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H7N9 Vaccination With and Without AS03 and Unadjuvanted H3N2v Vaccination: Standard and Systems Biology Analyses

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. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02921997
Recruitment Status : Completed
First Posted : October 3, 2016
Last Update Posted : November 5, 2019
Sponsor:
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)

Brief Summary:
This is a single center, randomized, partially-blinded, Phase II, small, targeted, prospective study in approximately 30 healthy male and non-pregnant female subjects aged 18 to 49 years old, inclusive, designed to evaluate and compare the immunogenicity between an intramuscular monovalent inactivated influenza A/H7N9 virus vaccine given with and without AS03 adjuvant, and an intramuscular unadjuvanted monovalent inactivated influenza A/H3N2v virus vaccine. The primary objectives are (1) assessing the serum anti-HA hemagglutination-inhibition (HAI) response to influenza A/H7N9 antigen (with and without adjuvant) at Day 57 (approximately one month after the second study vaccination with A/H7N9 vaccine with or without AS03) and influenza A/H3N2v antigen at Day 29 (approximately one month after the study vaccination with A/H3N2v), and (2) identifying differentially expressed genes in human immune cells on Days 2, 4, and 29 (following the first study vaccination with A/H7N9 vaccine with or without AS03) and on Days 30, 32, and 36 (following the second study vaccination with A/H7N9 vaccine with or without AS03), compared to baseline assessments performed prior to each study vaccination (Days -7, 1, and 29).

Condition or disease Intervention/treatment Phase
Avian Influenza H1N1 Influenza Influenza Drug: AS03 Biological: Influenza Virus Vaccine, Monovalent A/H3N2v A/Minnesota/11/2010 NYMC X-203 Biological: Monovalent influenza A/H7N9 virus vaccine Phase 2

Detailed Description:
This is a single center, randomized, partially-blinded, Phase II, small, targeted, prospective study in approximately 30 healthy male and non-pregnant female subjects aged 18 to 49 years old, inclusive, designed to evaluate and compare the immunogenicity between an intramuscular monovalent inactivated influenza A/H7N9 virus vaccine manufactured by Sanofi Pasteur given with and without AS03 adjuvant manufactured by GlaxoSmithKline, and an intramuscular unadjuvanted monovalent inactivated influenza A/H3N2v virus vaccine manufactured by Sanofi Pasteur. The primary objectives are (1) assessing the serum anti-HA hemagglutination-inhibition (HAI) response to influenza A/H7N9 antigen (with and without adjuvant) at Day 57 (approximately one month after the second study vaccination with A/H7N9 vaccine with or without AS03) and influenza A/H3N2v antigen at Day 29 (approximately one month after the study vaccination with A/H3N2v), and (2) identifying differentially expressed genes in human immune cells on Days 2, 4, and 29 (following the first study vaccination with A/H7N9 vaccine with or without AS03) and on Days 30, 32, and 36 (following the second study vaccination with A/H7N9 vaccine with or without AS03), compared to baseline assessments performed prior to each study vaccination (Days -7, 1, and 29). The secondary objectives are: (1) compare plasma cytokine and chemokine profiles at specific time points and between treatment arms at post vaccination points, (2) assess the neutralizing antibody responses to influenza A/H7N9 antigen (with and without adjuvant) at Day 57 (approximately one month after the second study vaccination with A/H7N9 vaccine with or without AS03) and influenza A/H3N2v antigen at Day 29 (approximately one month after the study vaccination with A/H3N2v vaccine), and (3) identify differentially expressed genes in human immune cells on Days 2, 4, and 8 following one intramuscular dose of influenza A/H3N2v vaccine compared to baseline assessments performed prior to study vaccination (Day -7 and Day 1).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 30 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Prevention
Official Title: A Phase II Study to Evaluate and Compare the Immunogenicity of Monovalent Inactivated Influenza A/H7N9 Virus Vaccine Administered With and Without AS03 Adjuvant and Monovalent Inactivated Influenza A/H3N2v Virus Vaccine Administered Without Adjuvant in Healthy Adults Through Standard and Systems Biology Analyses
Actual Study Start Date : November 1, 2016
Actual Primary Completion Date : March 28, 2017
Actual Study Completion Date : February 14, 2018

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Arm 1
10 Subjects: one dose of 15 µg of A/H3N2v, at Day 1
Biological: Influenza Virus Vaccine, Monovalent A/H3N2v A/Minnesota/11/2010 NYMC X-203
Inactivated monovalent subvirion H3N2v vaccine containing hemagglutinin (HA) of A/Minnesota/11/2010 NYMC X-203 virus.

Experimental: Arm 2
10 Subjects: two doses of 3.75 µg of AH7N9 AS03,at Day 1 and at Day 29
Drug: AS03
AS03 oil-in-water emulsion adjuvant.

Biological: Monovalent influenza A/H7N9 virus vaccine
Monovalent influenza A/H7N9 virus vaccine.

Experimental: Arm 3
10 Subjects: two doses of 3.75 µg of A/H7N9, at Day 1 and Day 29
Biological: Monovalent influenza A/H7N9 virus vaccine
Monovalent influenza A/H7N9 virus vaccine.




Primary Outcome Measures :
  1. Number of differentially expressed genes based on RNA expression as determined by RNA-Seq analysis, in human immune cells after vaccination with adjuvanted A/H7N9 compared to baseline RNA expression [ Time Frame: Day 1 through Day 36 ]
  2. Number of differentially expressed genes based on RNA expression as determined by RNA-Seq analysis, in human immune cells after vaccination with unadjuvanted A/H7N9 compared to baseline RNA expression [ Time Frame: Day 1 through Day 36 ]
  3. Percentage of subjects achieving HAI seroconversion (either pre-vaccination titer <1:10 and post-vaccination titer > / =1:40 or pre-vaccination titer > / =1:10 and min 4-fold rise in post-vaccination antibody titer) after adjuvanted A/H7N9 vaccination [ Time Frame: Day 1 through day 57 ]
  4. Percentage of subjects achieving HAI seroconversion (either pre-vaccination titer <1:10 and post-vaccination titer > / =1:40 or pre-vaccination titer > / =1:10 and min 4-fold rise in post-vaccination antibody titer) after unadjuvanted A/H7N9 vaccination [ Time Frame: Day 1 through 57 ]
  5. Percentage of subjects achieving seroconversion after A/H3N2v vaccination [ Time Frame: Day 1 through Day 29 ]

Secondary Outcome Measures :
  1. Change in plasma chemokine level from pre-vaccination to post-vaccination time points [ Time Frame: Day 1 through Day 57 ]
  2. Change in plasma cytokine level from pre-vaccination to post-vaccination time points [ Time Frame: Day 1 through Day 57 ]
  3. Changes in Geometric Mean Titers (GMTs) of serum HAI after A/H3N2v vaccination from baseline [ Time Frame: Day 1 through Day 29 ]
  4. Changes in Geometric Mean Titers (GMTs) of serum HAI after adjuvanted A/H7N9 vaccination from baseline [ Time Frame: Day 1 through 57 ]
  5. Changes in Geometric Mean Titers (GMTs) of serum HAI after unadjuvanted A/H7N9 vaccination from baseline [ Time Frame: Day 1 through Day 57 ]
  6. Changes in Geometric Mean Titers (GMTs) of serum Neut after A/H3N2v vaccination from baseline [ Time Frame: Day 1 through Day 29 ]
  7. Changes in Geometric Mean Titers (GMTs) of serum Neut after adjuvanted A/H7N9 vaccination from baseline [ Time Frame: Day 1 through Day 57 ]
  8. Changes in Geometric Mean Titers (GMTs) of serum Neut after unadjuvanted A/H7N9 vaccination from baseline [ Time Frame: Day 1 through Day 57 ]
  9. Changes in the number of differentially expressed genes based on RNA-Seq analysis in human immune cells after A/H3N2v vaccination from baseline [ Time Frame: Day 1 through Day 8 ]
  10. Percentage of subjects achieving Neut seroconversion (either pre-vaccination titer <1:10 and post-vaccination titer > / =1:40 or pre-vaccination titer > / =1:10 and min 4-fold rise in post-vaccination antibody titer) after adjuvanted A/H7N9 vaccination [ Time Frame: Day 1 through Day 57 ]
  11. Percentage of subjects achieving Neut seroconversion (either pre-vaccination titer <1:10 and post-vaccination titer > / =1:40 or pre-vaccination titer > / =1:10 and min 4-fold rise in post-vaccination antibody titer) after unadjuvanted A/H7N9 vaccination [ Time Frame: Day 1 through Day 57 ]
  12. Percentage of subjects achieving seroconversion after A/H3N2v vaccination [ Time Frame: Day 1 through Day 29 ]
  13. Plasma level of chemokines, comparing A/H3N2v vaccine to adjuvanted A/H7N9 vaccine [ Time Frame: Day 1 through Day 57 ]
  14. Plasma level of chemokines, comparing A/H3N2v vaccine to unadjuvanted A/H7N9 vaccine [ Time Frame: Day 1 through Day 57 ]
  15. Plasma level of chemokines, comparing AS03-adjuvanted A/H7N9 responses to unadjuvanted A/H7N9 responses [ Time Frame: Day 1 through Day 57 ]
  16. Plasma level of cytokines, comparing A/H3N2v vaccine to adjuvanted A/H7N9 vaccine [ Time Frame: Day 1 through Day 57 ]
  17. Plasma level of cytokines, comparing A/H3N2v vaccine to unadjuvanted A/H7N9 vaccine [ Time Frame: Day 1 through Day 57 ]
  18. Plasma level of cytokines, comparing AS03-adjuvanted A/H7N9 responses to unadjuvanted A/H7N9 responses [ Time Frame: Day 1 through Day 57 ]


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 49 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. Provide written informed consent prior to initiation of any study procedures.
  2. Are able to understand and comply with planned study procedures and be available for all study visits.
  3. Are males or non-pregnant females, 18 to 49 years old, inclusive.
  4. Are in good health*.

    *As determined by medical history and targeted physical examination, if indicated based on medical history, to evaluate acute or currently ongoing chronic medical diagnoses or conditions, defined as those that have been present for at least 90 days, that would affect the assessment of the safety of subjects or the immunogenicity of study vaccinations. Chronic medical diagnoses or conditions should be stable for the last 60 days. This includes no change in chronic prescription medication, dose, or frequency as a result of deterioration of the chronic medical diagnosis or condition in the 60 days prior to enrollment. Any prescription change that is due to change of health care provider, insurance company, etc., or that is done for financial reasons, as long as in the same class of medication, will not be considered a deviation of this inclusion criterion. Any change in prescription medication due to improvement of a disease outcome, as determined by the site principal investigator or appropriate sub-investigator, will not be considered a deviation of this inclusion criterion. Subjects may be on chronic or as needed (prn) medications if, in the opinion of the site principal investigator or appropriate sub-investigator, they pose no additional risk to subject safety or assessment of reactogenicity and immunogenicity and do not indicate a worsening of medical diagnosis or condition. Similarly, medication changes subsequent to enrollment and study vaccination are acceptable provided there was no deterioration in the subject's chronic medical condition that necessitated a medication change, and there is no additional risk to the subject or interference with the evaluation of responses to study vaccination. Note: Topical, nasal, and inhaled medications (with the exception of inhaled corticosteroids as outlined in the Subject Exclusion Criteria), herbals, vitamins, and supplements are permitted.

  5. Oral temperature is less than 100.4 degrees F.
  6. Pulse is 50 to 115 bpm, inclusive.
  7. Systolic blood pressure is 85 to 150 mm Hg, inclusive.
  8. Diastolic blood pressure is 55 to 95 mm Hg, inclusive.
  9. Erythrocyte sedimentation rate (ESR) is less than 30 mm per hour.
  10. Women of childbearing potential* must use an acceptable contraception method** from 30 days before first study vaccination until 60 days after last study vaccination.

    *Not sterilized via tubal ligation, bilateral oophorectomy, hysterectomy or successful Essure (R) placement (permanent, non-surgical, non-hormonal sterilization) with documented radiological confirmation test at least 90 days after the procedure, and still menstruating or <1 year of the last menses if menopausal.

    **Includes, but is not limited to, non-male sexual relationships abstinence from sexual intercourse with a male partner, monogamous relationship with vasectomized partner who has been vasectomized for 180 days or more prior to the subject receiving the first study vaccination, barrier methods such as condoms or diaphragms with spermicide or foam, effective intrauterine devices, NuvaRing (R), and licensed hormonal methods such as implants, injectables or oral contraceptives ("the pill").

  11. Women of childbearing potential must have a negative urine or serum pregnancy test within 24 hours prior to study vaccination.

Exclusion Criteria:

  1. Have an acute illness*, as determined by the site principal investigator or appropriate sub-investigator, within 72 hours prior to study vaccination.

    *An acute illness which is nearly resolved with only minor residual symptoms remaining is allowable if, in the opinion of the site principal investigator or appropriate sub-investigator, the residual symptoms will not interfere with the ability to assess safety parameters as required by the protocol.

  2. Have any medical disease or condition that, in the opinion of the site principal investigator or appropriate sub-investigator, is a contraindication to study participation*.

    *Including acute or chronic medical disease or condition, defined as persisting for at least 90 days that would place the subject at an unacceptable risk of injury, render the subject unable to meet the requirements of the protocol, or may interfere with the evaluation of responses or the subject's successful completion of this study.

  3. Have immunosuppression as a result of an underlying illness or treatment, or use of anticancer chemotherapy or radiation therapy (cytotoxic) within 3 years prior to study vaccination.
  4. Have known active neoplastic disease (excluding non-melanoma skin cancer) or a history of any hematologic malignancy.
  5. Have known human immunodeficiency virus (HIV), hepatitis B, or hepatitis C infection.
  6. Have known hypersensitivity or allergy to eggs, egg or chicken protein, squalene-based adjuvants, or other components of the study vaccines.
  7. Have a history of severe reactions following previous immunization with licensed or unlicensed influenza virus vaccines.
  8. Have a personal or family history of narcolepsy.
  9. Have a history of Guillain-Barré syndrome.
  10. Have a history of convulsions or encephalomyelitis within 90 days prior to study vaccination.
  11. Have a history of a potentially immune-mediated medical condition.
  12. Have a history of alcohol or drug abuse within 5 years prior to study vaccination.
  13. Have any diagnosis, current or past, of schizophrenia, bipolar disease, or other psychiatric diagnosis that may interfere with subject compliance or safety evaluations.
  14. Have been hospitalized for psychiatric illness, history of suicide attempt, or confinement for danger to self or others within 10 years prior to study vaccination.
  15. Have taken oral or parenteral (including intra-articular) corticosteroids of any dose within 30 days prior to study vaccination.
  16. Have taken high-dose inhaled corticosteroids within 30 days prior to study vaccination. High-dose defined as >840 mcg/day of beclomethasone dipropionate CFC or equivalent.
  17. Received licensed live vaccine within 30 days prior to the first study vaccination, or plans to receive licensed live vaccine within 30 days before or after each study vaccination.
  18. Received licensed inactivated vaccine within 14 days prior to the first study vaccination, or plans to receive licensed inactivated vaccine within 14 days before or after each study vaccination.
  19. Received immunoglobulin or other blood products (with exception of Rho D immunoglobulin) within 90 days prior to study vaccination.
  20. Received an experimental agent* within 30 days prior to the first study vaccination, or expects to receive an experimental agent** during the 13-month study-reporting period.

    *Including vaccine, drug, biologic, device, blood product, or medication.

    **Other than from participation in this study.

  21. Are participating or plan to participate in another clinical trial with an interventional agent* that will be received during the 13-month study-reporting period.

    *Including licensed or unlicensed vaccine, drug, biologic, device, blood product, or medication.

  22. Prior participation in a clinical trial of influenza A/H7 vaccine* or have a history of influenza A/H7 virus actual or potential exposure or infection prior to the first study vaccination.

    *And assigned to a group receiving influenza A/H7 vaccine, does not apply to documented placebo recipients.

  23. Prior participation in a clinical trial of influenza A/H3N2v vaccine* or have a history of influenza A/H3N2v virus actual or potential exposure or infection prior to the first study vaccination.

    *And assigned to a group receiving influenza A/H3N2v vaccine, does not apply to documented placebo recipients.

  24. Occupational exposure to or substantial direct physical contact* with birds in the past year or during the 28 days after each study vaccination.

    *Casual contact with birds at petting zoos or county or state fairs or having pet birds does not exclude subjects from study participation.

  25. Occupational exposure to or substantial direct physical contact* with pigs in the past year or during the 28 days after each study vaccination.

    *Casual contact with pigs at petting zoos or county or state fairs does not exclude subjects from study participation.

  26. Female subjects who are breastfeeding or plan to breastfeed at any given time from the first study vaccination until 30 days after the last study vaccination.
  27. Plan to travel outside the US (continental US, Hawaii, and Alaska) within 28 days after each study vaccination.
  28. Blood donation or planned blood donation within 30 days before enrollment until 30 days after the last blood draw for this study.

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): NCT02921997


Locations
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United States, Tennessee
Vanderbilt University Medical Center - Vanderbilt Institute for Clinical and Translational Research - Clinical Research Center (VICTR-CRC)
Nashville, Tennessee, United States, 37232-0011
Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
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Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT02921997    
Other Study ID Numbers: 14-0015
HHSN272201300023I
First Posted: October 3, 2016    Key Record Dates
Last Update Posted: November 5, 2019
Last Verified: October 2019

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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.: No
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
A/H5N1
A/H7N9
ASO3 Adjuvant
influenza
monovalent
pH1N1
vaccines
Additional relevant MeSH terms:
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Influenza, Human
Influenza in Birds
Orthomyxoviridae Infections
RNA Virus Infections
Virus Diseases
Respiratory Tract Infections
Respiratory Tract Diseases
Vaccines
Immunologic Factors
Physiological Effects of Drugs