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Safety and Immunogenicity of Omicron Variant-Matched Vaccine Booster in Adults (SH-MO-214)

Primary Purpose

COVID-19 Pandemic, Immunogenicity, SARS CoV 2 Infection

Status
Recruiting
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
mRNA-1273.214 Vaccine
MRNA-1273 Vaccine
Placebo
Sponsored by
Sheba Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for COVID-19 Pandemic focused on measuring mRNA1273.214, Omicron, Immunogenicity, COVID-19, Safety

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Male or female participants 21 years of age, inclusively.
  2. Individuals who previously received mRNA primary series vaccination AND a booster dose at least 4 months prior to Day 1. Documented confirmation of prior mRNA series vaccination receipt must be obtained prior to randomization.
  3. Females and males of childbearing potential must be willing to use effective methods of contraception such as hormones (OCP, oral contraceptive pill), condom or occlusive cap with spermicidal agents, intrauterine device (IUD), or intrauterine system (IUS) as well as to refrain from donating sperm through 28 days following the last vaccination.
  4. Participant who is willing and able to comply with all scheduled visits, vaccination plan, laboratory tests, lifestyle considerations, and other study procedures.
  5. For Women of Child Bearing Potential (WOCBP): a negative pregnancy test on the day of vaccination (Visit 1 and Visit 4).
  6. Participant who is willing and able to operate an electronic diary.
  7. Healthy participants who are determined by medical history, physical examination (if required), and clinical judgment of the investigator to be eligible for inclusion in the study.

    Note: Healthy participants with preexisting stable disease, defined as disease not requiring significant change in therapy or hospitalization for worsening disease during the six (6) weeks before enrollment, can be included.

  8. Capable of giving signed informed consent as described which includes understanding and compliance with the study procedures, requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
  9. Must agree not to enroll in another study of an investigational agent prior to completion of the study.

Exclusion Criteria:

  1. History of severe adverse reaction associated with a vaccine and/or severe allergic reaction (e.g., anaphylaxis) to any component of the study intervention(s).
  2. Previous clinical (based on COVID-19 symptoms/signs alone, if a SARS-CoV-2 NAAT result was not available) or microbiological (based on COVID-19 symptoms/signs and a positive SARS-CoV-2 NAAT result) diagnosis of COVID-19 or positive antigen test for SARS-CoV-2 at baseline.
  3. Immunocompromised individuals with known or suspected immunodeficiency, as determined by history and/or laboratory/physical examination.
  4. Has known or suspected allergy or history of anaphylaxis, urticaria, or other significant AR to the vaccine or its excipients.
  5. Bleeding diathesis or condition associated with prolonged bleeding that would, in the opinion of the investigator, contraindicate intramuscular injection.
  6. Inability to observe possible local reactions at the injection sites due to a physical condition or permanent body art.
  7. Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study.
  8. Pregnant or breastfeeding women.
  9. Individuals who receive treatment with radiotherapy or immunosuppressive therapy, including cytotoxic agents or systemic corticosteroids (if systemic corticosteroids are administered for ≥14 days at a dose of ≥20 mg/day of prednisone or equivalent), e.g., for cancer or an autoimmune disease, or planned receipt throughout the study. Inhaled/nebulized, intra-articular, intrabursal, or topical (skin or eyes) corticosteroids are permitted.
  10. Receipt of blood/plasma products, immunoglobulin, or monoclonal antibodies, from 60 days before study intervention administration, or receipt of any passive antibody therapy specific to COVID-19, from 90 days before study intervention administration, or planned receipt throughout the study.
  11. Participation in other studies involving study intervention within 28 days prior to study entry through and including 28 days after the last dose of study intervention.

Sites / Locations

  • Sheba Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

mRNA-1273.214 + mRNA-1273.214

mRNA-1273.214 + Placebo

mRNA-1273 + Placebo

Arm Description

Fourth & Fifth doses of an investigational mRNA vaccine, 56 days apart N ≈ 60

Fourth dose of an investigational mRNA vaccine followed by a fifth dose of placebo, 56 days apart N ≈ 60

Fourth dose of the commercial mRNA vaccine, followed by a fifth dose of placebo, 56 days apart N ≈ 30

Outcomes

Primary Outcome Measures

Safety of the study vaccines after each dose
Safety of the study vaccines will be measured by solicited and unsolicited adverse injection site reactions and systemic reactions from the time of each vaccination through 7 days post each vaccination/placebo administrations. AEs will be collected up to 29 days after injection. Unsolicited non-serious AEs, SAEs, NOCMCs, and MAAEs will be collected through 6 months after the first vaccine dose.
Reactogenicity of the study vaccines after each dose
Reactogenicity of the study vaccines will be measured by solicited and unsolicited adverse injection site reactions and systemic reactions from the time of each vaccination through 7 days post each vaccination/placebo administrations. AEs will be collected up to 29 days after injection. Unsolicited non-serious AEs, SAEs, NOCMCs, and MAAEs will be collected through 6 months after the first vaccine dose. The study will also assess reactogenicity using "Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials" Guide, via an electronic diary the participants would be required to complete every day for 7 consecutive days starting the day of each vaccine.
Immune response to mRNA-1273.214, given as a fourth and fifth dose to participants who previously received mRNA primary series vaccination and one booster dose (third dose).
Primary immunogenicity outcome will be measured by changes in geometric titers (GMTs) and geometric fold raise (GMFRs) of IgG and neutralizing antibodies (nAb), using a pseudovirus assay during all visits. Blood for immunogenicity will be collected at all visits (total of 6 visits).

Secondary Outcome Measures

Immunogenicity
Describe direct virus neutralization of Omicron VOC, Delta VOC and ancestral SARS-COV-2 VOC. Direct virus neutralization (in Biosafety Level 3 - BL3 - facility) of Omicron variant of concern (VOC) and two (2) additional strains [ancestral SARS-COV-2 and Delta VOC] Measured by GMT.
Investigational Product's Efficacy
COVID-19 infections and severity [based on CDC definition] in participants without evidence of past SARS-CoV-2 infection, occurring after day 7 from the booster dose throughout the blinded follow-up period. Laboratory defined SARS-CoV-2 infection and symptomatic COVID-19 and severe COVID-19.

Full Information

First Posted
May 15, 2022
Last Updated
October 26, 2022
Sponsor
Sheba Medical Center
Collaborators
ModernaTX, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05383560
Brief Title
Safety and Immunogenicity of Omicron Variant-Matched Vaccine Booster in Adults
Acronym
SH-MO-214
Official Title
Phase 2, Randomized, Observer-Blind, Investigator-Initiated, Collaborative Study to Evaluate the Safety and Immunogenicity of Omicron Variant-Matched Vaccine Booster in Adults
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 5, 2022 (Actual)
Primary Completion Date
May 2023 (Anticipated)
Study Completion Date
July 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sheba Medical Center
Collaborators
ModernaTX, Inc.

4. Oversight

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

5. Study Description

Brief Summary
The five recently emerged SARS-CoV2 variants that were designated as VOCs are the Alpha variant, Beta variant, Gamma variant, Delta variant and the Omicron variant. The current dominant Omicron variant was designated a VOC by WHO on Nov 26, 2021, and was found to comprise 85% of reported variants in late January 2022. Studies have shown that the prevalent Omicron mutations in the S1 subunit RBD region and NTD region could dramatically change the antigenic features of the viral spike, leading to significantly reduced neutralization Omicron harbors 30 signature mutations (>50% prevalence) of which 15 are in the S1 subunit RBD region and 8 are in the S1 subunit NTD region. Omicron is a highly contagious variant with threatening immune evasion capabilities even despite robust immune response. Initial modeling showed the Omicron variant being 2.8 times more infectious than the Delta variant. While current vaccines are losing protection against Omicron with respect to infection and mild disease, there is still considerable protection from hospitalisation and severe COVID-19, especially after a booster dose. The International Coalition of Medicines Regulatory Authorities (ICMRA) COVID-19 Omicron Variant Workshop encouraged the international scientific community and vaccine developers to look at alternative approaches to monovalent vaccines. In ICMRA's view, companies should also explore the feasibility of developing bivalent or multivalent variant vaccines to determine if they offer advantages to monovalent vaccines. As advised by ICMRA, the investigated vaccine, mRNA-1273.214 is a bivalent vaccine containing the ancestral SARS-CoV-2 and the Omicron variant spike sequences that will be evaluated as a heterologous boost.
Detailed Description
The trial aims to evaluate the safety and immunogenicity of the investigated covalent vaccine, mRNA-1273.214, administered as a heterologous vaccine after the primary series vaccination and boost with the BNT162b2 or mRNA-1273, in healthy adults aged ≥21 years. Three different treatment arms will be compared with participants being administered either: mRNA-1273.214 (Day 1) and mRNA-1273.214 (Day 56) mRNA-1273.214 (Day 1) and placebo (Day 56) mRNA-1273 (Day 1) and placebo (Day 56) Study procedures include two administrations of vaccine and/or placebo, nasopharyngeal swab for SARS-CoV-2 PCR, blood draws for antibody response: IgG, IgA, pseudo-neutralization antibody (ab) titers, B-Cell response, T-Cell response, and solicited and non-solicited adverse events. Subjects will be asked to complete an electronic diary for 7 consecutive days after each vaccination dose, regarding vaccine-related symptoms + temperature measured at home. One week after the day of vaccination or placebo, subjects will be asked to complete a COVID-19 questionnaire once a week, in which they will have to answer the question of whether they have experienced COVID-19 symptoms. Adverse reactions will be measured by the occurrence of solicited injection site reaction and systemic reaction from the time of each vaccination through 7 days post each vaccination/placebo administration. Unsolicited non-serious Adverse Events (AEs), Serious adverse events (SAEs), new-onset chronic medical conditions (NOCMCs), and medically-attended adverse events (MAAEs) will be collected from baseline through 6 months after the first booster dose vaccination. Nasopharyngeal Swab for SARS-CoV-2 PCR, Blood Samples For Immunogenicity Assessment, Serology and PBMC will be collected at each study visit (6 times during the subject's participation in the study).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19 Pandemic, Immunogenicity, SARS CoV 2 Infection, COVID-19
Keywords
mRNA1273.214, Omicron, Immunogenicity, COVID-19, Safety

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomized, Observer-Blinded (2:2:1 ratio)
Masking
ParticipantInvestigator
Masking Description
Pharmacy will be responsible for all IPs masking, using a masking sleeve on ready to use each injection.
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
mRNA-1273.214 + mRNA-1273.214
Arm Type
Experimental
Arm Description
Fourth & Fifth doses of an investigational mRNA vaccine, 56 days apart N ≈ 60
Arm Title
mRNA-1273.214 + Placebo
Arm Type
Experimental
Arm Description
Fourth dose of an investigational mRNA vaccine followed by a fifth dose of placebo, 56 days apart N ≈ 60
Arm Title
mRNA-1273 + Placebo
Arm Type
Active Comparator
Arm Description
Fourth dose of the commercial mRNA vaccine, followed by a fifth dose of placebo, 56 days apart N ≈ 30
Intervention Type
Biological
Intervention Name(s)
mRNA-1273.214 Vaccine
Intervention Description
Omicron Variant-Matched Vaccine
Intervention Type
Biological
Intervention Name(s)
MRNA-1273 Vaccine
Other Intervention Name(s)
Spikevax
Intervention Description
Moderna's commercial COVID-19 Vaccine
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
Normal Saline for injection
Primary Outcome Measure Information:
Title
Safety of the study vaccines after each dose
Description
Safety of the study vaccines will be measured by solicited and unsolicited adverse injection site reactions and systemic reactions from the time of each vaccination through 7 days post each vaccination/placebo administrations. AEs will be collected up to 29 days after injection. Unsolicited non-serious AEs, SAEs, NOCMCs, and MAAEs will be collected through 6 months after the first vaccine dose.
Time Frame
6 Months
Title
Reactogenicity of the study vaccines after each dose
Description
Reactogenicity of the study vaccines will be measured by solicited and unsolicited adverse injection site reactions and systemic reactions from the time of each vaccination through 7 days post each vaccination/placebo administrations. AEs will be collected up to 29 days after injection. Unsolicited non-serious AEs, SAEs, NOCMCs, and MAAEs will be collected through 6 months after the first vaccine dose. The study will also assess reactogenicity using "Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials" Guide, via an electronic diary the participants would be required to complete every day for 7 consecutive days starting the day of each vaccine.
Time Frame
6 Months
Title
Immune response to mRNA-1273.214, given as a fourth and fifth dose to participants who previously received mRNA primary series vaccination and one booster dose (third dose).
Description
Primary immunogenicity outcome will be measured by changes in geometric titers (GMTs) and geometric fold raise (GMFRs) of IgG and neutralizing antibodies (nAb), using a pseudovirus assay during all visits. Blood for immunogenicity will be collected at all visits (total of 6 visits).
Time Frame
6 Months
Secondary Outcome Measure Information:
Title
Immunogenicity
Description
Describe direct virus neutralization of Omicron VOC, Delta VOC and ancestral SARS-COV-2 VOC. Direct virus neutralization (in Biosafety Level 3 - BL3 - facility) of Omicron variant of concern (VOC) and two (2) additional strains [ancestral SARS-COV-2 and Delta VOC] Measured by GMT.
Time Frame
6 Months
Title
Investigational Product's Efficacy
Description
COVID-19 infections and severity [based on CDC definition] in participants without evidence of past SARS-CoV-2 infection, occurring after day 7 from the booster dose throughout the blinded follow-up period. Laboratory defined SARS-CoV-2 infection and symptomatic COVID-19 and severe COVID-19.
Time Frame
6 Months
Other Pre-specified Outcome Measures:
Title
Exploratory Immunogenicity
Description
Characterize T-cell activation post-boost 1273.214, Interferon Gamma per 106 cells. Characterize B-cell responses post-boost 1273.214. IgA response (IgA GMTs). Characterize any breakthrough cases of SARS-CoV-2 infections or COVID-19 and any SARS-CoV-2 isolates by Culture isolates for optional sequencing.
Time Frame
6 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female participants 21 years of age, inclusively. Individuals who previously received mRNA primary series vaccination AND a booster dose at least 4 months prior to Day 1. Documented confirmation of prior mRNA series vaccination receipt must be obtained prior to randomization. Females and males of childbearing potential must be willing to use effective methods of contraception such as hormones (OCP, oral contraceptive pill), condom or occlusive cap with spermicidal agents, intrauterine device (IUD), or intrauterine system (IUS) as well as to refrain from donating sperm through 28 days following the last vaccination. Participant who is willing and able to comply with all scheduled visits, vaccination plan, laboratory tests, lifestyle considerations, and other study procedures. For Women of Child Bearing Potential (WOCBP): a negative pregnancy test on the day of vaccination (Visit 1 and Visit 4). Participant who is willing and able to operate an electronic diary. Healthy participants who are determined by medical history, physical examination (if required), and clinical judgment of the investigator to be eligible for inclusion in the study. Note: Healthy participants with preexisting stable disease, defined as disease not requiring significant change in therapy or hospitalization for worsening disease during the six (6) weeks before enrollment, can be included. Capable of giving signed informed consent as described which includes understanding and compliance with the study procedures, requirements and restrictions listed in the informed consent form (ICF) and in this protocol. Must agree not to enroll in another study of an investigational agent prior to completion of the study. Exclusion Criteria: History of severe adverse reaction associated with a vaccine and/or severe allergic reaction (e.g., anaphylaxis) to any component of the study intervention(s). Previous clinical (based on COVID-19 symptoms/signs alone, if a SARS-CoV-2 NAAT result was not available) or microbiological (based on COVID-19 symptoms/signs and a positive SARS-CoV-2 NAAT result) diagnosis of COVID-19 or positive antigen test for SARS-CoV-2 at baseline. Immunocompromised individuals with known or suspected immunodeficiency, as determined by history and/or laboratory/physical examination. Has known or suspected allergy or history of anaphylaxis, urticaria, or other significant AR to the vaccine or its excipients. Bleeding diathesis or condition associated with prolonged bleeding that would, in the opinion of the investigator, contraindicate intramuscular injection. Inability to observe possible local reactions at the injection sites due to a physical condition or permanent body art. Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study. Pregnant or breastfeeding women. Individuals who receive treatment with radiotherapy or immunosuppressive therapy, including cytotoxic agents or systemic corticosteroids (if systemic corticosteroids are administered for ≥14 days at a dose of ≥20 mg/day of prednisone or equivalent), e.g., for cancer or an autoimmune disease, or planned receipt throughout the study. Inhaled/nebulized, intra-articular, intrabursal, or topical (skin or eyes) corticosteroids are permitted. Receipt of blood/plasma products, immunoglobulin, or monoclonal antibodies, from 60 days before study intervention administration, or receipt of any passive antibody therapy specific to COVID-19, from 90 days before study intervention administration, or planned receipt throughout the study. Participation in other studies involving study intervention within 28 days prior to study entry through and including 28 days after the last dose of study intervention.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gili Regev-Yochay, MD
Phone
+97235308520
Email
Gili.Regev@sheba.health.gov.il
Facility Information:
Facility Name
Sheba Medical Center
City
Ramat-Gan
ZIP/Postal Code
5265601
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gili Regev-Yochay
Phone
0526666197

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Unidentified data will be available after publication of the results.
IPD Sharing Time Frame
will be available upon publication of results
IPD Sharing Access Criteria
Upon request. Requires collaborator's approval as well.

Learn more about this trial

Safety and Immunogenicity of Omicron Variant-Matched Vaccine Booster in Adults

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