Randomized Trial of High Dose Influenza Vaccine in Long Term Care Setting
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Purpose
The purpose of the study is to compare the performance of two currently available influenza (flu) vaccines. This study will try and determine if the high dose flu vaccine provides protection that is the same or better than that of regular dose flu vaccine. Both the regular dose and the high dose flu vaccines are approved by the FDA for use in older adults.
| Condition | Intervention | Phase |
|---|---|---|
|
Influenza |
Biological: High Dose Inactivated Influenza Vaccine Biological: Standard Dose Inactivated Influenza Vaccine |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Prevention |
| Official Title: | Randomized Trial of High Dose Influenza Vaccine in Long Term Care Setting |
- Non-inferiority of high-dose inactivated influenza vaccine(HDIV) versus standard dose inactivated influenza vaccine(SDIV) among residents of long term care(LTC) settings [ Time Frame: 30 days ] [ Designated as safety issue: No ]The primary objective of this study is to determine the noninferiority of high- dose inactivated influenza vaccine (HDIV) versus standard dose inactivated influenza vaccine(SDIV)among residents of long term care(LTC)settings.Non-inferiority will be determined by comparing baseline and one month post vaccination HAI and MN titers using non-inferiority analysis.
- Non-inferiority and immunoprotection persistence at 6 months and the impact of potential immune modulators on titer response [ Time Frame: 6 months ] [ Designated as safety issue: No ]Compare the immunogenicity via HAI and MN titers for HDIV and SDIV at 6 months in frail LTC residents and potential modifiers of immune response
| Estimated Enrollment: | 320 |
| Study Start Date: | November 2011 |
| Estimated Study Completion Date: | June 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: High Dose Inactivated Influenza Vaccine
For HDIV,0.5 ml of high dose inactivated influenza vaccine consisting of a total of 180mcg (60 mcg each strain) of influenza virus hemagglutinin
|
Biological: High Dose Inactivated Influenza Vaccine
0.5 ml HDIV consisting of 180 mcg (60 mcg each strain) of influenza virus hemagglutinin
|
|
Active Comparator: Standard Dose Inactivated Influenza Vaccine
For SDIV, 0.5 ml of standard dose inactivated influenza vaccine consisting of a total of 45 mcg (15 mcg of each strain) of influenza virus hemagglutinin
|
Biological: Standard Dose Inactivated Influenza Vaccine
0.5 ml of standard dose inactivated influenza vaccine consisting of a total of 45 mcg (15 mcg each strain) of influenza virus hemagglutinin
|
Detailed Description:
Influenza and pneumonia are the fifth leading cause of death in the United States, the leading cause of vaccine preventable death, and the leading cause of infection related deaths among nursing home residents(Nace, Drinka et al.2010). Each year, an estimated 36,000 individuals die from seasonal influenza and over 90% of these deaths occur among older adults, primarily the frail older adults residing in LTC settings(Fiore,Uyeki et al. 2010).Vaccination is the most effective means of preventing influenza (Nichol and Treanor 2006). Despite increasing success in immunizing LTC residents though, outbreaks continue to occur annually with case fatality rates ranging between 5-55% (Nace 2008). Older adults have a reduced response to influenza vaccination, in part due to age related immunosenescence (Keitel, Atmar et al. 1121; Skowronski, Tweed et al. 2008). It is widely recognized that more effective vaccine options are needed for frail older adults. One option is to increase the hemagglutinin (HA) dose in influenza vaccines in an effort to increase antibodies to hemagglutinin. To date, no studies have evaluated the effectiveness of the HDIV among LTC residents.
Eligibility| Ages Eligible for Study: | 65 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Residents of one of the participating LTC sites
- 65 years or older at the time of consent
- require assistance in two or more Instrumental Activities of Daily Living and/or one or more Activities of Daily Living as identified by facility staff
Exclusion Criteria:
- Age less than 65 years
- Life expectancy less than 6 months
- History of allergic reaction to influenza vaccine, its components, or eggs
- History of severe allergic reaction to latex
- History of Guillian-Barre Syndrome
- Actively undergoing chemotherapy
- Actively undergoing radiation therapy
- Use of prednisone (or other steroid) at prednisone-equivalent dosages of 10mg or higher within the past 14 days
- Serious current immunosuppression or immunosuppression expected in the next 6 weeks
- Any condition that, in the opinion of the investigator,might interfere with the evaluation of study objectives
Contacts and Locations| Contact: David A. Nace, MD, MPH,CMD | (412) 692-2360 | naceda@upmc.edu |
| Contact: Stacey Saracco, RN | (412) 692-2348 | saraccos@upmc.edu |
| United States, Pennsylvania | |
| University of Pittsburgh, Division of Geriatric Medicine | Recruiting |
| Pittsburgh, Pennsylvania, United States, 15213 | |
| Contact: Stacey Saracco, RN 412-692-2348 saraccos@upmc.edu | |
| Principal Investigator: | David A. Nace, MD, MPH, CMD | University of Pittsburgh, Division of Geriatric Medicine |
More Information
No publications provided
| Responsible Party: | David Nace, Assistant Professor of Medicine, University of Pittsburgh |
| ClinicalTrials.gov Identifier: | NCT01654224 History of Changes |
| Other Study ID Numbers: | PRO10110247 |
| Study First Received: | July 27, 2012 |
| Last Updated: | July 31, 2012 |
| Health Authority: | United States: University of Pittsburgh IRB United States: Pennsylvania Department of Health IRB |
Keywords provided by University of Pittsburgh:
|
Influenza in Long Term Care Setting High dose Inactivated influenza vaccine Standard dose inactivated influenza vaccine |
Additional relevant MeSH terms:
|
Influenza, Human Orthomyxoviridae Infections RNA Virus Infections Virus Diseases Respiratory Tract Infections Respiratory Tract Diseases |
Hemagglutinins Agglutinins Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 22, 2013