Immune Response to Rotavirus Vaccine After a Supplemental Dose Given at 9 Months of Age With Local EPI Vaccines in Mali
Primary Purpose
Diarrhea Rotavirus
Status
Completed
Phase
Phase 4
Locations
Mali
Study Type
Interventional
Intervention
pentavalent rotavirus vaccine (PRV)
measles vaccine (MV)
yellow fever vaccine (YFV)
meningitis conjugate vaccine (PsA-TT-5μg)
Sponsored by
About this trial
This is an interventional treatment trial for Diarrhea Rotavirus focused on measuring rotavirus, rotavirus vaccine, Mali, EPI vaccines
Eligibility Criteria
Inclusion Criteria:
- At least 9 months of age through 11 months of age (has not yet reached 1st birthday) at the time of administration of study vaccines.
- Residence in the study area.
- At least one parent or guardian who is at least 18 years of age and is willing to provide written informed consent.
- Generally healthy and free of obvious health problems as established by medical history including physical examination and clinical judgment of the investigator.
- A child who is fully vaccinated according to the local EPI schedule (exclusive of oral polio vaccine birth dose).
- A parent or guardian is willing to attend all planned study visits or allow home visits and mobile phone contacts, as required by the protocol.
Exclusion Criteria:
- Previous receipt any measles-containing vaccine.
- Previous receipt of any yellow fever vaccine.
- Previous receipt of any meningitis vaccine.
- Receipt of rotavirus vaccine within the past 90 days.
- Administration of any other vaccine within 8 weeks prior to administration of study vaccines or planned vaccination during the 4 weeks after study vaccination.
- History of allergic disease or known hypersensitivity to any component of the study vaccines and/or following administration of vaccines included in the local program of immunization
- Use of any investigational or non-registered drug within 90 days prior to the administration of study vaccines.
- Administration of immunoglobulins and/or any blood products within 90 days prior to the administration of study vaccines or planned administration during the vaccine period.
- Chronic administration (defined as more than 14 days) of immunosuppressants or other immune-modifying agents since birth (including systemic corticosteroids, this means prednisone, or equivalent, ≥0.5 mg/kg/day; topical steroids including inhaled steroids are allowed).
- A family history of congenital or hereditary immunodeficiency.
- History of intussusception.
- Uncorrected congenital malformation of the gastrointestinal tract that would predispose for intussusception.
- Acute or chronic, clinically significant pulmonary, cardiovascular, hepatic, or renal functional abnormality, as determined by medical history or physical examination, which in the opinion of the investigator, might interfere with the study objectives.
- Acute illness at the time of enrollment (acute disease is defined as the presence of a moderate or severe illness with fever [axillary temperature ≥38°C] or without fever [severity determined at the discretion of the investigator]. Acute illness is a temporary exclusion.
- Any condition or criterion that in the opinion of the investigator might compromise the well-being of the subject or the compliance with study procedures or interfere with the outcome of the study.
Sites / Locations
- CVD-Mali
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Group A (without rotavirus vaccine)
Group B (with rotavirus vaccine)
Arm Description
Group A will receive measles vaccine (MV), yellow fever vaccine (YFV), and meningitis conjugate vaccine (PsA-TT-5μg).
Group A will receive measles vaccine (MV), yellow fever vaccine (YFV), and meningitis conjugate vaccine (PsA-TT-5μg) plus one oral dose of pentavalent rotavirus vaccine (PRV).
Outcomes
Primary Outcome Measures
Number/Percentage of Subjects With Seroconversion for Anti-measles Immunoglobulin G (IgG) Antibody
Measured using a commercially-available Enzyme Linked Immunosorbent Assay (ELISA). Seroconversion was defined as a measurement ≥1.10 geometric mean titer (GMT) at Day 28 among subjects with measurement ≤0.90 at baseline
Number/Percentage of Subjects With Seroresponses for Yellow Fever Neutralizing Antibody
Measured by virus neutralization assay, determined using Robert Koch Institute's yellow fever standard of practice and relative to international scientific references for which the level of anti-YF neutralizing IgG protection was known. Seroresponse was defined as a geometric mean titer (GMT) of at least four times baseline value.
Secondary Outcome Measures
Number/Percentage of Subjects With Seroconversion for Anti-measles Immunoglobulin G (IgG) Antibody
Measured using a commercially-available Enzyme Linked Immunosorbent Assay (ELISA). Seroconversion was defined as a measurement ≥1.10 geometric mean titer (GMT) at Day 28 among subjects with measurement ≤0.90 at baseline.
Serum Neutralization Geometric Mean Titers for Yellow Fever Vaccine
Measured by virus neutralization assay, determined using Robert Koch Institute's yellow fever standard of practice (SOP) and relative to international scientific references for which the level of anti-YF neutralizing IgG protection was known.
Number/Percentage of Subjects With Seroresponses for Meningitis Conjugate Serum Bactericidal Antibody (SBA)
Seroresponse was defined as a geometric mean titer (GMT) of at least four times baseline value. Measured using baby rabbit complement (rSBA).
Geometric Mean of Meningitis Serum Bactericidal Antibody Titer
Measured using baby rabbit complement (rSBA).
Number/Percentage of Subjects With Anti-rotavirus Immunoglobulin A (IgA) Titer at Least 3 Times Baseline Value
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Number/Percentage of Subjects With Anti-rotavirus IgA Titer of ≥20 Units/mL
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Number/Percentage of Subjects With Anti-rotavirus IgA <20 Units/mL at Baseline Visit That Had >=20 Units/mL at Day 28
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Number/Percentage of Subjects With Anti-rotavirus IgG Titer at Least 3 Times Baseline Value
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Number/Percentage of Subjects With Anti-rotavirus IgG Titer of ≥20 Units/mL
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Number/Percentage of Subjects With Anti-rotavirus IgG <20 Units/mL at Baseline Visit That Had >=20 Units/mL at Day 28
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Geometric Mean of Anti-rotavirus IgA Concentration
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Geometric Mean of Anti-rotavirus IgG Concentration
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Geometric Mean of Anti-rotavirus IgA Among Subjects With <20 Units/mL Concentration at Baseline
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Geometric Mean of Anti-rotavirus IgG Among Subjects With <20 Units/mL Concentration at Baseline
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Number/Percentage of Participants Experiencing Immediate Reactions Post-vaccination
With emphasis on allergic reactions, observed by study staff
Number of Solicited Adverse Reactions (AR) Experienced by Participants
identified or observed by study staff during home visits and/or reported by a parent at any time. Solicited adverse reactions were graded and sub-categorized as those deemed related to vaccination or not by the investigator.
Number/Percentage of Participants Experiencing Serious Adverse Events (SAE)
Occurring from vaccination through 3 months post-vaccination, identified or observed by study staff and/or reported by a parent at any time. Serious adverse events were graded for severity and sub-categorized as those deemed related to vaccination or not by the investigator.
Full Information
NCT ID
NCT02286895
First Posted
October 1, 2014
Last Updated
December 10, 2018
Sponsor
PATH
Collaborators
Center for Vaccine Development - Mali, University of Maryland
1. Study Identification
Unique Protocol Identification Number
NCT02286895
Brief Title
Immune Response to Rotavirus Vaccine After a Supplemental Dose Given at 9 Months of Age With Local EPI Vaccines in Mali
Official Title
An Evaluation of the Immune Response to Pentavalent Rotavirus Vaccine After a Supplemental Dose Given at 9 Months of Age With Local EPI Vaccines in Mali
Study Type
Interventional
2. Study Status
Record Verification Date
December 2018
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
March 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PATH
Collaborators
Center for Vaccine Development - Mali, University of Maryland
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study is an evaluation of the immune response to pentavalent rotavirus vaccine (PRV) after an additional fourth dose is given at 9 months of age with local World Health Organization (WHO) Expanded Programme on Immunization (EPI) vaccines in Mali.
Detailed Description
Vaccination is the best way to prevent severe rotavirus disease and the deadly, dehydrating diarrhea that it causes. However, given only moderate efficacy in the first year of life and a possible further decline in immunity, it is considered a top priority by public health experts to evaluate the possible value of a "booster" dose of rotavirus vaccine in low income countries to confer longer duration of protection into the second year of life when disease burden continues to be high.
This study is an open-label, individual-randomized, parallel-group, comparative immunogenicity trial. Participating infants randomized to Group A will receive one dose each of measles vaccine (MV), yellow fever vaccine (YFV), and meningitis conjugate vaccine (PsA-TT-5μg) at 9 months of age, and infants randomized to Group B will receive one dose each of MV, YFV, PsA-TT-5μg, and PRV at 9 months of age.
The study will simultaneously evaluate two primary objectives, one for noninferiority of the response to MV given with PRV (co-primary objective 1) and one for noninferiority of the response to YFV given with PRV (co-primary objective 2).
Secondary objectives of the study were the following:
To evaluate the non-inferiority of the immune response 3 months post-vaccination (as sero-conversion) to MV given with PRV (Group B) to that given without PRV (Group A).
To compare the immune response (as geometric mean titers [GMTs]) to YFV given with PRV (Group B) to that given without PRV (Group A).
To evaluate the non-inferiority of the immune response (as sero-response) to PsA-TT-5μg given with PRV (Group B) compared to that given without PRV (Group A).
To compare the immune response (as GMTs) to PsA-TT-5μg given with PRV (Group B) to that given without PRV (Group A).
To evaluate the superiority of the immune response (as sero-response and geometric mean concentrations [GMCs]) to a supplemental dose of PRV given at 9 months of age with local EPI vaccines (Group B) compared no supplemental dose (Group A).
To describe the safety profile of study vaccination with PRV.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea Rotavirus
Keywords
rotavirus, rotavirus vaccine, Mali, EPI vaccines
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
600 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group A (without rotavirus vaccine)
Arm Type
Active Comparator
Arm Description
Group A will receive measles vaccine (MV), yellow fever vaccine (YFV), and meningitis conjugate vaccine (PsA-TT-5μg).
Arm Title
Group B (with rotavirus vaccine)
Arm Type
Experimental
Arm Description
Group A will receive measles vaccine (MV), yellow fever vaccine (YFV), and meningitis conjugate vaccine (PsA-TT-5μg) plus one oral dose of pentavalent rotavirus vaccine (PRV).
Intervention Type
Biological
Intervention Name(s)
pentavalent rotavirus vaccine (PRV)
Other Intervention Name(s)
RotaTeq
Intervention Description
Each two-ml dose contains 5 live human-bovine reassortant rotaviruses with a minimum of 2.0 - 2.8 x 106 infectious units (IU) per reassortant, depending on the serotype, and not greater than 116 x 106 IU per aggregate dose. Each vaccine dose contains sucrose, sodium citrate, sodium phosphate monobasic monohydrate, sodium hydroxide, polysorbate 80, cell culture media, and trace amounts of fetal bovine serum. RotaTeq contains no preservatives. RotaTeq is a pale yellow clear liquid that may have a pink tint. This vaccine was administered orally.
Intervention Type
Biological
Intervention Name(s)
measles vaccine (MV)
Intervention Description
A lyophilized vaccine in a pack containing one vial plus one ampoule of sterile water for injection. After reconstitution, each 0.5 ml/dose of MV contains active substances not less than 1000 units of 50% cell culture infectious doses (CCID50) of MV. Measles Vaccine Live Attenuated virus is propagated on Human Diploid Cells. This MV is currently part of the local EPI program in Mali. This vaccine was administered subcutaneously to the right deltoid.
Intervention Type
Biological
Intervention Name(s)
yellow fever vaccine (YFV)
Intervention Description
A freeze-dried live attenuated yellow fever virus of the 17D strain for injection. After reconstitution, one dose (0.5 ml) contains active substances not less than 1000 units of 50% lethal doses (LD50) of yellow fever virus. This YFV is currently part of the local EPI program in Mali. This vaccine was administered intramuscularly to the left deltoid.
Intervention Type
Biological
Intervention Name(s)
meningitis conjugate vaccine (PsA-TT-5μg)
Other Intervention Name(s)
PsA-TT
Intervention Description
A meningococcal A vaccine, with meningococcal A polysaccharide (PsA) conjugated to the carrier protein, tetanus toxoid (TT). After reconstitution, one dose (0.5 ml) contains 5μg meningococcal A polysaccharide and 5-16 μg tetanus toxoid as a carrier protein. PsA-TT-5μg was considered experimental at the initiation of this study, but received approval from the WHO for infants on 30 December 2014. For all participants enrolled January 1st, 2015 or later, PsA-TT-5μg was not included in Group A or Group B, due to its December 2014 expiration date. This vaccine was administered intramuscularly to the right thigh.
Primary Outcome Measure Information:
Title
Number/Percentage of Subjects With Seroconversion for Anti-measles Immunoglobulin G (IgG) Antibody
Description
Measured using a commercially-available Enzyme Linked Immunosorbent Assay (ELISA). Seroconversion was defined as a measurement ≥1.10 geometric mean titer (GMT) at Day 28 among subjects with measurement ≤0.90 at baseline
Time Frame
28 days post-vaccination
Title
Number/Percentage of Subjects With Seroresponses for Yellow Fever Neutralizing Antibody
Description
Measured by virus neutralization assay, determined using Robert Koch Institute's yellow fever standard of practice and relative to international scientific references for which the level of anti-YF neutralizing IgG protection was known. Seroresponse was defined as a geometric mean titer (GMT) of at least four times baseline value.
Time Frame
28 days post-vaccination
Secondary Outcome Measure Information:
Title
Number/Percentage of Subjects With Seroconversion for Anti-measles Immunoglobulin G (IgG) Antibody
Description
Measured using a commercially-available Enzyme Linked Immunosorbent Assay (ELISA). Seroconversion was defined as a measurement ≥1.10 geometric mean titer (GMT) at Day 28 among subjects with measurement ≤0.90 at baseline.
Time Frame
3 months post-vaccination
Title
Serum Neutralization Geometric Mean Titers for Yellow Fever Vaccine
Description
Measured by virus neutralization assay, determined using Robert Koch Institute's yellow fever standard of practice (SOP) and relative to international scientific references for which the level of anti-YF neutralizing IgG protection was known.
Time Frame
28 days post-vaccination
Title
Number/Percentage of Subjects With Seroresponses for Meningitis Conjugate Serum Bactericidal Antibody (SBA)
Description
Seroresponse was defined as a geometric mean titer (GMT) of at least four times baseline value. Measured using baby rabbit complement (rSBA).
Time Frame
28 days post-vaccination
Title
Geometric Mean of Meningitis Serum Bactericidal Antibody Titer
Description
Measured using baby rabbit complement (rSBA).
Time Frame
Baseline to Day 28
Title
Number/Percentage of Subjects With Anti-rotavirus Immunoglobulin A (IgA) Titer at Least 3 Times Baseline Value
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Number/Percentage of Subjects With Anti-rotavirus IgA Titer of ≥20 Units/mL
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Number/Percentage of Subjects With Anti-rotavirus IgA <20 Units/mL at Baseline Visit That Had >=20 Units/mL at Day 28
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Number/Percentage of Subjects With Anti-rotavirus IgG Titer at Least 3 Times Baseline Value
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Number/Percentage of Subjects With Anti-rotavirus IgG Titer of ≥20 Units/mL
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Number/Percentage of Subjects With Anti-rotavirus IgG <20 Units/mL at Baseline Visit That Had >=20 Units/mL at Day 28
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Geometric Mean of Anti-rotavirus IgA Concentration
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Geometric Mean of Anti-rotavirus IgG Concentration
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Geometric Mean of Anti-rotavirus IgA Among Subjects With <20 Units/mL Concentration at Baseline
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Geometric Mean of Anti-rotavirus IgG Among Subjects With <20 Units/mL Concentration at Baseline
Description
Conducted by validated Enzyme Linked Immunosorbent Assay (ELISA). The pre- and post-vaccination samples were to be evaluated in one run for consistency and each specimen was to be tested with a negative control for better specificity.
Time Frame
28 days post-vaccination
Title
Number/Percentage of Participants Experiencing Immediate Reactions Post-vaccination
Description
With emphasis on allergic reactions, observed by study staff
Time Frame
Within 30 minutes post-vaccination
Title
Number of Solicited Adverse Reactions (AR) Experienced by Participants
Description
identified or observed by study staff during home visits and/or reported by a parent at any time. Solicited adverse reactions were graded and sub-categorized as those deemed related to vaccination or not by the investigator.
Time Frame
7 days post-vaccination
Title
Number/Percentage of Participants Experiencing Serious Adverse Events (SAE)
Description
Occurring from vaccination through 3 months post-vaccination, identified or observed by study staff and/or reported by a parent at any time. Serious adverse events were graded for severity and sub-categorized as those deemed related to vaccination or not by the investigator.
Time Frame
3 months post-vaccination
10. Eligibility
Sex
All
Minimum Age & Unit of Time
9 Months
Maximum Age & Unit of Time
11 Months
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
At least 9 months of age through 11 months of age (has not yet reached 1st birthday) at the time of administration of study vaccines.
Residence in the study area.
At least one parent or guardian who is at least 18 years of age and is willing to provide written informed consent.
Generally healthy and free of obvious health problems as established by medical history including physical examination and clinical judgment of the investigator.
A child who is fully vaccinated according to the local EPI schedule (exclusive of oral polio vaccine birth dose).
A parent or guardian is willing to attend all planned study visits or allow home visits and mobile phone contacts, as required by the protocol.
Exclusion Criteria:
Previous receipt any measles-containing vaccine.
Previous receipt of any yellow fever vaccine.
Previous receipt of any meningitis vaccine.
Receipt of rotavirus vaccine within the past 90 days.
Administration of any other vaccine within 8 weeks prior to administration of study vaccines or planned vaccination during the 4 weeks after study vaccination.
History of allergic disease or known hypersensitivity to any component of the study vaccines and/or following administration of vaccines included in the local program of immunization
Use of any investigational or non-registered drug within 90 days prior to the administration of study vaccines.
Administration of immunoglobulins and/or any blood products within 90 days prior to the administration of study vaccines or planned administration during the vaccine period.
Chronic administration (defined as more than 14 days) of immunosuppressants or other immune-modifying agents since birth (including systemic corticosteroids, this means prednisone, or equivalent, ≥0.5 mg/kg/day; topical steroids including inhaled steroids are allowed).
A family history of congenital or hereditary immunodeficiency.
History of intussusception.
Uncorrected congenital malformation of the gastrointestinal tract that would predispose for intussusception.
Acute or chronic, clinically significant pulmonary, cardiovascular, hepatic, or renal functional abnormality, as determined by medical history or physical examination, which in the opinion of the investigator, might interfere with the study objectives.
Acute illness at the time of enrollment (acute disease is defined as the presence of a moderate or severe illness with fever [axillary temperature ≥38°C] or without fever [severity determined at the discretion of the investigator]. Acute illness is a temporary exclusion.
Any condition or criterion that in the opinion of the investigator might compromise the well-being of the subject or the compliance with study procedures or interfere with the outcome of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Samba O Sow, MD, Msc
Organizational Affiliation
Center for Vaccine Development - Mali
Official's Role
Principal Investigator
Facility Information:
Facility Name
CVD-Mali
City
Bamako
Country
Mali
12. IPD Sharing Statement
Citations:
PubMed Identifier
29659924
Citation
Haidara FC, Tapia MD, Sow SO, Doumbia M, Coulibaly F, Diallo F, Traore A, Kodio M, Kelly CL, Fitzpatrick M, Kotloff K, Victor JC, Neuzil K. Evaluation of a Booster Dose of Pentavalent Rotavirus Vaccine Coadministered With Measles, Yellow Fever, and Meningitis A Vaccines in 9-Month-Old Malian Infants. J Infect Dis. 2018 Jul 13;218(4):606-613. doi: 10.1093/infdis/jiy215. Erratum In: J Infect Dis. 2019 Jan 7;219(2):339.
Results Reference
derived
Learn more about this trial
Immune Response to Rotavirus Vaccine After a Supplemental Dose Given at 9 Months of Age With Local EPI Vaccines in Mali
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