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Study of the Safety and Immunogenicity of Reduced Doses of the US Yellow Fever Vaccine

Primary Purpose

Yellow Fever Vaccination Reaction

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Yellow Fever Vaccine
Sponsored by
US Army Medical Research Institute of Infectious Diseases
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Yellow Fever Vaccination Reaction

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Males and Females 18 to 50 years of age.
  2. In good health, as determined by pertinent medical history, physical examination, vital signs, and clinical safety laboratory evaluations.
  3. Female of child bearing potential: Has a negative pregnancy test and is willing to use a reliable form of contraception for the duration of the study after vaccination.
  4. Negative human immunodeficiency virus (HIV) antibody screen, seronegative for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (following HIV and hepatitis testing, subjects will be provided with counseling and referral for health care if any test is positive).
  5. Ability to comprehend and a willingness to sign an informed consent, which includes the Health Insurance Portability and Accountability Act (HIPAA) Authorization, and a separate consent form for HIV testing.
  6. Be willing to comply with all follow-up visits, testing, adverse event (AE) reporting, and completion of diary card.

Exclusion Criteria:

  1. Receipt of any other investigational vaccine or investigational drug within 28 days prior to or after vaccination with YF-VAX® vaccine.
  2. Have had any known flavivirus disease or receipt of any flavivirus vaccine, licensed or investigational at any time; in addition to any yellow fever vaccine, these include; Japanese Encephalitis (JE), St. Louis Encephalitis, Tick Borne Encephalitis (TBE), West Nile, Dengue, Zika virus
  3. Anticipates receipt of any other vaccine within 28 days of YF-VAX®. Influenza vaccination will be permitted but not within 14 days of YF-VAX®.
  4. Acute or chronic medical conditions, or medications that, in the Principal Investigator's (PI) opinion, would impair the subject's ability to respond to vaccination.
  5. Hypersensitivity to any vaccine, eggs or egg products, or allergy to any component of the YF-VAX® (sorbitol, gelatin) or latex.
  6. Corticosteroids even ≥20 mg/day of prednisone for ≥ 2 weeks suppresses the immune system. Low-dose corticosteroid topical products and nasal sprays used sporadically (i.e. prn--according to circumstances) are permissible.
  7. History of immunosuppression, by any cause--primary or acquired immunodeficiencies, transplantation, malignant neoplasm, lymphoma, leukemia, thymoma, myasthenia gravis, radiation, immunosuppressive drugs, including antimetabolites, tumor necrosis factor (TNF)-alpha inhibitors (etanercept), interleukin-1 (IL-1) blocking agents and other monoclonal antibodies targeting immune cells (e.g., rituximab, alemtuzumab, etc), etc.
  8. Receipt of or anticipates receipt of/or donation of blood or blood products for 2 months after receipt of YF-VAX®. (Note: Blood banks require a minimum 2 week interval between the receipt of this FDA licensed vaccine and blood donations; however because of the blood collections in this study, an interval of 2 months is requested).
  9. Female: Pregnant (or planning to become pregnant) or breastfeeding for the duration of the study after receipt of YF-VAX®.
  10. Clinically significant abnormal laboratory tests (generally 2 times the upper limit of normal or as determined by the PI).

Sites / Locations

  • United States Army Medical Research Institute of Infectious Diseases

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

Standard Dose (Group 1)

Fractional dose (Group 2)

Fractional dose (Group 3)

Arm Description

Yellow Fever vaccine standard dose, 0.5mL.

Yellow Fever vaccine 1/5th standard dose, 0.1mL.

Yellow Fever vaccine 1/10th standard dose, 0.05mL.

Outcomes

Primary Outcome Measures

Adverse Events
Incidence of Adverse Events of fractional doses vs standard dose of YF-VAX as determined by subject diary and clinical history and physical examination. The incidence of solicited and unsolicited adverse events will be analyzed.
Neutralizing Antibody Response
Compare the neutralizing antibody response rate and mean of each ARM as determined by PRNT obtained at several time points. Fractional doses will be compared to the standard dose of YF-VAX. The primary data point is post vaccination day 28.

Secondary Outcome Measures

Viremia
Compare the incidence and level of viremia and mean viral load by RT-PCR (copies/mL) of fractional doses vs standard dose.

Full Information

First Posted
March 28, 2022
Last Updated
August 7, 2023
Sponsor
US Army Medical Research Institute of Infectious Diseases
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1. Study Identification

Unique Protocol Identification Number
NCT05374317
Brief Title
Study of the Safety and Immunogenicity of Reduced Doses of the US Yellow Fever Vaccine
Official Title
An Exploratory, Pilot Study of the Safety and Immunogenicity of Reduced Doses of the US Yellow Fever Vaccine
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
June 7, 2021 (Actual)
Primary Completion Date
November 2, 2022 (Actual)
Study Completion Date
November 2, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
US Army Medical Research Institute of Infectious Diseases

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 an open-label, randomized, exploratory study to evaluate the human immune response to reduced subcutaneous (SQ) dosing of Yellow Fever vaccine compared to the standard FDA approved subcutaneous vaccination dose. The current dose of the US FDA licensed Yellow Fever vaccine is approximately 55,000 plaque-forming unit(s) (PFU) in 0.5 mL administered SQ. Using the licensed dosage as standard, investigators are evaluating reduced doses of 1/5th (0.10 mL) and 1/10th (0.05 mL) Yellow Fever vaccine (YF-VAX).
Detailed Description
Up to 150 individuals will be screened in order to randomize 90 eligible individuals to one of three groups: Group 1- YF-VAX® standard dose 0.5 mL SQ = 30 subjects; Group 2-0.10 mL (1/5th) SQ = 30 subjects; Group 3-0.05 mL (1/10th) SQ = 30 subjects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Yellow Fever Vaccination Reaction

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Phase 4
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
88 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Standard Dose (Group 1)
Arm Type
Active Comparator
Arm Description
Yellow Fever vaccine standard dose, 0.5mL.
Arm Title
Fractional dose (Group 2)
Arm Type
Experimental
Arm Description
Yellow Fever vaccine 1/5th standard dose, 0.1mL.
Arm Title
Fractional dose (Group 3)
Arm Type
Experimental
Arm Description
Yellow Fever vaccine 1/10th standard dose, 0.05mL.
Intervention Type
Biological
Intervention Name(s)
Yellow Fever Vaccine
Other Intervention Name(s)
YF-VAX
Intervention Description
Administered subcutaneously once.
Primary Outcome Measure Information:
Title
Adverse Events
Description
Incidence of Adverse Events of fractional doses vs standard dose of YF-VAX as determined by subject diary and clinical history and physical examination. The incidence of solicited and unsolicited adverse events will be analyzed.
Time Frame
Up to one year following vaccination.
Title
Neutralizing Antibody Response
Description
Compare the neutralizing antibody response rate and mean of each ARM as determined by PRNT obtained at several time points. Fractional doses will be compared to the standard dose of YF-VAX. The primary data point is post vaccination day 28.
Time Frame
Up to one year following vaccination.
Secondary Outcome Measure Information:
Title
Viremia
Description
Compare the incidence and level of viremia and mean viral load by RT-PCR (copies/mL) of fractional doses vs standard dose.
Time Frame
First 14 days following vaccination.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Males and Females 18 to 50 years of age. In good health, as determined by pertinent medical history, physical examination, vital signs, and clinical safety laboratory evaluations. Female of child bearing potential: Has a negative pregnancy test and is willing to use a reliable form of contraception for the duration of the study after vaccination. Negative human immunodeficiency virus (HIV) antibody screen, seronegative for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (following HIV and hepatitis testing, subjects will be provided with counseling and referral for health care if any test is positive). Ability to comprehend and a willingness to sign an informed consent, which includes the Health Insurance Portability and Accountability Act (HIPAA) Authorization, and a separate consent form for HIV testing. Be willing to comply with all follow-up visits, testing, adverse event (AE) reporting, and completion of diary card. Exclusion Criteria: Receipt of any other investigational vaccine or investigational drug within 28 days prior to or after vaccination with YF-VAX® vaccine. Have had any known flavivirus disease or receipt of any flavivirus vaccine, licensed or investigational at any time; in addition to any yellow fever vaccine, these include; Japanese Encephalitis (JE), St. Louis Encephalitis, Tick Borne Encephalitis (TBE), West Nile, Dengue, Zika virus Anticipates receipt of any other vaccine within 28 days of YF-VAX®. Influenza vaccination will be permitted but not within 14 days of YF-VAX®. Acute or chronic medical conditions, or medications that, in the Principal Investigator's (PI) opinion, would impair the subject's ability to respond to vaccination. Hypersensitivity to any vaccine, eggs or egg products, or allergy to any component of the YF-VAX® (sorbitol, gelatin) or latex. Corticosteroids even ≥20 mg/day of prednisone for ≥ 2 weeks suppresses the immune system. Low-dose corticosteroid topical products and nasal sprays used sporadically (i.e. prn--according to circumstances) are permissible. History of immunosuppression, by any cause--primary or acquired immunodeficiencies, transplantation, malignant neoplasm, lymphoma, leukemia, thymoma, myasthenia gravis, radiation, immunosuppressive drugs, including antimetabolites, tumor necrosis factor (TNF)-alpha inhibitors (etanercept), interleukin-1 (IL-1) blocking agents and other monoclonal antibodies targeting immune cells (e.g., rituximab, alemtuzumab, etc), etc. Receipt of or anticipates receipt of/or donation of blood or blood products for 2 months after receipt of YF-VAX®. (Note: Blood banks require a minimum 2 week interval between the receipt of this FDA licensed vaccine and blood donations; however because of the blood collections in this study, an interval of 2 months is requested). Female: Pregnant (or planning to become pregnant) or breastfeeding for the duration of the study after receipt of YF-VAX®. Clinically significant abnormal laboratory tests (generally 2 times the upper limit of normal or as determined by the PI).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Phillip R Pittman, M.D., M.P.H.
Organizational Affiliation
US Army Medical Research Institute of Infectious Diseases
Official's Role
Principal Investigator
Facility Information:
Facility Name
United States Army Medical Research Institute of Infectious Diseases
City
Frederick
State/Province
Maryland
ZIP/Postal Code
21702
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
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27116054
Citation
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Results Reference
result
Links:
URL
http://dx.doi.org/10.15585/mmwr.mm6617e2
Description
Addressing a Yellow Fever Vaccine Shortage

Learn more about this trial

Study of the Safety and Immunogenicity of Reduced Doses of the US Yellow Fever Vaccine

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