Influenza
Conditions
Keywords
Comparator-Controlled, Dose-Escalation, Healthy Adults, Immunogenicity, Influenza, mRNA-LNP Vaccine, Randomized, Safety
Brief summary
This is a Phase 1, single-site, comparator-controlled, dosage-escalating study of an intramuscularly administered mRNA-LNP vaccine encoding for DCVC H1 HA in up to 50 adult volunteers aged 18 to 49 years, inclusive. This study is designed to assess the safety and immunogenicity of two doses of DCVC H1 HA mRNA vaccine administered 28 days apart. Eligible participants will be sequentially enrolled into dosage escalation groups (10 mcg, 25 mcg, and 50 mcg). A separate group of 10 participants will receive one dose of the licensed quadrivalent influenza vaccine (IIV4). Enrollment of participants into the IIV4 group is limited to when the vaccine is available for a given year. Concurrent enrollment of the IIV4 group and any pre-specified study product group or groups may present logistical challenges due to the availability of the IIV4 vaccine and may preclude enrollment of all study participants prior to the subsequent off-season. Participants receiving IIV4 will be followed for safety but only their immune responses will be compared to those of participants receiving DCVC H1 HA mRNA vaccine. Dosing of DCVC H1 HA mRNA vaccine will commence at the lowest dose (10 mcg) and only escalate to the next highest dose if safety concerns are not identified. For each DCVC H1 HA mRNA vaccine dosing group, the first two participants enrolled will be considered the sentinel subgroup. After the two participants in the Low Dose sentinel subgroup are enrolled and given their first vaccination, enrollment and subsequent vaccinations in that dosing group will then be stopped until Day 3. This review will be conducted by a Safety Review Committee (SRC). If no halting criteria are met, the SRC will allow administration of the second dose for the sentinel subgroup and continued enrollment of the remaining 8 Low Dose Group participants (expanded subgroup) to complete enrollment of 10 participants. In order for a timely receipt of a second dose of study product on Day 29, SRC review and approval must occur prior to Study Day 28 for the first sentinel participant in the Low Dose Group. After the Low Dose Group enrollment is completed and both doses have been administered, enrollment will be stopped pending SRC review. After all participants in the Low Dose Group have completed the Day 36 visit, the SRC will review the clinical laboratory, reactogenicity, and adverse event information through the Day 36 visit for all Low Dose Group participants that received two doses. Approval by the SRC will allow dose escalation and initiation of enrollment of the Medium Dose Group sentinel subgroup. The Medium and High Dose sentinel and expanded groups will be enrolled as described above for the Low Dose sentinel and expanded groups, respectively, with the High Dose expanded subgroup enrolling up to 18 individuals. The primary objective of this study is to assess the safety of two doses of DCVC H1 HA mRNA Vaccine administered intramuscularly in healthy adults (18-49 yrs) at dosage levels of 10 mcg, 25 mcg, and 50 mcg.
Detailed description
This is a Phase 1, single-site, comparator-controlled, dosage-escalating study of an intramuscularly administered mRNA-LNP vaccine encoding for DCVC H1 HA in up to 50 adult volunteers aged 18 to 49 years, inclusive. This study is designed to assess the safety and immunogenicity of two doses of DCVC H1 HA mRNA vaccine administered 28 days apart. Eligible participants will be sequentially enrolled into dosage escalation groups (10 mcg, 25 mcg, and 50 mcg). A separate group of 10 participants will receive one dose of the licensed quadrivalent influenza vaccine (IIV4). Enrollment of participants into the IIV4 group is limited to when the vaccine is available for a given year. Concurrent enrollment of the IIV4 group and any pre-specified study product group or groups may present logistical challenges due to the availability of the IIV4 vaccine and may preclude enrollment of all study participants prior to the subsequent off-season. Participants receiving IIV4 will be followed for safety but only their immune responses will be compared to those of participants receiving DCVC H1 HA mRNA vaccine. Dosing of DCVC H1 HA mRNA vaccine will commence at the lowest dose (10 mcg) and only escalate to the next highest dose if safety concerns are not identified. For each DCVC H1 HA mRNA vaccine dosing group, the first two participants enrolled will be considered the sentinel subgroup. After the two participants in the Low Dose sentinel subgroup are enrolled and given their first vaccination, enrollment and subsequent vaccinations in that dosing group will then be stopped until Day 3. This review will be conducted by a Safety Review Committee (SRC). If no halting criteria are met, the SRC will allow administration of the second dose for the sentinel subgroup and continued enrollment of the remaining 8 Low Dose Group participants (expanded subgroup) to complete enrollment of 10 participants. In order for a timely receipt of a second dose of study product on Day 29, SRC review and approval must occur prior to Study Day 28 for the first sentinel participant in the Low Dose Group. After the Low Dose Group enrollment is completed and both doses have been administered, enrollment will be stopped pending SRC review. After all participants in the Low Dose Group have completed the Day 36 visit, the SRC will review the clinical laboratory, reactogenicity, and adverse event information through the Day 36 visit for all Low Dose Group participants that received two doses. Approval by the SRC will allow dose escalation and initiation of enrollment of the Medium Dose Group sentinel subgroup. The Medium and High Dose sentinel and expanded groups will be enrolled as described above for the Low Dose sentinel and expanded groups, respectively, with the High Dose expanded subgroup enrolling up to 18 individuals. The primary objective of this study is to assess the safety of two doses of DCVC H1 HA mRNA Vaccine administered intramuscularly in healthy adults (18-49 yrs) at dosage levels of 10 mcg, 25 mcg, and 50 mcg. The secondary objective of this study is to assess the serum antibody responses to two doses of DCVC H1 HA mRNA Vaccine administered intramuscularly 28 days apart in healthy adults at dosage levels of 10 mcg, 25 mcg, and 50 mcg in comparison to a standard dose of IIV4.
Interventions
A modified nucleoside messenger RNA (mRNA) vaccine encoding the full length HA of influenza A/California/07/2009 (H1N1) encapsulated in lipid nanoparticle (LNP) composed of ionizable lipid, DSPC, cholesterol, and PEG lipid for delivery
The vaccine contains recombinant hemagglutinin (HA) proteins from four influenza viruses, expressed using a baculovirus vector. These HA proteins are produced in a continuous insect cell line.
0.9% Sodium Chloride Injection
Sponsors
Study design
Eligibility
Inclusion criteria
1. Provide written informed consent prior to initiation of any study procedure. 2. Are able to understand and comply with planned study procedures and be available for all study visits. 3. Are males or non-pregnant, non-breastfeeding females, 18 to 49 years of age, inclusive at time of enrollment. 4. Must agree to collection of venous blood and nasal absorption specimens per protocol and enrollment in DMID 19-0025 biorepository protocol for use of residual blood specimens. 5. Are in good health\* and not have clinically significant medical, psychiatric, chronic or intermittent health conditions including those listed in
Exclusion criteria
(Section 5.3) \*Refer to the protocol specific Manual of Procedures (Section 4.3) for this definition. 6. Does not have an ongoing symptomatic condition\* for which participant has had or has ongoing medical investigations but has not yet received a diagnosis or treatment plan. \*e.g., ongoing fatigue without a diagnosis for symptom. 7. Pulse is 50 to 100 beats per minute, inclusive. 8. Systolic blood pressure is 90 to 139 mmHg, inclusive. 9. Diastolic blood pressure is 55 to 89 mmHg, inclusive. 10. Body mass index (BMI) of 18 kilograms/square meter (kg/m\^2) to \<35 kg/m\^2 (inclusive) and weight \>/=110 lbs. at screening. 11. Women of childbearing potential\* must agree to use or have practiced true abstinence or use at least 1 acceptable primary form of contraception. \*\* * Not of child bearing potential - post-menopausal females (defined as having a history of amenorrhea for at least one year) or a documented status as being surgically sterile (hysterectomy, bilateral oophorectomy, salpingectomy, or Essure placement with history of documented radiological confirmation test at least 90 days after the procedure) * True abstinence is 100% of time no sexual intercourse (male's penis enters the female's vagina). (Periodic abstinence \[e.g. calendar, ovulation, symptothermal, post-ovulation methods\] and withdrawal are not acceptable methods of contraception). * Acceptable forms of primary contraception include monogamous relationship with a vasectomized partner who has been vasectomized for 180 days or more prior to the participant receiving the study product, tubal ligation, intrauterine devices, birth control pills, and injectable/implantable/insertable hormonal birth control products. * Must use at least one acceptable primary form of contraception or true abstinence for at least 30 days prior to receipt of study product and at least one acceptable primary form of contraception or true abstinence for at least 30 days following receipt of study product. 12. Women of childbearing potential\* must have a negative serum pregnancy test at screening and a negative urine pregnancy test within 24 hours prior to each study vaccination. 13. Male participants receiving DCVC H1 HA mRNA Vaccine must agree to refrain from donating sperm and to use contraception until day 90 after last vaccination. \*\* * Acceptable contraception includes abstinence from intercourse with a female of childbearing potential or use of a male condom when engaging in any activity that allows for passage of ejaculate to a female during the intervention period for at least 90 days after last study vaccination. * Males in the immunogenicity comparator group do not have to refrain from sperm donation or abstain from intercourse or agree to use a male condom for purposes of this study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number and percentage of participants experiencing any adverse events of special interest (AESIs) | Day 1 through Day 394 |
| Number and percentage of participants experiencing any influenza like illnesses (ILI) | Day 1 through Day 394 |
| Number and percentage of participants experiencing any medically-attended adverse events (MAAEs) | Day 1 through Day 394 |
| Number and percentage of participants experiencing any new-onset chronic medical conditions (NOCMCs) | Day 1 through Day 394 |
| Number and percentage of participants experiencing any serious adverse events (SAEs) | Day 1 through Day 394 |
| Number and percentage of participants experiencing any unsolicited adverse events (AEs) | Day 1 through Day 57 |
| Number and percentage of participants experiencing solicited adverse events (AEs) | Day 1 through Day 42 |
| Number and percentage of participants with clinical laboratory adverse events (AEs) | Day 1 through Day 57 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Geometric mean fold rise (GMFR) in homologous H1-specific anti-stalk serum antibodies | Day 1 through Day 57 | — |
| Geometric mean fold rise (GMFR) in homologous H1-specific MN antibody | Day 1 through Day 57 | — |
| Geometric mean fold rise in homologous H1-specific HAI antibody | Day 1 through 57 | — |
| Geometric mean titers of homologous H1-specific anti-stalk serum antibodies | Day 1 through Day 57 | — |
| Geometric mean titers of homologous H1-specific hemagglutinin inhibition (HAI) antibodies | Day 1 through Day 57 | — |
| Geometric mean titers of homologous H1-specific microneutralization (MN) antibodies | Day 1 through Day 57 | — |
| Number and percentage of participants achieving HAI titer seroconversion against the homologous H1-specific hemagglutinin | Day 1 through 57 | (defined as either a pre-vaccination titer \<1:10 and a post-vaccination titer \>/=1:40 or a pre-vaccination titer \>/=1:10 and a minimum four-fold rise in post-vaccination antibody titer) |
| Number and percentage of participants demonstrating HAI titer seroprotection against the homologous H1-specific hemagglutinin | Day 1 through 57 | (defined as \>/=1:40 titer) |
| The number and percentage of participants achieving MN titer seroconversion against the homologous H1-specific hemagglutinin | Day 1 through 57 | (defined as either a pre-vaccination titer \<1:10 and a post-vaccination titer \>/=1:40 or a pre-vaccination titer \>/=1:10 and a minimum four-fold rise in post-vaccination antibody titer) |
Countries
United States