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FLUAD vs. Fluzone High-Dose Study

This study is currently recruiting participants.
Verified May 2017 by Duke University
Sponsor:
ClinicalTrials.gov Identifier:
NCT03183908
First Posted: June 12, 2017
Last Update Posted: September 26, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Collaborators:
Centers for Disease Control and Prevention
Boston Medical Center
Information provided by (Responsible Party):
Duke University
  Purpose
The overall aim of the study is to compare safety and immunogenicity of adjuvanted inactivated influenza vaccine (IIV) (FLUAD) versus High-Dose inactivated influenza (Fluzone High Dose) vaccine in ≥65 years (20% aged ≥80 years). A prospective, randomized, blinded clinical trial that will be conducted during the 2017/2018 and 2018/2019 influenza seasons. During each season, approximately 220 older adults will be enrolled at Duke University Medical Center and 140 older adults at Boston University Medical Center. Eligible subjects will be randomized to receive either adjuvanted influenza vaccine or High-Dose influenza vaccine. All subjects will receive vaccine and provide a blood draw at Visit 1, and then return for a second blood draw without vaccination about 4 weeks later to assess for influenza antibody titers. A subset of 100 subjects at Duke will provide a third blood draw 6 months post-vaccination to assess for waning of influenza antibody titers. Subjects will record the occurrence of local and systemic reactions (including fever, pain, tenderness, swelling, redness, general systemic systems), unsolicited adverse events, medical care utilization, and changes in medications over 8 days following vaccination. In addition, serious adverse events and events of clinical interest will be assessed through 42 days post-vaccination. Quality of life will be assessed 8 days post-vaccination and vaccine perceptions surveys will be administered 8 days and 4 weeks post-vaccination.

Condition Intervention Phase
Pain Quality of Life Injection Site Reaction Side Effect of Drug Adverse Drug Event Biological: FLUAD Biological: Fluzone High-Dose Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Masking Description:
Subject, study coordinators, and investigators will be blinded to the type of flu vaccine administered. Only the vaccinator will be unblinded.
Primary Purpose: Prevention
Official Title: Safety and Immunogenicity of Adjuvanted Versus High-Dose Inactivated Influenza Vaccines in Older Adults

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Injection-Site Pain as Measured by visual analog scale [ Time Frame: 8 days post-vaccination ]
    Comparison of the proportion of subjects reporting moderate/severe injection site pain within the first week post-vaccination in both treatment groups.

  • Adverse Events of Clinical Interest [ Time Frame: 42 days post-vaccination OR 181 days post-vaccination (sub-group followed for 181 days) ]
    The frequency and descriptions of adverse events of clinical interest observed in the two treatment groups.

  • Serious Adverse Events [ Time Frame: 42 days post-vaccination OR 181 days post-vaccination (sub-group followed for 181 days) ]
    The frequency and descriptions of serious adverse events observed in the two treatment groups.

  • H3N2 HAI Seroconversion [ Time Frame: 29 days post-vaccination ]
    H3N2 hemagglutination inhibition assay (HAI) seroconversion: The proportion of subjects achieving H3N2 seroconversion at day 29 (an HAI titer > 1:40 at day 29 if the baseline titer is < 1:10 or a four-fold rise in HAI titer if the baseline titer is > 1:10) in the respective season's vaccine


Secondary Outcome Measures:
  • Local Reactions [ Time Frame: 8 days post-vaccination ]
    Comparison of local reactions within the first week post-vaccination in both treatment groups.

  • Systemic Reactions [ Time Frame: 8 days post-vaccination ]
    Comparison of systemic reactions within the first week post-vaccination in both treatment groups.

  • Quality of Life - Late Life Function & Disability Instrument [ Time Frame: 8 days post-vaccination ]
    Change in scores on the Late Life Function & Disability Instrument pre-vaccination and post-vaccination will be compared between the vaccination groups and age groups.

  • Quality of Life - EQ-5D-5L [ Time Frame: 8 days post-vaccination ]
    Change in scores on the EuroQOL 5 dimensions-5 level (EQ-5D-5L) pre-vaccination and post-vaccination will be compared between the vaccination groups and age groups.

  • Quality of Life - EQ VAS [ Time Frame: 8 days post-vaccination ]
    Change in scores on the EuroQOL visual analogue scale (EQ VAS) pre-vaccination and post-vaccination will be compared between the vaccination groups and age groups.

  • Seroconversion [ Time Frame: Day 29 (28 days post-vaccination) ]
    The proportion of subjects achieving seroconversion at day 29 (an HAI titer > 1:40 at day 29 if the baseline titer is < 1:10 or a four-fold rise in HAI titer if the baseline titer

  • Seroprotection [ Time Frame: Day 29 (28 days post-vaccination) ]
    Proportion of subjects with a seroprotective HAI titer (≥ 1:40) pre- and post-immunization at day 29 for each IIV antigen in the respective season's vaccine

  • Geometric Mean HAI Titer [ Time Frame: Day 29 (28 days post-vaccination) ]
    The geometric mean HAI titer (GMT) for each IIV antigen in the respective season's vaccine


Estimated Enrollment: 900
Actual Study Start Date: August 28, 2017
Estimated Study Completion Date: September 2019
Estimated Primary Completion Date: September 2019 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Adjuvanted influenza vaccine (FLUAD)
In the study arm, subjects will receive a single dose of FLUAD adjuvanted influenza vaccine during Visit 1.
Biological: FLUAD
Advisory Committee on Immunization Practices (ACIP) Recommended Vaccine
Other Name: Adjuvanted influenza vaccine
Active Comparator: High-dose influenza vaccine (Fluzone HD)
In the study arm, subjects will receive a single dose of Fluzone High-Dose influenza vaccine during Visit 1.
Biological: Fluzone High-Dose
Advisory Committee on Immunization Practices (ACIP) Recommended Vaccine
Other Name: influenza vaccine

  Eligibility

Information from the National Library of Medicine

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, Learn About Clinical Studies.


Ages Eligible for Study:   65 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. Persons aged ≥65 years, living in the community
  2. Intention of receiving IIV vaccine based on ACIP-CDC guidelines
  3. Willing to provide written informed consent prior to initiation of any study procedures
  4. Able to speak English at the Duke site and English or Spanish at the Boston site
  5. Able and willing to complete baseline assessments and questionnaires, and to allow information to be collected from their electronic medical record
  6. Able and willing to complete post-vaccine assessments and questionnaires independently or with assistance
  7. Able and willing to have blood drawn for the study
  8. Able and willing to return in about one month for a follow-up visit including completing questionnaires and having another blood test
  9. Access to and ability to use a phone, independently or with assistance
  10. Adequate vision and motor skills to complete the diary form independently or with assistance.
  11. Not living in a skilled nursing facility/nursing home/long term acute care facility

Exclusion Criteria:

  1. IIV receipt during the current influenza season prior to study enrollment
  2. Has immunosuppression as a result of an underlying illness or treatment, or use of anti-cancer chemotherapy or radiation therapy within the preceding 12 months.
  3. Has an active neoplastic disease (excluding non-melanoma skin cancer or prostate cancer that is stable in the absence of therapy) or a history of any hematologic malignancy*

    *Participants with a history of malignancy may be included if, after previous treatment by surgical excision, chemotherapy or radiation therapy, the participant has been observed for a period that in the investigator's estimation provides a reasonable assurance of sustained cure (not less than 12 months)

  4. Thrombocytopenia, bleeding disorder, or anticoagulant use contraindicating intramuscular injection (a daily aspirin may be acceptable).
  5. History of febrile illness (> 100.0°F or 37.8°C) within the past 24 hours prior to IIV administration (temporary deferral)
  6. Contraindication to IIV receipt including history of severe allergic reaction after a previous dose of any influenza vaccine; or to a vaccine component, including egg protein
  7. Any history of Guillain-Barré syndrome
  8. Mild to severe dementia as determined by the Mini-Cog tool and the Rowland Universal Dementia Assessment Scale (RUDAS)
  9. Substance use that could interfere with study compliance
  10. Receipt of any inactivated licensed vaccine within 2 weeks, or live attenuated licensed vaccine within 4 weeks prior to enrollment in this study, or planning receipt of any vaccines during the 28-day post-vaccination period (including pneumococcal vaccines)
  11. Anyone who is already enrolled or plans to enroll in another clinical trial with an investigational product within 28 days of vaccine receipt. Co-enrollment in observational or behavioral intervention studies are allowed at any time while enrollment in a clinical trial involving an investigational product (other than vaccine) may occur after 30 days following vaccine receipt.
  12. Hearing loss determined by the investigators to prevent successful communication over the phone
  13. Any condition which, in the opinion of the investigators, may pose a health risk to the subject or interfere with the evaluation of the study objectives.
  14. Anyone who is a relative or subordinate of any research study personnel.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03183908


Contacts
Contact: Kenneth Schmader, MD 919-660-7500 kenneth.schmader@duke.edu
Contact: Christopher A Todd, MPH 919-681-7791 chris.todd@duke.edu

Locations
United States, Georgia
Centers for Disease Control and Prevention Active, not recruiting
Atlanta, Georgia, United States, 30333
United States, Massachusetts
Boston Medical Center Recruiting
Boston, Massachusetts, United States, 02118
Contact: Elizabeth Barnett, MD         
Principal Investigator: Elizabeth Barnett, MD         
Sub-Investigator: Christine Liu, MD         
Sub-Investigator: Heidi Auerbach, MD         
United States, North Carolina
Duke University Recruiting
Durham, North Carolina, United States, 27705
Contact: Kenneth Schmader, MD    919-660-7500    kenneth.schmader@duke.edu   
Contact: Christopher A Todd, MPH    919-681-7791    chris.todd@duke.edu   
Principal Investigator: Kenneth Schmader, MD         
Sub-Investigator: Emmanuel B Walter, MD, MPH         
Sponsors and Collaborators
Duke University
Centers for Disease Control and Prevention
Boston Medical Center
Investigators
Principal Investigator: Kenneth Schmader, MD Duke University
Principal Investigator: Theresa Harrington, MD Centers for Disease Control and Prevention
Principal Investigator: Elizabeth Barnett, MD Boston University
  More Information

Responsible Party: Duke University
ClinicalTrials.gov Identifier: NCT03183908     History of Changes
Other Study ID Numbers: Pro00083845
First Submitted: June 7, 2017
First Posted: June 12, 2017
Last Update Posted: September 26, 2017
Last Verified: May 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: Yes

Keywords provided by Duke University:
influenza vaccine
fever following vaccination
pain following vaccination
quality of life

Additional relevant MeSH terms:
Drug-Related Side Effects and Adverse Reactions
Chemically-Induced Disorders
Vaccines
Immunologic Factors
Physiological Effects of Drugs