search
Back to results

Dose-Escalating Trial Using Vero Cell-culture Derived H5N1 +/- Aluminum in Adults

Primary Purpose

Influenza

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Aluminum hydroxide
Inactivated Vero cell based whole virus influenza A/H5N1
Placebo
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Influenza focused on measuring influenza, vaccine, A/H5N1, aluminum hydroxide, Vero cell

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

Stage 1 Cohort

  • Healthy males and females aged 18 to 40 years, inclusive;
  • Females of childbearing potential must agree to practice adequate contraception for the duration of the study (not surgically sterile or Aftermenopausal for at least 1 year);
  • Good health as determined by screening medical history and physical examination;
  • On no medications with the exception of licensed hormonal contraceptives and vitamins;
  • Willingness to comply with study procedures;
  • Ability to provide informed consent;
  • Availability for follow-up for 6 months after second vaccination;
  • Normal screening laboratory values for total WBC, platelet count, hemoglobin, creatinine, and alanine aminotransferase (Stage 1 only).

Stage 2 Cohort

  • Healthy males and non-pregnant females aged 18 to 40 years, inclusive.
  • Females of childbearing potential must agree to practice adequate contraception for the duration of the study.
  • Good health as determined by screening medical history and physical examination.
  • Willingness to comply with study procedures.
  • Ability to provide informed consent.
  • Availability for follow-up for 6 months after second vaccination.

Exclusion Criteria:

Stage 1 Cohort

  • Have a positive urine or serum pregnancy test in the 24 hours prior to vaccination (if female of childbearing potential) or are women who are breastfeeding.
  • Have immunosuppression as a result of an underlying illness or treatment, or use of anticancer chemotherapy or radiation therapy within the preceding 36 months.
  • Have an active neoplastic disease or a history of any hematologic malignancy.
  • Have long-term use of oral steroids, parenteral steroids, or high-dose inhaled steroids (>800 mcg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months. (Nasal and topical steroids are allowed.)
  • Have a diagnosis of schizophrenia, Bi-polar disease or other major psychiatric diagnosis.
  • Have been hospitalized for psychiatric illness, history of suicide attempt or confinement for danger to self or others.
  • Have a history of receiving immunoglobulin or other blood product within the 3 months prior to vaccination in this study.
  • Have received any other licensed vaccines within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to vaccination in this study.
  • Have an acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe or would interfere with the evaluation of responses (This includes, but is not limited to, known chronic liver disease, significant renal disease, unstable or progressive neurological disorders, diabetes mellitus, and transplant recipients.)
  • Have a history of severe reactions following immunization with contemporary influenza virus vaccines.
  • Have an acute illness, including an oral temperature greater than 100.4 degrees F, within 1 week of vaccination.
  • Received an experimental agent (vaccine, drug, biologic, device, blood product, or medication) within 1 month prior to vaccination in this study or expect to receive an experimental agent during the 7-month study period.
  • Have any condition that would, in the opinion of the site investigator, place them at an unacceptable risk of injury or render them unable to meet the requirements of the protocol.
  • Participated in an influenza A/H5 vaccine study in the past in a group receiving vaccine (but does not exclude documented placebo recipients).
  • Have a known active human immunodeficiency virus, hepatitis B, or hepatitis C infection.
  • Have a history of alcohol or drug abuse in the last 5 years.
  • Have a history of Guillain Barre Syndrome.
  • Have any condition that the investigator believes may interfere with successful completion of the study.

Stage 2 Cohort

  • Have a positive urine or serum pregnancy test prior to vaccination (if female of childbearing potential) or are women who are breastfeeding.
  • Have immunosuppression as a result of an underlying illness or treatment, or use of anticancer chemotherapy or radiation therapy within the preceding 36 months.
  • Have an active neoplastic disease or a history of any hematologic malignancy. Have long-term use of oral steroids, parenteral steroids, or high-dose inhaled steroids (>800 mcg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (Nasal and topical steroids are allowed.)
  • Have a diagnosis of schizophrenia, Bi-polar disease or other major psychiatric diagnosis.
  • Have been hospitalized for psychiatric illness, history of suicide attempt or confinement for danger to self or others.
  • Are receiving psychiatric drugs*. Subjects who are receiving a single antidepressant drug and stable for at least 3 months prior to enrollment, without de-compensating symptoms will be allowed to be enrolled in the study.

    • aripiprazole, clozapine, ziprasidone, haloperidol, molindone, loxapine, thioridazine, molindone, thiothixene, pimozide, fluphenazine, fluphenazine, risperidone, mesoridazine, quetiapine, trifluoperazine, chlorprothixene, chlorpromazine, perphenazine, trifluopromazine, olanzapine, carbamazepine, divalproex sodium, lithium carbonate or lithium citrate.
  • Have a history of receiving immunoglobulin or other blood product within the 3 months prior to vaccination in this study.
  • Have received any other licensed vaccines within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to vaccination in this study.
  • Have an acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe or would interfere with the evaluation of responses (This includes, but is not limited to, known chronic liver disease, significant renal disease, unstable or progressive neurological disorders, diabetes mellitus, and transplant recipients.)
  • Have a history of severe reactions following immunization with contemporary influenza virus vaccines.
  • Have an acute illness, including an oral temperature greater than 100.4 degrees F, within 1 week of vaccination.
  • Received an experimental agent (vaccine, drug, biologic, device, blood product, or medication) within 1 month prior to vaccination in this study or expect to receive an experimental agent during the 7-month study period.
  • Have any condition that would, in the opinion of the site investigator, place them at an unacceptable risk of injury or render them unable to meet the requirements of the protocol.
  • Participated in an influenza A/H5 vaccine study in the past in a group receiving vaccine (but does not exclude documented placebo recipients).
  • Have a known active human immunodeficiency virus, hepatitis B, or hepatitis C infection.
  • Have a history of alcohol or drug abuse in the last 5 years.
  • Have a history of Guillain Barre Syndrome.
  • Have any condition that the investigator believes may interfere with successful completion of the study.

Sites / Locations

  • Stanford University
  • UCLA Center For Vaccine Research
  • University of Maryland School of Medicine
  • Vanderbilt University
  • Baylor College of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Placebo Comparator

Experimental

Experimental

Experimental

Arm Label

7.5-

45-

Placebo

15+

7.5+

15-

Arm Description

7.5 mcg of vaccine without adjuvant administered on Days 0 and 28.

45 mcg of vaccine without adjuvant administered on Days 0 and 28.

Placebo administered on Days 0 and 28.

15 mcg of vaccine with aluminum hydroxide adjuvant administered on Days 0 and 28.

7.5 mcg of vaccine with aluminum hydroxide adjuvant administered on Days 0 and 28.

15 mcg of vaccine without adjuvant administered on Days 0 and 28.

Outcomes

Primary Outcome Measures

Adverse event (AE) or serious adverse event (SAE) information (solicited in the clinic and via memory aids, concomitant medications, periodic targeted physical assessment, and laboratory safety evaluations for a subset of subjects.
Proportion of subjects in each dose group achieving a serum neutralizing antibody titer of greater than or equal to 40 against the influenza A/H5N1 virus.
Proportion of subjects in each dose group achieving a serum hemagglutination inhibition (HAI) antibody titer of greater than or equal to 40 against the influenza A/H5N1 virus.
Geometric mean titer (GMT) and frequency of 4-fold or greater increases in neutralizing antibody titers in each group.
Geometric mean titer (GMT) and frequency of 4-fold or greater increases in serum HAI antibody titers in each group.

Secondary Outcome Measures

GMT and frequency of 4-fold or greater increases in neutralizing antibody titers in each group.
GMT and frequency of 4-fold or greater increases in serum HAI antibody titers in each group.

Full Information

First Posted
September 28, 2006
Last Updated
August 26, 2010
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
search

1. Study Identification

Unique Protocol Identification Number
NCT00382980
Brief Title
Dose-Escalating Trial Using Vero Cell-culture Derived H5N1 +/- Aluminum in Adults
Official Title
A Phase I, Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Clinical Trial of the Safety, Reactogenicity, and Immunogenicity of Intramuscular Immunization With Inactivated, Vero Cell-Culture Derived Influenza A/H5N1 Vaccine Given Alone or With Aluminum Hydroxide to Healthy Young Adults
Study Type
Interventional

2. Study Status

Record Verification Date
September 2008
Overall Recruitment Status
Completed
Study Start Date
October 2006 (undefined)
Primary Completion Date
September 2007 (Actual)
Study Completion Date
September 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
The purpose of this research study is to compare how the body reacts to different strengths of an experimental cell culture-grown whole virus A/H5N1 flu vaccine when given with or without the addition of aluminum hydroxide adjuvant. Researchers will also look at how much antibody is made to the influenza virus hemagglutinin (HA) after subjects receive the H5N1 vaccine. Three hundred healthy adults aged 18-40 years will participate for approximately 9 months, which includes screening. Participants will receive 2 doses of vaccine or placebo injected 28 days apart. Participants will have blood samples taken up to 7 times and have 8 scheduled study visits.
Detailed Description
This is a phase I, randomized, double-blind, placebo-controlled, dose-ranging clinical trial of the safety, reactogenicity, and immunogenicity of intramuscular immunization with inactivated, Vero cell-culture derived influenza A/H5N1 vaccine given alone or with aluminum hydroxide to healthy young adults. The primary objectives are to determine the dose-related safety of an inactivated, cell-culture grown whole virus influenza A/H5N1 vaccine with or without aluminum hydroxide adjuvant in healthy adults; to determine the potential for aluminum hydroxide to enhance the immune response to inactivated whole virus H5N1 vaccine in healthy adults approximately 1 month following receipt of 2 doses of vaccine; and to provide information for the selection of the best dosage level for further studies. The secondary objective is to evaluate dose-related immunogenicity and the percent of subjects responding approximately 1 and 7 months after the first vaccination. The primary endpoints are adverse event (AE) or serious adverse event (SAE) information (solicited in the clinic and via memory aids, concomitant medications, periodic targeted physical assessment, and laboratory safety evaluations in a subset of subjects); proportion of subjects in each dose group achieving a serum neutralizing antibody titer of greater than or equal to 40 against the influenza A/H5N1 virus 28 days after receipt of the second dose of vaccine (approximately Day 56); proportion of subjects in each dose group achieving a serum hemagglutination inhibition (HAI) antibody titer of greater than or equal to 40 against the influenza A/H5N1 virus 28 days after receipt of the second dose of vaccine (approximately Day 56); geometric mean titer (GMT) and frequency of 4-fold or greater increases in neutralizing antibody titers in each group 28 days after receipt of the second dose of vaccine; and GMT and frequency of 4-fold or greater increases in serum HAI antibody titers in each group 28 days after receipt of the second dose of vaccine (approximately Day 56). The secondary endpoints are GMT and frequency of 4-fold or greater increases in neutralizing antibody titers in each group 1 month and 7 months after receipt of the first dose of vaccine; and GMT and frequency of 4-fold or greater increases in serum HAI antibody titers in each group 1 month and 7 months after receipt of the first dose of vaccine. Approximately 300 healthy adults, 18-40 years old inclusive, will be enrolled at up to 5 sites in the United States for up to 9 months, including the screening period. Two doses of vaccine or placebo will be injected into the deltoid muscle approximately 28 days apart. The study will be conducted in 2 stages. During Stage 1, 90 subjects will be randomized to receive saline placebo or 7.5 micrograms (with or without aluminum hydroxide), 15 micrograms (with or without aluminum hydroxide), or 45 micrograms (without aluminum hydroxide) (6 groups; N=15 per group). Blood for safety evaluations will be obtained from all subjects in the Stage 1 cohort at screening, and before and 1 week after each vaccination. Subjects in Stage 1 will receive their second vaccinations following review of available clinical and laboratory safety data by the Safety Monitoring Committee (SMC). If no dose-limiting toxicity or safety-related issues are noted during the week after administration of the first dose of vaccine during Stage 1 (based on review of clinical and laboratory safety data by the SMC), then Stage 1 subjects will receive a second vaccination. A complete Stage 1 safety report will be reviewed by the SMC prior to the enrollment of the 210 additional subjects in Stage 2 (N=50 per formulation group total). Sera for immune assessment of antigen-specific immune responses will be collected from all subjects at baseline (Day 0), 1 month after each vaccine dose, and 6 months after the second vaccine dose. This study is linked to DMID protocol 07-0022.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
influenza, vaccine, A/H5N1, aluminum hydroxide, Vero cell

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
308 (Actual)

8. Arms, Groups, and Interventions

Arm Title
7.5-
Arm Type
Experimental
Arm Description
7.5 mcg of vaccine without adjuvant administered on Days 0 and 28.
Arm Title
45-
Arm Type
Experimental
Arm Description
45 mcg of vaccine without adjuvant administered on Days 0 and 28.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo administered on Days 0 and 28.
Arm Title
15+
Arm Type
Experimental
Arm Description
15 mcg of vaccine with aluminum hydroxide adjuvant administered on Days 0 and 28.
Arm Title
7.5+
Arm Type
Experimental
Arm Description
7.5 mcg of vaccine with aluminum hydroxide adjuvant administered on Days 0 and 28.
Arm Title
15-
Arm Type
Experimental
Arm Description
15 mcg of vaccine without adjuvant administered on Days 0 and 28.
Intervention Type
Biological
Intervention Name(s)
Aluminum hydroxide
Intervention Description
Adjuvant administered with A/H5N1 vaccine dosages 7.5 mcg and 15 mcg.
Intervention Type
Biological
Intervention Name(s)
Inactivated Vero cell based whole virus influenza A/H5N1
Intervention Description
Inactivated Vero cell-grown, whole virus, influenza A/H5N1 vaccine at dosages 7.5 mcg and 15 mcg of hemagglutinin (HA) per 0.5 mL, each dosage with and without aluminum hydroxide adjuvant; 45 mcg HA/0.5 mL without adjuvant.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Saline injected into the deltoid muscle. 2 identical dosages will be given approximately 28 days apart.
Primary Outcome Measure Information:
Title
Adverse event (AE) or serious adverse event (SAE) information (solicited in the clinic and via memory aids, concomitant medications, periodic targeted physical assessment, and laboratory safety evaluations for a subset of subjects.
Time Frame
Duration of study.
Title
Proportion of subjects in each dose group achieving a serum neutralizing antibody titer of greater than or equal to 40 against the influenza A/H5N1 virus.
Time Frame
28 days after receipt of the 2nd dose of vaccine, approximately Day 56.
Title
Proportion of subjects in each dose group achieving a serum hemagglutination inhibition (HAI) antibody titer of greater than or equal to 40 against the influenza A/H5N1 virus.
Time Frame
28 days after receipt of the 2nd dose of vaccine, approximately Day 56.
Title
Geometric mean titer (GMT) and frequency of 4-fold or greater increases in neutralizing antibody titers in each group.
Time Frame
28 days after receipt of the 2nd dose of vaccine, approximately Day 56.
Title
Geometric mean titer (GMT) and frequency of 4-fold or greater increases in serum HAI antibody titers in each group.
Time Frame
28 days after receipt of the 2nd dose of vaccine, approximately Day 56.
Secondary Outcome Measure Information:
Title
GMT and frequency of 4-fold or greater increases in neutralizing antibody titers in each group.
Time Frame
1 month and 7 months after receipt of the 1st dose of vaccine.
Title
GMT and frequency of 4-fold or greater increases in serum HAI antibody titers in each group.
Time Frame
1 month and 7 months after receipt of the 1st dose of vaccine.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Stage 1 Cohort Healthy males and females aged 18 to 40 years, inclusive; Females of childbearing potential must agree to practice adequate contraception for the duration of the study (not surgically sterile or Aftermenopausal for at least 1 year); Good health as determined by screening medical history and physical examination; On no medications with the exception of licensed hormonal contraceptives and vitamins; Willingness to comply with study procedures; Ability to provide informed consent; Availability for follow-up for 6 months after second vaccination; Normal screening laboratory values for total WBC, platelet count, hemoglobin, creatinine, and alanine aminotransferase (Stage 1 only). Stage 2 Cohort Healthy males and non-pregnant females aged 18 to 40 years, inclusive. Females of childbearing potential must agree to practice adequate contraception for the duration of the study. Good health as determined by screening medical history and physical examination. Willingness to comply with study procedures. Ability to provide informed consent. Availability for follow-up for 6 months after second vaccination. Exclusion Criteria: Stage 1 Cohort Have a positive urine or serum pregnancy test in the 24 hours prior to vaccination (if female of childbearing potential) or are women who are breastfeeding. Have immunosuppression as a result of an underlying illness or treatment, or use of anticancer chemotherapy or radiation therapy within the preceding 36 months. Have an active neoplastic disease or a history of any hematologic malignancy. Have long-term use of oral steroids, parenteral steroids, or high-dose inhaled steroids (>800 mcg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months. (Nasal and topical steroids are allowed.) Have a diagnosis of schizophrenia, Bi-polar disease or other major psychiatric diagnosis. Have been hospitalized for psychiatric illness, history of suicide attempt or confinement for danger to self or others. Have a history of receiving immunoglobulin or other blood product within the 3 months prior to vaccination in this study. Have received any other licensed vaccines within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to vaccination in this study. Have an acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe or would interfere with the evaluation of responses (This includes, but is not limited to, known chronic liver disease, significant renal disease, unstable or progressive neurological disorders, diabetes mellitus, and transplant recipients.) Have a history of severe reactions following immunization with contemporary influenza virus vaccines. Have an acute illness, including an oral temperature greater than 100.4 degrees F, within 1 week of vaccination. Received an experimental agent (vaccine, drug, biologic, device, blood product, or medication) within 1 month prior to vaccination in this study or expect to receive an experimental agent during the 7-month study period. Have any condition that would, in the opinion of the site investigator, place them at an unacceptable risk of injury or render them unable to meet the requirements of the protocol. Participated in an influenza A/H5 vaccine study in the past in a group receiving vaccine (but does not exclude documented placebo recipients). Have a known active human immunodeficiency virus, hepatitis B, or hepatitis C infection. Have a history of alcohol or drug abuse in the last 5 years. Have a history of Guillain Barre Syndrome. Have any condition that the investigator believes may interfere with successful completion of the study. Stage 2 Cohort Have a positive urine or serum pregnancy test prior to vaccination (if female of childbearing potential) or are women who are breastfeeding. Have immunosuppression as a result of an underlying illness or treatment, or use of anticancer chemotherapy or radiation therapy within the preceding 36 months. Have an active neoplastic disease or a history of any hematologic malignancy. Have long-term use of oral steroids, parenteral steroids, or high-dose inhaled steroids (>800 mcg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (Nasal and topical steroids are allowed.) Have a diagnosis of schizophrenia, Bi-polar disease or other major psychiatric diagnosis. Have been hospitalized for psychiatric illness, history of suicide attempt or confinement for danger to self or others. Are receiving psychiatric drugs*. Subjects who are receiving a single antidepressant drug and stable for at least 3 months prior to enrollment, without de-compensating symptoms will be allowed to be enrolled in the study. aripiprazole, clozapine, ziprasidone, haloperidol, molindone, loxapine, thioridazine, molindone, thiothixene, pimozide, fluphenazine, fluphenazine, risperidone, mesoridazine, quetiapine, trifluoperazine, chlorprothixene, chlorpromazine, perphenazine, trifluopromazine, olanzapine, carbamazepine, divalproex sodium, lithium carbonate or lithium citrate. Have a history of receiving immunoglobulin or other blood product within the 3 months prior to vaccination in this study. Have received any other licensed vaccines within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to vaccination in this study. Have an acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe or would interfere with the evaluation of responses (This includes, but is not limited to, known chronic liver disease, significant renal disease, unstable or progressive neurological disorders, diabetes mellitus, and transplant recipients.) Have a history of severe reactions following immunization with contemporary influenza virus vaccines. Have an acute illness, including an oral temperature greater than 100.4 degrees F, within 1 week of vaccination. Received an experimental agent (vaccine, drug, biologic, device, blood product, or medication) within 1 month prior to vaccination in this study or expect to receive an experimental agent during the 7-month study period. Have any condition that would, in the opinion of the site investigator, place them at an unacceptable risk of injury or render them unable to meet the requirements of the protocol. Participated in an influenza A/H5 vaccine study in the past in a group receiving vaccine (but does not exclude documented placebo recipients). Have a known active human immunodeficiency virus, hepatitis B, or hepatitis C infection. Have a history of alcohol or drug abuse in the last 5 years. Have a history of Guillain Barre Syndrome. Have any condition that the investigator believes may interfere with successful completion of the study.
Facility Information:
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
UCLA Center For Vaccine Research
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
University of Maryland School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Vanderbilt University
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19773098
Citation
Keitel WA, Dekker CL, Mink C, Campbell JD, Edwards KM, Patel SM, Ho DY, Talbot HK, Guo K, Noah DL, Hill H. Safety and immunogenicity of inactivated, Vero cell culture-derived whole virus influenza A/H5N1 vaccine given alone or with aluminum hydroxide adjuvant in healthy adults. Vaccine. 2009 Nov 5;27(47):6642-8. doi: 10.1016/j.vaccine.2009.03.015. Epub 2009 Mar 25.
Results Reference
derived

Learn more about this trial

Dose-Escalating Trial Using Vero Cell-culture Derived H5N1 +/- Aluminum in Adults

We'll reach out to this number within 24 hrs