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Sisonke (Together): OPEN LABEL TRIAL COVID-19 (Sisonke)

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ClinicalTrials.gov Identifier: NCT04838795
Recruitment Status : Recruiting
First Posted : April 9, 2021
Last Update Posted : October 18, 2021
Sponsor:
Collaborators:
National Department of Health of South Africa
National Institute for Communicable Diseases, South Africa
KwaZulu-Natal Research Innovation and Sequencing Platform - KRISP
Fred Hutchinson Cancer Center
Hutchinson Center Research Institute of South Africa (HCRISA)
Janssen Vaccines & Prevention B.V.
Bio Analytical Research Corporation
Dis-Chem Pharmacy
BioVac
Biocair
Right to Care
Clinical Laboratory Services
Information provided by (Responsible Party):
Wits Health Consortium (Pty) Ltd

Brief Summary:
To monitor the effectiveness of the single-dose Ad26.COV2.S COVID-19 vaccine among health care workers (HCW) in South Africa

Condition or disease Intervention/treatment Phase
SARS (Severe Acute Respiratory Syndrome) Biological: To monitor the effectiveness of the single dose Ad26.COV2.S COVID-19 vaccine Phase 3

Detailed Description:

Purpose To monitor the effectiveness of the single dose Ad26.COV2.S COVID-19 vaccine among health care workers (HCW) as compared to the general unvaccinated population in South Africa

Study design Open-label, single-arm phase 3B vaccine implementation study

Rationale South Africa is severely affected by the global COVID-19 epidemic, but currently no vaccine has been rolled out. The recent promising results of the 'ENSEMBLE' trial conducted by Janssen in South Africa, and the availability of a limited amount of vaccine doses, provide the rationale for a cohort study of vaccinated HCWs to inform the larger vaccine rollout.

Study participants Health Care workers age 18 and above working in the South African public and private health care sector (N=500 000) Study sites Department of Health Vaccine administration sites across South Africa supported by the Sisonke (Together) (VAC31518COV3012) trial Research Site Investigators and Study Staff

Study duration Participants will receive a single dose of vaccine at enrolment; to monitor outcomes the DATCOV surveillance system and NICD line list will be reviewed for up to 2 years post-vaccination.

A sub-cohort (approx. 850-1000 people) consisting of special sub-populations will be followed up at approx. 1, 3, 6 weeks and 6 months post vaccination. This group will also have outcomes monitored for up to a further 18 months, bringing their total follow-up duration to 2 years post-vaccination

Study products Ad26.COV2.S by Janssen administered as a single injection

Primary objectives • To assess the effectiveness of Ad26.COV2.S vaccine on severe COVID, hospitalizations and deaths in HCWs as compared with the general unvaccinated population in South Africa.

Secondary objectives • To estimate the incidence of symptomatic SARS CoV-2 infections in HCW

  • To estimate vaccine uptake among HCWs in South Africa
  • To monitor the genetic diversity of breakthrough SARS CoV-2 infections To monitor immunological responses (neutralising, non-neutralising antibodies and T cell responses) in HCWs with breakthrough infections
  • To measure baseline SARS CoV-2 antibody testing to evaluate pre-existing immunity in up to 100 000 HCWs.
  • In a subgroup of participants (approx. 850-1000 people) including representative sub-populations of interest, e.g. elderly, immune compromised:

    • To compare serum neutralization and immune responses before and after vaccination at 0, 6 weeks and up to 6 months.
    • To explore clotting parameters post vaccination at weeks 0, 1, 3.
    • To monitor for asymptomatic infection

Exploratory objectives To set up a comprehensive safety desk and establish a link between the national pharmacovigilance system to assist with monitoring safety and any unexpected adverse effects

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 500000 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: Open-label, single-arm phase 3B vaccine implementation study
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Open-label, Single-arm Phase 3B Implementation Study to Monitor the Effectiveness of the Single-dose Ad26.COV2.S COVID-19 Vaccine Among Health Care Workers in South Africa (VAC31518COV3012)
Actual Study Start Date : February 18, 2021
Estimated Primary Completion Date : March 31, 2022
Estimated Study Completion Date : March 31, 2022



Intervention Details:
  • Biological: To monitor the effectiveness of the single dose Ad26.COV2.S COVID-19 vaccine
    To monitor the effectiveness of the single dose Ad26.COV2.S COVID-19 vaccine among health care workers (HCW) as compared to the general unvaccinated population in South Africa


Primary Outcome Measures :
  1. Number of severe COVID, hospitalizations and deaths in HCWs as compared with the general unvaccinated population in South Africa [ Time Frame: 24 Months ]
    Rates of hospitalizations and deaths among vaccinated HCWs versus general unvaccinated population


Secondary Outcome Measures :
  1. The number of symptomatic SARSCoV-2 infections among vaccinated HCWs [ Time Frame: 24 Months ]

    Incidence rate of SARS CoV-2 infection as indicated by self-report and validation in national laboratory records.

    Rates of severe disease in HCW who are found to be RT-PCR positive at anytime up to 2 years post vaccination


  2. The measure of genetic diversity of breakthrough SARSCoV-2 infections [ Time Frame: 24 months ]
    Genetic diversity of breakthrough infection virus as determined by whole genome sequencing. This will be recovered from national laboratories.

  3. Monitoring for asymptomatic infection in a sub-set (10 000) of HCWs [ Time Frame: 24 Months ]
    Rates of asymptomatic infection at baseline and follow up using SARS CoV-2 virus and antibody testing.

  4. Monitor for safety and any unexpected adverse effects of the vaccine administration -pharmacovigilance [ Time Frame: 24 Months ]
    Conduct Pharmacovigilance to monitor for safety and adverse events Numbers of safety events and/or unexpected adverse effects reported to the study team Monitor pregnancies and pregnancy outcomes reported to safety desk.

  5. The vaccine uptake among HCWs in South Africa [ Time Frame: 12 Months ]
    Proportion of HCWs approached for study participation taking part in the study and receiving the vaccine


Other Outcome Measures:
  1. To monitor for safety and any unexpected adverse effects of the vaccine administration [ Time Frame: 24 Months ]
    To conduct pharmacovigilance to monitor for safety and any unexpected adverse effects of the vaccine administration



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.


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Ages Eligible for Study:   18 Years to 105 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion criteria

  • Age 18 and older
  • Health care worker in the private or public service
  • The President and Deputy President of South Africa* (The President and Deputy President of South Africa have been included in the protocol to address the issue of vaccine hesitancy. )
  • Willingness and ability to comply vaccination plan and other study procedures.
  • Capable of giving electronic or personal signed informed consent as described in Appendix 5, which includes compliance with the requirements in this protocol.

Inclusion criteria for the sub-cohort

  • Age 18 and older
  • Health care worker in the private or public service
  • Willingness and ability to comply with all scheduled visits, vaccination plan, laboratory tests, and other study procedures, with follow-up at an ENSEMBLE site.
  • Capable of giving electronic or personal signed informed consent as described in Appendix 5, which includes compliance with the requirements in this protocol.

Exclusion criteria

  • Any significant acute or chronic medical condition, situation or circumstance that in the opinion of the PI/designee makes the participant unsuitable for participation in the study, or jeopardises the safety or rights of the participant
  • Participant reports being pregnant at time of enrolment, planning conception within 3 months.
  • Participants who report breastfeeding at the time of enrolment will be excluded.
  • Current participation in any other research studies that would interfere with the objectives of this study. The determination of whether participation in another study would be exclusionary for a given participant will be made by the PI/designee.
  • History of severe adverse reaction associated with a vaccine and/or severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine.
  • Participants who have experienced major venous and arterial thrombosis occurring with thrombocytopenia following vaccination with any COVID-19 vaccine should not enrol in Sisonke.
  • Participants with a history of heparin-induced thrombocytopenia.

Note:

• Vaccination within 14-90 days with other COVID19 or non-specific vaccines are not exclusionary but should be discussed with study PI or designee.

Conditions of interest:

We note that international reports of VITT have not identified a risk factor, nor does there appear to be any prothrombotic state that indicates a risk factor for this immune response.

Nevertheless, the Sisonke study will enrol participants with chronic history of severe clotting disorders only after consultation and approval of the study Protocol Safety Review Team (PSRT).

We have identified certain specific conditions of special interest such as:

  • cerebral venous sinus thrombosis,
  • antiphospholipid syndrome
  • Individuals on therapeutic anticoagulants for current or previous arterial or venous thrombosis or embolism

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): NCT04838795


Contacts
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Contact: Ravindre Panchia, MBChB 0119890700 panchiar@phru.co.za
Contact: Fatima Mayat, BPharm 0119899798 mayatf@phru.co.za

Locations
Show Show 31 study locations
Sponsors and Collaborators
Wits Health Consortium (Pty) Ltd
National Department of Health of South Africa
National Institute for Communicable Diseases, South Africa
KwaZulu-Natal Research Innovation and Sequencing Platform - KRISP
Fred Hutchinson Cancer Center
Hutchinson Center Research Institute of South Africa (HCRISA)
Janssen Vaccines & Prevention B.V.
Bio Analytical Research Corporation
Dis-Chem Pharmacy
BioVac
Biocair
Right to Care
Clinical Laboratory Services
Investigators
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Principal Investigator: Glenda E Gray, MBChB Non-Executive Director
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Wits Health Consortium (Pty) Ltd
ClinicalTrials.gov Identifier: NCT04838795    
Other Study ID Numbers: Sisonke (Together): OPEN LABEL
First Posted: April 9, 2021    Key Record Dates
Last Update Posted: October 18, 2021
Last Verified: October 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Additional relevant MeSH terms:
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Severe Acute Respiratory Syndrome
Respiratory Tract Infections
Infections
Coronavirus Infections
Coronaviridae Infections
Nidovirales Infections
RNA Virus Infections
Virus Diseases
Respiratory Tract Diseases