Effect of Age and Prior Immunity to Response to Seasonal Influenza Vaccines in Children

The recruitment status of this study is unknown because the information has not been verified recently.
Verified November 2010 by University of Rochester.
Recruitment status was  Active, not recruiting
Sponsor:
Collaborators:
Dartmouth-Hitchcock Medical Center
Information provided by:
University of Rochester
ClinicalTrials.gov Identifier:
NCT01246999
First received: November 22, 2010
Last updated: August 2, 2011
Last verified: November 2010
  Purpose

A total of 88 children between 2 and 9 years of age will be randomized to receive a two dose schedule of either licensed live attenuated trivalent seasonal influenza vaccine (LAIV) or licensed inactivated seasonal influenza vaccine (TIV)or TIV followed by LAIV or LAIV followed by TIV separated by 28 days. Children with a laboratory documented history of prior H1N1 infection will be excluded.


Condition Intervention Phase
Influenza
Biological: Trivalent Seasonal Live attenuated Influenza vaccine
Biological: Seasonal Trivalent Influenza Vaccine 2010-2011
Biological: Seasonal Influenza Vaccine TIV/LAIV
Biological: Seasonal Influenza Vaccines LAIV/TIV
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Evaluation of the Effect of Age and Prior Immunity on the Response to Live or Inactivated Seasonal (A/California/7/2009-like (2009 H1N1), A/Perth/16/2009-like (H3N2), and B/Brisbane/60/2008-like (B/Victoria Lineage) Influenza Vaccines in Children

Resource links provided by NLM:


Further study details as provided by University of Rochester:

Primary Outcome Measures:
  • The primary end point for assessment of live attenuated vaccine take will be the AUC of nasopharyngeal strain-specific virus assessed by immunoperoxidase stained plaquesin MDCK cells at 33 degrees C [ Time Frame: nasal swabs obtained at day 2 post vacination ] [ Designated as safety issue: No ]
  • The primary end point for assessment of live attenuated vaccine take will be the AUC of nasopharyngeal strain-specific virus assessed by immunoperoxidase stained plaquesin MDCK cells at 33 degrees C [ Time Frame: nasal swab at day 4 post vaccination ] [ Designated as safety issue: No ]
  • The primary end point for assessment of live attenuated vaccine take will be the AUC of nasopharyngeal strain-specific virus assessed by immunoperoxidase stained plaquesin MDCK cells at 33 degrees C [ Time Frame: nasal swab obtained at 7 days post vaccination ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • The AUC of live vaccine shedding determined by quantitative rtRT-PCR [ Time Frame: nasal swab on day 2 post vaccination ] [ Designated as safety issue: No ]
  • The frequency and magnitude of hemagglutinin-inhibition (HAI) IgG and IgA ELISA, and neutralizing antibody response to vaccine [ Time Frame: at day 28 ] [ Designated as safety issue: No ]
  • The frequency and magnitude of hemagglutinin-specific mucosal IgG and IgA responses assessed by ELISA on nasal secretions [ Time Frame: day 28 ] [ Designated as safety issue: No ]
  • Development of specific local and systemic symptoms occurring after vaccine [ Time Frame: for 7 days post each vaccination ] [ Designated as safety issue: Yes ]
  • The frequency and magnitude of hemagglutinin-inhibition (HAI) IgG and IgA ELISA, and neutralizing antibody response to vaccine [ Time Frame: day 56 ] [ Designated as safety issue: No ]
  • The frequency and magnitude of hemagglutinin-specific mucosal IgG and IgA responses assessed by ELISA on nasal secretions [ Time Frame: day 56 ] [ Designated as safety issue: No ]

Estimated Enrollment: 88
Study Start Date: October 2010
Estimated Study Completion Date: April 2012
Estimated Primary Completion Date: April 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: LAIV-LAIV Biological: Trivalent Seasonal Live attenuated Influenza vaccine
0.2 mL dose delivered through nasal spray, 0.1 ml in each nostril, 2 doses separated by 28 days
Other Name: FluMist
Active Comparator: TIV-TIV Biological: Seasonal Trivalent Influenza Vaccine 2010-2011
.25 mL given intramuscularly to children 24 to 25 months of age, 2 doses given 28 days apart, .5 mL given intramuscularly to children 36 months to 9 years of age, 2 doses given 28 day s apart.
Other Name: Seasonal Influenza Vaccine
Active Comparator: TIV-LAIV Biological: Seasonal Influenza Vaccine TIV/LAIV
TIV .25 mL given intramuscularly to children 24 to 25 months of age or .5 mL given intramuscularly to children 36 months to 9 years of age, followed by FluMist 0.2 mL delivered by nasal spray (.1 mL in each nostril)28 days later
Other Name: Seasonal Influenza Vaccines
Active Comparator: LAIV-TIV Biological: Seasonal Influenza Vaccines LAIV/TIV
LAIV .2 mL given through nasal spray (.1 mL in each nostril) Followed by TIV .25 mL given intramuscularly to children 24 to 25 months of age or .5 mL given intramuscularly to children 36 months to 9 years of age 28 days later
Other Name: Seasonal Influenza Vaccines

Detailed Description:

The study will be conducted as a randomized, prospective, open-label evaluation of the clinical tolerability, vaccine virus shedding, and serum and mucosal antibody response to vaccination with either live trivalent influenza vaccine (LAIV) or trivalent influenza vaccine (TIV) in healthy children between the ages of 2 and 9 years. Children will be screened for antibody to A/Brisbane/57/07 (H1N1) and A/California/07/09 (H1N1), A/Perth/16/2009 (H3N2) and B/Brisbane/60/2008 before and at indicated times after the start of the study. They will not be randomized based on antibody levels. Children with prior documented infection with the 2009 pandemic H1N1 virus will be excluded. Vaccine will be administered on days 0 and 28.

Safety of vaccination will be assessed using symptoms collected by parents for 7 days after each dose of vaccine. Serum will be obtained prior to and on day 28 following each dose of vaccine and assessed for antibody by HAI, ELISA, and neutralization techniques. Nasal secretions will be obtained by nasal wick prior to and on day 28 after each dose and assessed for HA-specific IgA and IgG antibody by ELISA. Nasal swabs will be obtained on days 2, 4, and 7 after each dose of live vaccine and assessed for the presence and magnitude of vaccine virus shedding of the live attenuated vaccine by rtRT-PCR and TCID50 on MDCK cells.

  Eligibility

Ages Eligible for Study:   2 Years to 9 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Aged between 2 and 9 years, inclusive.
  • No prior history of laboratory documented infection with novel H1N1 virus
  • The subject must be in good health, as determined by: vital signs (heart rate <140 bpm; blood pressure: systolic ≥ 90 mm Hg and ≤140 mm Hg; diastolic ≤ 90 mm Hg; oral temperature <100.0ºF); medical history; and targeted physical examination, when necessary, based on medical history. Stable medical condition is defined as: no recent increase in prescription medication, dose, or frequency of medication in the last 3 months and health outcomes of the specific disease are considered to be within acceptable limits in the last 6 months.
  • The subject/parents are able to understand and comply with the planned study procedures, including being available for all study visits.
  • The subject/parents have provided informed consent prior to any study procedures. (An assent will be obtained for all children as required by the institutional IRB.)

Exclusion Criteria:

  • Subjects with a laboratory documented history of previous novel H1N1 infection.
  • History of egg allergy or allergy to other components of vaccine.
  • History of wheezing.
  • The subject is immunosuppressed as a result of an underlying illness or treatment with immunosuppressive or cytotoxic drugs, or use of anticancer chemotherapy or radiation therapy.
  • The subject has an active neoplastic disease.
  • The subject has long-term (greater than 2 weeks) use of oral or parenteral steroids, or high-dose inhaled steroids (>800 mg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (nasal and topical steroids are allowed).
  • The subject received immunoglobulin or another blood product within the 3 months prior to enrollment in this study.
  • The subject has received an inactivated vaccine within the 2 weeks or a live vaccine within the 4 weeks prior to enrollment in this study or plans to receive another vaccine within the next 28 days (or 56 days for vaccine naïve recipients).
  • The subject has an acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe or would interfere with the evaluation of responses. These conditions include chronic conditions recognized as risk factors for influenza complications or as contraindications for live vaccination, including chronic cardiac (exclusive of hypertension) or pulmonary conditions (including asthma), diabetes mellitus, or renal impairment.
  • The subject has an acute illness or an oral temperature greater than 99.9 degreesF (37.7 degrees C) within 3 days prior to enrollment or vaccination. Subjects who had an acute illness that was treated symptoms resolved are eligible to enroll as long as treatment is completed and symptoms resolve > 3 days prior to enrollment.
  • The subject is currently participating or plans to participate in a study that involves an experimental agent (vaccine, drug, biologic, device, blood product, or medication) or has received an experimental agent within 1 month prior to enrollment in this study, or expects to receive another experimental agent during participation in this study, or intends to donate blood during the study period.
  • The subject has any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol.
  • The subject has a known human immunodeficiency virus, hepatitis B, or hepatitis C infection.
  • The subject has a previous history of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccination.
  • The subject has any condition that the principal investigator (PI) believes may interfere with successful completion of the study.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01246999

Locations
United States, New Hampshire
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, United States, 03756
United States, New York
Vaccine Research Unit Room 3-5000
Rochester, New York, United States, 14642
Sponsors and Collaborators
University of Rochester
Dartmouth-Hitchcock Medical Center
  More Information

Publications:

Responsible Party: John J. Treanor, MD, Department of Internal Medicine, Division of Infectious Diseases, University of Rochester Medical Center
ClinicalTrials.gov Identifier: NCT01246999     History of Changes
Other Study ID Numbers: URMC10-005/Dartmouth 22164
Study First Received: November 22, 2010
Last Updated: August 2, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by University of Rochester:
Influenza
A/California/7/2009-like (2009 H1N1)
A/Perth/16/2009-like (H3N2)
B/Brisbane/60/2008-like (B/Victoria lineage)

Additional relevant MeSH terms:
Influenza, Human
Orthomyxoviridae Infections
RNA Virus Infections
Virus Diseases
Respiratory Tract Infections
Respiratory Tract Diseases

ClinicalTrials.gov processed this record on October 19, 2014