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Immunogenicity and Safety of Live Attenuated Influenza Vaccine (Flumist) Administered by Nasal and Sublingual Route

Primary Purpose

Healthy

Status
Completed
Phase
Phase 1
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Influenza vaccine
Influenza vaccine
Sponsored by
International Vaccine Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Healthy focused on measuring Influenza vaccine, nasal route, sublingual route, immunogenicity, safety

Eligibility Criteria

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

Inclusion Criteria:

  • Healthy volunteers who are able and willing to give informed consent, following a detailed explanation of participation in the study.
  • Volunteers who will be available for the duration of the study and available for scheduled and potential additional visits

Exclusion Criteria:

  • Subjects with any clinically significant medical or psychiatric condition or clinically significant abnormal serum biochemistry or haematology results that, in opinion of the Investigator, preclude participation in the study.
  • Female subjects who are pregnant (using urine test) or breast-feeding, or of childbearing potential and unwilling to use a reliable method of contraception (e.g. oral contraceptives or contraceptive during sexual activities such as a condom, contraceptive diaphragm, intrauterine device, hormonal contraceptive, or intercourse with a male partner who has had a vasectomy etc.) throughout the study period.
  • Subjects who have known airway hypersensitivity to one of Flu vaccine excipients within 14 days prior to administration of study medication.
  • Subjects who have known buccal hypersensitivity to any component of the vaccine or buffer solution used in this study, including subjects with phenylketonuria.
  • Subjects with direct contact with at risk groups (e.g. patients in special care units, immuno-compromised individuals, pregnant women, children under 2 years of age and individuals over 70 years).
  • Subjects with a known impairment of immune function including seropositive for HIV or those receiving (or have received in the 6 months prior to study entry) cytotoxic drugs immunosuppressive therapy (including systemic corticosteroids).
  • Subjects with a significant acute febrile illness (fever of 38.0 Celsius degree or more) at time of dosing.
  • Subjects who have chronic diseases: Chronic diseases will include all autoimmune and immuno-compromising conditions and any other chronic condition, which at the judgement of the Investigator, may put the subject at higher risk of side effects from the study vaccine. Conditions in the latter category might include unexplained anaemia, hepato-biliary disease, uncontrolled hypertension, subjects with prosthetic joints or heart valves, etc.
  • Subjects with a current problem, based on history, with substance abuse or with a history of substance abuse
  • Subjects who are currently involved in a clinical trial, have taken an investigational drug or have received investigational or licensed vaccines in the preceding 4 weeks or anticipate receiving a vaccine other than study medication during the first 4 weeks of the study
  • Subjects who have known hypersensitivity to eggs or egg proteins
  • Subjects who have chronic respiratory infections or syndromes
  • Unable to receive oral (sublingual) administration.
  • Receiving anti-viral agents.
  • Subjected to contraindications and/or precautions described in drug information

Sites / Locations

  • Seoul National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Influenza vaccine-Nasal

Influenza vaccine -Sublingual

Arm Description

Nasal administration

Sublingual administration

Outcomes

Primary Outcome Measures

Passive Haemagglutination Inhibition Titer.
Passive haemagglutination inhibition titer of serum at 21 days after vaccination.

Secondary Outcome Measures

Blood Immunoglobulin G (IgG) and Immunoglobulin A (IgA)-Antibody Secreting Cell Number to Flu Virus
Flu virus-specific IgG- and IgA -antibody secreting cells per ml of blood at 7 days after vaccination
Salivary IgA
Salivary Flu-specific IgA titer at Days 21 after vaccination
Cell Mediated Immune Responses
Interferon gamma production in peripheral blood monocyte (PBMC) after in vitro re-stimulation with influenza virus antigen at 21 days after vaccination.

Full Information

First Posted
December 4, 2011
Last Updated
November 5, 2013
Sponsor
International Vaccine Institute
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1. Study Identification

Unique Protocol Identification Number
NCT01488188
Brief Title
Immunogenicity and Safety of Live Attenuated Influenza Vaccine (Flumist) Administered by Nasal and Sublingual Route
Official Title
A Controlled Study to Determine the Immunogenicity and Safety of Cold-adaptive Live Attenuated Influenza Vaccine (Flumist) Administered by the Nasal and Sublingual Route in Healthy Adult Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
November 2013
Overall Recruitment Status
Completed
Study Start Date
December 2011 (undefined)
Primary Completion Date
May 2013 (Actual)
Study Completion Date
May 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
International Vaccine Institute

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Background: It is well established that live attenuated organisms can be highly effective vaccines, immune responses elicited can often be of greater magnitude and of longer duration than those produced by non-living antigens and are often able to confer protection after a single dose. Unlike killed influenza vaccine preparations injected by the parenteral route, live influenza vaccines are able to induce potent secretory (mainly IgA) antibody responses in the airway mucosae and can also evoke cell mediated responses. T cell proliferation, cytokine production, cytotoxic T cell responses and antibody-dependent cell cytotoxicity have all been elicited by live attenuated vaccines. There has been a history of the use of live attenuated flu vaccines as safe and effective vaccines for the prevention of flu in animals and humans. Live-attenuated cold-adapted influenza vaccines have been proved to be highly efficacious to protect against clinical fly symptoms. Among these, FluMist, a nasal vaccine formulation developed by Medimmune Inc, has been approved by the US FDA. Recent side by side clinical trials have demonstrated that this nasal vaccine was significantly superior to conventional killed flu vaccine in protecting against flu symptoms. Sublingual administration of live influenza virus at a dose lethal by the nasal route was well tolerated and did not redirect virus to the olfactory bulb. In addition, in a recent Phase I clinical study (NCT00820144) conducted in France, the sublingual administration of recombinant cholera toxin B subunit (rCTB,up to 1 mg) in healthy adult volunteers was found to be safe. A major issue has arisen regarding the ease with which vaccines could be administered to young children, especially infants, and to elderly subjects in whom nasal vaccination has not been possible and/or approved due to difficulties of administering nasal vaccines in infants and to undesired side effects related to frequent rhinitis and sneezing episodes in elderly subjects. This study is designed to investigate the safety, tolerability and immunogenicity of a new route of administration of vaccines, using the nasal FluMist formulation as prototype vaccine. Objectives: To evaluate the immunogenicity and safety of a nasal and sublingual influenza virus vaccine (FluMist) in healthy adult volunteers Study design: This will be a randomized study on a total 40 subjects; each 20 subjects will receive vaccine via nasal and sublingual route, respectively

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Healthy
Keywords
Influenza vaccine, nasal route, sublingual route, immunogenicity, safety

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Influenza vaccine-Nasal
Arm Type
Active Comparator
Arm Description
Nasal administration
Arm Title
Influenza vaccine -Sublingual
Arm Type
Active Comparator
Arm Description
Sublingual administration
Intervention Type
Biological
Intervention Name(s)
Influenza vaccine
Other Intervention Name(s)
Flumist (2011-2012)
Intervention Description
Administration of 1 dose (0.2 ml) by nasal route
Intervention Type
Biological
Intervention Name(s)
Influenza vaccine
Other Intervention Name(s)
Flumist (2011-2012)
Intervention Description
Administration of 1 dose (0.2 ml) by sublingual route
Primary Outcome Measure Information:
Title
Passive Haemagglutination Inhibition Titer.
Description
Passive haemagglutination inhibition titer of serum at 21 days after vaccination.
Time Frame
21 days after vaccination
Secondary Outcome Measure Information:
Title
Blood Immunoglobulin G (IgG) and Immunoglobulin A (IgA)-Antibody Secreting Cell Number to Flu Virus
Description
Flu virus-specific IgG- and IgA -antibody secreting cells per ml of blood at 7 days after vaccination
Time Frame
7 days after vaccination
Title
Salivary IgA
Description
Salivary Flu-specific IgA titer at Days 21 after vaccination
Time Frame
21 days after vaccination
Title
Cell Mediated Immune Responses
Description
Interferon gamma production in peripheral blood monocyte (PBMC) after in vitro re-stimulation with influenza virus antigen at 21 days after vaccination.
Time Frame
21 days after vaccination

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy volunteers who are able and willing to give informed consent, following a detailed explanation of participation in the study. Volunteers who will be available for the duration of the study and available for scheduled and potential additional visits Exclusion Criteria: Subjects with any clinically significant medical or psychiatric condition or clinically significant abnormal serum biochemistry or haematology results that, in opinion of the Investigator, preclude participation in the study. Female subjects who are pregnant (using urine test) or breast-feeding, or of childbearing potential and unwilling to use a reliable method of contraception (e.g. oral contraceptives or contraceptive during sexual activities such as a condom, contraceptive diaphragm, intrauterine device, hormonal contraceptive, or intercourse with a male partner who has had a vasectomy etc.) throughout the study period. Subjects who have known airway hypersensitivity to one of Flu vaccine excipients within 14 days prior to administration of study medication. Subjects who have known buccal hypersensitivity to any component of the vaccine or buffer solution used in this study, including subjects with phenylketonuria. Subjects with direct contact with at risk groups (e.g. patients in special care units, immuno-compromised individuals, pregnant women, children under 2 years of age and individuals over 70 years). Subjects with a known impairment of immune function including seropositive for HIV or those receiving (or have received in the 6 months prior to study entry) cytotoxic drugs immunosuppressive therapy (including systemic corticosteroids). Subjects with a significant acute febrile illness (fever of 38.0 Celsius degree or more) at time of dosing. Subjects who have chronic diseases: Chronic diseases will include all autoimmune and immuno-compromising conditions and any other chronic condition, which at the judgement of the Investigator, may put the subject at higher risk of side effects from the study vaccine. Conditions in the latter category might include unexplained anaemia, hepato-biliary disease, uncontrolled hypertension, subjects with prosthetic joints or heart valves, etc. Subjects with a current problem, based on history, with substance abuse or with a history of substance abuse Subjects who are currently involved in a clinical trial, have taken an investigational drug or have received investigational or licensed vaccines in the preceding 4 weeks or anticipate receiving a vaccine other than study medication during the first 4 weeks of the study Subjects who have known hypersensitivity to eggs or egg proteins Subjects who have chronic respiratory infections or syndromes Unable to receive oral (sublingual) administration. Receiving anti-viral agents. Subjected to contraindications and/or precautions described in drug information
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kyung-Sang Yu, M.D.
Organizational Affiliation
Seoul National University Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Cecil Czerkinsky, Ph.D.
Organizational Affiliation
International Vaccine Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Seoul National University Hospital
City
Seoul
ZIP/Postal Code
110744
Country
Korea, Republic of

12. IPD Sharing Statement

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Immunogenicity and Safety of Live Attenuated Influenza Vaccine (Flumist) Administered by Nasal and Sublingual Route

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