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Age and Response to Flu Vaccines

Primary Purpose

Influenza, Influenza Immunisation

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Influenza Virus Quadrivalent Inactivated Vaccine
Influenza Virus Quadrivalent Inactivated Vaccine
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Influenza focused on measuring B Cell Response, Children, Evaluation, Healthy Adults, Influenza Vaccine

Eligibility Criteria

9 Years - 99 Years (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Aged equal to or greater than 9 years of age and weigh at least 50 pounds
  2. The subject must be in good health, as determined by: medical history; and targeted physical examination, when necessary, based on medical history. Stable medical or psychiatric condition is defined as: no recent increase in prescription medication, dose, or frequency of medication in the last 3 months and health outcomes of the specific disease are considered to be within acceptable limits in the last 6 months
  3. The subject is able to understand and comply with the planned study procedures, including being available for all study visits
  4. The subject/parent has provided informed consent/assent prior to any study procedures
  5. Subjects who have not received seasonal flu vaccine for the current year

Exclusion Criteria:

  1. Subject report of known hypersensitivity to allergy to components of the study vaccine or other components of the study vaccine
  2. Subject report of known latex allergy
  3. Subject report of a history of severe reactions following previous immunization with licensed or unlicensed influenza virus vaccines
  4. Subject report of a history of Guillain-Barre syndrome within 6 weeks of receipt of a previous influenza vaccine
  5. The subject is a female of childbearing potential who is currently pregnant or breastfeeding or intends to become pregnant during the study period between enrollment and 90 days following receipt of vaccine. Pregnancy will be determined by subject interview. Pregnancy testing is not done in this study since there is no increased risk in pregnancy
  6. The subject is immunosuppressed as a result of an underlying illness or treatment with immunosuppressive or cytotoxic drugs, or use of anticancer chemotherapy or radiation therapy within the preceding 36 months
  7. The subject has an active neoplastic disease (excluding non-melanoma skin cancer or prostate cancer that is stable in the absence of therapy) or a history of any hematological malignancy. For this criterion, "active" is defined as having received treatment within the past 5 years
  8. Have taken high-dose inhaled corticosteroids within 30 days prior to study vaccination. High-dose defined as per age as using inhaled high dose per reference chart https://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/quick-reference-html#estimated-comparative-daily-doses
  9. The subject received immunoglobulin or another blood product within the 3 months prior to enrollment in this study
  10. The subject has received an inactivated vaccine within the 2 weeks or a live vaccine within the 4 weeks prior to enrollment in this study or plans to receive another vaccine within the next 28 days after vaccination
  11. The subject has an acute or chronic medical condition that, in the opinion of the investigator or appropriate sub-investigator, would render vaccination unsafe or would interfere with the evaluation of responses. These conditions include any acute or chronic medical disease or conditions defined as persisting for 3 months (defined as 90 days) or longer, that would place the subject at an unacceptable risk of injury, render the subject unable to meet the requirements of the protocol, or may interfere with the evaluation of responses of the subject's successful completion of the study
  12. Subjects with an active infection or that has an acute illness or an oral temperature greater than 99.9 degrees Fahrenheit (37.7 degrees Celsius) within 3 days prior to enrollment or vaccination. Subjects who had an acute illness that was treated symptoms resolved are eligible to enroll as long as treatment is completed and symptoms resolved > 3 days prior to enrollment
  13. The subject is currently participating or plans to participate in a study that involves an experimental agent (vaccine, drug, biologic, device, blood product, or medication) or has received an experimental agent within 1 month prior to enrollment in this study, or expects to receive another experimental agent during participation in this study, or intends to donate blood during the study period
  14. The subject has any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol
  15. The subject has a history of alcohol or drug abuse in the 5 years prior to enrollment
  16. The subject has a known human immunodeficiency virus, hepatitis B, or hepatitis C infection
  17. Subject weighs less than 50 lbs
  18. Subject expects to have a medical procedure during the upcoming 8 weeks that estimates blood loss to exceed 400 cc for adults or for children would exceed 3 ml/kg

Sites / Locations

  • Rochester General Hospital - Infectious Disease Unit
  • University of Rochester Medical Center - Strong Memorial Hospital - Infectious Diseases

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

0.5 mL dose of quadrivalent (IIV-4) vaccine administered once intramuscularly, n=240

Outcomes

Primary Outcome Measures

Magnitude of the Serum Antibody Response by Hemagglutination-inhibition (HAI)
A/Hong Kong/4801/2014 (H3N2) day 28 Season 2017-2018
Magnitude of the Serum Antibody Response by Microneutralization (MN)
A/Hong Kong/4801/2014 (H3N2) Day 28 MN Season 2017-2018
Serum Antibody Response by Hemagglutination-inhibition (HAI)
A/Hong Kong/4801/2014 (H3N2) Day 90 Season 2017-2018
Serum Antibody Response by Microneutralization (MN)
A/Hong Kong/4801/2014 (H3N2) Day 90 MN Season 2017-2018
Specificity of the Serum Antibody Response by Hemagglutination-inhibition (HAI)
A/H1N1/Michigan/45/2015 pdm09 Day 28 Season 2017-2018
Specificity of the Serum Antibody Response by Microneutralization (MN)
A/H1N1/Michigan/45/2015 pdm09 Day 28 Season 2017-18

Secondary Outcome Measures

Age at Time of First Influenza A Exposure
Comparison between groups: subjects who develop symptomatic influenza (Vaccine Failures) vs. subjects who do not
Baseline B Cell Reactivity
Comparison between groups: subjects who develop symptomatic influenza (Vaccine Failures) vs. subjects who do not
Vaccine History (Number and Percentage of Participants to Receive Vaccine)
Comparison between groups: subjects who develop symptomatic influenza (Vaccine Failures) vs. subjects who do not

Full Information

First Posted
October 26, 2017
Last Updated
April 29, 2021
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03328325
Brief Title
Age and Response to Flu Vaccines
Official Title
Evaluation of the Effects of Age, Prior Exposure, and Previous Vaccination on the B Cell Response to Inactivated Influenza Vaccine in Healthy Adults and Children
Study Type
Interventional

2. Study Status

Record Verification Date
March 3, 2021
Overall Recruitment Status
Completed
Study Start Date
December 14, 2017 (Actual)
Primary Completion Date
February 9, 2020 (Actual)
Study Completion Date
April 20, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
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.
No

5. Study Description

Brief Summary
The study will be designed as a prospective surveillance of the immune response to seasonal influenza vaccination in 240 healthy children and adults ages 9 and over. Study duration will be 5 years, with a participant duration of 6 months. Subjects will receive a quadrivalent inactivated influenza vaccine, at a dose of not less than 15 ug of hemagglutinin (HA), by intramuscular injection in open label fashion on day 0. Blood draws will occur at baseline, day 7, 28 and 90. The primary objective of this study is to evaluate the relationship between first influenza A virus exposure (inferred by age), vaccine history, and baseline serum antibody response to seasonal influenza vaccine in healthy adults and children.
Detailed Description
The study will be designed as a prospective surveillance of the immune response to seasonal influenza vaccination in 240 healthy children and adults ages 9 and over. Study duration will be 5 years, with a participant duration of 6 months. Subjects will receive a quadrivalent inactivated influenza vaccine, at a dose of not less than 15 ug of hemagglutinin (HA), by intramuscular injection in open label fashion on day 0. Blood draws will occur at baseline, day 7, 28 and 90. The primary hypothesis being tested in this study is that there will be differences in the specificity and magnitude of the HA-specific B cell response depending on the age, previous vaccine history and baseline B cell reactivity. The primary objective of this study is to evaluate the relationship between first influenza A virus exposure (inferred by age), vaccine history, and baseline serum antibody response to seasonal influenza vaccine in healthy adults and children. The secondary objective is to evaluate factors related to failure of vaccine to provide protection against symptomatic influenza and the immune response to infection in vaccinated individuals by prospective surveillance of the vaccine cohort.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza, Influenza Immunisation
Keywords
B Cell Response, Children, Evaluation, Healthy Adults, Influenza Vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
152 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
0.5 mL dose of quadrivalent (IIV-4) vaccine administered once intramuscularly, n=240
Intervention Type
Biological
Intervention Name(s)
Influenza Virus Quadrivalent Inactivated Vaccine
Intervention Description
A seasonal quadrivalent inactivated influenza vaccine (IIV4), prepared from influenza viruses propagated in embryonated chicken eggs, protecting against 2 influenza A subtypes and 2 influenza B subtypes: A/Singapore/GP1908/2015 (H1N1) IVR-180 (an A/Michigan/45/2015 [H1N1] pdm09-like virus), A/Singapore/INFIMH-16-0019/2016 (H3N2) IVR-186, B/Maryland/15/2016 NYMC BX-69A, (a B/Colorado/06/2017-like virus), and B/Phuket/3073/2013.
Intervention Type
Biological
Intervention Name(s)
Influenza Virus Quadrivalent Inactivated Vaccine
Intervention Description
A seasonal quadrivalent inactivated influenza vaccine (IIV4), prepared from influenza viruses propagated in embryonated chicken eggs, protecting against 2 influenza A subtypes and 2 influenza B subtypes: A/Singapore/GP1908/2015 (H1N1) IVR-180 (an A/Michigan/45/2015 [H1N1] pdm09-like virus), A/Singapore/INFIMH-16-0019/2016 (H3N2) NIB-104, B/Maryland/15/2016 NYMC BX-69A (a B/Colorado/06/2017-like virus), and B/Phuket/3073/2013.
Primary Outcome Measure Information:
Title
Magnitude of the Serum Antibody Response by Hemagglutination-inhibition (HAI)
Description
A/Hong Kong/4801/2014 (H3N2) day 28 Season 2017-2018
Time Frame
Through Day 28
Title
Magnitude of the Serum Antibody Response by Microneutralization (MN)
Description
A/Hong Kong/4801/2014 (H3N2) Day 28 MN Season 2017-2018
Time Frame
Day 28
Title
Serum Antibody Response by Hemagglutination-inhibition (HAI)
Description
A/Hong Kong/4801/2014 (H3N2) Day 90 Season 2017-2018
Time Frame
Day 90
Title
Serum Antibody Response by Microneutralization (MN)
Description
A/Hong Kong/4801/2014 (H3N2) Day 90 MN Season 2017-2018
Time Frame
Day 90
Title
Specificity of the Serum Antibody Response by Hemagglutination-inhibition (HAI)
Description
A/H1N1/Michigan/45/2015 pdm09 Day 28 Season 2017-2018
Time Frame
Day 28
Title
Specificity of the Serum Antibody Response by Microneutralization (MN)
Description
A/H1N1/Michigan/45/2015 pdm09 Day 28 Season 2017-18
Time Frame
Day 28
Secondary Outcome Measure Information:
Title
Age at Time of First Influenza A Exposure
Description
Comparison between groups: subjects who develop symptomatic influenza (Vaccine Failures) vs. subjects who do not
Time Frame
Baseline
Title
Baseline B Cell Reactivity
Description
Comparison between groups: subjects who develop symptomatic influenza (Vaccine Failures) vs. subjects who do not
Time Frame
Baseline
Title
Vaccine History (Number and Percentage of Participants to Receive Vaccine)
Description
Comparison between groups: subjects who develop symptomatic influenza (Vaccine Failures) vs. subjects who do not
Time Frame
Baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
9 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Aged equal to or greater than 9 years of age and weigh at least 50 pounds The subject must be in good health, as determined by: medical history; and targeted physical examination, when necessary, based on medical history. Stable medical or psychiatric condition is defined as: no recent increase in prescription medication, dose, or frequency of medication in the last 3 months and health outcomes of the specific disease are considered to be within acceptable limits in the last 6 months The subject is able to understand and comply with the planned study procedures, including being available for all study visits The subject/parent has provided informed consent/assent prior to any study procedures Subjects who have not received seasonal flu vaccine for the current year Exclusion Criteria: Subject report of known hypersensitivity to allergy to components of the study vaccine or other components of the study vaccine Subject report of known latex allergy Subject report of a history of severe reactions following previous immunization with licensed or unlicensed influenza virus vaccines Subject report of a history of Guillain-Barre syndrome within 6 weeks of receipt of a previous influenza vaccine The subject is a female of childbearing potential who is currently pregnant or breastfeeding or intends to become pregnant during the study period between enrollment and 90 days following receipt of vaccine. Pregnancy will be determined by subject interview. Pregnancy testing is not done in this study since there is no increased risk in pregnancy The subject is immunosuppressed as a result of an underlying illness or treatment with immunosuppressive or cytotoxic drugs, or use of anticancer chemotherapy or radiation therapy within the preceding 36 months The subject has an active neoplastic disease (excluding non-melanoma skin cancer or prostate cancer that is stable in the absence of therapy) or a history of any hematological malignancy. For this criterion, "active" is defined as having received treatment within the past 5 years Have taken high-dose inhaled corticosteroids within 30 days prior to study vaccination. High-dose defined as per age as using inhaled high dose per reference chart https://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/quick-reference-html#estimated-comparative-daily-doses The subject received immunoglobulin or another blood product within the 3 months prior to enrollment in this study The subject has received an inactivated vaccine within the 2 weeks or a live vaccine within the 4 weeks prior to enrollment in this study or plans to receive another vaccine within the next 28 days after vaccination The subject has an acute or chronic medical condition that, in the opinion of the investigator or appropriate sub-investigator, would render vaccination unsafe or would interfere with the evaluation of responses. These conditions include any acute or chronic medical disease or conditions defined as persisting for 3 months (defined as 90 days) or longer, that would place the subject at an unacceptable risk of injury, render the subject unable to meet the requirements of the protocol, or may interfere with the evaluation of responses of the subject's successful completion of the study Subjects with an active infection or that has an acute illness or an oral temperature greater than 99.9 degrees Fahrenheit (37.7 degrees Celsius) within 3 days prior to enrollment or vaccination. Subjects who had an acute illness that was treated symptoms resolved are eligible to enroll as long as treatment is completed and symptoms resolved > 3 days prior to enrollment The subject is currently participating or plans to participate in a study that involves an experimental agent (vaccine, drug, biologic, device, blood product, or medication) or has received an experimental agent within 1 month prior to enrollment in this study, or expects to receive another experimental agent during participation in this study, or intends to donate blood during the study period The subject has any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol The subject has a history of alcohol or drug abuse in the 5 years prior to enrollment The subject has a known human immunodeficiency virus, hepatitis B, or hepatitis C infection Subject weighs less than 50 lbs Subject expects to have a medical procedure during the upcoming 8 weeks that estimates blood loss to exceed 400 cc for adults or for children would exceed 3 ml/kg
Facility Information:
Facility Name
Rochester General Hospital - Infectious Disease Unit
City
Rochester
State/Province
New York
ZIP/Postal Code
14621-3001
Country
United States
Facility Name
University of Rochester Medical Center - Strong Memorial Hospital - Infectious Diseases
City
Rochester
State/Province
New York
ZIP/Postal Code
14642-0001
Country
United States

12. IPD Sharing Statement

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Age and Response to Flu Vaccines

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