Safety, Tolerability, Immunogenicity and Protective Efficacy of PfSPZ Vaccine and PfSPZ-CVac in Indonesian Adults Against Naturally-Transmitted Malaria
Malaria
About this trial
This is an interventional prevention trial for Malaria focused on measuring Plasmodium falciparum, Sporozoites, PfSPZ
Eligibility Criteria
Inclusion Criteria:
- A male aged 18-55 years at the time of screening.
- Assigned to the battalion of study and programmed to accompany it to eastern Indonesia for the duration of the deployment.
- Freely provides written informed consent to participate in the study.
- Agrees to adhere to Indonesian military medical guidance regarding screening and treatment of malaria.
- Physical examination and laboratory results without clinically significant findings and a body mass index (BMI) ≤35 kg/m^2.
Exclusion Criteria:
- Previous vaccination with an investigational malaria vaccine.
- Use of an investigational or non-registered drug or vaccine other than the study vaccine(s) within 30 days before the first study vaccination, or planned use up to 30 days after last vaccination.
- Chronic administration (defined as more than 14 days) of immunosuppressant or other immune-modifying drugs within six months before the first vaccination. This includes any dose level of oral steroids, but not inhaled steroids or topical steroids.
- Administration or planned administration of 1 live or 3 or more other type vaccines in the period beginning 28 days before the first study vaccination and ending 28 days after the last vaccination.
- Confirmed or suspected immunosuppressive or immunodeficient condition.
- Confirmed or suspected autoimmune disease.
- History of allergic reactions or anaphylaxis to CQ or other 4-aminoquinolone derivatives.
- History of serious allergic reactions to a drug (anaphylaxis, or requiring hospitalization).
- History of allergy to phosphate buffered saline or human serum albumin.
- Use or planned use of any drug with anti-malarial activity during the course of the study except for antimalarial medication administered by study clinicians.
- History of splenectomy.
- Laboratory evidence of liver disease (the final decision will be made by the PI and clinical officers, but in general a volunteer will be excluded if any of the screening liver function tests (ALT, bilirubin, gamma GTP) are > double the upper limit of normal measured twice without an explanation for the abnormal values).
- Laboratory evidence of renal disease (serum creatinine > 1.5 mg/dL. measured twice).
- Laboratory evidence of hematologic disease (platelet count or hemoglobin <80% of the lower limit of normal for Indonesia measured twice).
- Abnormal screening ECG showing prolonged QTc interval (>450 msec) or any signs of arrythmia/irregularity, ischemia, cardiac enlargement considered considered indicative of acute or chronic cardiovascular disease.
- Acute or chronic pulmonary, cardiovascular, hepatic, renal or neurological condition, severe malnutrition, or any other clinical findings that may increase the risk of participating in the study as determined by the principal investigator or her designee.
- Administration of immunoglobulin and/or any blood products within the three months preceding the first study vaccination or planned administration during the study period.
- Simultaneous participation in any other interventional clinical trial.
- Other conditions that in the opinion of the principal investigator or her designee would jeopardize the safety or rights of a participant in the trial or would render the participant unable to comply with the protocol or might compromise the integrity of the data.
- Any evidence of active malaria, whether symptomatic or asymptomatic, confirmed by RDT, microscopy or PCR before first injection of PfSPZ Vaccine or PfSPZ-CVac, unless treated by the clinical team.
- History of non-febrile seizures or atypical febrile seizures.
- Under treatment for tuberculosis.
- Laboratory evidence of active infection with hepatitis B, hepatitis C or HIV.
- Subjects with > 5% 5-year cardiovascular risk (fatal and non-fatal) based on the Gaziano scoring system; subjects in the 18-34 year old age group will be assessed as though they are in the 35-44 age group.
- History of psychiatric disorders (such as personality disorders, anxiety disorders, or schizophrenia) or behavioral tendencies (including active alcohol or drug abuse) discovered during the screening process that in the opinion of the investigator would make compliance with the protocol difficult.
Sites / Locations
- Department of Internal Medicine, Universitas IndonesiaRecruiting
- Eijkman-Oxford Clinical Research Unit, Eijkman Institute of Molecular BiologyRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Placebo Comparator
Experimental
Placebo Comparator
Group 1
Group 2
Group 3
Group 4
N=124 will receive PfSPZ Vaccine; three doses of 9x10^5 PfSPZ of PfSPZ Vaccine administered by direct venous inoculation (DVI) given on day 1, 8 and 29.
N=62 will receive normal saline; three doses of NS administered by DVI given on day 1, 8 and 29.
N=124 will receive PfSPZ Challenge under chloroquine (CQ) chemoprophylaxis; three doses of 2x10^5 PfSPZ of PfSPZ Challenge administered by DVI on day 1, 29 and 57, with weekly CQ. Loading Dose: 10 mg/kg of CQ base (will be orally administered as a single loading dose to the participant by the study staff via directly observed therapy on PfSPZ-CVac Day -2. Weekly Dose: Subsequent doses of maintenance dose CQ (5 mg/kg CQ base) will be given weekly as a single dose, with the last dose 5 days after the last dose of PfSPZ Challenge.
N=62 will receive normal; three doses of NS administered by DVI given on day 1, 29 and 57, with weekly CQ. Loading Dose: 10 mg/kg of CQ base (will be orally administered as a single loading dose to the participant by the study staff via directly observed therapy on PfSPZ-CVac Day -2. Weekly Dose: Subsequent doses of maintenance dose CQ (5 mg/kg CQ base) will be given weekly as a single dose, with the last dose 5 days after the last dose of PfSPZ Challenge.