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Innate and Acquired Immunity to Influenza Infection and Immunization (SLVP029)

Primary Purpose

Influenza

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Fluzone®
FluMist®
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, Young children, Adults

Eligibility Criteria

6 Months - 49 Years (Child, Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Otherwise healthy, 6 mo-49 year-old volunteers.
  2. Willing to complete the informed consent process (including assent for minors 7-17 years of age).
  3. Availability for follow-up for the planned duration of the study.
  4. For parents of children 6 months - 4 years of age: Willing to participate in the study annually for up to 5 years (if yes, consider for annual return groups).
  5. Acceptable medical history by review of inclusion/exclusion criteria and vital signs.
  6. Influenza vaccine-naive or only one prior season of flu immunization with IIV (does not apply to Groups F and G).

Exclusion Criteria:

  1. Prior off-study vaccination with the current year's seasonal influenza vaccine
  2. Receipt of LAIV in the prior season (does not apply to Groups F and G)
  3. Received flu immunizations in 2 or more prior flu seasons (does not apply to Groups F and G)
  4. Allergy to egg or egg products, or to vaccine components, (including gentamicin, gelatin, arginine or MSG if given LAIV4)
  5. Life-threatening reactions to previous influenza vaccinations
  6. Asthma in adults. Children aged 2 through 4 years who have asthma or who have had a wheezing episode noted in the medical record within the past 12 months, or for whom parents report that a health care provider stated that they had wheezing or asthma within the last 12 months [If yes, not eligible for LAIV Groups A, B, C, & F].
  7. Active systemic or serious concurrent illness, including febrile illness on the day of vaccination
  8. History of immunodeficiency (including HIV infection)
  9. For children or adolescents through 17 years of age,receiving aspirin therapy or aspirin-containing products [If yes, not eligible for LAIV Groups A, B, C, and F].
  10. 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.
  11. Blood pressure >150 systolic or >95 diastolic at first study visit and the day of vaccination (for children 12 yrs and older, and adults).
  12. Hospitalization in the past year for congestive heart failure or emphysema.
  13. Chronic Hepatitis B or C
  14. Recent or current use of immunosuppressive medication, including systemic glucocorticoids (corticosteroid nasal sprays and topical steroids are permissible in all groups; inhaled steroid use is not permissible)
  15. Participants in close contact with anyone who has a severely weakened immune system and requires a protective environment. Exposure to such persons should be avoided for 7 days after receipt of LAIV. [If yes, may be ineligible for Groups A,B, C and F].
  16. 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).
  17. 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
  18. History of blood dyscrasias, renal disease, or hemoglobinopathies requiring regular medical follow up or hospitalization during the preceding year
  19. Use of any anti-coagulation medication such as Coumadin or Lovenox, or anti-platelet agents such as aspirin (except up to 325 mg. per day), Plavix, or Aggrenox must be reviewed by investigator to determine if this would affect the volunteer's safety.
  20. Has taken an influenza antiviral medication within 48 hours prior to study vaccination [If yes, not eligible for LAIV Groups A, B, C and F].
  21. Receipt of blood or blood products within the past 6 months or planned used during the study
  22. Medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol.
  23. Receipt of inactivated vaccine 14 days prior to study enrollment, or planned vaccinations prior to completion of last study visit
  24. Receipt of live, attenuated vaccine within 60 days prior to enrollment of planned vaccination prior to completion of last study visit
  25. Need for allergy immunization (that cannot be postponed) during the study period
  26. History of Guillain-Barre syndrome
  27. Pregnant woman
  28. Breastfeeding [If yes, not eligible for LAIV Group F]
  29. Use of investigational agents within 30 days prior to enrollment or planned use during the study
  30. Donation of the equivalent of a unit of blood within 6 weeks prior to enrollment or planned donation prior to completion of the last visit
  31. 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.

Sites / Locations

  • Stanford University School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Other

Other

Other

Other

Other

Other

Other

Arm Label

Group A: 2-4 yo LAIV4 (Return)

Group B: 2-4 yo LAIV4 (Single Yr)

Group C: 2-4 yo LAIV4 (Swab/Single Yr)

Group D: 6 - 23 mos old IIV4 (Return)

Group E: 6 - 23 mos old IIV4 (Single Yr)

Group F: 9-13/18-49 yo LAIV4 (Single Yr)

Group G: 9-13/18-49 yo IIV4 (Single Yr)

Arm Description

Participants are given quadrivalent live, attenuated influenza vaccine (LAIV4)/ FluMist® . For children requiring 2 doses of vaccine, a second immunization will be given at Day 28-32 after Dose 1. All participants in this group will be asked to return annually for repeat immunization per ACIP guidelines and blood sample collection.

Participants are given LAIV4/ FluMist® and participate for single year. For children requiring 2 doses of vaccine, a second immunization will be given at Day 28-32 after Dose 1.

Participants are given LAIV4/ FluMist® and participate for single year. NP swabs are collected; no blood samples will be collected for this group. For children requiring 2 doses of vaccine, a second immunization will be given at least 28 days after Dose 1.

Participants are given a quadrivalent inactivated influenza vaccine (IIV4)/ Fluzone® . For children requiring 2 doses of vaccine (vaccine-naïve), a second immunization will be given at Day 28-32 after Dose 1. Participants are asked to return annually for repeat immunization per ACIP guidelines and blood sample collection.

Participants are given IIV4/ Fluzone® and participate for a single year. For children requiring 2 doses of vaccine (vaccine-naïve), a second immunization will be given at Day 28-32 after Dose 1.

Participants 9-13 year old and 18-49 year old are given LAIV4/ FluMist® . Participants will participate for a single year.

Participants 9-13 year old and 18-49 year old are given IIV4/ Fluzone® and participate for single year.

Outcomes

Primary Outcome Measures

Count of Participants From Each Arm Who Received Influenza Vaccine

Secondary Outcome Measures

Count of Participants With Related Adverse Events

Full Information

First Posted
January 19, 2017
Last Updated
November 20, 2018
Sponsor
Stanford University
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03028974
Brief Title
Innate and Acquired Immunity to Influenza Infection and Immunization (SLVP029)
Official Title
Adaptive and Innate Immunity, Memory and Repertoire in Vaccination and Infection
Study Type
Interventional

2. Study Status

Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
September 17, 2014 (Actual)
Primary Completion Date
November 20, 2017 (Actual)
Study Completion Date
November 20, 2017 (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
The purpose of the study is to get a better understanding of the natural and adaptive immune response to the flu virus and to compare the immune cell responses to FDA-licensed flu vaccines in nasal mucosal cells and in blood.
Detailed Description
This is a study of healthy children and adults receive the current seasonal influenza vaccine. The volunteers were enrolled into one of 7 groups over a 5-year period. Immunization is administered; blood samples and NP swabs are collected at various time points based on groups assigned. Group A (LAIV4/annual return): Up to six 2-4 year old volunteers are given a quadrivalent live, attenuated influenza vaccine (LAIV4). All participants in this group are asked to return annually for flu immunization and blood samples on Day 0 and Day 7 post immunization. Vaccine naive children returned 30 days later for a second immunization per standard of care. This group was discontinued in year 3 due to Advisory Committee on Immunization Practices (ACIP) recommendations against the use of LAIV. Group B (LAIV4/ single year): Up to twenty 2-4 year old volunteers were given a quadrivalent live, attenuated influenza vaccine (LAIV4). Volunteers will participate for a single year. All participants in this group were immunized on Day 0. Blood samples were taken on on Day 0 and Day 7 post immunization. Vaccine naive children returned 30 days later for a second immunization per standard of care. This group was discontinued in year 3 due to ACIP recommendations against the use of LAIV. Group C (LAIV4/NP swab group): Up to twenty 2-4 year old volunteers were given a quadrivalent live, attenuated influenza vaccine (LAIV4). Nasopharyngeal samples (NP) swabs were collected Day 1 and 21 and 28 post immunization. No blood was collected for this group. Vaccine naive children returned 30 days later for a second immunization per standard of care. This group was discontinued in year 3 due to ACIP recommendations against the use of LAIV. Group D (IIV4/annual return): Up to six 6 month-23 month old (inclusive) volunteers are given a quadrivalent inactivated influenza vaccine (IIV4). All participants in this group are asked to return annually for flu immunization and blood samples on Day 0 and Day 7 post immunization. Vaccine naive children returned 30 days later for a second immunization per standard of care. Group E (IIV4/single year): Up to twenty 6 month-23 month old (inclusive) volunteers were given a quadrivalent inactivated influenza vaccine (IIV4). Volunteers participate for a single year. All participants in this group were immunized on Day 0. Blood samples were taken on on Day 0 and Day 7 post immunization. Vaccine naive children returned 30 days later for a second immunization per standard of care. Group F (LAIV4/single year) Up to forty 9-13 year old (n= 20) and 18-49 year old (n= 20) volunteers were given live, attenuated influenza vaccine (LAIV). Blood samples were collected Days 0, 7, and 28 and NP swabs were collected Days 1 and 28. This group was discontinued in year 3 due to ACIP recommendations against the use of LAIV. Group G (IIV4/single year) Up to forty, 9-13 year old (n= 20) and 18-49 year old (n= 20) volunteers were given a quadrivalent inactivated influenza vaccine (IIV4). Blood samples were collected Day 0,7, and 28

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, Young children, Adults

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Group A: 2-4 yo LAIV4 (Return)
Arm Type
Other
Arm Description
Participants are given quadrivalent live, attenuated influenza vaccine (LAIV4)/ FluMist® . For children requiring 2 doses of vaccine, a second immunization will be given at Day 28-32 after Dose 1. All participants in this group will be asked to return annually for repeat immunization per ACIP guidelines and blood sample collection.
Arm Title
Group B: 2-4 yo LAIV4 (Single Yr)
Arm Type
Other
Arm Description
Participants are given LAIV4/ FluMist® and participate for single year. For children requiring 2 doses of vaccine, a second immunization will be given at Day 28-32 after Dose 1.
Arm Title
Group C: 2-4 yo LAIV4 (Swab/Single Yr)
Arm Type
Other
Arm Description
Participants are given LAIV4/ FluMist® and participate for single year. NP swabs are collected; no blood samples will be collected for this group. For children requiring 2 doses of vaccine, a second immunization will be given at least 28 days after Dose 1.
Arm Title
Group D: 6 - 23 mos old IIV4 (Return)
Arm Type
Other
Arm Description
Participants are given a quadrivalent inactivated influenza vaccine (IIV4)/ Fluzone® . For children requiring 2 doses of vaccine (vaccine-naïve), a second immunization will be given at Day 28-32 after Dose 1. Participants are asked to return annually for repeat immunization per ACIP guidelines and blood sample collection.
Arm Title
Group E: 6 - 23 mos old IIV4 (Single Yr)
Arm Type
Other
Arm Description
Participants are given IIV4/ Fluzone® and participate for a single year. For children requiring 2 doses of vaccine (vaccine-naïve), a second immunization will be given at Day 28-32 after Dose 1.
Arm Title
Group F: 9-13/18-49 yo LAIV4 (Single Yr)
Arm Type
Other
Arm Description
Participants 9-13 year old and 18-49 year old are given LAIV4/ FluMist® . Participants will participate for a single year.
Arm Title
Group G: 9-13/18-49 yo IIV4 (Single Yr)
Arm Type
Other
Arm Description
Participants 9-13 year old and 18-49 year old are given IIV4/ Fluzone® and participate for single year.
Intervention Type
Biological
Intervention Name(s)
Fluzone®
Intervention Description
Fluzone® Quadrivalent: Quadrivalent influenza virus vaccine
Intervention Type
Biological
Intervention Name(s)
FluMist®
Intervention Description
FluMist® Quadrivalent: Quadrivalent influenza virus vaccine live, intranasal spray
Primary Outcome Measure Information:
Title
Count of Participants From Each Arm Who Received Influenza Vaccine
Time Frame
Day 0 to 28-32 post immunization
Secondary Outcome Measure Information:
Title
Count of Participants With Related Adverse Events
Time Frame
Day 0 to 28-32 post-immunization

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Otherwise healthy, 6 mo-49 year-old volunteers. Willing to complete the informed consent process (including assent for minors 7-17 years of age). Availability for follow-up for the planned duration of the study. For parents of children 6 months - 4 years of age: Willing to participate in the study annually for up to 5 years (if yes, consider for annual return groups). Acceptable medical history by review of inclusion/exclusion criteria and vital signs. Influenza vaccine-naive or only one prior season of flu immunization with IIV (does not apply to Groups F and G). Exclusion Criteria: Prior off-study vaccination with the current year's seasonal influenza vaccine Receipt of LAIV in the prior season (does not apply to Groups F and G) Received flu immunizations in 2 or more prior flu seasons (does not apply to Groups F and G) Allergy to egg or egg products, or to vaccine components, (including gentamicin, gelatin, arginine or MSG if given LAIV4) Life-threatening reactions to previous influenza vaccinations Asthma in adults. Children aged 2 through 4 years who have asthma or who have had a wheezing episode noted in the medical record within the past 12 months, or for whom parents report that a health care provider stated that they had wheezing or asthma within the last 12 months [If yes, not eligible for LAIV Groups A, B, C, & F]. Active systemic or serious concurrent illness, including febrile illness on the day of vaccination History of immunodeficiency (including HIV infection) For children or adolescents through 17 years of age,receiving aspirin therapy or aspirin-containing products [If yes, not eligible for LAIV Groups A, B, C, and F]. 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 first study visit and the day of vaccination (for children 12 yrs and older, and adults). Hospitalization in the past year for congestive heart failure or emphysema. Chronic Hepatitis B or C Recent or current use of immunosuppressive medication, including systemic glucocorticoids (corticosteroid nasal sprays and topical steroids are permissible in all groups; inhaled steroid use is not permissible) Participants in close contact with anyone who has a severely weakened immune system and requires a protective environment. Exposure to such persons should be avoided for 7 days after receipt of LAIV. [If yes, may be ineligible for Groups A,B, C and F]. 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 up to 325 mg. per day), Plavix, or Aggrenox must be reviewed by investigator to determine if this would affect the volunteer's safety. Has taken an influenza antiviral medication within 48 hours prior to study vaccination [If yes, not eligible for LAIV Groups A, B, C and F]. Receipt of blood or blood products within the past 6 months or planned used during the study Medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol. Receipt of inactivated vaccine 14 days prior to study enrollment, or planned vaccinations prior to completion of last study visit Receipt of live, attenuated vaccine within 60 days prior to enrollment of planned vaccination prior to completion of last study visit Need for allergy immunization (that cannot be postponed) during the study period History of Guillain-Barre syndrome Pregnant woman Breastfeeding [If yes, not eligible for LAIV Group F] Use of investigational agents within 30 days prior to enrollment or planned use during the study Donation of the equivalent of a unit of blood within 6 weeks prior to enrollment or planned donation prior to completion of the last visit 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.
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
Harry Greenberg, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Xiaosong He, PhD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Innate and Acquired Immunity to Influenza Infection and Immunization (SLVP029)

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