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Self-Administered Nasal Influenza Feasibility Study (SNIF)

Primary Purpose

Influenza

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
FluMist
Sponsored by
Henry M. Jackson Foundation for the Advancement of Military Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Influenza focused on measuring influenza

Eligibility Criteria

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

Inclusion Criteria:

  • Healthy males or healthy, non-pregnant females
  • 18-49 years of age
  • Department of Defense beneficiary including active duty members
  • Able to speak and understand English, and provide written informed consent

Exclusion Criteria:

  • Known hypersensitivity to eggs, egg-proteins, gentamicin, gelatin, or arginine or life-threatening reactions to previous influenza vaccination
  • Prior receipt of the 2012-2013 seasonal influenza vaccine for 2012-2013 season or prior receipt of the 2013-2014 seasonal influenza vaccine for 2013-2014 season
  • Known clinical diagnosis of reactive airway disease, wheezing, or asthma (excluding exercise-induced asthma)
  • Reported febrile upper respiratory illness (oral or tympanic temperature greater than 100°F or a subjective fever) at the time of or within the 24 hours prior to immunization
  • Known to be pregnant, possibly pregnant or breast-feeding
  • Known diagnosis of human immunodeficiency virus (HIV) infection, chronic active hepatitis B infection, or chronic hepatitis C infection
  • History of Guillain-Barre Syndrome
  • Household member known to be immunocompromised (either a known disease or disorder such as HIV, or other acquired or congenital immunodeficiency disorder, or taking systemic steroids (any dose) or high daily dose inhaled steroids, tumor necrosis factor-alpha inhibitors, or monoclonal antibodies used to treat autoimmune disease)
  • Receipt of medications with activity against influenza A and/or B (ex: Tamiflu®, Relenza®, amantadine, or rimantadine) within 48 hours prior to vaccine administration
  • Use of any oral or intravenous systemic steroids (any dose) or any daily dose inhaled steroids
  • At the time of enrollment, any person who is trained to administer intranasal vaccines or who has been involved in any recurring role associated with the administration of intranasal vaccines to others in the clinic or military treatment facility (MTF)
  • Prior participation in this research study
  • Any acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe, interfere with the evaluation of responses, or render the subject unable to meet the requirements of the protocol. These conditions may include, but are not limited to: history of significant renal impairment (dialysis and treatment for kidney disease, including diabetic and hypertensive kidney disease); poorly controlled diabetes mellitus or patients with diabetes mellitus on insulin (subjects with well-controlled diabetes mellitus on oral agents may enroll as long there has been no dosage increase within the past 6 months); cardiac insufficiency, if heart failure is present; an arteriosclerotic event during the 6 months prior to enrollment (e.g., history of myocardial infarction, stroke, recanalization of femoral arteries, or transient ischemic attack).
  • If the individual received a live virus vaccine (e.g., Varicella, Measles-Mumps-Rubella, Yellow Fever, Smallpox) in the past 4 weeks, they should wait 28 days before receiving LAIV. There is no reason to defer vaccination if the individual was vaccinated with an inactivated vaccine or if they have recently received blood or other antibody-containing blood products.

Sites / Locations

  • Naval Medical Center San Diego
  • San Antonio Military Health System

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Experimental

Arm Label

Healthcare Worker Administration

Self-Administration

Arm Description

FluMist administered by a Healthcare Worker

FluMist self-administered by subject

Outcomes

Primary Outcome Measures

Post-vaccination Geometric Mean Titer (GMT) Ratios Between HCWA and SA Subjects

Secondary Outcome Measures

Difference and Proportion in Seroresponse of Subjects
Difference and Proportion in Seroconversion of Subjects

Full Information

First Posted
August 8, 2013
Last Updated
February 13, 2023
Sponsor
Henry M. Jackson Foundation for the Advancement of Military Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT01933048
Brief Title
Self-Administered Nasal Influenza Feasibility Study
Acronym
SNIF
Official Title
Self-Administered Nasal Influenza Vaccine: Immunogenicity and Feasibility of Group Administration
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
September 2012 (undefined)
Primary Completion Date
October 2013 (Actual)
Study Completion Date
October 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Henry M. Jackson Foundation for the Advancement of Military Medicine

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this prospective, open-label clinical trial is to evaluate the immunogenicity of self-administered (SA) live, attenuated influenza vaccine (LAIV) in comparison with healthcare worker administered (HCWA) LAIV and to evaluate the feasibility of group self-administration of LAIV.
Detailed Description
This Phase IV, open-label, prospective clinical trial assesses SA-LAIV, testing whether the immunogenicity of SA-LAIV is non-inferior to that of HCWA-LAIV, as well as evaluating the feasibility of utilizing group administration for SA-LAIV. Subjects will be enrolled into one of two major treatment arms: HCWA-LAIV (Estimated N = 550) and SA-LAIV (Estimated N = 550). Enrollment into each major treatment arm will be stratified by study site. Enrollment in the HCWA-LAIV and SA-LAIV treatment arms may occur concurrently at each site. Subjects enrolling in the study will be randomized to HCWA or SA, and within the SA arm to either individual self-administration, or group administration. Specifically, following self-administration of LAIV to 190 individual subjects, 180 subjects will be vaccinated in 36 groups of 5 and 180 subjects will be vaccinated in 18 groups of 10. All vaccinations in the SA-LAIV arm will be given under the direction and supervision of a research staff member who is trained to administer LAIV vaccines. Following immunization all subjects will return for one visit at approximately 28 (± 7) days for follow-up.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Other
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
1077 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Healthcare Worker Administration
Arm Type
Other
Arm Description
FluMist administered by a Healthcare Worker
Arm Title
Self-Administration
Arm Type
Experimental
Arm Description
FluMist self-administered by subject
Intervention Type
Drug
Intervention Name(s)
FluMist
Other Intervention Name(s)
influenza virus vaccine LAIV4
Intervention Description
FluMist Intranasal Vaccine
Primary Outcome Measure Information:
Title
Post-vaccination Geometric Mean Titer (GMT) Ratios Between HCWA and SA Subjects
Time Frame
28+/- 7 days post-vaccination
Secondary Outcome Measure Information:
Title
Difference and Proportion in Seroresponse of Subjects
Time Frame
28+/- 7 days post-vaccination
Title
Difference and Proportion in Seroconversion of Subjects
Time Frame
28+/- 7 days post-vaccination
Other Pre-specified Outcome Measures:
Title
Feasibility of Self-administration Prior to Vaccine Administration
Time Frame
28+/- 7 days post-vaccination
Title
Feasibility of Self-administration Following Vaccine Administration
Time Frame
28+/- 7 days post-vaccination

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: Healthy males or healthy, non-pregnant females 18-49 years of age Department of Defense beneficiary including active duty members Able to speak and understand English, and provide written informed consent Exclusion Criteria: Known hypersensitivity to eggs, egg-proteins, gentamicin, gelatin, or arginine or life-threatening reactions to previous influenza vaccination Prior receipt of the 2012-2013 seasonal influenza vaccine for 2012-2013 season or prior receipt of the 2013-2014 seasonal influenza vaccine for 2013-2014 season Known clinical diagnosis of reactive airway disease, wheezing, or asthma (excluding exercise-induced asthma) Reported febrile upper respiratory illness (oral or tympanic temperature greater than 100°F or a subjective fever) at the time of or within the 24 hours prior to immunization Known to be pregnant, possibly pregnant or breast-feeding Known diagnosis of human immunodeficiency virus (HIV) infection, chronic active hepatitis B infection, or chronic hepatitis C infection History of Guillain-Barre Syndrome Household member known to be immunocompromised (either a known disease or disorder such as HIV, or other acquired or congenital immunodeficiency disorder, or taking systemic steroids (any dose) or high daily dose inhaled steroids, tumor necrosis factor-alpha inhibitors, or monoclonal antibodies used to treat autoimmune disease) Receipt of medications with activity against influenza A and/or B (ex: Tamiflu®, Relenza®, amantadine, or rimantadine) within 48 hours prior to vaccine administration Use of any oral or intravenous systemic steroids (any dose) or any daily dose inhaled steroids At the time of enrollment, any person who is trained to administer intranasal vaccines or who has been involved in any recurring role associated with the administration of intranasal vaccines to others in the clinic or military treatment facility (MTF) Prior participation in this research study Any acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe, interfere with the evaluation of responses, or render the subject unable to meet the requirements of the protocol. These conditions may include, but are not limited to: history of significant renal impairment (dialysis and treatment for kidney disease, including diabetic and hypertensive kidney disease); poorly controlled diabetes mellitus or patients with diabetes mellitus on insulin (subjects with well-controlled diabetes mellitus on oral agents may enroll as long there has been no dosage increase within the past 6 months); cardiac insufficiency, if heart failure is present; an arteriosclerotic event during the 6 months prior to enrollment (e.g., history of myocardial infarction, stroke, recanalization of femoral arteries, or transient ischemic attack). If the individual received a live virus vaccine (e.g., Varicella, Measles-Mumps-Rubella, Yellow Fever, Smallpox) in the past 4 weeks, they should wait 28 days before receiving LAIV. There is no reason to defer vaccination if the individual was vaccinated with an inactivated vaccine or if they have recently received blood or other antibody-containing blood products.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Timothy Burgess, MD, MPH
Organizational Affiliation
Uniformed Services University of the Health Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Naval Medical Center San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92134
Country
United States
Facility Name
San Antonio Military Health System
City
Fort Sam Houston
State/Province
Texas
ZIP/Postal Code
78234
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Sharing of individual participant data (IPD) would require revisions and additional regulatory approval, that will not be pursued.
Citations:
PubMed Identifier
26117150
Citation
Burgess TH, Murray CK, Bavaro MF, Landrum ML, O'Bryan TA, Rosas JG, Cammarata SM, Martin NJ, Ewing D, Raviprakash K, Mor D, Zell ER, Wilkins KJ, Millar EV. Self-administration of intranasal influenza vaccine: Immunogenicity and volunteer acceptance. Vaccine. 2015 Jul 31;33(32):3894-9. doi: 10.1016/j.vaccine.2015.06.061. Epub 2015 Jun 25.
Results Reference
derived

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Self-Administered Nasal Influenza Feasibility Study

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