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Combination Study With MVA BN and Dryvax

Primary Purpose

Smallpox

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Live vaccinia virus vaccine
MVA Smallpox Vaccine
MVA Smallpox Vaccine
Placebo
Placebo
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 Smallpox focused on measuring Smallpox, vaccine

Eligibility Criteria

18 Years - 32 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Ages 18-32. Never received smallpox vaccination. Read, signed and dated informed consent document. Availability for follow-up for the planned duration of the study two years after first immunization. Acceptable medical history by screening evaluation and limited physical examination. For women, negative serum pregnancy test at screening and negative urine or serum pregnancy test within 24 hours prior to vaccination. If the volunteer is female and of child bearing potential, she agrees to use acceptable contraception, and not become pregnant for at least 56 days after the last vaccination. A woman is considered of child bearing potential unless post-menopausal or surgically sterilized. [Acceptable contraception methods are restricted to effective intrauterine devices (IUDs) or licensed hormonal products with use of method for a minimum of 30 days prior to vaccination.] Women who are not sexually active must agree to use one of the acceptable contraception methods if they are of childbearing potential. Negative ELISA for HIV. ALT<1.25 times institutional upper limit of normal. Negative hepatitis B surface antigen and negative antibody to hepatitis C virus. Negative urine glucose by dipstick or urinalysis. Adequate renal function defined as a serum creatinine less than or equal to 1.4mg/dL for males and less than or equal to 1.2mg/dL for females; urine protein < 30 mg/dL or none or trace proteinuria (by urinalysis or dipstick); and a calculated creatine clearance greater than or equal to 80 mL/min. based on the following formulas: Males [(140-age in years) X weight in kg]/(72 X serum creatinine) Females 0.85X[(140-age in years) X weight in kg]/(72 X serum creatinine) ECG without clinical significance (e.g., all kinds of atrioventricular or intraventricular conditions or blocks such as complete left or right bundle branch block, AV-node block, QTc or PR prolongation, premature atrial contractions or other atrial arrhythmia, sustained ventricular arrhythmia, or 2 premature ventricular contractions (PVC) in a row, or ST elevation consistent with ischemia) CBC: Hemoglobin >11g/dl; White blood cells greater than 2,500 and less than 11,000/cubic mm; Platelets greater than or equal to 140,000/cubic mm. Exclusion Criteria: History of immunodeficiency. Typical vaccinia scar. Known or suspected history of smallpox vaccination. Military service prior to 1989 or after January 2003. Known or suspected impairment of immunologic function including, but not limited to, clinically significant liver disease; diabetes mellitus; moderate to severe kidney impairment. Malignancy, including squamous cell skin cancer or basal cell skin cancer at vaccination site or history of skin cancer at the vaccination site. Active autoimmune disease. Persons with vitiligo or thyroid disease on thyroid replacement are not excluded. History of keloid formation. History of myocardial infarction, angina, congestive heart failure, cardiomyopathy, stroke or transient ischemic attack, or other heart condition under the care of a doctor. History of an immediate family member (father, mother, brother or sister) who has had onset of ischemic heart disease before age 50 years. Ten percent or greater risk of developing a myocardial infarction or coronary death within the next 10 years using the National Cholesterol Education Program's Risk Assessment Tool for Estimating Your 10-Year Risk of Having a Heart Attack, located at the following URL: http://hin.nhlbi.nih.gov/atpiii/calculator.asp. NOTE: This criterion applies only to volunteers 20 years of age and older. Abnormal troponin I. Use of immunosuppressive medication. Corticosteroid nasal sprays are permissible. Persons who have used topical steroid can be enrolled after their therapy is completed. Medical or psychiatric condition or occupational responsibilities that preclude volunteer compliance with the protocol. Any history of "illegal" injection drug use. Receipt of inactivated vaccine 14 days prior to vaccination. Receipt of live attenuated vaccines within 30 days of vaccination. Use of experimental agents within 30 days prior to vaccination. Receipt of blood products or immunoglobulin in the 6 months prior to vaccination. Acute febrile illness (greater than or equal to 100.5 degrees F) on the day of vaccination. Pregnant or lactating women. Eczema of any degree or history of eczema. People with atopic dermatitis, Varicella zoster, chronic exfoliative skin disorders/conditions or any acute skin disorders of large magnitude, e.g., laceration requiring sutures, burn greater than 2x2 cm. Household contacts/sexual contacts with, or occupational exposure to (other than minimal contact), any of the following: Pregnant women; Children <12 months of age; People with or history of eczema; People with atopic dermatitis, Varicella zoster, chronic exfoliative skin disorders/conditions or any acute skin disorders of large magnitude, e.g., laceration requiring sutures, burn greater than 2x2 cm; People with immunodeficiency disease or use of immunosuppressive medications. Any condition that, in the opinion of the investigator, might interfere with study objectives. Known allergies to or any component of MVA or MVA-BN vaccine (e.g., tris(hydroxymethl)-amino methane, sodium chloride, sucrose, dextran, L-Glutamic acid monopotassium, chicken embryo fibroblast proteins, gentamycin). Known allergy to egg or aminoglycoside. Known allergies to any component of the Dryvax® vaccine (e.g. polymyxin B sulfate, dihydrostreptomycin sulfate, chlorotetracycline hydrochloride, neomycin sulfate). Known allergies to any known component of the Dryvax® diluent (i.e. glycerin and phenol). Known allergies to any known components of vaccinia immunoglobulin (VIG), i.e. thimerosal or previous allergic reaction to immunoglobulins. Known allergies to cidofovir or probenecid. Study personnel.

Sites / Locations

  • Saint Louis University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Active Comparator

Experimental

Experimental

Experimental

Experimental

Arm Label

E

D

C

B

A

F

Arm Description

Subject will receive an SC dose of MVA 1x10^8 on day 0 and day 28. On day 112 subjects will receive a dose of placebo by scarification.

Subject will receive a SC dose of placebo on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.

Subject will receive a SC dose of MVA 1x10^8 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.

Subjects will receive a SC dose of MVA 5x10^7 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.

Subjects will receive a SC dose of MVA 2x10^7 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.

Subject will receive an IM dose of MVA 1x10^8 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.

Outcomes

Primary Outcome Measures

Adverse Events and side effects to the vaccines.

Secondary Outcome Measures

Immunogenicity testing of antibody and cellular responses to the vaccines.

Full Information

First Posted
May 10, 2004
Last Updated
December 18, 2014
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT00082446
Brief Title
Combination Study With MVA BN and Dryvax
Official Title
A Phase I Clinical Trial to Evaluate the Safety and Immunogenicity of MVA-BN in a Dose Response Regimen Followed by Administration of Dryvax in Healthy Adult Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
September 2008
Overall Recruitment Status
Completed
Study Start Date
May 2004 (undefined)
Primary Completion Date
August 2007 (Actual)
Study Completion Date
August 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
The overall goals of this study are to expand the available data on the safety and immunogenicity of MVA-BN in vaccinia-naive adults and to determine the optimum dose of MVA-BN to induce immune responses and attenuate Dryvax take reactions. Participants will include 90 healthy volunteers, ages 18-32 years. Participants will be randomly assigned to 1 of 6 study groups (groups A-F). Participants will be involved in study related procedures for up to 2 years. During this time, volunteers will return periodically for blood draws to check immune responses.
Detailed Description
The primary goal of this phase I trial is to expand the available data on the safety and immunogenicity of MVA-BN in vaccinia-naïve adults. The secondary goals of this vaccine trial are: to determine the optimum dose of MVA-BN, given twice, to induce an immune response and attenuate Dryvax® take reactions; and to compare the ability of 2 routes of administration of MVA-BN, subcutaneous and intramuscular, to induce an immune response at the highest tested dose. A total of 90 healthy adult volunteers ages 18-32 will participate in this study. The volunteers will be randomly assigned to 1 of 6 groups to be immunized with: MVA-BN (subcutaneously) at 1 of 3 dose levels and Dryvax® (per scarification); placebo (subcutaneously) and Dryvax® (per scarification); MVA-BN (subcutaneously) at the highest dose level and placebo scarification; or MVA-BN (intramuscularly) at the highest dose level and Dryvax® (per scarification). The study will last about 30 months. Each volunteer's participation will last 6 months for all treatment groups. Subjects randomized to treatment groups D and E will have follow-up for 2 years. During this time, volunteers will return periodically for blood draws to check immune responses. Subjects will require visits for dressing changes as needed post-Dryvax vaccination. Variables to be investigated include: adverse events and side effects to the vaccines, and immunogenicity testing including antibody and cellular responses to the vaccines.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
91 (Actual)

8. Arms, Groups, and Interventions

Arm Title
E
Arm Type
Experimental
Arm Description
Subject will receive an SC dose of MVA 1x10^8 on day 0 and day 28. On day 112 subjects will receive a dose of placebo by scarification.
Arm Title
D
Arm Type
Active Comparator
Arm Description
Subject will receive a SC dose of placebo on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.
Arm Title
C
Arm Type
Experimental
Arm Description
Subject will receive a SC dose of MVA 1x10^8 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.
Arm Title
B
Arm Type
Experimental
Arm Description
Subjects will receive a SC dose of MVA 5x10^7 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.
Arm Title
A
Arm Type
Experimental
Arm Description
Subjects will receive a SC dose of MVA 2x10^7 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.
Arm Title
F
Arm Type
Experimental
Arm Description
Subject will receive an IM dose of MVA 1x10^8 on day 0 and day 28. On day 112 subjects will receive a dose of Dryvax® by scarification.
Intervention Type
Biological
Intervention Name(s)
Live vaccinia virus vaccine
Intervention Description
Dryvax®: 0.25 mL of vaccine will be administered by the standard route of scarification using a bifurcated needle on day 112 for Groups A, B, C, D and F.
Intervention Type
Biological
Intervention Name(s)
MVA Smallpox Vaccine
Intervention Description
Imvamune/MVA-BN 1x10^8 will be administered intramuscularly to Group F on day 0 and day 28.
Intervention Type
Biological
Intervention Name(s)
MVA Smallpox Vaccine
Intervention Description
Imvamune/MVA-BN Groups A, B C and E will be administered subcutaneously: 2x10^7, 5x10^7, 1x10^8, 1x10^8, respectively, on days 0 and day 28.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Group E will receive sterile saline placebo for injection via scarification on day 112.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Group D will receive sterile saline placebo for injection subcutaneously on day 0 and day 28.
Primary Outcome Measure Information:
Title
Adverse Events and side effects to the vaccines.
Time Frame
Reactogenicity will be evaluated for a 2-week period post-vaccination at each time point and for the duration of study.
Secondary Outcome Measure Information:
Title
Immunogenicity testing of antibody and cellular responses to the vaccines.
Time Frame
Visit days 0, 14, 28, 42, 56, 112, 140, 182, 365, and 730.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
32 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Ages 18-32. Never received smallpox vaccination. Read, signed and dated informed consent document. Availability for follow-up for the planned duration of the study two years after first immunization. Acceptable medical history by screening evaluation and limited physical examination. For women, negative serum pregnancy test at screening and negative urine or serum pregnancy test within 24 hours prior to vaccination. If the volunteer is female and of child bearing potential, she agrees to use acceptable contraception, and not become pregnant for at least 56 days after the last vaccination. A woman is considered of child bearing potential unless post-menopausal or surgically sterilized. [Acceptable contraception methods are restricted to effective intrauterine devices (IUDs) or licensed hormonal products with use of method for a minimum of 30 days prior to vaccination.] Women who are not sexually active must agree to use one of the acceptable contraception methods if they are of childbearing potential. Negative ELISA for HIV. ALT<1.25 times institutional upper limit of normal. Negative hepatitis B surface antigen and negative antibody to hepatitis C virus. Negative urine glucose by dipstick or urinalysis. Adequate renal function defined as a serum creatinine less than or equal to 1.4mg/dL for males and less than or equal to 1.2mg/dL for females; urine protein < 30 mg/dL or none or trace proteinuria (by urinalysis or dipstick); and a calculated creatine clearance greater than or equal to 80 mL/min. based on the following formulas: Males [(140-age in years) X weight in kg]/(72 X serum creatinine) Females 0.85X[(140-age in years) X weight in kg]/(72 X serum creatinine) ECG without clinical significance (e.g., all kinds of atrioventricular or intraventricular conditions or blocks such as complete left or right bundle branch block, AV-node block, QTc or PR prolongation, premature atrial contractions or other atrial arrhythmia, sustained ventricular arrhythmia, or 2 premature ventricular contractions (PVC) in a row, or ST elevation consistent with ischemia) CBC: Hemoglobin >11g/dl; White blood cells greater than 2,500 and less than 11,000/cubic mm; Platelets greater than or equal to 140,000/cubic mm. Exclusion Criteria: History of immunodeficiency. Typical vaccinia scar. Known or suspected history of smallpox vaccination. Military service prior to 1989 or after January 2003. Known or suspected impairment of immunologic function including, but not limited to, clinically significant liver disease; diabetes mellitus; moderate to severe kidney impairment. Malignancy, including squamous cell skin cancer or basal cell skin cancer at vaccination site or history of skin cancer at the vaccination site. Active autoimmune disease. Persons with vitiligo or thyroid disease on thyroid replacement are not excluded. History of keloid formation. History of myocardial infarction, angina, congestive heart failure, cardiomyopathy, stroke or transient ischemic attack, or other heart condition under the care of a doctor. History of an immediate family member (father, mother, brother or sister) who has had onset of ischemic heart disease before age 50 years. Ten percent or greater risk of developing a myocardial infarction or coronary death within the next 10 years using the National Cholesterol Education Program's Risk Assessment Tool for Estimating Your 10-Year Risk of Having a Heart Attack, located at the following URL: http://hin.nhlbi.nih.gov/atpiii/calculator.asp. NOTE: This criterion applies only to volunteers 20 years of age and older. Abnormal troponin I. Use of immunosuppressive medication. Corticosteroid nasal sprays are permissible. Persons who have used topical steroid can be enrolled after their therapy is completed. Medical or psychiatric condition or occupational responsibilities that preclude volunteer compliance with the protocol. Any history of "illegal" injection drug use. Receipt of inactivated vaccine 14 days prior to vaccination. Receipt of live attenuated vaccines within 30 days of vaccination. Use of experimental agents within 30 days prior to vaccination. Receipt of blood products or immunoglobulin in the 6 months prior to vaccination. Acute febrile illness (greater than or equal to 100.5 degrees F) on the day of vaccination. Pregnant or lactating women. Eczema of any degree or history of eczema. People with atopic dermatitis, Varicella zoster, chronic exfoliative skin disorders/conditions or any acute skin disorders of large magnitude, e.g., laceration requiring sutures, burn greater than 2x2 cm. Household contacts/sexual contacts with, or occupational exposure to (other than minimal contact), any of the following: Pregnant women; Children <12 months of age; People with or history of eczema; People with atopic dermatitis, Varicella zoster, chronic exfoliative skin disorders/conditions or any acute skin disorders of large magnitude, e.g., laceration requiring sutures, burn greater than 2x2 cm; People with immunodeficiency disease or use of immunosuppressive medications. Any condition that, in the opinion of the investigator, might interfere with study objectives. Known allergies to or any component of MVA or MVA-BN vaccine (e.g., tris(hydroxymethl)-amino methane, sodium chloride, sucrose, dextran, L-Glutamic acid monopotassium, chicken embryo fibroblast proteins, gentamycin). Known allergy to egg or aminoglycoside. Known allergies to any component of the Dryvax® vaccine (e.g. polymyxin B sulfate, dihydrostreptomycin sulfate, chlorotetracycline hydrochloride, neomycin sulfate). Known allergies to any known component of the Dryvax® diluent (i.e. glycerin and phenol). Known allergies to any known components of vaccinia immunoglobulin (VIG), i.e. thimerosal or previous allergic reaction to immunoglobulins. Known allergies to cidofovir or probenecid. Study personnel.
Facility Information:
Facility Name
Saint Louis University
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23349878
Citation
Elizaga ML, Vasan S, Marovich MA, Sato AH, Lawrence DN, Chaitman BR, Frey SE, Keefer MC; MVA Cardiac Safety Working Group. Prospective surveillance for cardiac adverse events in healthy adults receiving modified vaccinia Ankara vaccines: a systematic review. PLoS One. 2013;8(1):e54407. doi: 10.1371/journal.pone.0054407. Epub 2013 Jan 17.
Results Reference
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Combination Study With MVA BN and Dryvax

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