Fever, Fever After Vaccination, Seizures Fever
Conditions
Keywords
COVID vaccine, Fever following vaccination
Brief summary
This is a prospective, randomized, open-label clinical trial to evaluate the safety of COVID-19 vaccination and other routine childhood vaccines given simultaneously at Visit 1, as compared to sequential vaccination of COVID-19 vaccine and other vaccines at separate visits (Visits 1 and 2). Parent(s) or legal authorized representative(s) (LAR) will assess fever and other solicited systemic adverse events on the day of vaccination (Day 1) and the next 6 days (through Day 7) following Visit 1 and Visit 2 using either a web-based data collection system or a paper memory aid. Serious adverse events and adverse events of special interest will be captured during the entire study period. Parental/LAR perceptions about their child's vaccine schedule will be assessed on Day 7 following Visit 2.
Detailed description
Intent-to-Treat (ITT) Analysis Population: Defined as any participant who was enrolled and randomized into the study. Modified Intent-to-Treat (mITT) Analysis Population: Defined as any participant who was enrolled, randomized into the study, and received at least one study vaccine at Visit 1.
Interventions
BIOLOGICALmRNA COVID-19 Vaccine
ACIP Recommended Vaccine
BIOLOGICALRoutine Childhood Vaccinations
ACIP Recommended Vaccines
Sponsors
Duke University
Kaiser Permanente
Columbia University
Children's Hospital Medical Center, Cincinnati
Centers for Disease Control and Prevention
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Months to 4 Years
Healthy volunteers
Yes
Inclusion criteria
* Child 6 months through \<5 years of age at time of enrollment. * Child is due to receive mRNA COVID-19 vaccine and at least one other routinely recommended non-live vaccine per CDC or ACIP recommendations. * Parental/LAR intention of child receiving mRNA COVID-19 vaccine and at least one recommended non-live vaccine. * The parent/LAR must be willing and capable of providing permission for their child to participate through the written informed consent process. * The parent/LAR must be available for follow-up and must at minimum have telephone access. * The parent/LAR must agree to sign a medical release for the child so that study personnel may obtain medical information about the child's health (if needed). * The parent/LAR must be willing to delay COVID-19 vaccination for their child for up to 3 weeks. * The parent/LAR must be able to read English or Spanish.
Exclusion criteria
* History of any seizure (including febrile seizure) or first degree relative (biologic parent or biologic sibling including half-sibling) with a history of febrile seizure. * Contraindication to mRNA COVID-19 vaccine: A history of a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the COVID-19 vaccine or a known diagnosed allergy to a component of COVID-19 vaccine. * A history of a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of a vaccine administered on the day of study enrollment. * For children receiving DTaP vaccine (alone or combination vaccine): Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures), not attributable to another identifiable cause, within 7 days of administration of previous dose of DTP or DTaP. * Received any other non-live vaccines within 14 days prior to enrollment or any other live vaccines within 28 days prior to enrollment. * Intention to receive non-COVID-19 non-live or live vaccines during the 4 weeks after Visit 1; vaccines may be administered after enrollment if deemed a personal or public health priority by the health care provider caring for this patient or the study team. * Received prior COVID-19 vaccine as part of a clinical trial. * Received any experimental/investigational agent (vaccine, drug, biologic, device, blood product, or medication) within 28 days prior to enrollment in this study or expects to receive an experimental/investigational agent during the study. * A moderate to severe acute illness and/or a reported temperature ≥ 100.4°F (≥38.0°C) within 48 hours prior to enrollment or a temperature (measured by temporal artery thermometer) ≥100.4°F (≥38.0°C) at the time of enrollment. (This may result in a temporary delay of vaccination). * Receipt of an antipyretic medication (acetaminophen or ibuprofen) within 72 hours prior to enrollment (this may result in a temporary delay of vaccination) or planned receipt of a prophylactic antipyretic medication on the day of and/or days following vaccination prior to any measured increase in temperature in anticipation of a fever (this exclusion does not apply if the Parent/LAR indicates they might administer antipyretics or analgesics after vaccination to reduce a fever or pain). * Immunosuppression as a result of an underlying illness or treatment, or use of anti-cancer chemotherapy or radiation therapy since birth. * Long term (at least 14 days of prednisone 2 mg/kg/day or equivalent other glucocorticoid) use of any parenteral steroids or high-dose inhaled steroids (\>800 mcg/day of beclomethasone dipropionate or equivalent) within the 6 months prior to enrollment (topical and nasal steroids are allowed). * Has an active case of COVID-19 infection. * History of multisystem inflammatory syndrome (MIS-C). * History of myocarditis or pericarditis. * Has any condition that would, in the opinion of the site investigator, place the participant at an unacceptable risk of injury or render the participant unable to meet the requirements of the protocol. * Any child or grandchild of a study investigator or study team member.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Fever Following Vaccination | 2 Days Post-Administration | Number of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 1 and/or Visit 2. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Fever Following Visit 1 | 2 Days Post Visit 1 | Number of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 1 |
| Number of Participants With Fever Following Visit 2 | 2 Days Post Visit 2 | Number of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 2 |
| Number of Participants With Grade 2 and/or 3 Fever Following Visit 1 and Visit 2 Combined | 2 Days Post Administration | Number of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 1 and Visit 2 combined. (Moderate/severe fever: ≥ 38.4°C or ≥ 101.2°F) |
| Number of Participants With Grade 2 and/or 3 Fever Following Visit 1 | 2 Days Post Visit 1 | Number of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 1. (Moderate/severe fever: ≥ 38.4°C or ≥ 101.2°F) |
| Number of Participants With Grade 2 and/or 3 Fever Following Visit 2 | 2 Days Post Visit 2 | Number of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 2. (Moderate/severe fever: ≥ 38.4°C or ≥ 101.2°F) |
| Number of Participants With Medical Care Utilization for Fever - Visit 1 and Visit 2 Combined | 2 Days Post Administration | Number of children with medical care utilization (medical advice (telephone, patient portal), urgent care visit, emergency department visit, and hospital admission) for fever on day 1 and /or day 2 following Visit 1 and Visit 2 combined. |
| Number of Participants With Medical Care Utilization for Fever - Visit 1 | 2 Days Post Visit 1 | Number of children with medical care utilization (medical advice (telephone, patient portal),urgent care visit, emergency department visit, and hospital admission) for fever on day 1 and/or day 2 following Visit 1. |
| Number of Participants With Medical Care Utilization for Fever- Visit 2 | 2 Days Post Visit 2 | Number of children with medical care utilization (medical advice (telephone, patient portal),urgent care visit, emergency department visit, and hospital admission) for fever on day 1 and/or day 2 following Visit 2. |
| Number of Participants Who Received Antipyretics - Visit 1 and Visit 2 Combined | 2 Days Post Administration | Number of children who received antipyretics on day 1 and/or day 2 following Visit 1 and Visit 2 combined. |
| Number of Participants Who Received Antipyretics - Visit 1 | 2 Days Post Visit 1 | Number of children who received antipyretics on day 1 and/or day 2 following Visit 1. |
| Number of Participants Who Received Antipyretics - Visit 2 | 2 Days Post Visit 2 | Number of children who received antipyretics on day 1 and/or day 2 following Visit 2. |
| Number of Participants With Defined Systemic Reactogenicity Events at Visit 1, Ages 6-23 Months Old | Up to 7 Days Post Visit 1 | Tables summarizing each solicited local and systemic reactogenicity event by maximum classification (none, mild, moderate, and severe), as well as by moderate or severe |
| Number of Participants With Defined Systemic Reactogenicity Events at Visit 2, Ages 6-23 Months Old | Up to 7 Days Post Visit 2 | Tables summarizing each solicited local and systemic reactogenicity event by maximum classification (none, mild, moderate, and severe), as well as by moderate or severe |
| Number of Participants With Defined Systemic Reactogenicity Events at Visit 1, Ages 2-5 Years Old | Up to 7 Days Post Visit 1 | Tables summarizing each solicited local and systemic reactogenicity event by maximum classification (none, mild, moderate, and severe), as well as by moderate or severe |
| Number of Participants With Defined Systemic Reactogenicity Events at Visit 2, Ages 2-5 Years Old | Up to 7 Days Post Visit 2 | Tables summarizing each solicited local and systemic reactogenicity event by maximum classification (none, mild, moderate, and severe), as well as by moderate or severe |
| The Number of Individuals With At Least One Serious Adverse Event | Up to 105 Days Post Administration | — |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORMichael J Smith, MD
Duke University
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 12.5 months |
| Ethnicity (NIH/OMB) Hispanic or Latino | 49 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 118 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 2 Participants |
| Race/Ethnicity, Customized 2 or More Races | 26 Participants |
| Race/Ethnicity, Customized Black or African American | 41 Participants |
| Race/Ethnicity, Customized Other | 32 Participants |
| Race/Ethnicity, Customized Unknown | 4 Participants |
| Race/Ethnicity, Customized White | 95 Participants |
| Sex: Female, Male Female | 157 Participants |
| Sex: Female, Male Male | 97 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 174 | 0 / 168 |
| other Total, other adverse events | 0 / 174 | 9 / 168 |
| serious Total, serious adverse events | 2 / 174 | 1 / 168 |
Outcome results
None listed