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Intradermal Fractional Dose IPV (fIPV) in Combination With dmLT

Primary Purpose

Poliomyelitis

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Intradermal fractional dose inactivated polio vaccine (fIPV) in combination with recombinant double mutant heat labile toxin, LT(R192G/L211A), (dmLT)
Intradermal fractional dose inactivated polio vaccine (fIPV)
Monovalent oral poliomyelitis vaccine (mOPV), Sabin strain
Sponsored by
University of Vermont
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Poliomyelitis focused on measuring polio, dmLT, mucosal adjuvant, fecal shedding, mOPV Challenge, fractional dose IPV (fIPV), intradermal vaccination

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Aged 18 to 45 years old
  2. Signed informed consent form prior to initiation of any study activity
  3. Good general health as determined by review of medical history, physical exam, and basic laboratory screening
  4. Agrees to complete all study visits and procedures
  5. History of receipt of childhood polio vaccine series consisting of at least 3 doses of Inactivated Polio Vaccine (IPV). No history of receipt of OPV.
  6. Neutralizing antibody titers > 1:8 for polio type 1

Exclusion Criteria:

  • 1. Any condition (medical, psychiatric or behavioral) that, in the opinion of the investigator, would increase the volunteer's health risks in study participation or would increase the risk of not achieving the study's objectives (e.g., would compromise adherence to protocol requirements or interfere with planned safety and immunogenicity assessments) 2. Females of childbearing* potential only: currently lactating, breastfeeding, pregnant, or not agreeing to have repeated pregnancy tests prior to any study or challenge vaccination, and/or not having practiced adequate contraception** for 30 days prior to first study vaccination and/or not willing to continue using adequate contraception consistently for at least 90 days after the last study or challenge vaccination

    a. *Females can be considered not of childbearing potential if they are with current bilateral tubal ligation or occlusion, or post-hysterectomy, or post-bilateral ovariectomy, or post-menopause b. ** Adequate contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly and when applicable, in accordance with the product label, for example: i. Abstinence from penile-vaginal intercourse ii. Combined estrogen and progesterone oral contraceptives iii. Injectable progestogen iv. Implants of etonogestrel or levonorgestrel v. Contraceptive vaginal ring vi. Percutaneous contraceptive patches vii. Intrauterine device or intrauterine system viii. Male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository), and/or progesterone alone oral contraceptive

    3. Symptoms of an acute self-limited illness, such as an upper respiratory infection, febrile illness (≥38.0°C (100.4°F), or gastroenteritis within 3 days of administration of IP including an oral temperature 4. History of antimicrobial treatment in the 10 days before administration of IP 5. History of a severe allergic reaction or anaphylaxis 6. Receipt of a vaccine within 21 days prior to the Investigational vaccination or anticipated receipt of any vaccine during the 28 days following Investigational vaccination 7. Receipt of a vaccine within the 21 days prior to OPV Challenge vaccination or anticipated receipt of any vaccine during the 28 days following OPV Challenge vaccination 8. Anticipated receipt of any investigational agent in the 28 days before or after receipt of investigational product without permission from the sponsor.

    9. Known history of hypersensitivity to any component of IPV or OPV to include: 2phenoxyethanol, formaldehyde, neomycin, streptomycin, polymyxin B erythromycin, and kanamycin 10. Receipt of polio vaccine within 12 months before the start of the study 11. Agrees not to and has no plans to travel outside the United States (US) until confirmation of cessation of vaccine virus shedding in stool 12. Having Crohn's disease or ulcerative colitis or having had major surgery of the gastrointestinal tract involving significant loss or resection of the bowel 13. Receipt of transfusion of any blood product or application of immunoglobulins within the 12 weeks prior to the first administration of study vaccine or planned use during the study period 14. Self-reported or suspected immunodeficiency, or receipt of immunosuppressive therapy within the preceding 6 months, or long-term systemic corticosteroid therapy (inhaled, topical and intra-articular and epidural injections are allowed at this discretion of the investigator.

    15. Will have household or close professional contact during the mOPV challenge phase (C+0-C+28) of the study with individuals expected to be immunosuppressed (due to underlying condition or treatments) or individuals who have not yet completed their primary infant polio immunization series (i.e., three doses) 16. Will have household or close professional contact during the mOPV challenge phase (C+0-C+28) of the study with infants less than 6 months of age (e.g. neonatal nurses) or with pregnant women 17. Will have professional handling of food, catering or food production activities during the during the mOPV challenge phase (C+0-C+28) of the study 18. Indications of drug abuse or excessive use of alcohol that in the opinion of the investigator may interfere with their ability to comply with study related activities.

    19. Abnormal routine bowel habits as defined by fewer than three stools per week in the past 6 months 20. Regular use (weekly or more often) of laxatives, anti-diarrheal, or anti-constipation medications.

    21. Hepatitis B or C virus infection 22. Any confirmed or suspected immunosuppressive or immunodeficiency condition (human immunodeficiency virus [HIV] infection, or total serum immunoglobulin A (IgA) level below the testing laboratory lower limit of normal).

    23. Any hematological# or chemistry** parameter that is out of range of normal and is considered clinically significant by the investigator

    1. #Complete blood cell count (hemoglobin, hematocrit, white blood cell [WBC] and platelet count)
    2. **Creatinine, ALT, total bilirubin

Sites / Locations

  • University of Vermont Vaccine Testing Center at the Larner College of MedicineRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

fIPV-dmLT

fIPV

Arm Description

Intradermal administration of fIPV with the addition of 0.47ug dmLT

Intradermal administration of fIPV alone.

Outcomes

Primary Outcome Measures

mucosal immunity to poliovirus
Stimulation of mucosal immunity to poliovirus via comparison of fecal shedding dynamics using longitudinal stool collections following mOPV1 challenge in fIPV-dmLT recipients versus fIPV only recipients.

Secondary Outcome Measures

Safety and local reactogenicity: systemic and local injection site adverse reactions (ARs)
Frequency of systemic and local injection site adverse reactions (ARs) defined as vaccine-related adverse events (AEs), graded by severity, occurring within 28 days of dosing
Safety: serious adverse events
percentage of subjects with at least one vaccine-related serious adverse event (SAE) occurring within 28 days of dosing
Systemic Immunogenicity: poliovirus-specific serum neutralizing antibody responses
poliovirus-specific serum neutralizing antibody responses in fIPV-dmLT recipients versus fIPV only recipients.

Full Information

First Posted
April 6, 2022
Last Updated
September 2, 2022
Sponsor
University of Vermont
Collaborators
World Health Organization
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1. Study Identification

Unique Protocol Identification Number
NCT05327426
Brief Title
Intradermal Fractional Dose IPV (fIPV) in Combination With dmLT
Official Title
Evaluating the Safety, Reactogenicity, and Immunogenicity of Intradermal Fractional Dose IPV (fIPV) in Combination With the Novel Mucosal Adjuvant, dmLT
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 1, 2022 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
April 25, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Vermont
Collaborators
World Health Organization

4. Oversight

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

5. Study Description

Brief Summary
This is a single site, phase 1 study of dmLT as a mucosal adjuvant to control fecal viral shedding when used in combination with intradermally administered fractional dose trivalent IPV (fIPV). It will be a 2-arm, randomized, double-blind controlled trial of intradermal fIPV versus fIPV+dmLT in healthy adults with a monovalent oral polio vaccine (OPV) challenge administered as a test of mucosal immunity. A maximum of 30 healthy subjects will be recruited, all of whom will have received IPV only as part of their primary childhood immunization series (cohort 1); they will be randomized 2:1 to receive fIPV-dmLT or fIPV alone. A maximum of 27 participants will be recruited from an earlier pilot study population exposed to fIPV+/-dmLT and will provide follow-up samples for immunologic studies only (cohort 2).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Poliomyelitis
Keywords
polio, dmLT, mucosal adjuvant, fecal shedding, mOPV Challenge, fractional dose IPV (fIPV), intradermal vaccination

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
fIPV-dmLT
Arm Type
Experimental
Arm Description
Intradermal administration of fIPV with the addition of 0.47ug dmLT
Arm Title
fIPV
Arm Type
Active Comparator
Arm Description
Intradermal administration of fIPV alone.
Intervention Type
Biological
Intervention Name(s)
Intradermal fractional dose inactivated polio vaccine (fIPV) in combination with recombinant double mutant heat labile toxin, LT(R192G/L211A), (dmLT)
Intervention Description
Sanofi's licensed IPOL trivalent inactivated polio vaccine (NDC 49281-860-78) delivered at the dose-sparing fractional volume of 1/5 the full dose (0.1mL) admixed with 0.47µg of recombinant double mutant [LT(R192G/L211A)] Enterotoxigenic Escherichia coli heat labile toxin (dmLT) adjuvant.
Intervention Type
Biological
Intervention Name(s)
Intradermal fractional dose inactivated polio vaccine (fIPV)
Intervention Description
Sanofi's licensed IPOL trivalent inactivated polio vaccine (NDC 49281-860-78) delivered at the dose-sparing fractional volume of 1/5 the full dose (0.1mL).
Intervention Type
Biological
Intervention Name(s)
Monovalent oral poliomyelitis vaccine (mOPV), Sabin strain
Intervention Description
Monovalent oral polio vaccine (OPV) challenge administered as a test of mucosal immunity.
Primary Outcome Measure Information:
Title
mucosal immunity to poliovirus
Description
Stimulation of mucosal immunity to poliovirus via comparison of fecal shedding dynamics using longitudinal stool collections following mOPV1 challenge in fIPV-dmLT recipients versus fIPV only recipients.
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Safety and local reactogenicity: systemic and local injection site adverse reactions (ARs)
Description
Frequency of systemic and local injection site adverse reactions (ARs) defined as vaccine-related adverse events (AEs), graded by severity, occurring within 28 days of dosing
Time Frame
1 month
Title
Safety: serious adverse events
Description
percentage of subjects with at least one vaccine-related serious adverse event (SAE) occurring within 28 days of dosing
Time Frame
1 month
Title
Systemic Immunogenicity: poliovirus-specific serum neutralizing antibody responses
Description
poliovirus-specific serum neutralizing antibody responses in fIPV-dmLT recipients versus fIPV only recipients.
Time Frame
1 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Aged 18 to 45 years old Signed informed consent form prior to initiation of any study activity Good general health as determined by review of medical history, physical exam, and basic laboratory screening Agrees to complete all study visits and procedures History of receipt of childhood polio vaccine series consisting of at least 3 doses of Inactivated Polio Vaccine (IPV). No history of receipt of OPV. Neutralizing antibody titers > 1:8 for polio type 1 Exclusion Criteria: 1. Any condition (medical, psychiatric or behavioral) that, in the opinion of the investigator, would increase the volunteer's health risks in study participation or would increase the risk of not achieving the study's objectives (e.g., would compromise adherence to protocol requirements or interfere with planned safety and immunogenicity assessments) 2. Females of childbearing* potential only: currently lactating, breastfeeding, pregnant, or not agreeing to have repeated pregnancy tests prior to any study or challenge vaccination, and/or not having practiced adequate contraception** for 30 days prior to first study vaccination and/or not willing to continue using adequate contraception consistently for at least 90 days after the last study or challenge vaccination a. *Females can be considered not of childbearing potential if they are with current bilateral tubal ligation or occlusion, or post-hysterectomy, or post-bilateral ovariectomy, or post-menopause b. ** Adequate contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly and when applicable, in accordance with the product label, for example: i. Abstinence from penile-vaginal intercourse ii. Combined estrogen and progesterone oral contraceptives iii. Injectable progestogen iv. Implants of etonogestrel or levonorgestrel v. Contraceptive vaginal ring vi. Percutaneous contraceptive patches vii. Intrauterine device or intrauterine system viii. Male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository), and/or progesterone alone oral contraceptive 3. Symptoms of an acute self-limited illness, such as an upper respiratory infection, febrile illness (≥38.0°C (100.4°F), or gastroenteritis within 3 days of administration of IP including an oral temperature 4. History of antimicrobial treatment in the 10 days before administration of IP 5. History of a severe allergic reaction or anaphylaxis 6. Receipt of a vaccine within 21 days prior to the Investigational vaccination or anticipated receipt of any vaccine during the 28 days following Investigational vaccination 7. Receipt of a vaccine within the 21 days prior to OPV Challenge vaccination or anticipated receipt of any vaccine during the 28 days following OPV Challenge vaccination 8. Anticipated receipt of any investigational agent in the 28 days before or after receipt of investigational product without permission from the sponsor. 9. Known history of hypersensitivity to any component of IPV or OPV to include: 2phenoxyethanol, formaldehyde, neomycin, streptomycin, polymyxin B erythromycin, and kanamycin 10. Receipt of polio vaccine within 12 months before the start of the study 11. Agrees not to and has no plans to travel outside the United States (US) until confirmation of cessation of vaccine virus shedding in stool 12. Having Crohn's disease or ulcerative colitis or having had major surgery of the gastrointestinal tract involving significant loss or resection of the bowel 13. Receipt of transfusion of any blood product or application of immunoglobulins within the 12 weeks prior to the first administration of study vaccine or planned use during the study period 14. Self-reported or suspected immunodeficiency, or receipt of immunosuppressive therapy within the preceding 6 months, or long-term systemic corticosteroid therapy (inhaled, topical and intra-articular and epidural injections are allowed at this discretion of the investigator. 15. Will have household or close professional contact during the mOPV challenge phase (C+0-C+28) of the study with individuals expected to be immunosuppressed (due to underlying condition or treatments) or individuals who have not yet completed their primary infant polio immunization series (i.e., three doses) 16. Will have household or close professional contact during the mOPV challenge phase (C+0-C+28) of the study with infants less than 6 months of age (e.g. neonatal nurses) or with pregnant women 17. Will have professional handling of food, catering or food production activities during the during the mOPV challenge phase (C+0-C+28) of the study 18. Indications of drug abuse or excessive use of alcohol that in the opinion of the investigator may interfere with their ability to comply with study related activities. 19. Abnormal routine bowel habits as defined by fewer than three stools per week in the past 6 months 20. Regular use (weekly or more often) of laxatives, anti-diarrheal, or anti-constipation medications. 21. Hepatitis B or C virus infection 22. Any confirmed or suspected immunosuppressive or immunodeficiency condition (human immunodeficiency virus [HIV] infection, or total serum immunoglobulin A (IgA) level below the testing laboratory lower limit of normal). 23. Any hematological# or chemistry** parameter that is out of range of normal and is considered clinically significant by the investigator #Complete blood cell count (hemoglobin, hematocrit, white blood cell [WBC] and platelet count) **Creatinine, ALT, total bilirubin
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jessica W Crothers, MD
Phone
8029221969
Email
Jessica.Crothers@med.uvm.edu
First Name & Middle Initial & Last Name or Official Title & Degree
MaryClaire Walsh, PA
Phone
802-656-7764
Email
MaryClaire.Walsh@uvmhealth.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jessica W Crothers, MD
Organizational Affiliation
UVM Vaccine Testing Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Vermont Vaccine Testing Center at the Larner College of Medicine
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05401
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jessica W Crothers, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Aggregated data will be made available to other researchers.

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Intradermal Fractional Dose IPV (fIPV) in Combination With dmLT

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