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Effect of Age and Prior Immunity on Response to H1N1 Vaccines in Children (H1N1Children)

Primary Purpose

2009 H1N1 Influenza

Status
Withdrawn
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Live Attenuated H1N1 Influenza Vaccine
Influenza A (H1N1) 2009 Monovalent Vaccine
Influenza A (H1N1) 2009 Monovalent Vaccine/ Influenza A (H1N1) Monovalent Vaccine Live
Sponsored by
University of Rochester
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for 2009 H1N1 Influenza focused on measuring Influenza, H1N1

Eligibility Criteria

4 Years - 9 Years (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Aged between 4 and 9 years, inclusive.
  • Pre-vaccination serum HAI titer to A/California/07/09 of 8 or less
  • No prior history of laboratory documented infection with novel H1N1 virus or immunization with novel H1N1 vaccine.
  • in good health, as determined by: vital signs (heart rate <140 bpm; blood pressure: systolic ≥ 90 mm Hg and ≤140 mm Hg; diastolic ≤ 90 mm Hg; oral temperature <100.0ºF); medical history; and targeted physical examination, when necessary, based on medical history. Stable medical condition is defined as: no recent increase in prescription medication, dose, or frequency of medication in the last 3 months and health outcomes of the specific disease are considered to be within acceptable limits in the last 6 months.
  • subject/parents are able to understand and comply with the planned study procedures, including being available for all study visits.
  • subject/parents have provided informed consent prior to any study procedures. (An assent will be obtained for all children 6 years and older)

Exclusion Criteria:

  • a previous history of vaccination against novel H1N1 virus or a laboratory documented history of previous novel H1N1 infection.
  • History of egg allergy or allergy to other components of vaccine.
  • History of wheezing.
  • immunosuppressed as a result of an underlying illness or treatment with immunosuppressive or cytotoxic drugs, or use of anticancer chemotherapy or radiation therapy.
  • has an active neoplastic disease.
  • has long-term (greater than 2 weeks) use of oral or parenteral steroids, or high-dose inhaled steroids (>800 mg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (nasal and topical steroids are allowed).
  • received immunoglobulin or another blood product within the 3 months prior to enrollment in this study.
  • has received an inactivated vaccine within the 2 weeks or a live vaccine within the 4 weeks prior to enrollment in this study or plans to receive another vaccine within the next 28 days (or 56 days for vaccine naïve recipients).
  • has 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. These conditions include chronic conditions recognized as risk factors for influenza complications or as contraindications for live vaccination, including chronic cardiac (exclusive of hypertension) or pulmonary conditions (including asthma), diabetes mellitus, or renal impairment.
  • has an acute illness or an oral temperature greater than 99.9 degrees F (37.7 degrees C) within 3 days prior to enrollment or vaccination. Subjects who had an acute illness that was treated symptoms resolved are eligible to enroll as long as treatment is completed and symptoms resolve > 3 days prior to enrollment.
  • is currently participating or plans to participate in a study that involves an experimental agent (vaccine, drug, biologic, device, blood product, or medication) or has received an experimental agent within 1 month prior to enrollment in this study, or expects to receive another experimental agent during participation in this study, or intends to donate blood during the study period.
  • has any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol.
  • has a known human immunodeficiency virus, hepatitis B, or hepatitis C infection.
  • has a previous history of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccination.
  • has any condition that the principal investigator (PI) believes may interfere with successful completion of the study.

Sites / Locations

  • University of Rochester Medical Center, Vaccine Research Unit Room 3-5000

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Active Comparator

Arm Label

LAIV/LAIV

IIV/IIV

IIV/LAIV

Arm Description

Outcomes

Primary Outcome Measures

The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C

Secondary Outcome Measures

The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
The frequency and magnitude of serum hemagglutination-inhibition (HAI), ELISA, and neutralizing antibody response to vaccine
The frequency and magnitude of hemagglutinin-specific mucosal IgA response assessed by ELISA on nasal secretions
The frequency and magnitude of antibody secreting cell and memory B cells developing after vaccination
Development of specific local and systemic symptoms occuring after vaccine
The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
The frequency and magnitude of serum hemagglutination-inhibition (HAI), ELISA, and neutralizing antibody response to vaccine
The frequency and magnitude of hemagglutinin-specific mucosal IgA response assessed by ELISA on nasal secretions
The frequency and magnitude of antibody secreting cell and memory B cells developing after vaccination

Full Information

First Posted
March 30, 2010
Last Updated
September 22, 2015
Sponsor
University of Rochester
Collaborators
National Institutes of Health (NIH)
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1. Study Identification

Unique Protocol Identification Number
NCT01097941
Brief Title
Effect of Age and Prior Immunity on Response to H1N1 Vaccines in Children
Acronym
H1N1Children
Official Title
Evaluation of the Effect of Age and Prior Immunity on the Response to Live or Inactivated A/California/07/09 H1N1 Influenza Vaccines in Children
Study Type
Interventional

2. Study Status

Record Verification Date
September 2015
Overall Recruitment Status
Withdrawn
Why Stopped
Live H1N1 vaccine expired and unable to get new supply
Study Start Date
March 2010 (undefined)
Primary Completion Date
September 2010 (Actual)
Study Completion Date
September 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Rochester
Collaborators
National Institutes of Health (NIH)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A total of 51 children between the ages of 4 and 9 will be randomized to receive a two dose schedule of either licensed live attenuated A/California/07/09 influenza vaccine (LAIV) or licensed inactivated A/California/07/09 influenza vaccine (IIV) or IIV followed by LAIV separated by 28 days. Children with prior vaccination or natural infection with novel H1N1 influenza will be excluded. Randomization will be stratified by pre-existing HAI titers to the previous winter's seasonal H1N1 A/Brisbane/57/07 reference virus.
Detailed Description
The study will be conducted as a randomized, prospective, open-label evaluation of the clinical tolerability, vaccine virus shedding, and serum and mucosal antibody response to vaccination with either live monovalent novel H1N1 influenza vaccine (LAIV) or monovalent inactivated novel H1N1 influenza vaccine (IIV) in healthy children between the ages of 4 and 9 years. Children will be screened for antibody to A/Brisbane/57/07 (H1N1) and A/California/07/09 (H1N1) prior to randomization. Children with evidence of prior exposure to the 2009 pandemic H1N1 virus will be excluded. Those with antibodies to A/Brisbane/57/07 (H1N1) will be stratified by preexisting antibody. Vaccine will be administered on days 0 and 28. Safety of vaccination will be assessed using symptoms collected by parents for 7 days after each dose of vaccine. Serum will be obtained prior to and on day 28 following each dose of vaccine and assessed for antibody by HAI, ELISA, B-cell ELISPOT and neutralization techniques. Nasal secretions will be obtained by nasal aspiration prior to and on day 28 after each dose and assessed for HA-specific IgA antibody by ELISA. Nasal swabs will be obtained on days 2, 4, and 7 after each dose of live vaccine and assessed for the presence and magnitude of vaccine virus shedding of the live attenuated vaccine by rtRT-PCR and TCID50 on MDCK cells.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
2009 H1N1 Influenza
Keywords
Influenza, H1N1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
LAIV/LAIV
Arm Type
Active Comparator
Arm Title
IIV/IIV
Arm Type
Active Comparator
Arm Title
IIV/LAIV
Arm Type
Active Comparator
Intervention Type
Biological
Intervention Name(s)
Live Attenuated H1N1 Influenza Vaccine
Other Intervention Name(s)
Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal
Intervention Description
0.2 ml dose of live monovalent vaccine delivered through nasal spray, 2 doses given 28 days apart
Intervention Type
Biological
Intervention Name(s)
Influenza A (H1N1) 2009 Monovalent Vaccine
Other Intervention Name(s)
Influenza vaccine
Intervention Description
0.5 ml IM, 2 doses given 28 days apart
Intervention Type
Biological
Intervention Name(s)
Influenza A (H1N1) 2009 Monovalent Vaccine/ Influenza A (H1N1) Monovalent Vaccine Live
Other Intervention Name(s)
Influenza Vaccine
Intervention Description
0.5 ml IM given X1 with 0.1 ml intranasally given 28 days later
Primary Outcome Measure Information:
Title
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
Time Frame
nasal swabs obtained at days 2 post vaccination
Title
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
Time Frame
nasal swab at 4 days post vaccination
Title
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
Time Frame
nasal swab obtained at 7 days post vaccination
Secondary Outcome Measure Information:
Title
The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
Time Frame
swabs will be obtained on day 2 post vaccination
Title
The frequency and magnitude of serum hemagglutination-inhibition (HAI), ELISA, and neutralizing antibody response to vaccine
Time Frame
at day 28
Title
The frequency and magnitude of hemagglutinin-specific mucosal IgA response assessed by ELISA on nasal secretions
Time Frame
day 28
Title
The frequency and magnitude of antibody secreting cell and memory B cells developing after vaccination
Time Frame
on day 7
Title
Development of specific local and systemic symptoms occuring after vaccine
Time Frame
for 7 days post each vaccination
Title
The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
Time Frame
swab obtained at day 4 post vaccination
Title
The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
Time Frame
swab obtained at day 7 post vaccination
Title
The frequency and magnitude of serum hemagglutination-inhibition (HAI), ELISA, and neutralizing antibody response to vaccine
Time Frame
at day 56
Title
The frequency and magnitude of hemagglutinin-specific mucosal IgA response assessed by ELISA on nasal secretions
Time Frame
at day 56
Title
The frequency and magnitude of antibody secreting cell and memory B cells developing after vaccination
Time Frame
on day 35

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
9 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Aged between 4 and 9 years, inclusive. Pre-vaccination serum HAI titer to A/California/07/09 of 8 or less No prior history of laboratory documented infection with novel H1N1 virus or immunization with novel H1N1 vaccine. in good health, as determined by: vital signs (heart rate <140 bpm; blood pressure: systolic ≥ 90 mm Hg and ≤140 mm Hg; diastolic ≤ 90 mm Hg; oral temperature <100.0ºF); medical history; and targeted physical examination, when necessary, based on medical history. Stable medical condition is defined as: no recent increase in prescription medication, dose, or frequency of medication in the last 3 months and health outcomes of the specific disease are considered to be within acceptable limits in the last 6 months. subject/parents are able to understand and comply with the planned study procedures, including being available for all study visits. subject/parents have provided informed consent prior to any study procedures. (An assent will be obtained for all children 6 years and older) Exclusion Criteria: a previous history of vaccination against novel H1N1 virus or a laboratory documented history of previous novel H1N1 infection. History of egg allergy or allergy to other components of vaccine. History of wheezing. immunosuppressed as a result of an underlying illness or treatment with immunosuppressive or cytotoxic drugs, or use of anticancer chemotherapy or radiation therapy. has an active neoplastic disease. has long-term (greater than 2 weeks) use of oral or parenteral steroids, or high-dose inhaled steroids (>800 mg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (nasal and topical steroids are allowed). received immunoglobulin or another blood product within the 3 months prior to enrollment in this study. has received an inactivated vaccine within the 2 weeks or a live vaccine within the 4 weeks prior to enrollment in this study or plans to receive another vaccine within the next 28 days (or 56 days for vaccine naïve recipients). has 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. These conditions include chronic conditions recognized as risk factors for influenza complications or as contraindications for live vaccination, including chronic cardiac (exclusive of hypertension) or pulmonary conditions (including asthma), diabetes mellitus, or renal impairment. has an acute illness or an oral temperature greater than 99.9 degrees F (37.7 degrees C) within 3 days prior to enrollment or vaccination. Subjects who had an acute illness that was treated symptoms resolved are eligible to enroll as long as treatment is completed and symptoms resolve > 3 days prior to enrollment. is currently participating or plans to participate in a study that involves an experimental agent (vaccine, drug, biologic, device, blood product, or medication) or has received an experimental agent within 1 month prior to enrollment in this study, or expects to receive another experimental agent during participation in this study, or intends to donate blood during the study period. has any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol. has a known human immunodeficiency virus, hepatitis B, or hepatitis C infection. has a previous history of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccination. has any condition that the principal investigator (PI) believes may interfere with successful completion of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John J Treanor, MD
Organizational Affiliation
University of Rochester
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Rochester Medical Center, Vaccine Research Unit Room 3-5000
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States

12. IPD Sharing Statement

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Effect of Age and Prior Immunity on Response to H1N1 Vaccines in Children

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