Intradermal Influenza Vaccine Study in Elders
Primary Purpose
Influenza
Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Fluzone Influenza Vaccine (2007-2008)
Sponsored by
About this trial
This is an interventional prevention trial for Influenza focused on measuring influenza, prevention, intradermal, vaccine, delivery, elderly
Eligibility Criteria
Inclusion Criteria:
- Ambulatory, medically stable persons 65 years of age or older
- Able to read and understand informed consent
- Available during the trial period and for follow-up
- Able to understand and comply with planned study procedures
- Able to be contacted by telephone for follow-up of adverse events
Exclusion Criteria:
- Known allergy to eggs or other components of vaccine (i.e., thimerosal)
- History of Guillain-Barré Syndrome (GBS)
- Has a confirmed or suspected immunodeficient or immunosuppressive condition (including congenital or acquired immunosuppressive therapy, and human immunodeficiency virus [HIV])
- End-stage renal disease requiring hemodialysis
- Active neoplastic disease or history of any hematologic malignancy (except localized skin or prostate cancer that is stable in the absence of therapy)
- Acute or chronic condition that (in the opinion of the investigator) would render vaccination unsafe or would interfere with the evaluation of responses (including but not limited to the following: known chronic liver disease, significant renal disease, oxygen-dependent chronic lung disease, New York Heart Association Functional Class III or IV, unstable or progressive neurologic disorder, insulin controlled diabetes mellitus)
- Use of experimental vaccines within the month prior to study entry, or expected use of experimental or licensed vaccines or blood/blood products during the duration of the study.
- Receipt of immunoglobulin or other blood product within 3 months prior to enrollment
- Receipt of other licensed vaccines within the preceding 4 weeks
- History of a severe reaction following influenza vaccination
- Current or planned participation in a research study of an investigational drug. Participation in research studies that involve use of licensed drugs, for either approved or investigational indications, will be permitted with the approval of the PI, as will participation in research studies that do not involve vaccines or medications.
- Current use or previous chronic administration, defined as >14 days during the previous six months, of immunosuppressants or other immune-modifying drugs. (For oral or injected corticosteroids, the immune-modifying dose is defined as prednisone or its equivalent >10 mg/day or >800mcg per day of inhaled beclomethasone dipropionate or equivalent ). Topical steroids are allowed.
- Use of cytotoxic therapy in the previous 2 years.
- Plans to receive cytotoxic therapy during the study period.
- Concurrent moderate to severe illness. Need to defer vaccination until recovery. (Vaccination is not contraindicated in subjects with mild illnesses or with low-grade fever).
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Active Comparator
Experimental
Arm Label
0.3 mL Influenza Vaccine ID
0.15 mL twice Influenza Vaccine ID
0.5 mL Influenza Vaccine by IM
0.3 mL Influenza Vaccine IM
Arm Description
60% dose - 0.3 mL delivered intradermally with needle and syringe
60% dose - 0.15 mL delivered twice intradermally with needle and syringe
100% dose - 0.5mL delivered intramuscularly with needle and syringe
60% dose - 0.3 mL delivered intramuscularly with needle and syringe
Outcomes
Primary Outcome Measures
Seroprotection Pre- and Post- Vaccination
Seroprotection before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) Intramuscular (IM) or Reduced-Dose (9 mg) Intradermal (ID) Injections for A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)
Secondary Outcome Measures
Geometric Mean Titer (GMT) Pre- and Post- Vaccination
GMT before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) IM or Reduced-Dose (9 mg) ID Injections. A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)
Assessment of Reactogenicity
Maximum solicited systemic and local signs and symptoms during the week after initial vaccination, by Dose and Randomization Assignment
Full Information
NCT ID
NCT00504231
First Posted
July 12, 2007
Last Updated
June 8, 2012
Sponsor
PATH
Collaborators
VA Puget Sound Health Care System, Seattle Institute for Biomedical and Clinical Research
1. Study Identification
Unique Protocol Identification Number
NCT00504231
Brief Title
Intradermal Influenza Vaccine Study in Elders
Official Title
Intradermal vs. Intramuscular Delivery of Influenza Vaccine in Immunocompetent Elders
Study Type
Interventional
2. Study Status
Record Verification Date
July 2011
Overall Recruitment Status
Completed
Study Start Date
September 2007 (undefined)
Primary Completion Date
January 2008 (Actual)
Study Completion Date
January 2008 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PATH
Collaborators
VA Puget Sound Health Care System, Seattle Institute for Biomedical and Clinical Research
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This randomized trial compared the immunogenicity of 60% dose intradermal (ID) influenza vaccination to standard intramuscular (IM) vaccination of full-dose or 60% dose vaccine. Pre- and postvaccination measurements in the hemagglutination inhibition antibody (HAI) titer were compared. Participants who received reduced-dose vaccine were revaccinated with full-dose IM vaccine.
Detailed Description
This study was an open-label randomized trial consisting of community-dwelling adults 65 years and older living in Puget Sound area in Washington State. Subjects were enrolled and randomly assigned to receive licensed, 2007-2008 Northern Hemisphere TIV vaccine (Fluzone, lot U2440AA; Sanofi Pasteur) containing concentrations of hemagglutinin of each of A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), and B/Malaysia/2506/2004 (B): 15 ug/0.5 mL by the IM route, 9 ug/0.3 mL by the ID or IM route, or 4.5 ug/0.15 mL given twice by ID route to the nondominant arm. A block randomization scheme (1:1:1:1), stratified by sex, was used. For IM vaccination, 0.3 mL or 0.5 mL of vaccine was removed from a multidose (5 mL) vial through a 25-gauge, 1-inch detachable needle (Becton Dickinson) and was injected into the deltoid muscle at a 90 degree angle to the skin. For ID vaccination, 0.3 mL or 0.15 mL was drawn by a TB syringe through a 25-gauge, 5/8-inch needle (Terumo Medical). The needle was inserted at a 15 degree angle to the skin overlying the deltoid of the arm. The vaccine was slowly injected until all material was expelled and induration appeared. Subjects randomized to the 0.15-mL group received 2 side-by-side ID injections 3 cm apart. Participants returned at 4 weeks to determine postvaccination antibody titers. At this follow-up visit, those assigned to reduced dose IM or ID influenza vaccinations then received full-dose IM influenza vaccination. These participants returned in another 4 weeks to repeat HAI titers. A nonrandomized subset of subjects (based on availability and willingness to participate) returned at 14 days after initial vaccination for T cell assays in an exploratory substudy to examine cellular immune response.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
influenza, prevention, intradermal, vaccine, delivery, elderly
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
257 (Actual)
8. Arms, Groups, and Interventions
Arm Title
0.3 mL Influenza Vaccine ID
Arm Type
Experimental
Arm Description
60% dose - 0.3 mL delivered intradermally with needle and syringe
Arm Title
0.15 mL twice Influenza Vaccine ID
Arm Type
Experimental
Arm Description
60% dose - 0.15 mL delivered twice intradermally with needle and syringe
Arm Title
0.5 mL Influenza Vaccine by IM
Arm Type
Active Comparator
Arm Description
100% dose - 0.5mL delivered intramuscularly with needle and syringe
Arm Title
0.3 mL Influenza Vaccine IM
Arm Type
Experimental
Arm Description
60% dose - 0.3 mL delivered intramuscularly with needle and syringe
Intervention Type
Biological
Intervention Name(s)
Fluzone Influenza Vaccine (2007-2008)
Other Intervention Name(s)
Fluzone
Intervention Description
Manufactured by Sanofi Pasteur
Primary Outcome Measure Information:
Title
Seroprotection Pre- and Post- Vaccination
Description
Seroprotection before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) Intramuscular (IM) or Reduced-Dose (9 mg) Intradermal (ID) Injections for A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)
Time Frame
1 month
Secondary Outcome Measure Information:
Title
Geometric Mean Titer (GMT) Pre- and Post- Vaccination
Description
GMT before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) IM or Reduced-Dose (9 mg) ID Injections. A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)
Time Frame
1 month
Title
Assessment of Reactogenicity
Description
Maximum solicited systemic and local signs and symptoms during the week after initial vaccination, by Dose and Randomization Assignment
Time Frame
1 week
10. Eligibility
Sex
All
Minimum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Ambulatory, medically stable persons 65 years of age or older
Able to read and understand informed consent
Available during the trial period and for follow-up
Able to understand and comply with planned study procedures
Able to be contacted by telephone for follow-up of adverse events
Exclusion Criteria:
Known allergy to eggs or other components of vaccine (i.e., thimerosal)
History of Guillain-Barré Syndrome (GBS)
Has a confirmed or suspected immunodeficient or immunosuppressive condition (including congenital or acquired immunosuppressive therapy, and human immunodeficiency virus [HIV])
End-stage renal disease requiring hemodialysis
Active neoplastic disease or history of any hematologic malignancy (except localized skin or prostate cancer that is stable in the absence of therapy)
Acute or chronic condition that (in the opinion of the investigator) would render vaccination unsafe or would interfere with the evaluation of responses (including but not limited to the following: known chronic liver disease, significant renal disease, oxygen-dependent chronic lung disease, New York Heart Association Functional Class III or IV, unstable or progressive neurologic disorder, insulin controlled diabetes mellitus)
Use of experimental vaccines within the month prior to study entry, or expected use of experimental or licensed vaccines or blood/blood products during the duration of the study.
Receipt of immunoglobulin or other blood product within 3 months prior to enrollment
Receipt of other licensed vaccines within the preceding 4 weeks
History of a severe reaction following influenza vaccination
Current or planned participation in a research study of an investigational drug. Participation in research studies that involve use of licensed drugs, for either approved or investigational indications, will be permitted with the approval of the PI, as will participation in research studies that do not involve vaccines or medications.
Current use or previous chronic administration, defined as >14 days during the previous six months, of immunosuppressants or other immune-modifying drugs. (For oral or injected corticosteroids, the immune-modifying dose is defined as prednisone or its equivalent >10 mg/day or >800mcg per day of inhaled beclomethasone dipropionate or equivalent ). Topical steroids are allowed.
Use of cytotoxic therapy in the previous 2 years.
Plans to receive cytotoxic therapy during the study period.
Concurrent moderate to severe illness. Need to defer vaccination until recovery. (Vaccination is not contraindicated in subjects with mild illnesses or with low-grade fever).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ru-Chien Chi, MD
Organizational Affiliation
VAPSHCS
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Kathy Neuzil, MD
Organizational Affiliation
PATH
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
20377407
Citation
Chi RC, Rock MT, Neuzil KM. Immunogenicity and safety of intradermal influenza vaccination in healthy older adults. Clin Infect Dis. 2010 May 15;50(10):1331-8. doi: 10.1086/652144.
Results Reference
derived
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Intradermal Influenza Vaccine Study in Elders
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