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B Cell and Antibody Response to Seasonal Influenza Vaccines in Younger and Older Adults

Primary Purpose

Influenza

Status
Recruiting
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Fluzone
Flucelvax
Fluzone High-Dose
Fluad
Sponsored by
University of Alabama at Birmingham
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Influenza focused on measuring vaccine

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Participation in ancillary clinical research study
  • Able to give informed consent
  • Age 18-50 years old for Arm 1 and Arm 2
  • Age 65-80 years old for Arm 3, Arm 4, and Arm 5
  • Weight of at least 110 lbs as determined by self-reporting

Exclusion Criteria:

  • Inability to give informed consent
  • Refusal or inability to have blood drawn or participate in study procedures
  • Previous adverse reaction to influenza vaccine or medical history contraindicated for receiving influenza vaccine, including but not limited to:

    1. History of Guillain-Barre Syndrome
    2. History of egg allergy
    3. History of gelatin allergy
    4. History of moderate to severe illness with or without fever within 6 weeks of receipt of influenza vaccine
  • Previous receipt of influenza vaccine outside of study within current season
  • Bleeding disorder diagnosed by a doctor (eg, factor deficiency, coagulopathy, or platelet disorder requiring special precautions)
  • Participant has any medical, psychiatric, or social condition, or occupational or other responsibility that, in the judgement of the investigator would interfere with, or serve as a contraindication to the planned procedure(s).
  • These following criteria are used for scientific reasons, and not safety reasons. Specifically, the criteria are used to obtain a population that is healthy and less likely to have conditions that may influence the immune system:

    1. No recent respiratory infections in the past 4 weeks at time of vaccination
    2. Malignancy
    3. Evidence of Inflammation: Systemic Lupus Erythematosis, Rheumatoid Arthritis, Polymyositis, Dermatomyositis, Scleroderma, Crohn's Disease, Ulcerative Colitis.
    4. Lymphoproliferative Disorder
    5. Known Immunodeficiency
    6. Myocardial Infarction <6 months
    7. Cerebral Vascular Accident
    8. Peripheral Vascular Disease- recannulation <6months
    9. Cardiac Insufficiency - congestive heart failure
    10. Hypertension with increased blood urea nitrogen (BUN)
    11. Renal Failure
    12. Dementia
    13. Alcoholism (defined as >17 drinks/week)
    14. Drug Abuse (excluding marijuana)
    15. HIV positive
    16. History of hepatitis
    17. History of immunization within 4 weeks of study participation or plan to receive non- IIV vaccination within 4 weeks of receiving IIV
    18. Moderate to severe illness at time of enrollment
  • Donations of blood in the 8 weeks prior to enrollment which, combined with expected volumes to be drawn for this study, would exceed 450 mL in an 8 week period.
  • Current pregnancy at time of enrollment or pregnancy within last 4 months
  • Active or planned breastfeeding during study participation
  • Psychiatric condition that precludes compliance with the protocol. Specifically excluded are persons with psychoses within the past 3 years, ongoing risk for suicide, or history of suicide attempt or gesture within the past 3 years.

Sites / Locations

  • University of Alabama at BirminghamRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Fluzone Younger

Flucelvax

Fluzone Older

Fluzone High Dose

Fluad

Arm Description

10 adults 18-50 years old, will receive a single dose of the Fluzone influenza vaccine each year for two sequential years

10 adults 18-50 years old, will receive a single dose of the Flucelvax influenza vaccine each year for two sequential years

10 adults 65-80 years old, will receive a single dose of the Fluzone influenza vaccine

10 adults 65-80 years old, will receive a single dose of the Fluzone High-Dose influenza vaccine

10 adults 65-80 years old, will receive a single dose of the Fluad influenza vaccine

Outcomes

Primary Outcome Measures

Hemagglutinin antibody
hemagglutinin plasma antibody titer
Neuraminidase antibody
Neuraminidase plasma antibody titer

Secondary Outcome Measures

Hemagglutinin Memory B cell ELISPOT Response
hemagglutinin-specific memory B cells
Neuraminidase Memory B cell ELISPOT Response
Neuraminidase-specific memory B cells

Full Information

First Posted
September 22, 2019
Last Updated
June 7, 2023
Sponsor
University of Alabama at Birmingham
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1. Study Identification

Unique Protocol Identification Number
NCT04101838
Brief Title
B Cell and Antibody Response to Seasonal Influenza Vaccines in Younger and Older Adults
Official Title
B Cell and Antibody Response to Seasonal Influenza Vaccines in Younger and Older Adults
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 1, 2021 (Actual)
Primary Completion Date
May 2024 (Anticipated)
Study Completion Date
May 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Alabama at Birmingham

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.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will examine how various FDA-approved seasonal influenza vaccine types, used in a manner consistent with their approved use, impact the characteristics of influenza specific antibodies in humans, and how these responses differ based on age and prior immunization history.
Detailed Description
This study is particularly focused on studying antibodies, a protein in blood that react with foreign substances (such as bacteria and viruses) to help eliminate them. This study will examine antibodies and the cells that they are produced by, B cells that develop in response to the influenza vaccine. The majority of antibodies that develop following seasonal influenza vaccine are highly specific for particular influenza strain that comprises the influenza vaccine, necessitating the annual reformulation of the influenza vaccine to match strains expected to be in circulation for the upcoming season. This is problematic, and strategies to develop an influenza vaccine that can promote the robust and persistent development of antibodies that are effective against a wide range of influenza strains are needed. One potential strategy is to promote antibody responses targeting the neuraminidase (NA) protein of influenza. NA is more highly conserved across influenza viruses as compared to the hemagglutinin (HA) protein which is the major component of the influenza vaccine. Thus understanding how differences in seasonal influenza vaccines may influence the quality and breadth of HA and NA specific antibodies is of importance in the development of more effective influenza vaccines. There are several FDA-approved seasonal inactivated influenza vaccines (IIVs) and it remains unknown the extent to which they may induce HA and NA-specific B cells and antibodies, and particularly those that may have broad protective activity against influenza. Differences in the various seasonal IIVs, such as how they were produced, their dose, and the immune stimulating components (adjuvant) they contain may influence the HA and NA-specific response. The two major types of seasonal IIV approved for adults are IIV that is comprised of inactivated influenza virus that was grown in chicken eggs (e.g. Sanofi Fluzone, IIV), and the other comprised of inactivated influenza virus that was grown in cell culture (e.g. Seqirus Flucelvax, cc-IIV). Additionally, for adults 65 years and older, High Dose Fluzone (HD-IIV3), and Sequris Fluad IIV, which includes an adjuvant (a-IIV3). This study will evaluate the relative induction of HA and NA-specific antibodies and B cells from adults immunized with these various seasonal influenza vaccines, and how these responses may change after each year, and differ in older adults who may have a different past exposure history to influenza compared to younger adults. The seasonal influenza vaccines will be given as standard of care, in populations they are approved for, and administered in approved dose and route.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Participant
Masking Description
Participant will be blinded to which vaccine they receive until immediately after vaccination.
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Fluzone Younger
Arm Type
Active Comparator
Arm Description
10 adults 18-50 years old, will receive a single dose of the Fluzone influenza vaccine each year for two sequential years
Arm Title
Flucelvax
Arm Type
Active Comparator
Arm Description
10 adults 18-50 years old, will receive a single dose of the Flucelvax influenza vaccine each year for two sequential years
Arm Title
Fluzone Older
Arm Type
Active Comparator
Arm Description
10 adults 65-80 years old, will receive a single dose of the Fluzone influenza vaccine
Arm Title
Fluzone High Dose
Arm Type
Active Comparator
Arm Description
10 adults 65-80 years old, will receive a single dose of the Fluzone High-Dose influenza vaccine
Arm Title
Fluad
Arm Type
Active Comparator
Arm Description
10 adults 65-80 years old, will receive a single dose of the Fluad influenza vaccine
Intervention Type
Drug
Intervention Name(s)
Fluzone
Other Intervention Name(s)
influenza vaccine
Intervention Description
inactivated seasonal influenza vaccine
Intervention Type
Drug
Intervention Name(s)
Flucelvax
Other Intervention Name(s)
influenza vaccine
Intervention Description
inactivated seasonal influenza vaccine
Intervention Type
Drug
Intervention Name(s)
Fluzone High-Dose
Other Intervention Name(s)
high dose influenza vaccine
Intervention Description
inactivated seasonal influenza vaccine
Intervention Type
Drug
Intervention Name(s)
Fluad
Other Intervention Name(s)
adjuvanted influenza vaccine
Intervention Description
inactivated seasonal influenza vaccine
Primary Outcome Measure Information:
Title
Hemagglutinin antibody
Description
hemagglutinin plasma antibody titer
Time Frame
3 months after vaccination
Title
Neuraminidase antibody
Description
Neuraminidase plasma antibody titer
Time Frame
3 months after vaccination
Secondary Outcome Measure Information:
Title
Hemagglutinin Memory B cell ELISPOT Response
Description
hemagglutinin-specific memory B cells
Time Frame
3 months after vaccination
Title
Neuraminidase Memory B cell ELISPOT Response
Description
Neuraminidase-specific memory B cells
Time Frame
3 months after vaccination

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participation in ancillary clinical research study Able to give informed consent Age 18-50 years old for Arm 1 and Arm 2 Age 65-80 years old for Arm 3, Arm 4, and Arm 5 Weight of at least 110 lbs as determined by self-reporting Exclusion Criteria: Inability to give informed consent Refusal or inability to have blood drawn or participate in study procedures Previous adverse reaction to influenza vaccine or medical history contraindicated for receiving influenza vaccine, including but not limited to: History of Guillain-Barre Syndrome History of egg allergy History of gelatin allergy History of moderate to severe illness with or without fever within 6 weeks of receipt of influenza vaccine Previous receipt of influenza vaccine outside of study within current season Bleeding disorder diagnosed by a doctor (eg, factor deficiency, coagulopathy, or platelet disorder requiring special precautions) Participant has any medical, psychiatric, or social condition, or occupational or other responsibility that, in the judgement of the investigator would interfere with, or serve as a contraindication to the planned procedure(s). These following criteria are used for scientific reasons, and not safety reasons. Specifically, the criteria are used to obtain a population that is healthy and less likely to have conditions that may influence the immune system: No recent respiratory infections in the past 4 weeks at time of vaccination Malignancy Evidence of Inflammation: Systemic Lupus Erythematosis, Rheumatoid Arthritis, Polymyositis, Dermatomyositis, Scleroderma, Crohn's Disease, Ulcerative Colitis. Lymphoproliferative Disorder Known Immunodeficiency Myocardial Infarction <6 months Cerebral Vascular Accident Peripheral Vascular Disease- recannulation <6months Cardiac Insufficiency - congestive heart failure Hypertension with increased blood urea nitrogen (BUN) Renal Failure Dementia Alcoholism (defined as >17 drinks/week) Drug Abuse (excluding marijuana) HIV positive History of hepatitis History of immunization within 4 weeks of study participation or plan to receive non- IIV vaccination within 4 weeks of receiving IIV Moderate to severe illness at time of enrollment Donations of blood in the 8 weeks prior to enrollment which, combined with expected volumes to be drawn for this study, would exceed 450 mL in an 8 week period. Current pregnancy at time of enrollment or pregnancy within last 4 months Active or planned breastfeeding during study participation Psychiatric condition that precludes compliance with the protocol. Specifically excluded are persons with psychoses within the past 3 years, ongoing risk for suicide, or history of suicide attempt or gesture within the past 3 years.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
James J Kobie, PhD
Phone
205-975-2760
Email
jjkobie@uabmc.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James J Kobie, PhD
Organizational Affiliation
University of Alabama at Birmingham
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
James J Kobie, PhD
Phone
205-975-2760
Email
jjkobie@uabmc.edu
First Name & Middle Initial & Last Name & Degree
James J Kobie, PhD
First Name & Middle Initial & Last Name & Degree
Paul A Goepfert, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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B Cell and Antibody Response to Seasonal Influenza Vaccines in Younger and Older Adults

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