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T-cell And General Immune Response to Seasonal Influenza Vaccine (SLVP018) Year 4, 2012

Primary Purpose

Influenza

Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
TIV
High-Dose TIV
LAIV
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Influenza focused on measuring Inactivated influenza vaccine, Live, attenuated influenza vaccine, Adult and elderly identical twins, Adult fraternal twins

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Otherwise healthy, ambulatory adults, ages 18-30 years (identical or fraternal twin pairs), 40-64 years (identical or fraternal twin pairs) or 65-100 years (identical twin pairs).
  2. Willing to complete the informed consent process.
  3. Availability for follow-up for the planned duration of the study at least 28 days after immunization.
  4. Acceptable medical history and vital signs.

Exclusion Criteria:

  1. Prior off-study vaccination with trivalent inactivated influenza vaccine (TIV) or live attenuated influenza vaccine (LAIV) in Fall 2012
  2. Allergy to egg or egg products, or to vaccine components (including gentamicin, gelatin, arginine or MSG (LAIV for Group B only), and thimerosal (if TIV multidose vials used)
  3. Life-threatening reactions to previous influenza vaccinations
  4. Active systemic or serious concurrent illness, including febrile illness the day of vaccination
  5. History of immunodeficiency (including HIV infection)
  6. Known or suspected impairment of immunologic function, including, but not limited to, clinically significant liver disease, diabetes mellitus treated with insulin, moderate to severe renal disease or any other chronic disorder which, in the opinion of the investigator, might jeopardize volunteer safety or compliance with the protocol.
  7. Blood pressure >150 systolic or > 95 diastolic at Visit 1
  8. Hospitalization in the past year for congestive heart failure or emphysema.
  9. Chronic Hepatitis B or C
  10. Recent or current use of immunosuppressive medication, including glucocorticoids (corticosteroid nasal sprays, topical steroids and inhaled steroids are permissible). Use of oral steroids (<20mg prednisone-equivalent/day) may be acceptable after review by the investigator.
  11. Malignancy, other than squamous cell or basal cell skin cancer (includes solid tumors such as breast cancer or prostate cancer with recurrence in the past year, and any hematologic cancer such as leukemia).
  12. Autoimmune disease (including rheumatoid arthritis treated with immunosuppressive medication such as Plaquenil, methotrexate, prednisone, Enbrel) which, in the opinion of the investigator, might jeopardize volunteer safety or compliance with the protocol.
  13. History of blood dyscrasias, renal disease, or hemoglobinopathies requiring regular medical follow up or hospitalization during the preceding year
  14. Use of any anti-coagulation medication such as Coumadin or Lovenox, or anti-platelet agents such as aspirin (except aspirin up to 325 mg.day), Plavix, or Aggrenox must be reviewed by investigator to determine if this would affect the volunteer's safety.
  15. Receipt of blood or blood products within the past 6 months or planned receipt of blood products prior to completion of study visits.
  16. Medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol
  17. Receipt of inactivated vaccine 14 days prior to study vaccination, or planned non-study vaccination prior to completion of Visit 03 (~Day 28 after the study vaccination)
  18. Receipt of live, attenuated vaccine within 60 days of vaccination, or planned non-study vaccination prior to completion of Visit 03 (~Day 28 after the study vaccination)
  19. Need for allergy immunization (that cannot be postponed) during the study period V01 to V03 (~Day 28)
  20. History of Guillain-Barre Syndrome
  21. Pregnant or lactating woman
  22. Use of investigational agents within 30 days prior to enrollment or planned use of investigational agents prior to completion of study visits.
  23. Donation of the equivalent of a unit of blood within 6 weeks prior to enrollment or planned blood donation prior to completion of Visit 03 ( ~28 Day after study vaccination)
  24. A current member of the clinical study team.
  25. Any condition which, in the opinion of the investigator, might interfere with volunteer safety, study objectives or the ability of the participant to understand or comply with the study protocol.
  26. Asthma or history of wheezing (for Group B volunteers only)
  27. Participants in close contact with anyone who has a severely weakened immune system should not receive LAIV (for Group B volunteers only)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm Type

    Other

    Other

    Other

    Other

    Other

    Arm Label

    Group B: 18-30 yo identical twins (LAIV)

    Group B: 18-30 yo identical twins (TIV)

    Group D: 40-64 yo identical twins (TIV)

    Group F: 65-100 yo identical twins (TIV)

    Group F: 65-100 yo identical twins (High-Dose TIV)

    Arm Description

    Participants to receive FluMist® LAIV by nasal spray.

    Participants to receive Fluzone® standard TIV

    Participants to receive Fluzone® standard TIV

    Participants to receive Fluzone® standard TIV

    Participants to receive High-Dose Fluzone® standard TIV

    Outcomes

    Primary Outcome Measures

    Number of Participants Who Received Influenza Vaccine

    Secondary Outcome Measures

    Number of Participants With Related Adverse Events

    Full Information

    First Posted
    January 12, 2017
    Last Updated
    May 18, 2017
    Sponsor
    Stanford University
    Collaborators
    National Institute of Allergy and Infectious Diseases (NIAID)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03022435
    Brief Title
    T-cell And General Immune Response to Seasonal Influenza Vaccine (SLVP018) Year 4, 2012
    Official Title
    Protective Mechanisms Against a Pandemic Respiratory Virus: B-cell, T-cell, and General Immune Response to Seasonal Influenza Vaccine. Year 4, 2012
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    October 2012 (Actual)
    Primary Completion Date
    January 2013 (Actual)
    Study Completion Date
    January 2013 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Stanford University
    Collaborators
    National Institute of Allergy and Infectious Diseases (NIAID)

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This study will investigate markers, mechanisms and define general predictors for immunological health by comparing influenza vaccine responses in monozygotic and dizygotic twins.
    Detailed Description
    The investigators plan to study the response to different influenza vaccines much more broadly and deeply across different age groups and with different vaccine modalities and to probe the influence of genetics on these responses using monozygotic and dizygotic twins. On an investigational basis, the investigators plan to compare various immunological responses, identify age-specific biomarkers or clusters of markers, quantify the frequency of influenza-specific T-cells pre- and post-vaccination, and determine the effective breadth of T-cell repertoire to an influenza vaccine within an individual as a function of age and to what degree this is genetically determined. Twin group B will will be randomly assigned to receive a single dose of inactivated vaccine, either the trivalent inactivated influenza vaccine (TIV) or intranasal live, attenuated influenza vaccine (LAIV). Twin Groups C-E will receive a single administration of TIV. Group F, elderly participants, will be randomly assigned to receive a single dose of inactivated vaccine, either the standard dose or the high-dose TIV. Blood samples to conduct the assays described will be taken at pre-immunization, Days 7-10 and 28 post-immunization. Groups A, C and E were not enrolled for this year of the five year annual study.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Influenza
    Keywords
    Inactivated influenza vaccine, Live, attenuated influenza vaccine, Adult and elderly identical twins, Adult fraternal twins

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    22 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Group B: 18-30 yo identical twins (LAIV)
    Arm Type
    Other
    Arm Description
    Participants to receive FluMist® LAIV by nasal spray.
    Arm Title
    Group B: 18-30 yo identical twins (TIV)
    Arm Type
    Other
    Arm Description
    Participants to receive Fluzone® standard TIV
    Arm Title
    Group D: 40-64 yo identical twins (TIV)
    Arm Type
    Other
    Arm Description
    Participants to receive Fluzone® standard TIV
    Arm Title
    Group F: 65-100 yo identical twins (TIV)
    Arm Type
    Other
    Arm Description
    Participants to receive Fluzone® standard TIV
    Arm Title
    Group F: 65-100 yo identical twins (High-Dose TIV)
    Arm Type
    Other
    Arm Description
    Participants to receive High-Dose Fluzone® standard TIV
    Intervention Type
    Biological
    Intervention Name(s)
    TIV
    Other Intervention Name(s)
    Fluzone® standard TIV
    Intervention Description
    Influenza Virus Vaccine Suspension for Intramuscular Injection
    Intervention Type
    Biological
    Intervention Name(s)
    High-Dose TIV
    Other Intervention Name(s)
    High-Dose Fluzone® TIV
    Intervention Description
    High-Dose Influenza Virus Vaccine supplied in a prefilled, single-dose syringe
    Intervention Type
    Biological
    Intervention Name(s)
    LAIV
    Other Intervention Name(s)
    FluMist®
    Intervention Description
    Live, attenuated influenza vaccine for Intranasal Spray
    Primary Outcome Measure Information:
    Title
    Number of Participants Who Received Influenza Vaccine
    Time Frame
    Day 0
    Secondary Outcome Measure Information:
    Title
    Number of Participants With Related Adverse Events
    Time Frame
    Day 0 to 28 post-immunization

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    100 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Otherwise healthy, ambulatory adults, ages 18-30 years (identical or fraternal twin pairs), 40-64 years (identical or fraternal twin pairs) or 65-100 years (identical twin pairs). Willing to complete the informed consent process. Availability for follow-up for the planned duration of the study at least 28 days after immunization. Acceptable medical history and vital signs. Exclusion Criteria: Prior off-study vaccination with trivalent inactivated influenza vaccine (TIV) or live attenuated influenza vaccine (LAIV) in Fall 2012 Allergy to egg or egg products, or to vaccine components (including gentamicin, gelatin, arginine or MSG (LAIV for Group B only), and thimerosal (if TIV multidose vials used) Life-threatening reactions to previous influenza vaccinations Active systemic or serious concurrent illness, including febrile illness the day of vaccination History of immunodeficiency (including HIV infection) Known or suspected impairment of immunologic function, including, but not limited to, clinically significant liver disease, diabetes mellitus treated with insulin, moderate to severe renal disease or any other chronic disorder which, in the opinion of the investigator, might jeopardize volunteer safety or compliance with the protocol. Blood pressure >150 systolic or > 95 diastolic at Visit 1 Hospitalization in the past year for congestive heart failure or emphysema. Chronic Hepatitis B or C Recent or current use of immunosuppressive medication, including glucocorticoids (corticosteroid nasal sprays, topical steroids and inhaled steroids are permissible). Use of oral steroids (<20mg prednisone-equivalent/day) may be acceptable after review by the investigator. Malignancy, other than squamous cell or basal cell skin cancer (includes solid tumors such as breast cancer or prostate cancer with recurrence in the past year, and any hematologic cancer such as leukemia). Autoimmune disease (including rheumatoid arthritis treated with immunosuppressive medication such as Plaquenil, methotrexate, prednisone, Enbrel) which, in the opinion of the investigator, might jeopardize volunteer safety or compliance with the protocol. History of blood dyscrasias, renal disease, or hemoglobinopathies requiring regular medical follow up or hospitalization during the preceding year Use of any anti-coagulation medication such as Coumadin or Lovenox, or anti-platelet agents such as aspirin (except aspirin up to 325 mg.day), Plavix, or Aggrenox must be reviewed by investigator to determine if this would affect the volunteer's safety. Receipt of blood or blood products within the past 6 months or planned receipt of blood products prior to completion of study visits. Medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol Receipt of inactivated vaccine 14 days prior to study vaccination, or planned non-study vaccination prior to completion of Visit 03 (~Day 28 after the study vaccination) Receipt of live, attenuated vaccine within 60 days of vaccination, or planned non-study vaccination prior to completion of Visit 03 (~Day 28 after the study vaccination) Need for allergy immunization (that cannot be postponed) during the study period V01 to V03 (~Day 28) History of Guillain-Barre Syndrome Pregnant or lactating woman Use of investigational agents within 30 days prior to enrollment or planned use of investigational agents prior to completion of study visits. Donation of the equivalent of a unit of blood within 6 weeks prior to enrollment or planned blood donation prior to completion of Visit 03 ( ~28 Day after study vaccination) A current member of the clinical study team. Any condition which, in the opinion of the investigator, might interfere with volunteer safety, study objectives or the ability of the participant to understand or comply with the study protocol. Asthma or history of wheezing (for Group B volunteers only) Participants in close contact with anyone who has a severely weakened immune system should not receive LAIV (for Group B volunteers only)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Cornelia Dekker, MD
    Organizational Affiliation
    Stanford University
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Mark Davis, PhD
    Organizational Affiliation
    Stanford University
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Garry Nolan, PhD
    Organizational Affiliation
    Stanford University
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Ann Arvin, MD
    Organizational Affiliation
    Stanford University
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Stephen Quake, PhD
    Organizational Affiliation
    Stanford University
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    25246558
    Citation
    Kay AW, Fukuyama J, Aziz N, Dekker CL, Mackey S, Swan GE, Davis MM, Holmes S, Blish CA. Enhanced natural killer-cell and T-cell responses to influenza A virus during pregnancy. Proc Natl Acad Sci U S A. 2014 Oct 7;111(40):14506-11. doi: 10.1073/pnas.1416569111. Epub 2014 Sep 22.
    Results Reference
    background
    PubMed Identifier
    25203448
    Citation
    O'Gorman WE, Huang H, Wei YL, Davis KL, Leipold MD, Bendall SC, Kidd BA, Dekker CL, Maecker HT, Chien YH, Davis MM. The Split Virus Influenza Vaccine rapidly activates immune cells through Fcgamma receptors. Vaccine. 2014 Oct 14;32(45):5989-97. doi: 10.1016/j.vaccine.2014.07.115. Epub 2014 Sep 6.
    Results Reference
    background
    PubMed Identifier
    25740957
    Citation
    Kay AW, Bayless NL, Fukuyama J, Aziz N, Dekker CL, Mackey S, Swan GE, Davis MM, Blish CA. Pregnancy Does Not Attenuate the Antibody or Plasmablast Response to Inactivated Influenza Vaccine. J Infect Dis. 2015 Sep 15;212(6):861-70. doi: 10.1093/infdis/jiv138. Epub 2015 Mar 4.
    Results Reference
    background

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    T-cell And General Immune Response to Seasonal Influenza Vaccine (SLVP018) Year 4, 2012

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