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Response to Live Attenuated Influenza Vaccine in Tonsillar Tissues and Blood (FLU-Tonsil)

Primary Purpose

Influenza

Status
Recruiting
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
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 Obstructive sleep apnea, Quadrivalent live, attenuated influenza vaccine, Flumist

Eligibility Criteria

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

Inclusion Criteria:

  1. 2-49-year-old male and female patients undergoing tonsillectomy for obstructive sleep apnea or other non-infectious indication.
  2. Willing and able to complete the informed consent process
  3. Availability for follow-up for the planned duration of the study
  4. Acceptable medical history by review of inclusion/exclusion criteria

Exclusion Criteria:

  1. Prior off-study vaccination with seasonal influenza vaccine within three months of study vaccination
  2. Life-threatening reactions to previous influenza vaccinations
  3. Asthma (contraindication for receipt of LAIV4)
  4. Allergy to egg or egg products or to vaccine components including gentamicin, gelatin, arginine or MSG.
  5. Active systemic or serious concurrent illness, including febrile illness on the day of vaccination
  6. History of immunodeficiency (including HIV infection)
  7. Known or suspected impairment of immunologic function; may include significant liver disease, diabetes mellitus treated with insulin or moderate to severe renal disease
  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 systemic glucocorticoids (corticosteroid nasal sprays and topical steroids are permissible). Use of oral steroids (<20mg prednisone-equivalent/day) may be acceptable after review by the investigator.
  11. Participants in close contact with anyone who has a severely weakened immune system
  12. 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).
  13. 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.
  14. History of blood dyscrasias, renal disease, or hemoglobinopathies requiring regular medical follow up or hospitalization during the preceding year
  15. 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 will be reviewed by investigators to determine if study participation would affect the volunteer's safety or compliance with the protocol.
  16. Receipt of blood or blood products within the past 6 months or planned used during the study.
  17. A medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol
  18. Receipt of an inactivated vaccine 14 days prior to study enrollment, or planned vaccinations prior to completion of last study visit (~ 14 days after study vaccination)
  19. Receipt of a live, attenuated vaccine within 60 days prior to enrollment of planned vaccination prior to completion of last study visit (~ 14 days after study enrollment)
  20. Need for allergy immunization (that cannot be postponed) until after the last study visit.
  21. History of Guillain-Barre# syndrome
  22. Pregnant or breastfeeding woman
  23. Use of investigational agents within 30 days prior to enrollment or planned use during the study.
  24. Donation of the equivalent of a unit of blood within 6 weeks prior to enrollment or donation of platelets within 2 weeks of enrollment or planned donation prior to completion of the last visit.
  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.

Sites / Locations

  • Stanford University Medical Center, Lane building L134Recruiting

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Study Phase

Arm Description

Participants will be given the current year's quadrivalent, live, attenuated seasonal influenza vaccine (LAIV4)/FluMist® intranasally 3-14 days prior to tonsillectomy.

Outcomes

Primary Outcome Measures

Plasma HAI titer
HAI titer measures imune response to influenza vaccination
Number of Participants With Related Adverse Events
We will capture AEs to LAIV

Secondary Outcome Measures

Full Information

First Posted
March 19, 2019
Last Updated
May 3, 2022
Sponsor
Stanford University
Collaborators
National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03884296
Brief Title
Response to Live Attenuated Influenza Vaccine in Tonsillar Tissues and Blood
Acronym
FLU-Tonsil
Official Title
Response to Live Attenuated Influenza Vaccine in Tonsillar Tissues and Blood
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 15, 2019 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Stanford University
Collaborators
National Institutes of Health (NIH), 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
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is one project of a larger ongoing study related to the immune system's response to the flu virus. This study is designed to investigate the immune response to a nasal flu immunization in tonsillar tissue compared to what can be measured in the blood.
Detailed Description
This is a Phase IV study of licensed influenza vaccines with up to 50 male and female volunteers, 2-49 years of age. Volunteers were patients undergoing tonsillectomy for treatment of obstructive sleep apnea (OSA) or other non-infectious indication as part of their routine medical care. The investigator intends to collect blood and lymphoid tissues routinely discarded during surgery from adults and children after routine seasonal live attenuated influenza vaccination (LAIV) to determine how immune memory develops at the actual site of infection, and how immunization may alter this process. The first research study visit will take place approximately 3-14 days prior to the scheduled date of tonsillectomy surgery. During this visit, 20 mL blood sample will be obtained and participants will receive FluMist (intranasal, quadrivalent, live-attenuated influenza vaccine). This is one of the routinely available and recommended vaccines for the age groups included in this study. The second study visit will take place on the same day of the scheduled surgery for the tonsillectomy. Another blood sample (maximum volume of 20 mL) will be collected along with the discarded tonsillar tissue. Blood and tissues will be sent to the lab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
Obstructive sleep apnea, Quadrivalent live, attenuated influenza vaccine, Flumist

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Study Phase
Arm Type
Other
Arm Description
Participants will be given the current year's quadrivalent, live, attenuated seasonal influenza vaccine (LAIV4)/FluMist® intranasally 3-14 days prior to tonsillectomy.
Intervention Type
Biological
Intervention Name(s)
FluMist
Intervention Description
Quadrivalent, live, attenuated influenza vaccine, intranasal spray
Primary Outcome Measure Information:
Title
Plasma HAI titer
Description
HAI titer measures imune response to influenza vaccination
Time Frame
Day 3-14 after receipt of LAIV
Title
Number of Participants With Related Adverse Events
Description
We will capture AEs to LAIV
Time Frame
Day 0 to 14 post-immunization

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 2-49-year-old male and female patients undergoing tonsillectomy for obstructive sleep apnea or other non-infectious indication. Willing and able to complete the informed consent process Availability for follow-up for the planned duration of the study Acceptable medical history by review of inclusion/exclusion criteria Exclusion Criteria: Prior off-study vaccination with seasonal influenza vaccine within three months of study vaccination Life-threatening reactions to previous influenza vaccinations Asthma (contraindication for receipt of LAIV4) Allergy to egg or egg products or to vaccine components including gentamicin, gelatin, arginine or MSG. Active systemic or serious concurrent illness, including febrile illness on the day of vaccination History of immunodeficiency (including HIV infection) Known or suspected impairment of immunologic function; may include significant liver disease, diabetes mellitus treated with insulin or moderate to severe renal disease 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). Use of oral steroids (<20mg prednisone-equivalent/day) may be acceptable after review by the investigator. Participants in close contact with anyone who has a severely weakened immune system 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 will be reviewed by investigators to determine if study participation would affect the volunteer's safety or compliance with the protocol. Receipt of blood or blood products within the past 6 months or planned used during the study. A medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol Receipt of an inactivated vaccine 14 days prior to study enrollment, or planned vaccinations prior to completion of last study visit (~ 14 days after study vaccination) Receipt of a live, attenuated vaccine within 60 days prior to enrollment of planned vaccination prior to completion of last study visit (~ 14 days after study enrollment) Need for allergy immunization (that cannot be postponed) until after the last study visit. History of Guillain-Barre# syndrome Pregnant or breastfeeding woman 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 donation of platelets within 2 weeks of 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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Philip Grant, MD
Phone
6507239443
Email
pmgrant@stanford.edu
Facility Information:
Facility Name
Stanford University Medical Center, Lane building L134
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Philip M Grant, MD
Phone
650-723-9443
Email
pmgrant@stanford.edu

12. IPD Sharing Statement

Plan to Share IPD
No

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Response to Live Attenuated Influenza Vaccine in Tonsillar Tissues and Blood

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