study intervention: Abstain from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent; or must agree to use contraception unless confirmed to be azoospermic (vasectomized or secondary to medical cause). * A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies: Is NOT women of child-bearing potential; or is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of \<1% per year), or is abstinent from heterosexual intercourse as her preferred and usual lifestyle (abstinent on a long term and persistent basis), for at least 90 days after administration of study intervention. (Contraceptive use by women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.)
Exclusion criteria
* Has known history of dengue or zika natural infection. * Has an acute febrile illness (temperature ≥38.0°C \[≥100.4°F\] oral or equivalent) occurring within 72 hours before receipt of study vaccine or placebo. * Has a serious or progressive disease, including but not limited to cancer; uncontrolled diabetes; severe cardiac, renal, or hepatic insufficiency; or systemic autoimmune or neurologic disorder. * Has known or suspected impairment of immunological function, including but not limited to congenital or acquired immunodeficiency, human immunodeficiency virus (HIV) infection, hematologic malignancy, or treatment for autoimmune diseases. * Has a condition in which repeated venipuncture or injections pose more than minimal risk for the participant, such as hemophilia, thrombocytopenia, other severe coagulation disorders, or significantly impaired venous access. * Has a known hypersensitivity to any component of the study vaccine or placebo, or history of severe allergic reaction (eg, swelling of the mouth and throat, difficulty breathing, hypotension or shock) that required medical intervention. * Has received a dose of any dengue vaccine (investigational or approved) before study entry, or plans to receive any dengue vaccine (investigational or approved) for the duration of the trial. * Has received other licensed non-live vaccines within 14 days before receipt of study vaccine or placebo, or is scheduled to receive any licensed non-live vaccine within 28 days following receipt of study vaccine or placebo. Exception: Inactivated influenza vaccine may be administered but must be given at least 7 days before receipt of study vaccine or placebo, or at least 28 days after receipt of study vaccine or placebo. * Has received a licensed live vaccine within 28 days before receipt of study vaccine or placebo, or is scheduled to receive any live vaccine within 28 days following receipt of study vaccine or placebo. * Has received systemic corticosteroids (equivalent of ≥2 mg/kg/day of prednisone or ≥20 mg/d for persons weighing \>10 kg) for ≥14 consecutive days and has not completed treatment at least 30 days before study entry or is expected to receive systemic corticosteroids at aforementioned dose and duration within 28 days following receipt of study vaccine or placebo. (Note: Topical and inhaled/nebulized steroids are permitted.) * Has received systemic corticosteroids exceeding physiologic replacement doses (approximately 5 mg/day prednisone equivalent) within 14 days before vaccination. * Has received immunosuppressive therapies, including chemotherapeutic agents used to treat cancer or other conditions, treatments associated with organ or bone marrow transplantation, or autoimmune disease, within 6 months before receipt of study vaccine or placebo, or plans to receive immunosuppressive therapies within 28 days following receipt of study vaccine or placebo. * Has received a blood transfusion or blood products (including immunoglobulins) within 6 months before receipt of a study vaccine or placebo, or plans to receive a blood transfusion or blood products (including immunoglobulins) within 28 days following receipt of study vaccine or placebo. * Has participated in another clinical study of an investigational product within 6 months before signing the informed consent, or plans to participate in another interventional clinical study at any time during the duration of the current clinical study. Participants enrolled in observational studies may be included; these will be reviewed on a case-by-case basis for approval by the Sponsor. * Has planned donation of blood, eggs, or sperm at any time from signing the informed consent through 90 days post-vaccination.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | Day 28 post-vaccination | A dengue VRNT was conducted to assess neutralizing antibody Geometric Mean Titers (GMTs) for each of the 4 dengue vaccine serotypes (DENV1, DENV2, DENV3, and DENV4) in specimens collected from participants on Day 28 post-vaccination. |
| Percentage of Participants With Vaccine-Related Serious Adverse Events (SAEs) | Up to 28 days post-vaccination | An SAE is an AE that results in death, is life-threatening, requires or prolongs an existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, or is another important medical event deemed such by medical or scientific judgment. Relatedness of an SAE to the study vaccine will be determined by the investigator. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Up to 5 days post-vaccination | An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited injection-site AEs include pain, erythema (redness), and swelling. |
| Percentage of Participants With Solicited Systemic AEs | Up to 28 days post-vaccination | An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited systemic AEs include rash, headache, fatigue (tiredness), pyrexia (oral temperature ≥100.4 °F or 38.0 °C), myalgia (muscle pain), and arthralgia (joint pain). |
Countries
Australia, Canada, Finland, Germany, Israel, Taiwan, United States
Participant flow
Recruitment details
Adult males or females, in generally good health, between 18 to 50 years of age, and without a history of dengue or Zika natural infection or prior receipt of any other dengue vaccine were enrolled in this study.
Participants by arm
| Arm | Count |
|---|---|
| V181 High-Potency Level Group Participants received a single 0.5 mL SC dose of V181 High-Potency vaccine. | 231 |
| V181 Mid-Potency Level Group Participants received a single 0.5 mL SC dose of V181 Mid-Potency vaccine. | 463 |
| V181 Low-Potency Level Group Participants received a single 0.5 mL SC dose of V181 Low-Potency vaccine. | 461 |
| Placebo Participants received a single SC 0.5 mL dose of placebo. | 116 |
| Total | 1,271 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Death | 0 | 0 | 1 | 0 |
| Overall Study | Lost to Follow-up | 22 | 20 | 20 | 7 |
| Overall Study | Participant left the country | 0 | 0 | 1 | 0 |
| Overall Study | Randomized By Mistake Without Study Treatment | 0 | 2 | 1 | 0 |
| Overall Study | Withdrawal by Subject | 4 | 11 | 7 | 3 |
Baseline characteristics
| Characteristic | V181 High-Potency Level Group | Total | Placebo | V181 Low-Potency Level Group | V181 Mid-Potency Level Group |
|---|---|---|---|---|---|
| Age, Continuous | 33.8 Years STANDARD_DEVIATION 9.5 | 33.3 Years STANDARD_DEVIATION 9.5 | 33.2 Years STANDARD_DEVIATION 9.1 | 33.3 Years STANDARD_DEVIATION 9.3 | 33.1 Years STANDARD_DEVIATION 9.8 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 31 Participants | 157 Participants | 20 Participants | 55 Participants | 51 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 195 Participants | 1074 Participants | 94 Participants | 389 Participants | 396 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 5 Participants | 40 Participants | 2 Participants | 17 Participants | 16 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 3 Participants | 0 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 15 Participants | 86 Participants | 6 Participants | 33 Participants | 32 Participants |
| Race (NIH/OMB) Black or African American | 5 Participants | 40 Participants | 9 Participants | 14 Participants | 12 Participants |
| Race (NIH/OMB) More than one race | 2 Participants | 23 Participants | 1 Participants | 10 Participants | 10 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 6 Participants | 0 Participants | 2 Participants | 3 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 207 Participants | 1113 Participants | 100 Participants | 400 Participants | 406 Participants |
| Sex/Gender, Customized Female | 129 Participants | 715 Participants | 59 Participants | 262 Participants | 265 Participants |
| Sex/Gender, Customized Male | 102 Participants | 555 Participants | 57 Participants | 198 Participants | 198 Participants |
| Sex/Gender, Customized Undifferentiated | 0 Participants | 1 Participants | 0 Participants | 1 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 231 | 0 / 463 | 1 / 461 | 0 / 116 |
| other Total, other adverse events | 200 / 231 | 402 / 461 | 406 / 459 | 79 / 115 |
| serious Total, serious adverse events | 8 / 231 | 9 / 461 | 12 / 459 | 6 / 115 |
Outcome results
Primary
Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT)
A dengue VRNT was conducted to assess neutralizing antibody Geometric Mean Titers (GMTs) for each of the 4 dengue vaccine serotypes (DENV1, DENV2, DENV3, and DENV4) in specimens collected from participants on Day 28 post-vaccination.
Time frame: Day 28 post-vaccination
Population: The population analyzed was all randomized participants without protocol deviations that could have substantially impacted the results of the immunogenicity analyses. These deviations include participant was seropositive at baseline as assessed by VRNT and missing serology results.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) |
|---|---|---|---|
| V181 High-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV1 Serotype | 326.31 Titer |
| V181 High-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV2 Serotype | 815.79 Titer |
| V181 High-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV3 Serotype | 203.04 Titer |
| V181 High-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV4 Serotype | 102.13 Titer |
| V181 Mid-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV2 Serotype | 766.98 Titer |
| V181 Mid-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV3 Serotype | 135.19 Titer |
| V181 Mid-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV4 Serotype | 68.33 Titer |
| V181 Mid-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV1 Serotype | 261.10 Titer |
| V181 Low-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV3 Serotype | 94.69 Titer |
| V181 Low-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV2 Serotype | 854.59 Titer |
| V181 Low-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV4 Serotype | 64.43 Titer |
| V181 Low-Potency Level Group | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV1 Serotype | 184.85 Titer |
| Placebo | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV4 Serotype | 6.50 Titer |
| Placebo | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV2 Serotype | 7.50 Titer |
| Placebo | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV1 Serotype | 10.33 Titer |
| Placebo | Dengue Virus-Neutralizing Antibody Titers, as Measured by Virus Reduction Neutralization Test (VRNT) | DENV3 Serotype | 7.20 Titer |
Primary
Percentage of Participants With Vaccine-Related Serious Adverse Events (SAEs)
An SAE is an AE that results in death, is life-threatening, requires or prolongs an existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, or is another important medical event deemed such by medical or scientific judgment. Relatedness of an SAE to the study vaccine will be determined by the investigator.
Time frame: Up to 28 days post-vaccination
Population: The population analyzed was all randomized participants who received at least 1 dose of study intervention according to the study intervention they received.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| V181 High-Potency Level Group | Percentage of Participants With Vaccine-Related Serious Adverse Events (SAEs) | 0.0 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Vaccine-Related Serious Adverse Events (SAEs) | 0.0 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Vaccine-Related Serious Adverse Events (SAEs) | 0.0 Percentage of participants |
| Placebo | Percentage of Participants With Vaccine-Related Serious Adverse Events (SAEs) | 0.0 Percentage of participants |
Secondary
Percentage of Participants With Solicited Injection-Site Adverse Events (AEs)
An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited injection-site AEs include pain, erythema (redness), and swelling.
Time frame: Up to 5 days post-vaccination
Population: The population analyzed was all randomized participants who received at least 1 dose of study intervention according to the study intervention they received.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| V181 High-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site swelling | 10.0 Percentage of participants |
| V181 High-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site erythema | 35.5 Percentage of participants |
| V181 High-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site pain | 34.2 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site swelling | 5.4 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site pain | 19.7 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site erythema | 21.7 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site erythema | 15.0 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site pain | 13.5 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site swelling | 2.4 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site swelling | 2.6 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site erythema | 1.7 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Injection-Site Adverse Events (AEs) | Injection site pain | 14.8 Percentage of participants |
Secondary
Percentage of Participants With Solicited Systemic AEs
An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited systemic AEs include rash, headache, fatigue (tiredness), pyrexia (oral temperature ≥100.4 °F or 38.0 °C), myalgia (muscle pain), and arthralgia (joint pain).
Time frame: Up to 28 days post-vaccination
Population: The population analyzed was all randomized participants who received at least 1 dose of study intervention according to the study intervention they received.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| V181 High-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Myalgia | 32.0 Percentage of participants |
| V181 High-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Arthralgia | 21.2 Percentage of participants |
| V181 High-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Rash | 55.8 Percentage of participants |
| V181 High-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Headache | 54.5 Percentage of participants |
| V181 High-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Pyrexia | 10.8 Percentage of participants |
| V181 High-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Fatigue | 52.8 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Fatigue | 48.6 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Pyrexia | 7.6 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Arthralgia | 12.6 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Myalgia | 26.5 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Headache | 49.9 Percentage of participants |
| V181 Mid-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Rash | 64.0 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Pyrexia | 5.7 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Myalgia | 24.0 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Rash | 68.6 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Headache | 46.2 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Fatigue | 44.0 Percentage of participants |
| V181 Low-Potency Level Group | Percentage of Participants With Solicited Systemic AEs | Arthralgia | 13.1 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Systemic AEs | Arthralgia | 7.8 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Systemic AEs | Rash | 8.7 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Systemic AEs | Headache | 47.0 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Systemic AEs | Myalgia | 18.3 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Systemic AEs | Fatigue | 33.9 Percentage of participants |
| Placebo | Percentage of Participants With Solicited Systemic AEs | Pyrexia | 0.9 Percentage of participants |