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Fever After Simultaneous Versus Sequential Vaccination in Young Children

Primary Purpose

Fever After Vaccination, Fever, Febrile Seizure

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
PCV13
DTaP
IIV
Sponsored by
Duke University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Fever After Vaccination focused on measuring Influenza vaccine, fever following vaccination, PCV13 vaccine, DTaP vaccine, pneumococcal vaccine

Eligibility Criteria

12 Months - 16 Months (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. 12 through 16 months of age (i.e. from the 1-year birthday until the day before 17 months of age) at the time of vaccination
  2. Stable health as determined by investigator's clinical examination and assessment of child's medical history
  3. Has received all immunizations recommended by Advisory Committee for Immunization Practices (ACIP) during the first year of life with the exception of rotavirus and influenza vaccines.
  4. The parent(s)/ legally authorized representative(s) LAR(s) intend for the child to receive DTaP and PCV13 in addition to this season's IIV
  5. The parent(s)/LAR(s) must be willing and capable of providing permission for their child to participate through the written informed consent process
  6. The parent(s)/LAR(s) must be able to comply with the requirements of the protocol (e.g., completion of the memory aid (either electronic or paper diary), return for follow-up visits, respects intervals between the visits and have telephone access.
  7. The parent(s)/LAR(s) must be English speaking
  8. The parent(s)/LAR(s) must agree to sign a medical release for the child so that study personnel may obtain medical information about the child's health (if needed)

Exclusion Criteria:

  1. History of any seizure (including febrile seizure) in the child or a febrile seizure in a first degree relative
  2. Has already completed influenza vaccination during the current season per ACIP recommendations
  3. Receipt of more than 3 previous doses of DTaP
  4. Received the 3rd dose of DTaP within 6 months of Visit 1
  5. Receipt of more than 3 previous doses of PCV13
  6. Received the 3rd dose of PCV13 within 8 weeks of Visit 1
  7. History of a severe allergic reaction (e.g. anaphylaxis) to a previous dose of any influenza, diphtheria toxoid-, tetanus toxoid-, or pertussis-containing vaccine, or pneumococcal vaccine.
  8. History of a severe allergic reaction (e.g., anaphylaxis) to any component (including egg protein) of any of the three vaccines used in this study; or a latex allergy.
  9. History of Guillain-Barré syndrome within 6 weeks following a prior dose of influenza, DTaP, or tetanus toxoid containing vaccine
  10. History of a progressive neurologic disorder
  11. History of encephalopathy within 7 days of a previous pertussis-containing vaccine
  12. History of collapse within 3 days after a prior dose of DTaP
  13. Received any other licensed vaccines within 14 days (for inactivated vaccines) or 28 days (for live vaccines) prior to Visit 1
  14. Received an experimental/investigational agent (vaccine, drug, biologic, device, blood product, or medication) within 28 days prior to Visit 1, or expects to receive an experimental/investigational agent during the study period (up to 8 days after visit 2)
  15. A moderate to severe acute illness within 72 hours of Visit 1
  16. A reported temperature greater than or equal to 100.4°F (38.0°C) within 72 hours prior enrollment or a temperature (measured by temporal artery thermometer) greater than or equal to 100.4°F (38.0°C) at the time of enrollment
  17. Receipt of an antipyretic medication (acetaminophen or ibuprofen) within 24 hours prior to enrollment
  18. Parent(s)/LAR is planning to administer a prophylactic antipyretic or medication on the day of, and/or within 7 days following Visit 1 or Visit 2
  19. Long term (at least 14 consecutive days) oral corticosteroids (prednisone 2 mg/kg/day or equivalent other glucocorticoid), any parenteral steroids, high-dose inhaled steroids (>800 mcg/day of beclomethasone dipropionate or equivalent) or other immune-modifying drugs or immunosuppressants within the preceding 6 months prior to Visit 1
  20. Any confirmed or suspected immunosuppressive or immunodeficient condition, based on medical history and or their provider's routine physical examination
  21. Has an active neoplastic disease, a history of any hematologic malignancy, current bleeding disorder, or taking anticoagulants.
  22. Unable to receive an intramuscular injection in the thigh
  23. Any condition deemed by the investigator to place the child at increased risk as a result of their participation in the study
  24. Any child or grandchild of a study investigator or study team member

Sites / Locations

  • Kaiser Permanente Northern California
  • Centers for Disease Control and Prevention
  • Duke University

Arms of the Study

Arm 1

Arm 2

Arm Type

Other

Other

Arm Label

Simultaneous vaccination arm

Sequential vaccination arm

Arm Description

In the study arm, subjects will receive PCV13, DTaP and IIV vaccines during visit 1. Approximately 2 weeks later, subjects will receive a health education visit without vaccination during study visit 2.

In the study arm, subjects will receive PCV13 and DTaP during study visit 1. Approximately 2 weeks later, subjects will receive the IIV vaccine during study visit 2.

Outcomes

Primary Outcome Measures

Number of Participants With Fever Following Vaccination
Proportion of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 1 and/or Visit 2.

Secondary Outcome Measures

Number of Participants With Fever Visit 1
Proportion of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 1
Number of Participants With Fever Visit 2
Proportion of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 2
Number of Participants With Grade 2 and/or 3 Following Visit 1
Proportions of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 1. (Moderate/severe fever: ≥ 38.6°C or ≥ 101.4°F)
Number of Participants With Grade 2 and/or 3 Following Visit 2
Proportions of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 2.
Number of Participants With Grade 2 and/or 3 Following Visit 1 and Visit 2
Proportions of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 1 and Visit 2 combined.
Duration of Fever - Visit 1
Average number of consecutive days of fever (temperature ≥ 38.0°C or ≥ 100.4°F) per subject for fever starting on day 1 or 2 following Visit 1. Note: fever starting on day 1 or 2 could continue through day 8.
Duration of Fever - Visit 2
Average number of consecutive days of fever (temperature ≥ 38.0°C or ≥ 100.4°F) per subject for fever starting on day 1 or 2 following Visit 2. Note: fever starting on day 1 or 2 could continue through day 8.
Duration of Fever - Visit 1 and 2 Combined
Average number of consecutive days of fever (temperature ≥ 38.0°C or ≥ 100.4°F) per subject for fever starting on day 1 or 2 following and Visit 1 and Visit 2 combined. Note: fever starting on day 1 or 2 could continue through day 8.
Number of Participants With Medical Care Utilization - Visit 1
Proportion of children with medical care utilization (telephone call, medical office visit, emergency department visit, or hospital admission) for fever on day 1 and/or day 2 following Visit 1.
Number of Participants With Medical Care Utilization - Visit 2
Proportion of children with medical care utilization (telephone call, medical office visit, emergency department visit, or hospital admission) for fever on day 1 and/or day 2 following Visit 2.
Number of Participants With Medical Care Utilization - Visit 1 and 2 Combined
Proportion of children with medical care utilization (telephone call, medical office visit, emergency department visit, or hospital admission) for fever on day 1 and/or day 2 following Visit 1 and Visit 2 combined.

Full Information

First Posted
May 23, 2017
Last Updated
February 5, 2019
Sponsor
Duke University
Collaborators
Centers for Disease Control and Prevention, Kaiser Permanente
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1. Study Identification

Unique Protocol Identification Number
NCT03165981
Brief Title
Fever After Simultaneous Versus Sequential Vaccination in Young Children
Official Title
A Prospective, Randomized, Open-label Clinical Trial to Assess Fever Following Simultaneous Versus Sequential Administration of PCV13, DTaP Vaccine and IIV in Young Children
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
August 25, 2017 (Actual)
Primary Completion Date
January 15, 2018 (Actual)
Study Completion Date
January 15, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Duke University
Collaborators
Centers for Disease Control and Prevention, Kaiser Permanente

4. Oversight

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

5. Study Description

Brief Summary
A prospective, randomized open-label clinical trial that will be conducted during the 2017-2018 influenza season. During the 2017-2018 season, approximately 280 children will be enrolled at Duke University Medical Center and Kaiser Permanente Northern California. Eligible children will be randomized to receive simultaneous or sequentially administered US licensed PCV13, US-licensed DTaP vaccine, and US-licensed inactivated influenza vaccine (IIV). Children in the simultaneous group will receive PCV13, DTaP, and IIV vaccines at Visit 1, and then return for a health education visit without vaccination about 2 weeks later (Visit 2). Children in the sequential group will receive both PCV13 and DTaP without IIV at Visit 1, and then will receive IIV and health education about 2 weeks later (Visit 2). Parents will record the occurrence of fever, solicited adverse events, medical care utilization, and receipt of antipyretics over 8 days following Visit 1 and Visit 2. In addition, febrile seizures and serious adverse events will be recorded for the entire study period (from enrollment through 8 days following the Visit 2) as determined through parental report and chart review. Parental perceptions about their child's vaccine schedule will be assessed on the 8th day following Visit 2.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fever After Vaccination, Fever, Febrile Seizure
Keywords
Influenza vaccine, fever following vaccination, PCV13 vaccine, DTaP vaccine, pneumococcal vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
221 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Simultaneous vaccination arm
Arm Type
Other
Arm Description
In the study arm, subjects will receive PCV13, DTaP and IIV vaccines during visit 1. Approximately 2 weeks later, subjects will receive a health education visit without vaccination during study visit 2.
Arm Title
Sequential vaccination arm
Arm Type
Other
Arm Description
In the study arm, subjects will receive PCV13 and DTaP during study visit 1. Approximately 2 weeks later, subjects will receive the IIV vaccine during study visit 2.
Intervention Type
Biological
Intervention Name(s)
PCV13
Other Intervention Name(s)
13-valent Conjugate Pneumococcal Vaccine
Intervention Description
ACIP Recommended vaccine
Intervention Type
Biological
Intervention Name(s)
DTaP
Other Intervention Name(s)
Diphtheria, Tetanus, and Acellular Pertussis Vaccine
Intervention Description
ACIP Recommended vaccine
Intervention Type
Biological
Intervention Name(s)
IIV
Other Intervention Name(s)
Quadrivalent Inactivated Influenza Vaccine, IIV4, Flu Vaccine
Intervention Description
ACIP Recommended vaccine
Primary Outcome Measure Information:
Title
Number of Participants With Fever Following Vaccination
Description
Proportion of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 1 and/or Visit 2.
Time Frame
2 days post administration
Secondary Outcome Measure Information:
Title
Number of Participants With Fever Visit 1
Description
Proportion of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 1
Time Frame
2 days post administration
Title
Number of Participants With Fever Visit 2
Description
Proportion of children with fever (temperature ≥ 38.0°C or ≥ 100.4°F) on day 1 and/or day 2 following Visit 2
Time Frame
2 days post administration
Title
Number of Participants With Grade 2 and/or 3 Following Visit 1
Description
Proportions of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 1. (Moderate/severe fever: ≥ 38.6°C or ≥ 101.4°F)
Time Frame
2 days post administration
Title
Number of Participants With Grade 2 and/or 3 Following Visit 2
Description
Proportions of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 2.
Time Frame
2 days post administration
Title
Number of Participants With Grade 2 and/or 3 Following Visit 1 and Visit 2
Description
Proportions of children with moderate/severe fever (Grade 2 and/or 3) on day 1 and/or day 2 following Visit 1 and Visit 2 combined.
Time Frame
2 days post administration
Title
Duration of Fever - Visit 1
Description
Average number of consecutive days of fever (temperature ≥ 38.0°C or ≥ 100.4°F) per subject for fever starting on day 1 or 2 following Visit 1. Note: fever starting on day 1 or 2 could continue through day 8.
Time Frame
8 days post administration
Title
Duration of Fever - Visit 2
Description
Average number of consecutive days of fever (temperature ≥ 38.0°C or ≥ 100.4°F) per subject for fever starting on day 1 or 2 following Visit 2. Note: fever starting on day 1 or 2 could continue through day 8.
Time Frame
8 days post administration
Title
Duration of Fever - Visit 1 and 2 Combined
Description
Average number of consecutive days of fever (temperature ≥ 38.0°C or ≥ 100.4°F) per subject for fever starting on day 1 or 2 following and Visit 1 and Visit 2 combined. Note: fever starting on day 1 or 2 could continue through day 8.
Time Frame
8 days post administration
Title
Number of Participants With Medical Care Utilization - Visit 1
Description
Proportion of children with medical care utilization (telephone call, medical office visit, emergency department visit, or hospital admission) for fever on day 1 and/or day 2 following Visit 1.
Time Frame
2 days post administration
Title
Number of Participants With Medical Care Utilization - Visit 2
Description
Proportion of children with medical care utilization (telephone call, medical office visit, emergency department visit, or hospital admission) for fever on day 1 and/or day 2 following Visit 2.
Time Frame
2 days post administration
Title
Number of Participants With Medical Care Utilization - Visit 1 and 2 Combined
Description
Proportion of children with medical care utilization (telephone call, medical office visit, emergency department visit, or hospital admission) for fever on day 1 and/or day 2 following Visit 1 and Visit 2 combined.
Time Frame
2 days post administration

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Months
Maximum Age & Unit of Time
16 Months
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 12 through 16 months of age (i.e. from the 1-year birthday until the day before 17 months of age) at the time of vaccination Stable health as determined by investigator's clinical examination and assessment of child's medical history Has received all immunizations recommended by Advisory Committee for Immunization Practices (ACIP) during the first year of life with the exception of rotavirus and influenza vaccines. The parent(s)/ legally authorized representative(s) LAR(s) intend for the child to receive DTaP and PCV13 in addition to this season's IIV The parent(s)/LAR(s) must be willing and capable of providing permission for their child to participate through the written informed consent process The parent(s)/LAR(s) must be able to comply with the requirements of the protocol (e.g., completion of the memory aid (either electronic or paper diary), return for follow-up visits, respects intervals between the visits and have telephone access. The parent(s)/LAR(s) must be English speaking The parent(s)/LAR(s) must agree to sign a medical release for the child so that study personnel may obtain medical information about the child's health (if needed) Exclusion Criteria: History of any seizure (including febrile seizure) in the child or a febrile seizure in a first degree relative Has already completed influenza vaccination during the current season per ACIP recommendations Receipt of more than 3 previous doses of DTaP Received the 3rd dose of DTaP within 6 months of Visit 1 Receipt of more than 3 previous doses of PCV13 Received the 3rd dose of PCV13 within 8 weeks of Visit 1 History of a severe allergic reaction (e.g. anaphylaxis) to a previous dose of any influenza, diphtheria toxoid-, tetanus toxoid-, or pertussis-containing vaccine, or pneumococcal vaccine. History of a severe allergic reaction (e.g., anaphylaxis) to any component (including egg protein) of any of the three vaccines used in this study; or a latex allergy. History of Guillain-Barré syndrome within 6 weeks following a prior dose of influenza, DTaP, or tetanus toxoid containing vaccine History of a progressive neurologic disorder History of encephalopathy within 7 days of a previous pertussis-containing vaccine History of collapse within 3 days after a prior dose of DTaP Received any other licensed vaccines within 14 days (for inactivated vaccines) or 28 days (for live vaccines) prior to Visit 1 Received an experimental/investigational agent (vaccine, drug, biologic, device, blood product, or medication) within 28 days prior to Visit 1, or expects to receive an experimental/investigational agent during the study period (up to 8 days after visit 2) A moderate to severe acute illness within 72 hours of Visit 1 A reported temperature greater than or equal to 100.4°F (38.0°C) within 72 hours prior enrollment or a temperature (measured by temporal artery thermometer) greater than or equal to 100.4°F (38.0°C) at the time of enrollment Receipt of an antipyretic medication (acetaminophen or ibuprofen) within 24 hours prior to enrollment Parent(s)/LAR is planning to administer a prophylactic antipyretic or medication on the day of, and/or within 7 days following Visit 1 or Visit 2 Long term (at least 14 consecutive days) oral corticosteroids (prednisone 2 mg/kg/day or equivalent other glucocorticoid), any parenteral steroids, high-dose inhaled steroids (>800 mcg/day of beclomethasone dipropionate or equivalent) or other immune-modifying drugs or immunosuppressants within the preceding 6 months prior to Visit 1 Any confirmed or suspected immunosuppressive or immunodeficient condition, based on medical history and or their provider's routine physical examination Has an active neoplastic disease, a history of any hematologic malignancy, current bleeding disorder, or taking anticoagulants. Unable to receive an intramuscular injection in the thigh Any condition deemed by the investigator to place the child at increased risk as a result of their participation in the study Any child or grandchild of a study investigator or study team member
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Emmanuel B Walter, MD, MPH
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Karen Broder, MD
Organizational Affiliation
Centers for Disease Control and Prevention
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Nicola Klein, MD, PhD
Organizational Affiliation
Kaiser Permanente
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kaiser Permanente Northern California
City
Oakland
State/Province
California
ZIP/Postal Code
94612
Country
United States
Facility Name
Centers for Disease Control and Prevention
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30333
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32029684
Citation
Walter EB, Klein NP, Wodi AP, Rountree W, Todd CA, Wiesner A, Duffy J, Marquez PL, Broder KR. Fever After Influenza, Diphtheria-Tetanus-Acellular Pertussis, and Pneumococcal Vaccinations. Pediatrics. 2020 Mar;145(3):e20191909. doi: 10.1542/peds.2019-1909. Epub 2020 Feb 6.
Results Reference
derived

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Fever After Simultaneous Versus Sequential Vaccination in Young Children

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