Study of a Candidate Clostridium Difficile Toxoid Vaccine in Subjects at Risk for C. Difficile Infection

This study is currently recruiting participants. (see Contacts and Locations)
Verified April 2014 by Sanofi
Sponsor:
Information provided by (Responsible Party):
Sanofi ( Sanofi Pasteur, a Sanofi Company )
ClinicalTrials.gov Identifier:
NCT01887912
First received: June 20, 2013
Last updated: April 11, 2014
Last verified: April 2014
  Purpose

The aim of this study is to evaluate the efficacy of the candidate Clostridium difficile (C. difficile) vaccine to prevent primary symptomatic C. difficile infection (CDI) in subjects a risk for CDI where there is a substantial unmet medical need.

Primary objective:

  • To assess the efficacy of the C. difficile vaccine in preventing the onset of symptomatic primary CDI confirmed by polymerase chain reaction (PCR) in adult subjects aged ≥ 50 years who are at risk for CDI and have received at least 1 injection.

Secondary Objectives:

Efficacy:

  • To assess prevention of symptomatic PCR-confirmed primary CDI cases after 3 injections administered at 0, 7, and 30 days
  • To assess prevention of symptomatic PCR-confirmed primary CDI cases after completion of at least 2 injections.

Immunogenicity:

  • To describe the immunogenicity to toxin A and toxin B in the subset of subjects at specific time points.

Safety:

  • To describe the safety profile of all subjects who receive at least 1 injection.

Condition Intervention Phase
Clostridium Difficile Infection
Biological: C. difficile Toxoid Vaccine
Biological: Placebo: 0.9% normal saline
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Efficacy, Immunogenicity, and Safety Study of Clostridium Difficile Toxoid Vaccine in Subjects at Risk for C. Difficile Infection

Further study details as provided by Sanofi:

Primary Outcome Measures:
  • Number of participants with symptomatic PCR-confirmed primary CDI cases [ Time Frame: Up to 3 years post-vaccination 1 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • The number of participants with symptomatic PCR confirmed primary CDI cases after 3 injections [ Time Frame: Up to 3 years post-vaccination 3 ] [ Designated as safety issue: No ]
  • The number of participants with symptomatic PCR-confirmed primary CDI cases after 2 injections [ Time Frame: Up to 3 years post-vaccination 2 ] [ Designated as safety issue: No ]
  • The number of symptomatic PCR-confirmed primary CDI cases after 3 injections as a function of time since enrollment and within 3.0 years or 2.5 years in Stage 1 or Stage 2, respectively, after the third injection [ Time Frame: Up to 3 years post-vaccination 3 ] [ Designated as safety issue: No ]
  • Serum antibody concentrations against toxins A and B [ Time Frame: 60 Days post-vaccination 1 ] [ Designated as safety issue: No ]
  • Number of Participants Reporting Solicited Injection Site Reactions, Solicited Systemic Reactions, Unsolicited Systemic Reactions, and Serious Adverse Events Occurring Throughout the Trial [ Time Frame: Day 0 up to Day 90 post-vaccination ] [ Designated as safety issue: No ]
    Solicited injection site reactions: Pain, Erythema, and Swelling. Solicited systemic reactions: Fever (temperature), Headache, Malaise, Myalgia, and Arthralgia.


Estimated Enrollment: 15000
Study Start Date: July 2013
Estimated Study Completion Date: December 2017
Estimated Primary Completion Date: December 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: C. difficile Vaccine Group
Participants will receive 1 injection of the C. difficile vaccine at Days 0, 7, and 30, respectively.
Biological: C. difficile Toxoid Vaccine
0.5 mL, Intramuscular
Placebo Comparator: Placebo Vaccine Group
Participants will receive 1 injection of 0.9% normal saline at Days 0, 7, and 30, respectively.
Biological: Placebo: 0.9% normal saline
0.5 mL, Intramuscular

Detailed Description:

The study is designed as an event-driven group sequential protocol with 2 stages of enrollment, 3 interim analyses at defined clinical endpoints and a final analysis when number of clinical endpoints are reached.

In both Stage 1 and Stage 2, subjects will be randomly assigned to receive either the candidate vaccine or a placebo that will be administered in a 3-dose schedule. Stage 2 will be initiated after completing the second interim analysis of the Stage 1 cohort.

  Eligibility

Ages Eligible for Study:   50 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Aged ≥ 50 years on the day of inclusion
  • Informed consent form has been signed and dated
  • Able to attend all scheduled visits and to comply with all trial procedures
  • Covered by health insurance (if required)
  • Must fulfill at least 1 of the following criteria

Risk Stratum 1:

  • Has had at least 2 hospital stays, each lasting at least ≥ 24 hours, in the 12 months before enrollment, and
  • Has received systemic (not topical) antibiotics in the 12 months before enrollment, or

Risk Stratum 2:

  • Is anticipated to have an in-patient hospitalization for a planned surgical procedure within 60 days of enrollment. The impending hospital stay is planned to be ≥ 72 hours for a surgery involving 1 of the following:
  • Kidney/bladder/urinary system
  • Musculoskeletal system
  • Respiratory system
  • Circulatory system
  • Central nervous system.

Exclusion Criteria:

  • Subject is pregnant, or lactating, or of childbearing potential (to be considered of non-childbearing potential, a female must be post-menopausal for at least 1 year, surgically sterile, or using an effective method of contraception or abstinence from at least 4 weeks prior to the first vaccination and until at least 4 weeks after the last vaccination)
  • Participation in the 4 weeks preceding the first trial vaccination or participation during the present trial period in another clinical trial investigating a vaccine, drug, medical device, or medical procedure
  • Receipt of any vaccine in the 4 weeks preceding the first trial vaccination except for influenza (seasonal or pandemic) and pneumococcal vaccines. This exception includes monovalent pandemic influenza vaccines and multivalent influenza vaccines
  • Previous vaccination against C. difficile with either the trial vaccine, another vaccine, or monoclonal antibodies
  • Diarrhea on day of enrollment
  • Self-reported current or prior CDI episode
  • Anticipated or current receipt of kidney dialysis treatment
  • History of gastrointestinal surgery for gastrointestinal malignancy (Note: Colonoscopy, polypectomy, and appendectomy are not exclusion criteria.)
  • History of inflammatory bowel disease, irritable bowel syndrome, colostomy, or small or large intestine bowel surgery where resection was performed
  • Receiving enteral feeding (e.g., nasogastric, gastrostomy, and jejunostomy tube feeding)
  • Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy, such as anti-cancer chemotherapy or radiation therapy, within the preceding 6 months; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months)
  • Known systemic hypersensitivity to any of the vaccine components, or history of a life-threatening reaction to the vaccine used in the trial or to a vaccine containing any of the same substances
  • Self-reported thrombocytopenia, contraindicating intramuscular vaccination
  • Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily
  • Current alcohol abuse or drug addiction that might interfere with the ability to comply with trial procedures in the opinion of the Investigator
  • Chronic illness that, in the opinion of the investigator, is at a stage where it might interfere with trial conduct or completion
  • Moderate or severe acute illness/infection (according to investigator judgment) on the day of vaccination or febrile illness (temperature ≥ 38.0°C [≥ 100.4°F]). A prospective subject should not be included in the study until the condition has resolved or the febrile event has subsided
  • Identified as an Investigator or employee of the Investigator or study center with direct involvement in the proposed study, or identified as an immediate family member (i.e., parent, spouse, natural or adopted child) of the Investigator or employee with direct involvement in the proposed 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: NCT01887912

Contacts
Contact: Public Registry Sanofi Pasteur RegistryContactUs@sanofipasteur.com

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Locations
United States, Arizona
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Flagstaff, Arizona, United States, 86001
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Tucson, Arizona, United States, 85712
United States, Arkansas
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Little Rock, Arkansas, United States, 72205
United States, California
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Chula Vista, California, United States, 91911
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La Mesa, California, United States, 91942
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Laguna Hills, California, United States, 92653
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Los Angeles, California, United States, 90027
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Modesto, California, United States, 95350
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Oceanside, California, United States, 92056
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Palm Springs, California, United States, 92262
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Redding, California, United States, 96001
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San Diego, California, United States, 92134
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Santa Rosa, California, United States, 95405
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Stanford, California, United States, 94305
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Ventura, California, United States, 93003
United States, Colorado
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Wheat Ridge, Colorado, United States, 80033
United States, Connecticut
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Danbury, Connecticut, United States, 06810
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Boynton Beach, Florida, United States, 33472
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Brooksville, Florida, United States, 34601
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Clearwater, Florida, United States, 33756
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Crystal River, Florida, United States, 34429
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Jacksonville, Florida, United States, 32207
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Jacksonville, Florida, United States, 32216
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Sarasota, Florida, United States, 34239
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St. Petersburg, Florida, United States, 33709
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Tampa, Florida, United States, 33612
United States, Georgia
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Gainesville, Georgia, United States, 30501
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Savannah, Georgia, United States, 31406
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Idaho Falls, Idaho, United States, 83494
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Peoria, Illinois, United States, 61602
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Anderson, Indiana, United States, 46011
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Louisville, Kentucky, United States, 40202
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Metairie, Louisiana, United States, 70006
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New Orleans, Louisiana, United States, 70121
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Shreveport, Louisiana, United States, 71101
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Baltimore, Maryland, United States, 21224
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Boston, Massachusetts, United States, 02215
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Framingham, Massachusetts, United States, 01702
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West Roxbury, Massachusetts, United States, 02132
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East Lansing, Michigan, United States, 48824
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Royal Oak, Michigan, United States, 48073
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Troy, Michigan, United States, 48098
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Butte, Montana, United States, 59701
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Missoula, Montana, United States, 59802
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Neptune, New Jersey, United States, 07753
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Teaneck, New Jersey, United States, 07666
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Bronx, New York, United States, 10468
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Bronx, New York, United States, 10467
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Endwell, New York, United States, 13760
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New York, New York, United States, 10029
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Rochester, New York, United States, 14642
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Rochester, New York, United States, 14621
United States, North Carolina
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Cary, North Carolina, United States, 27518
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Charlotte, North Carolina, United States, 28209
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Hickory, North Carolina, United States, 28602
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Wilmington, North Carolina, United States, 28401
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Fargo, North Dakota, United States, 58104
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Fargo, North Dakota, United States, 58122
United States, Ohio
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Columbus, Ohio, United States, 43215
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Dayton, Ohio, United States, 45428
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Kettering, Ohio, United States, 45429
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Toledo, Ohio, United States, 43623
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Philadelphia, Pennsylvania, United States, 19140
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Pittsburgh, Pennsylvania, United States, 15240
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Uniontown, Pennsylvania, United States, 15401
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Wilkes-Barre, Pennsylvania, United States, 18711
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Pawtucket, Rhode Island, United States, 02860
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Providence, Rhode Island, United States, 02906
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Mt. Pleasant, South Carolina, United States, 29464
United States, South Dakota
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Rapid City, South Dakota, United States, 57701
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Sioux Falls, South Dakota, United States, 57104
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Columbia, Tennessee, United States, 38401
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Franklin, Tennessee, United States, 37067
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Nashville, Tennessee, United States, 37082
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Dallas, Texas, United States, 75216
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Houston, Texas, United States, 77030
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San Antonio, Texas, United States, 78229
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Temple, Texas, United States, 76508
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Salt Lake City, Utah, United States, 84124
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Lynchburg, Virginia, United States, 24501
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Williamsburg, Virginia, United States, 23185
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Tacoma, Washington, United States, 98405
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Marshfield, Wisconsin, United States, 54449
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Weston, Wisconsin, United States, 54476
Australia
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Bedford Park, Australia, SA 504
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Cairns, Australia, QLD 4870
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Clayton, Australia, VIC 3168
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Nedlands, Australia, WA 6009
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Richmond, Australia, VIC 3121
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Westmead, Australia, NSW 2145
Brazil
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Salvado, BA, Brazil, 41253-190
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Belo Horizonte, MG, Brazil, 30150-221
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Belo Horizonte, MG, Brazil, 30140-062
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Juiz de Fora, MG, Brazil, 36010-570
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Recife, PE, Brazil, 52020-010
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Curitiba, PR, Brazil, 80810-040
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Nova Iguaçu, RJ, Brazil, 26030-380
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Rio de Janeiro, RJ, Brazil, 22271-100
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Natal, RN, Brazil, 59025-600
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Natal, RN, Brazil, 59072-520
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Porto Alegre, RS, Brazil, 90035-003
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Santo Andre, SP, Brazil, 09060-650
Canada, British Columbia
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New Westminster, British Columbia, Canada, V3L 3W7
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Surrey, British Columbia, Canada, V3V 1N1
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Vancouver, British Columbia, Canada, V5Z 3J5
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Winnipeg, Manitoba, Canada, R3E 0J9
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Toronto, Ontario, Canada, M5G 1X5
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Finland
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Espoo, Finland, FIN-02100
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Helsinki, Finland, FIN-00100
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Helsinki, Finland, FIN-00930
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Järvenpää, Finland, FIN-04400
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Oulu, Finland, FIN-90220
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Tampere, Finland, FIN-33100
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Turku, Finland, FIN-20520
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Vantaa, Finland, FIN-01300
France
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Annecy, France, 74374
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Clermont-Ferrand, France, 63003
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Dijon, France, 21079
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Lille, France, 49100
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Limoges, France, 87042
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Lyon, France, 69004
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Montpellier, France, 34295
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Nancy, France, 54500
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Orleans, France, 45100
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Paris, France, 75018
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Paris, France, 75014
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Saint Etienne, France, 42055
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Tours, France, 37044
Germany
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Munich, Bavaria, Germany, 49100
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Wuerzburg, Bayern, Germany, 49100
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Deggingen, BW, Germany, 49100
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Cologne, NRW, Germany, 49100
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Leipzig, Sachsen, Germany, 49100
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Jena, Thuringia, Germany, 49100
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Hamburg, Germany, 49100
Korea, Republic of
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Ansan-Si, Danwon-Gu, Korea, Republic of
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Seoul, Gangnam-gu, Korea, Republic of
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Daegu, Jung-Gu, Korea, Republic of
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Incheon, Namdong-gu, Korea, Republic of
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Seoul, Seocho-gu, Korea, Republic of
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Seoul, Seonganro, Korea, Republic of
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Seoul, Seongbuk-gu, Korea, Republic of
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Seoul, Seongdong-gu, Korea, Republic of
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Seoul, Songpa-gu, Korea, Republic of
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Suwon, Youngtonggu, Korea, Republic of
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Seoul, Korea, Republic of, Seodaemun-gu
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Wonju, Korea, Republic of
Mexico
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Aguascalientes, AGS, Mexico, 20230
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Tijuana, Baja California, Mexico, 22320
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Mexico City, D.f., Mexico, 14000
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Mexico City, D.f., Mexico, 10480
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Guadalajara, JAL, Mexico, 44280
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Monterrey, Nuevo Leon, Mexico, 64460
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San Luis Potosi, SLP, Mexico, 78240
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Durango, Mexico, 34000
Peru
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Cercado de Lima, Lima 1, Lima, Peru
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Jesus Maria Lima 11, Lima, Peru
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San Martín de Porres, Lima 31, Lima, Peru
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Lima, Peru
Puerto Rico
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Bayamon, Puerto Rico, 00960
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Ponce, Puerto Rico, 00717
Singapore
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Singapore, Singapore, 119074
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Singapore, Singapore, 169608
Sweden
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Stockholm, STH, Sweden, 11157
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Göteborg, SWE, Sweden, S-41685
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Örebro, Sweden, 70352
Taiwan
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Kaohsiung, Taiwan, 813
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New Taipei City, Taiwan, 23561
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Tainan, Taiwan, 710
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Taipei, Taiwan, 10002
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Tiachung, Taiwan, 404
United Kingdom
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Blackpool, United Kingdom, FY3 7EN
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Coventry, United Kingdom, CV2 2DX
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Harrow, United Kingdom, HA1 3UJ
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London, United Kingdom, SW17 0RE
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Manchester, United Kingdom, M8 5RB
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North Shields, United Kingdom, NE61 2YL
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Penzance, United Kingdom, TR19 7HX
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Stoke on Trent, United Kingdom, st53sy
Sponsors and Collaborators
Sanofi Pasteur, a Sanofi Company
Investigators
Study Director: Medical Director Sanofi Pasteur Inc.
  More Information

Additional Information:
No publications provided

Responsible Party: Sanofi ( Sanofi Pasteur, a Sanofi Company )
ClinicalTrials.gov Identifier: NCT01887912     History of Changes
Other Study ID Numbers: H-030-014, 2013-000775-32, U1111-1127-7162
Study First Received: June 20, 2013
Last Updated: April 11, 2014
Health Authority: United States: Food and Drug Administration
France: Agence Nationale de Sécurité du Médicament et des produits de santé
Australia: Department of Health and Ageing Therapeutic Goods Administration
Brazil: National Health Surveillance Agency
Canada: Health Canada
Chile: Instituto de Salud Pública de Chile
Colombia: INVIMA Instituto Nacional de Vigilancia de Medicamentos y Alimentos
Finland: Finnish Medicines Agency
Germany: Paul-Ehrlich-Institut
Mexico: Federal Commission for Protection Against Health Risks
Peru: General Directorate of Pharmaceuticals, Devices, and Drugs
Singapore: Health Sciences Authority
South Korea: Korea Food and Drug Administration (KFDA)
Sweden: Medical Products Agency
Taiwan : Food and Drug Administration
United Kingdom: Medicines and Healthcare Products Regulatory Agency

Keywords provided by Sanofi:
Clostridium difficile Toxoid Vaccine
Clostridium difficile infection

Additional relevant MeSH terms:
Communicable Diseases
Infection

ClinicalTrials.gov processed this record on October 20, 2014