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Adaptive Immune Responses and Repertoire in Influenza Vaccination and Infection (SLVP031)

Primary Purpose

Influenza

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Fluzone®
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 Quadrivalent, inactivated influenza vaccine, Quadrivalent, live, attenuated influenza vaccine, Identical twin adults

Eligibility Criteria

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

Inclusion Criteria:

  1. Otherwise healthy 18-49 years old identical (MZ) twins identified as DR1501+ or DR0701+ by lab assay results. Both twins in the pair must be willing to participate in the study.
  2. Willing 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 and vital signs.

Exclusion Criteria:

  1. Prior off-study vaccination with the current year's seasonal influenza vaccine.
  2. Allergy to egg or egg products or to vaccine components including gentamicin, gelatin, arginine or MSG
  3. Life-threatening reactions to previous influenza vaccinations
  4. Asthma (a contraindication for receipt of LAIV4)
  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, including, but not limited to, clinically significant liver disease, diabetes mellitus treated with insulin, moderate to severe renal disease, or any other chronic disorder which, in the opinion of the investigator, might jeopardize volunteer safety or compliance with the protocol.
  8. Blood pressure >150 systolic or >95 diastolic at first study visit and the day of vaccination.
  9. Hospitalization in the past year for congestive heart failure or emphysema.
  10. Chronic Hepatitis B or C.
  11. Recent or current use of immunosuppressive medication, including systemic glucocorticoids (corticosteroid nasal sprays and topical steroids are permissible in all groups; inhaled steroid use is not permissible)
  12. Participants who care for severely immunosuppressed persons that require a protective environment should not receive LAIV, or should avoid contact with such persons for 7 days after receipt, given the theoretical risk for transmission of the live attenuated vaccine virus to close contacts. [If yes, may be ineligible]
  13. 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).
  14. 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.
  15. History of blood dyscrasias, renal disease, or hemoglobinopathies requiring regular medical follow up or hospitalization during the preceding year
  16. 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 must be reviewed by investigator to determine if this would affect the volunteer's safety.
  17. Has taken an influenza antiviral medication within 48 hours prior to study vaccination [If yes, may not eligible if unable to schedule at an appropriate interval].
  18. Receipt of blood or blood products within the past 6 months or planned used during the study.
  19. Medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol
  20. Receipt of an inactivated vaccine 14 days prior to study enrollment, or planned vaccinations prior to completion of last study visit ( ~ 28 days after study vaccination)
  21. Receipt of a live, attenuated vaccine within 60 days prior to enrollment of planned vaccination prior to completion of last study visit (~ 28 days after study vaccination)
  22. Need for allergy immunization (that cannot be postponed) during the study period.
  23. History of Guillain-Barré syndrome
  24. Pregnant or lactating woman
  25. Use of investigational agents within 30 days prior to enrollment or planned use during the study.
  26. Donation of the equivalent of a unit of blood within 6 weeks prior to enrollment or planned donation prior to completion of the last visit.
  27. 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 School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Other

Arm Label

LAIV randomized

IIV4 randomized

Arm Description

Volunteers are past participants who have been identified as HLA DR1501+ or DR0701+ by lab assay results. All participants will be randomized within the twin pair to receive either the seasonal quadrivalent live, attenuated influenza vaccine (LAIV4)/ FluMist® or the seasonal quadrivalent inactivated influenza vaccine (IIV4)/ Fluzone® .

Volunteers are past participants who have been identified as HLA DR1501+ or DR0701+ by lab assay results. All participants will be randomized within the twin pair to receive either the seasonal quadrivalent live, attenuated influenza vaccine (LAIV4)/ FluMist® or the seasonal quadrivalent inactivated influenza vaccine (IIV4)/ Fluzone®

Outcomes

Primary Outcome Measures

Number of Participants Who Received Influenza Vaccine
Number of individual twins who received either LAIV or IIV4 as dictated by their group assignment

Secondary Outcome Measures

Number of Participants With Related Adverse Events
Number of individual twins who experienced related adverse events through the course of the study.

Full Information

First Posted
January 19, 2017
Last Updated
August 10, 2017
Sponsor
Stanford University
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03028987
Brief Title
Adaptive Immune Responses and Repertoire in Influenza Vaccination and Infection (SLVP031)
Official Title
Project 1. The Role of CD4+ Memory Phenotype, Memory, and Effector T-Cells in Vaccination and Infection - Influenza-specific DR1501+ and DR0701+ T-cells
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Terminated
Why Stopped
LAIV was no longer recommended by ACIP
Study Start Date
November 19, 2014 (Actual)
Primary Completion Date
November 18, 2015 (Actual)
Study Completion Date
November 18, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Stanford University
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is provide a better understanding of the adaptive immune response to the licensed flu vaccines. The investigators hope the information learned from this study will help identify and describe important factors of influenza immunity especially of or specific proteins associated with the T-cell immune response.
Detailed Description
This is a study of up to 20 healthy monozygotic (MZ) twins, 18-49 years old, that are participants from past Stanford-LPCH Vaccine Program trials and who have been identified as human leukocyte antigen (HLA) DR1501+ or DR0701+ by lab assay results. Volunteers will be contacted to assess interest in participating in this study. Both twins in the pair must be willing to participate in the study. All participants will be randomized within the twin pair to receive either the seasonal live, attenuated influenza vaccine (LAIV) or the seasonal quadrivalent inactivated influenza vaccine (IIV4). Immunization will be at Day 0, blood samples for immunogenicity assays will be collected prior to immunization and at Days 7 (6-8) and 28 (24-32). This study was halted due to the Advisory Committee on Immunization Practices decision not to recommend use of LAIV.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
Quadrivalent, inactivated influenza vaccine, Quadrivalent, live, attenuated influenza vaccine, Identical twin adults

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
LAIV randomized
Arm Type
Other
Arm Description
Volunteers are past participants who have been identified as HLA DR1501+ or DR0701+ by lab assay results. All participants will be randomized within the twin pair to receive either the seasonal quadrivalent live, attenuated influenza vaccine (LAIV4)/ FluMist® or the seasonal quadrivalent inactivated influenza vaccine (IIV4)/ Fluzone® .
Arm Title
IIV4 randomized
Arm Type
Other
Arm Description
Volunteers are past participants who have been identified as HLA DR1501+ or DR0701+ by lab assay results. All participants will be randomized within the twin pair to receive either the seasonal quadrivalent live, attenuated influenza vaccine (LAIV4)/ FluMist® or the seasonal quadrivalent inactivated influenza vaccine (IIV4)/ Fluzone®
Intervention Type
Biological
Intervention Name(s)
Fluzone®
Intervention Description
Fluzone® Quadrivalent (IIV4; inactivated influenza virus vaccine)
Intervention Type
Biological
Intervention Name(s)
FluMist®
Intervention Description
FluMist® Intranasal Spray (quadrivalent, live, attenuated influenza vaccine)
Primary Outcome Measure Information:
Title
Number of Participants Who Received Influenza Vaccine
Description
Number of individual twins who received either LAIV or IIV4 as dictated by their group assignment
Time Frame
Day 0
Secondary Outcome Measure Information:
Title
Number of Participants With Related Adverse Events
Description
Number of individual twins who experienced related adverse events through the course of the study.
Time Frame
Day 0 to 28 post-immunization

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: Otherwise healthy 18-49 years old identical (MZ) twins identified as DR1501+ or DR0701+ by lab assay results. Both twins in the pair must be willing to participate in the study. Willing 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 and vital signs. Exclusion Criteria: Prior off-study vaccination with the current year's seasonal influenza vaccine. Allergy to egg or egg products or to vaccine components including gentamicin, gelatin, arginine or MSG Life-threatening reactions to previous influenza vaccinations Asthma (a contraindication for receipt of LAIV4) 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, including, but not limited to, clinically significant liver disease, diabetes mellitus treated with insulin, moderate to severe renal disease, or any other chronic disorder which, in the opinion of the investigator, might jeopardize volunteer safety or compliance with the protocol. Blood pressure >150 systolic or >95 diastolic at first study visit and the day of vaccination. 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 in all groups; inhaled steroid use is not permissible) Participants who care for severely immunosuppressed persons that require a protective environment should not receive LAIV, or should avoid contact with such persons for 7 days after receipt, given the theoretical risk for transmission of the live attenuated vaccine virus to close contacts. [If yes, may be ineligible] 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 must be reviewed by investigator to determine if this would affect the volunteer's safety. Has taken an influenza antiviral medication within 48 hours prior to study vaccination [If yes, may not eligible if unable to schedule at an appropriate interval]. Receipt of blood or blood products within the past 6 months or planned used during the study. 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 ( ~ 28 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 (~ 28 days after study vaccination) Need for allergy immunization (that cannot be postponed) during the study period. History of Guillain-Barré syndrome Pregnant or lactating 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 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.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cornelia Dekker, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mark Davis, PhD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
K. Christopher Garcia, PhD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Adaptive Immune Responses and Repertoire in Influenza Vaccination and Infection (SLVP031)

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