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A Study in Healthy Adults to Assess Priming With Antigenically Mismatched Live Attenuated A/H7N3 Influenza Virus Vaccine Followed by Inactivated A/H7N9 Influenza Virus Vaccine

Primary Purpose

Influenza

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
H7N3 pLAIV
H7N9 pIIV
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Influenza

Eligibility Criteria

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

Inclusion Criteria:

  • Adult males and non-pregnant, non-breastfeeding females between 18 years and 49 years of age, inclusive. Children will not be recruited or enrolled in this study because they are not in the apparent risk group, for safety considerations, and because of the need for isolation.
  • Are in good health, as determined by medical history and targeted physical examination to ensure any existing medical diagnoses or conditions (except those exclusionary) are stable. More information on this criterion can be found in the protocol.
  • Agree to storage of blood specimens for future research.
  • Available for the duration of the trial. Subjects must be willing and able to remain within the Isolation Unit for the specified duration of confinement.
  • Provide written informed consent prior to initiation of any study procedures, including future use of specimens.
  • Female subjects of child-bearing potential must agree to use effective birth control methods for the duration of the study (for example, pharmacologic contraceptives including oral, parenteral, and transcutaneous delivery; condoms with spermicide; diaphragm with spermicide; intrauterine device; abstinence from heterosexual intercourse, surgical sterilization). All female subjects will be considered being of child bearing potential except those who have undergone hysterectomy or tubal ligation and those in whom menopause occurred at least 1 year prior to the study.
  • Agrees not to participate in another clinical trial with an investigational product for the entire duration of the study.
  • Female subjects of childbearing potential must have a negative urine and serum pregnancy test within 24 hours (urine) to 48 hours (serum) prior to study vaccination.

Exclusion Criteria:

  • Pregnancy as determined by a positive human choriogonadotropin (beta-HCG) test.
  • Currently breastfeeding or planning to breastfeed or become pregnant at some point during the duration of the study.
  • Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, autoimmune, or renal disease by history, physical examination, electrocardiogram (EKG) and/or laboratory studies including urine testing. Alanine aminotransferase (ALT) levels greater than 2 times the upper normal limit will be exclusionary at baseline, prior to vaccination.
  • Any current illness requiring daily medication other than the following: vitamins, birth control, anti-hypertensive medication, antihistamines, anti-depressant medication, cholesterol-lowering medication, treatment for gastroesophageal reflux disease, and thyroid medication unless approved by the principal investigator (PI).
  • Behavioral or cognitive impairment or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and cooperate with the study protocol.
  • Previous enrollment in an H7 vaccine trial or in any study of an avian influenza vaccine.
  • Seropositive to the H7N3 or H7N9 influenza A virus (serum HAI titer greater than 1:8).
  • Positive urine drug toxicology test indicating narcotic use/dependency.
  • Have medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
  • Other condition that in the opinion of the investigator would jeopardize the safety or rights of a subject participating in the trial or would render the subject unable to comply with the protocol.
  • Have a history of severe reactions following previous immunization with licensed or unlicensed influenza virus vaccines.
  • Have known hypersensitivity or allergy to eggs, egg or chicken protein, or other components of the study vaccine.
  • Allergy to oseltamivir as determined by subject report.
  • Current diagnosis of asthma or reactive airway disease (within the past 2 years).
  • History of Guillain-Barré Syndrome.
  • Positive enzyme-linked immunosorbent assay (ELISA) and confirmatory Western blot tests for human immunodeficiency virus-1 (HIV-1).
  • Positive ELISA and confirmatory test (e.g., recombinant immunoblot assay) for hepatitis C virus (HCV).
  • Positive hepatitis B virus surface antigen (HBsAg) by ELISA.
  • Known immunodeficiency syndrome.
  • Use of corticosteroids (excluding topical preparations) or immunosuppressive drugs within 30 days prior to vaccination.
  • Receipt of a live vaccine within 4 weeks or a killed vaccine within 2 weeks prior to study vaccination.
  • History of asplenia
  • Use of anticancer chemotherapy or radiation therapy (cytotoxic) within 36 months prior to vaccination.
  • Have known active neoplastic disease or a history of any hematologic malignancy.
  • Receipt of blood or blood-derived products (including immunoglobulin) within 6 months prior to study vaccination.
  • Current smoker unwilling to stop smoking for the duration of the inpatient stay.

    • A current smoker includes anyone stating they currently smoke or use any amount of a tobacco product, including electronic cigarettes.
    • After admission to the unit, nicotine patches will be provided to current smokers who request them for the inpatient portion of the study.
  • Travel to the Southern Hemisphere within 14 days prior to study vaccination.
  • Travel on a cruise ship within 14 days prior to study vaccination.
  • Receipt of another investigational vaccine or drug within 30 days prior to study vaccination.

Sites / Locations

  • University of Rochester Medical Center Vaccine Research Unit (Outpatient)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

H7N3 pLAIV + H7N9 pIIV

Arm Description

Participants will receive H7N3 pLAIV on Days 0 and 28, followed by H7N9 pIIV on Day 84.

Outcomes

Primary Outcome Measures

Hemagglutination-inhibition (HAI) antibody response to H7N9 virus following administration of pIIV
Defined as 4-fold or greater response to a titer of 1:40 or above with 95% confidence intervals for both antigens

Secondary Outcome Measures

Frequency of reactogenicity events following each dose of vaccine
Reactogenicity events will be collected and assessed for each individual subject, taking the pattern of viral shedding into account.
Severity of reactogenicity events following each dose of vaccine
Assessed according to the Reactogenicity Event Severity Grading System provided in the protocol
Frequency of adverse events following each dose of vaccine
All adverse events will be recorded and relationship to study product will be assessed.
Severity of adverse events following each dose of vaccine
Assessed according to the Adverse Event Severity Grading System provided in the study protocol
Frequency of vaccine viral shedding after each dose
Determined by rtRT-PCR and culture at each day tested after inoculation
Serum HAI and neutralizing antibody response following 1 or 2 doses of pLAIV
Response rates defined as 4-fold or greater response to a titer of 1:40 or above with 95% confidence intervals for both antigens
Neutralizing and HAI responses after pIIV boost against antigenic variants of H7 virus, including H7N7, H7N3, and H7N9 North American and Eurasian lineage viruses
Response rates defined as 4-fold or greater response to a titer of 1:40 or above with 95% confidence intervals for both antigens

Full Information

First Posted
June 26, 2018
Last Updated
March 22, 2019
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03581903
Brief Title
A Study in Healthy Adults to Assess Priming With Antigenically Mismatched Live Attenuated A/H7N3 Influenza Virus Vaccine Followed by Inactivated A/H7N9 Influenza Virus Vaccine
Official Title
A Phase I Study in Healthy Adults to Assess Priming With Antigenically Mismatched Live Attenuated A/H7N3 Influenza Virus Vaccine Followed by Inactivated A/H7N9 Influenza Virus Vaccine
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
September 19, 2017 (Actual)
Primary Completion Date
September 14, 2018 (Actual)
Study Completion Date
February 6, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess priming with antigenically mismatched live attenuated A/H7N3 influenza virus vaccine followed by inactivated A/H7N9 influenza virus vaccine in healthy adults.
Detailed Description
This study will assess priming with antigenically mismatched live attenuated A/H7N3 influenza virus vaccine (H7N3 pLAIV) followed by inactivated A/H7N9 influenza virus vaccine (H7N9 pIIV) in healthy adults. Participants will receive a dose of H7N3 pLAIV on Days 0 and 28, followed by a single dose of H7N9 pIIV on Day 84. On Days -2 and 26, participants will be admitted to an inpatient clinic. They will receive the H7N3 pLAIV vaccine on Days 0 and 28. They will remain in the clinic for 9 days after receiving the vaccine and until they are no longer shedding vaccine virus. An additional study visit will occur on Day 56. On Day 84, participants will receive the H7N9 pIIV vaccine. Additional study visits will occur on Days 87, 91, 98, 112, 140, and 180. Study visits may include physical examinations, nasal washes, and blood and urine collection. Participants will be contacted by phone on Day 264 for follow-up health monitoring.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
H7N3 pLAIV + H7N9 pIIV
Arm Type
Experimental
Arm Description
Participants will receive H7N3 pLAIV on Days 0 and 28, followed by H7N9 pIIV on Day 84.
Intervention Type
Biological
Intervention Name(s)
H7N3 pLAIV
Other Intervention Name(s)
Live attenuated A/H7N3 influenza virus vaccine
Intervention Description
Approximately 10^7.0 fluorescent focus units (FFUs) administered intranasally by an Accuspray device
Intervention Type
Biological
Intervention Name(s)
H7N9 pIIV
Other Intervention Name(s)
Inactivated A/H7N9 influenza virus vaccine
Intervention Description
30 micrograms administered by intramuscular (IM) injection
Primary Outcome Measure Information:
Title
Hemagglutination-inhibition (HAI) antibody response to H7N9 virus following administration of pIIV
Description
Defined as 4-fold or greater response to a titer of 1:40 or above with 95% confidence intervals for both antigens
Time Frame
Measured through Day 28
Secondary Outcome Measure Information:
Title
Frequency of reactogenicity events following each dose of vaccine
Description
Reactogenicity events will be collected and assessed for each individual subject, taking the pattern of viral shedding into account.
Time Frame
Measured through Day 180
Title
Severity of reactogenicity events following each dose of vaccine
Description
Assessed according to the Reactogenicity Event Severity Grading System provided in the protocol
Time Frame
Measured through Day 180
Title
Frequency of adverse events following each dose of vaccine
Description
All adverse events will be recorded and relationship to study product will be assessed.
Time Frame
Measured through Day 180
Title
Severity of adverse events following each dose of vaccine
Description
Assessed according to the Adverse Event Severity Grading System provided in the study protocol
Time Frame
Measured through Day 180
Title
Frequency of vaccine viral shedding after each dose
Description
Determined by rtRT-PCR and culture at each day tested after inoculation
Time Frame
Measured through Day 180
Title
Serum HAI and neutralizing antibody response following 1 or 2 doses of pLAIV
Description
Response rates defined as 4-fold or greater response to a titer of 1:40 or above with 95% confidence intervals for both antigens
Time Frame
Measured through Day 56
Title
Neutralizing and HAI responses after pIIV boost against antigenic variants of H7 virus, including H7N7, H7N3, and H7N9 North American and Eurasian lineage viruses
Description
Response rates defined as 4-fold or greater response to a titer of 1:40 or above with 95% confidence intervals for both antigens
Time Frame
Measured through Day 28

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: Adult males and non-pregnant, non-breastfeeding females between 18 years and 49 years of age, inclusive. Children will not be recruited or enrolled in this study because they are not in the apparent risk group, for safety considerations, and because of the need for isolation. Are in good health, as determined by medical history and targeted physical examination to ensure any existing medical diagnoses or conditions (except those exclusionary) are stable. More information on this criterion can be found in the protocol. Agree to storage of blood specimens for future research. Available for the duration of the trial. Subjects must be willing and able to remain within the Isolation Unit for the specified duration of confinement. Provide written informed consent prior to initiation of any study procedures, including future use of specimens. Female subjects of child-bearing potential must agree to use effective birth control methods for the duration of the study (for example, pharmacologic contraceptives including oral, parenteral, and transcutaneous delivery; condoms with spermicide; diaphragm with spermicide; intrauterine device; abstinence from heterosexual intercourse, surgical sterilization). All female subjects will be considered being of child bearing potential except those who have undergone hysterectomy or tubal ligation and those in whom menopause occurred at least 1 year prior to the study. Agrees not to participate in another clinical trial with an investigational product for the entire duration of the study. Female subjects of childbearing potential must have a negative urine and serum pregnancy test within 24 hours (urine) to 48 hours (serum) prior to study vaccination. Exclusion Criteria: Pregnancy as determined by a positive human choriogonadotropin (beta-HCG) test. Currently breastfeeding or planning to breastfeed or become pregnant at some point during the duration of the study. Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, autoimmune, or renal disease by history, physical examination, electrocardiogram (EKG) and/or laboratory studies including urine testing. Alanine aminotransferase (ALT) levels greater than 2 times the upper normal limit will be exclusionary at baseline, prior to vaccination. Any current illness requiring daily medication other than the following: vitamins, birth control, anti-hypertensive medication, antihistamines, anti-depressant medication, cholesterol-lowering medication, treatment for gastroesophageal reflux disease, and thyroid medication unless approved by the principal investigator (PI). Behavioral or cognitive impairment or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and cooperate with the study protocol. Previous enrollment in an H7 vaccine trial or in any study of an avian influenza vaccine. Seropositive to the H7N3 or H7N9 influenza A virus (serum HAI titer greater than 1:8). Positive urine drug toxicology test indicating narcotic use/dependency. Have medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months. Other condition that in the opinion of the investigator would jeopardize the safety or rights of a subject participating in the trial or would render the subject unable to comply with the protocol. Have a history of severe reactions following previous immunization with licensed or unlicensed influenza virus vaccines. Have known hypersensitivity or allergy to eggs, egg or chicken protein, or other components of the study vaccine. Allergy to oseltamivir as determined by subject report. Current diagnosis of asthma or reactive airway disease (within the past 2 years). History of Guillain-Barré Syndrome. Positive enzyme-linked immunosorbent assay (ELISA) and confirmatory Western blot tests for human immunodeficiency virus-1 (HIV-1). Positive ELISA and confirmatory test (e.g., recombinant immunoblot assay) for hepatitis C virus (HCV). Positive hepatitis B virus surface antigen (HBsAg) by ELISA. Known immunodeficiency syndrome. Use of corticosteroids (excluding topical preparations) or immunosuppressive drugs within 30 days prior to vaccination. Receipt of a live vaccine within 4 weeks or a killed vaccine within 2 weeks prior to study vaccination. History of asplenia Use of anticancer chemotherapy or radiation therapy (cytotoxic) within 36 months prior to vaccination. Have known active neoplastic disease or a history of any hematologic malignancy. Receipt of blood or blood-derived products (including immunoglobulin) within 6 months prior to study vaccination. Current smoker unwilling to stop smoking for the duration of the inpatient stay. A current smoker includes anyone stating they currently smoke or use any amount of a tobacco product, including electronic cigarettes. After admission to the unit, nicotine patches will be provided to current smokers who request them for the inpatient portion of the study. Travel to the Southern Hemisphere within 14 days prior to study vaccination. Travel on a cruise ship within 14 days prior to study vaccination. Receipt of another investigational vaccine or drug within 30 days prior to study vaccination.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Angela Branche, M.D.
Organizational Affiliation
University of Rochester
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Rochester Medical Center Vaccine Research Unit (Outpatient)
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Study in Healthy Adults to Assess Priming With Antigenically Mismatched Live Attenuated A/H7N3 Influenza Virus Vaccine Followed by Inactivated A/H7N9 Influenza Virus Vaccine

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