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Reactogenicity, Safety, and Immunogenicity of a Live Monovalent H5N2 Influenza Vaccine

Primary Purpose

Influenza

Status
Completed
Phase
Phase 1
Locations
Russian Federation
Study Type
Interventional
Intervention
LAIV H5N2
Placebo
Sponsored by
PATH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Influenza focused on measuring influenza, vaccine, pandemic

Eligibility Criteria

18 Years - 49 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Legal male or female adult 18 through 49 years of age at the enrollment visit.
  • Literate and willing to provide written informed consent.
  • Free of obvious health problems, as established by the medical history and screening evaluations, including physical examination.
  • Capable and willing to complete diary cards and willing to return for all follow-up visits
  • Willing to comply with the rules of the isolation unit (including willing and able to take oseltamivir influenza antiviral medication, should that be recommended by a study physician).
  • For females, willing to take reliable birth control measures throughout the entire period of participation in the study.

Exclusion Criteria:

  • Participation in another clinical trial involving any therapy within the previous three months or planned enrollment in such a trial during the period of this study.
  • Receipt of any non-study vaccine within four weeks prior to enrollment or refusal to postpone receipt of such vaccines until four weeks after study completion.
  • Practice of nasal irrigation on a regular basis within the past six months or has engaged in nasal irrigation within two weeks prior to enrollment.
  • Recent history of frequent nose bleeds (>5 within the past year).
  • Clinically relevant abnormal paranasal anatomy.
  • Recent history (within the past month) of rhino or sinus surgery, or surgery for any traumatic injury of the nose.
  • Current or recent (within two weeks of enrollment) acute respiratory illness with or without fever.
  • Other acute illness at the time of study enrollment.
  • Receipt of immune globulin or other blood products within three months prior to study enrollment or planned receipt of such products during the period of subject participation in the study.
  • Chronic administration (defined as more than 14 consecutively-prescribed days) of immunosuppressants or other immune-modulating therapy within six months prior to study enrollment. (For corticosteroids, this means prednisone or equivalent, 0.5 mg per kg per day; topical steroids are allowed, exclusive of nasal.)
  • Participation in any previous trial of any H5 or H7 containing influenza vaccine.
  • History of asthma.
  • Hypersensitivity after previous administration of any influenza vaccine.
  • History of wheezing after past receipt of any live influenza vaccine.
  • Other adverse event (AE) following immunization, at least possibly related to previous receipt of any influenza vaccine.
  • Suspected or known hypersensitivity to any of the study vaccine components, including chicken or egg protein.
  • Seasonal (autumnal) hypersensitivity to the natural environment.
  • Acute or chronic clinically significant pulmonary, cardiovascular, hepatic, metabolic, neurologic, psychiatric or renal functional abnormality, as determined by medical history, physical examination or clinical laboratory screening tests, which in the opinion of the investigator, might interfere with the study objectives. Subjects with physical examination findings or clinical laboratory screening results which would be graded 2 or higher on the AE severity grading scale (see Attachments) will be excluded from entry into the study and will be excluded from receipt of dose two of study vaccine or placebo.
  • History of leukemia or any other blood or solid organ cancer.
  • History of thrombocytopenic purpura or known bleeding disorder.
  • History of seizures.
  • Known or suspected immunosuppressive or immunodeficient condition of any kind, including HIV infection.
  • Known chronic hepatitis B (HBV) or hepatitis C (HCV) infection.
  • Known tuberculosis infection or evidence of previous tuberculosis exposure.
  • History of chronic alcohol abuse and/or illegal drug use.
  • Claustrophobia or sociophobia.
  • Pregnancy or lactation. (A negative pregnancy test will be required before administration of study vaccine or placebo for all women of childbearing potential.)
  • Any condition that, in the opinion of the investigator, would increase the health risk to the subject if he/she participates in the study or would interfere with the evaluation of the study objectives

Sites / Locations

  • Research Institute of Influenza

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

LAIV H5N2

Placebo

Arm Description

Two doses of live monovalent influenza vaccine A/17/turkey/Turkey/05/133 ( live monovalent (LAIV H5N2) given intranasally

two doses of placebo solution intranasal

Outcomes

Primary Outcome Measures

Adverse Events by Severity
Occurrence of participants with adverse events associated with intranasal administration, by worst grade of severity

Secondary Outcome Measures

Number/Percentage of Subjects With Seroconversion for Serum Hemagglutination Inhibition (HAI)
Defined as a four-fold or greater antibody rise in titer from pre-vaccination level. HAI = hemagglutination-inhibition, conducted using World Health Organization (WHO)-recommended protocols.
Number/Percentage of Subjects With Serum Neutralizing Antibodies
Defined as a four-fold or greater antibody rise in titer from pre-vaccination level. Measured by microneutralization assay in Madin-Darby canine kidney cells (MDCK).
Number/Percentage of Subjects With Seroconversion for Serum Immunoglobulin A (IgA)
IgA = immunoglobulin class A antibodies Determined using ELISA using whole purified H5N2
Number/Percentage of Subjects With Seroconversion for Serum Immunoglobulin G (IgG)
Determined using ELISA using whole purified H5N2.
Number/Percentage of Subjects With Seroconversion for Secretory IgA
IgA antibodies from the nasal mucosa detected in nasal wick specimens. Determined using ELISA using whole purified H5N2
Number/Percentage of Subjects With Seroconversion for IgA in Saliva
IgA = Immunoglobulin Class A antibodies. Determined using ELISA using whole purified H5N2.
Number/Percentage of Vaccinated Participants Shedding Influenza Virus After First Dose
Nasal swabs were collected and used for Reverse transcription polymerase chain reaction (rRTPCR) assays to detect shedding of influenza virus for days 1-6 of the study.
Number/Percentage of Vaccinated Participants Shedding Influenza Virus After Second Dose
Nasal swabs were collected and used for Reverse transcription polymerase chain reaction (rRTPCR) assays to detect shedding of influenza virus for days 29-34 of the study (6 days after the second vaccination).
Geometric Mean Titers for Serum HAI Antibodies
Geometric mean titers for serum hemagglutination inhibition antibodies
Geometric Mean Titers (GMT) for Serum Neutralizing Antibodies
Geometric mean titers for serum neutralizing antibodies measured by microneutralization assay

Full Information

First Posted
October 26, 2012
Last Updated
November 26, 2018
Sponsor
PATH
Collaborators
Microgen, Institute of Experimental Medicine, Russia
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1. Study Identification

Unique Protocol Identification Number
NCT01719783
Brief Title
Reactogenicity, Safety, and Immunogenicity of a Live Monovalent H5N2 Influenza Vaccine
Official Title
Reactogenicity, Safety and Immunogenicity of a Live Monovalent A/17/Turkey/Turkey/05/133 (H5N2) Influenza Vaccine
Study Type
Interventional

2. Study Status

Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
September 2012 (undefined)
Primary Completion Date
January 2013 (Actual)
Study Completion Date
January 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PATH
Collaborators
Microgen, Institute of Experimental Medicine, Russia

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To evaluate the safety profile of two intranasal doses of LAIV A/17/turkey/Turkey/05/133 (H5N2) in healthy adults.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
influenza, vaccine, pandemic

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
LAIV H5N2
Arm Type
Experimental
Arm Description
Two doses of live monovalent influenza vaccine A/17/turkey/Turkey/05/133 ( live monovalent (LAIV H5N2) given intranasally
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
two doses of placebo solution intranasal
Intervention Type
Biological
Intervention Name(s)
LAIV H5N2
Other Intervention Name(s)
A/17/turkey/Turkey/05/133(H5N2)live influenza vaccine
Intervention Description
2 doses provided intranasally
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
2 doses of placebo provided intranasally
Primary Outcome Measure Information:
Title
Adverse Events by Severity
Description
Occurrence of participants with adverse events associated with intranasal administration, by worst grade of severity
Time Frame
6 days
Secondary Outcome Measure Information:
Title
Number/Percentage of Subjects With Seroconversion for Serum Hemagglutination Inhibition (HAI)
Description
Defined as a four-fold or greater antibody rise in titer from pre-vaccination level. HAI = hemagglutination-inhibition, conducted using World Health Organization (WHO)-recommended protocols.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects With Serum Neutralizing Antibodies
Description
Defined as a four-fold or greater antibody rise in titer from pre-vaccination level. Measured by microneutralization assay in Madin-Darby canine kidney cells (MDCK).
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects With Seroconversion for Serum Immunoglobulin A (IgA)
Description
IgA = immunoglobulin class A antibodies Determined using ELISA using whole purified H5N2
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects With Seroconversion for Serum Immunoglobulin G (IgG)
Description
Determined using ELISA using whole purified H5N2.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects With Seroconversion for Secretory IgA
Description
IgA antibodies from the nasal mucosa detected in nasal wick specimens. Determined using ELISA using whole purified H5N2
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects With Seroconversion for IgA in Saliva
Description
IgA = Immunoglobulin Class A antibodies. Determined using ELISA using whole purified H5N2.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Vaccinated Participants Shedding Influenza Virus After First Dose
Description
Nasal swabs were collected and used for Reverse transcription polymerase chain reaction (rRTPCR) assays to detect shedding of influenza virus for days 1-6 of the study.
Time Frame
6 days post-vaccination
Title
Number/Percentage of Vaccinated Participants Shedding Influenza Virus After Second Dose
Description
Nasal swabs were collected and used for Reverse transcription polymerase chain reaction (rRTPCR) assays to detect shedding of influenza virus for days 29-34 of the study (6 days after the second vaccination).
Time Frame
6 days post-vaccination
Title
Geometric Mean Titers for Serum HAI Antibodies
Description
Geometric mean titers for serum hemagglutination inhibition antibodies
Time Frame
0 days, 28 days (Dose 1) and 56 days (Dose 2)
Title
Geometric Mean Titers (GMT) for Serum Neutralizing Antibodies
Description
Geometric mean titers for serum neutralizing antibodies measured by microneutralization assay
Time Frame
0 days, 28 days (Dose 1) and 56 days (Dose 2)
Other Pre-specified Outcome Measures:
Title
Number/Percentage of Subjects Exhibiting CD8+ IFNγ+ Responses
Description
Nasal swabs from days 1, 2, 3, 5, and 7 after the first vaccination and on days 1 and 3, corresponding to days 29 and 31,respectively, after the second dose were tested for viral shedding by inoculation in 10- to 11-day-old embryonated chicken eggs (ECE) followed by incubation at 32◦C for 72 h. Influenza virus was detected by standard hemagglutination test with 1% chicken red blood cells. An increase in the number of antigenic-specific T cells greater than 3 standard deviations over the mean placebo values was regarded as a positive T cell response.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects Exhibiting CD4+ IFNγ+ Responses
Description
Nasal swabs from days 1, 2, 3, 5, and 7 after the first vaccination and on days 1 and 3, corresponding to days 29 and 31,respectively, after the second dose were tested for viral shedding by inoculation in 10- to 11-day-old ECE followed by incubation at 32◦C for 72 h. Influenza virus was detected by standard hemagglutination test with 1% chicken red blood cells. An increase in the number of antigenic-specific T cells greater than 3 standard deviations over the mean placebo values was regarded as a positive T cell response.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects Exhibiting CD8+ IFNγ+ Effector Memory T Cell Responses
Description
Nasal swabs from days 1, 2, 3, 5, and 7 after the first vaccination and on days 1 and 3, corresponding to days 29 and 31,respectively, after the second dose were tested for viral shedding by inoculation in 10- to 11-day-old ECE followed by incubation at 32◦C for 72 h. Influenza virus was detected by standard hemagglutination test with 1% chicken red blood cells. An increase in the number of antigenic-specific T cells greater than 3SD over the mean placebo values was regarded as a positive T cell response.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects Exhibiting CD4+ IFNγ+ Central Memory T Cell Responses
Description
Nasal swabs from days 1, 2, 3, 5, and 7 after the first vaccination and on days 1 and 3, corresponding to days 29 and 31,respectively, after the second dose were tested for viral shedding by inoculation in 10- to 11-day-old ECE followed by incubation at 32◦C for 72 h. Influenza virus was detected by standard hemagglutination test with 1% chicken red blood cells. An increase in the number of antigenic-specific T cells greater than 3SD over the mean placebo values was regarded as a positive T cell response.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects Exhibiting CD4+ IFNγ+ Effector Memory T Cell Responses
Description
Nasal swabs from days 1, 2, 3, 5, and 7 after the first vaccination and on days 1 and 3, corresponding to days 29 and 31,respectively, after the second dose were tested for viral shedding by inoculation in 10- to 11-day-old ECE followed by incubation at 32◦C for 72 h. Influenza virus was detected by standard hemagglutination test with 1% chicken red blood cells. An increase in the number of antigenic-specific T cells greater than 3SD over the mean placebo values was regarded as a positive T cell response.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)
Title
Number/Percentage of Subjects Exhibiting CD8+ IFNγ+ Central Memory T Cell Responses
Description
Nasal swabs from days 1, 2, 3, 5, and 7 after the first vaccination and on days 1 and 3, corresponding to days 29 and 31,respectively, after the second dose were tested for viral shedding by inoculation in 10- to 11-day-old ECE followed by incubation at 32◦C for 72 h. Influenza virus was detected by standard hemagglutination test with 1% chicken red blood cells. An increase in the number of antigenic-specific T cells greater than 3SD over the mean placebo values was regarded as a positive T cell response.
Time Frame
28 days (Dose 1) and 56 days (Dose 2)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Legal male or female adult 18 through 49 years of age at the enrollment visit. Literate and willing to provide written informed consent. Free of obvious health problems, as established by the medical history and screening evaluations, including physical examination. Capable and willing to complete diary cards and willing to return for all follow-up visits Willing to comply with the rules of the isolation unit (including willing and able to take oseltamivir influenza antiviral medication, should that be recommended by a study physician). For females, willing to take reliable birth control measures throughout the entire period of participation in the study. Exclusion Criteria: Participation in another clinical trial involving any therapy within the previous three months or planned enrollment in such a trial during the period of this study. Receipt of any non-study vaccine within four weeks prior to enrollment or refusal to postpone receipt of such vaccines until four weeks after study completion. Practice of nasal irrigation on a regular basis within the past six months or has engaged in nasal irrigation within two weeks prior to enrollment. Recent history of frequent nose bleeds (>5 within the past year). Clinically relevant abnormal paranasal anatomy. Recent history (within the past month) of rhino or sinus surgery, or surgery for any traumatic injury of the nose. Current or recent (within two weeks of enrollment) acute respiratory illness with or without fever. Other acute illness at the time of study enrollment. Receipt of immune globulin or other blood products within three months prior to study enrollment or planned receipt of such products during the period of subject participation in the study. Chronic administration (defined as more than 14 consecutively-prescribed days) of immunosuppressants or other immune-modulating therapy within six months prior to study enrollment. (For corticosteroids, this means prednisone or equivalent, 0.5 mg per kg per day; topical steroids are allowed, exclusive of nasal.) Participation in any previous trial of any H5 or H7 containing influenza vaccine. History of asthma. Hypersensitivity after previous administration of any influenza vaccine. History of wheezing after past receipt of any live influenza vaccine. Other adverse event (AE) following immunization, at least possibly related to previous receipt of any influenza vaccine. Suspected or known hypersensitivity to any of the study vaccine components, including chicken or egg protein. Seasonal (autumnal) hypersensitivity to the natural environment. Acute or chronic clinically significant pulmonary, cardiovascular, hepatic, metabolic, neurologic, psychiatric or renal functional abnormality, as determined by medical history, physical examination or clinical laboratory screening tests, which in the opinion of the investigator, might interfere with the study objectives. Subjects with physical examination findings or clinical laboratory screening results which would be graded 2 or higher on the AE severity grading scale (see Attachments) will be excluded from entry into the study and will be excluded from receipt of dose two of study vaccine or placebo. History of leukemia or any other blood or solid organ cancer. History of thrombocytopenic purpura or known bleeding disorder. History of seizures. Known or suspected immunosuppressive or immunodeficient condition of any kind, including HIV infection. Known chronic hepatitis B (HBV) or hepatitis C (HCV) infection. Known tuberculosis infection or evidence of previous tuberculosis exposure. History of chronic alcohol abuse and/or illegal drug use. Claustrophobia or sociophobia. Pregnancy or lactation. (A negative pregnancy test will be required before administration of study vaccine or placebo for all women of childbearing potential.) Any condition that, in the opinion of the investigator, would increase the health risk to the subject if he/she participates in the study or would interfere with the evaluation of the study objectives
Facility Information:
Facility Name
Research Institute of Influenza
City
St. Petersburg
ZIP/Postal Code
197376
Country
Russian Federation

12. IPD Sharing Statement

Citations:
PubMed Identifier
26432909
Citation
Kiseleva I, Dubrovina I, Fedorova E, Larionova N, Isakova-Sivak I, Bazhenova E, Pisareva M, Kuznetsova V, Flores J, Rudenko L. Genetic stability of live attenuated vaccines against potentially pandemic influenza viruses. Vaccine. 2015 Dec 8;33(49):7008-14. doi: 10.1016/j.vaccine.2015.09.050. Epub 2015 Oct 2.
Results Reference
derived
PubMed Identifier
26296497
Citation
Rudenko L, Kiseleva I, Stukova M, Erofeeva M, Naykhin A, Donina S, Larionova N, Pisareva M, Krivitskaya V, Flores J; Russian LAIV Trial Study Group. Clinical testing of pre-pandemic live attenuated A/H5N2 influenza candidate vaccine in adult volunteers: results from a placebo-controlled, randomized double-blind phase I study. Vaccine. 2015 Sep 22;33(39):5110-7. doi: 10.1016/j.vaccine.2015.08.019. Epub 2015 Aug 19.
Results Reference
derived

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Reactogenicity, Safety, and Immunogenicity of a Live Monovalent H5N2 Influenza Vaccine

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