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Long-term Immunogenicity After Receipt of JE Vaccine and Antibody Response and Safety to a Booster Dose

Primary Purpose

Encephalitis, Japanese

Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Live Attenuated Japanese Encephalitis SA-14-14-2 Vaccine
Sponsored by
PATH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Encephalitis, Japanese focused on measuring Japanese Encephalitis Vaccines, Flavivirus Infections

Eligibility Criteria

43 Months - 51 Months (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Participant in JEV05 study (NCT01567865) and received one dose of CD-JEV.
  • Resides in the Matlab or Mirpur study area.
  • At least one parent or guardian willing to provide written informed consent.

Exclusion Criteria:

  • Received a second dose of Japanese encephalitis vaccine within the past three years.
  • Received immunoglobulins and/or any blood products within 90 days prior to enrollment.
  • Been diagnosed with a primary or acquired immunodeficiency, including human immunodeficiency virus (HIV) infection within the past three years.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Live Attenuated JE SA-14-14-2 Vaccine (CD-JEV)

    Arm Description

    Participants previously vaccinated with CD-JEV will receive a booster dose of live, attenuated Japanese encephalitis SA-14-14-2 vaccine four years after initial vaccination.

    Outcomes

    Primary Outcome Measures

    Seroprotection Rate Three and Four Years After Initial Vaccination With CD-JEV
    Seroprotection rate is defined as the percentage of participants with an anti-Japanese encephalitis (JE) neutralizing antibody titer ≥ 1:10 as measured using a 50% plaque reduction neutralization test (PRNT-50). Seroprotection was assessed at 3 and 4 years after the initial vaccination in Study JEV05, prior to participants receiving a booster vaccination in the current study.
    Geometric Mean Titer of Anti-JE Neutralizing Antibodies Three and Four Years After Initial Vaccination With CD-JEV
    The geometric mean titer (GMT) of anti-JE neutralizing antibodies 3 and 4 years after initial vaccination with CD-JEV in Study JEV05 and prior to receiving the booster vaccination in the current study, measured using PRNT-50.

    Secondary Outcome Measures

    Seroprotection Rate 7 Days and 28 Days After Booster Dose
    Seroprotection rate is defined as the percentage of study participants with an anti-JE neutralizing antibody titer ≥1:10 assessed using PRNT-50.
    GMT of Anti-JE Neutralizing Antibodies 7 Days and 28 Days After Booster Dose
    Geometric mean titer of anti-JE neutralizing antibodies measured using PRNT-50.
    Seroconversion Rate 7 Days and 28 Days After Booster Dose
    Seroconversion rate is defined as the percentage of study participants with either: For participants who were seronegative at Baseline (defined as anti-JE neutralizing antibody titer of < 1:10 assessed using PRNT-50 at Year 4, prior to booster vaccination): A change in serostatus from seronegative (anti-JE neutralizing antibody titer of < 1:10) to positive (anti-JE neutralizing antibody titer ≥ 1:10) For participants who were seropositive at Baseline (defined as an anti-JE neutralizing antibody titer ≥1:10 assessed using PRNT-50 at Year 4, prior to booster vaccination): a 4-fold increase in anti-JE neutralizing antibody titer relative to Baseline anti-JE neutralizing antibody titer
    GMT Ratio of Anti-JE Neutralizing Antibody Titers Between Post-Booster and Pre-Booster Vaccination
    To evaluate the magnitude of the increase in GMTs, the GMT ratio of anti-JE neutralizing antibody titers between post-booster vaccination and pre-booster vaccination was calculated for the following: GMT of anti-JE neutralizing antibodies at 7 days after booster vaccination to the Year 4, pre-booster GMT of anti-JE neutralizing antibodies GMT of anti-JE neutralizing antibodies at 28 days after booster vaccination to the Year 4, pre-booster GMT of anti-JE neutralizing antibodies
    Number of Participants With Immediate Reactions 30 Minutes Following Booster Vaccination
    The number of participants with at least one occurrence of an immediate reaction, including local, systemic, or unsolicited adverse event that occurred within 30 minutes of the booster vaccination.
    Number of Participants With Solicited Local Reactions Occurring Within 7 Days of Booster Vaccination
    Participants were monitored for local reactions from 30 minutes through 7 days post booster vaccination. Local reactions (at the injection site) included the following: Ecchymosis (bruising) Erythema (redness) Edema (swelling) Induration (hardness) Pain/tenderness Local ecchymosis, erythema, edema, and induration were graded as follows: Grade 1: ≤ 2.5 cm in diameter Grade 2: > 2.5 cm in diameter with < 50% surface area of extremity involved Grade 3: ≥ 50% surface area of extremity involved OR ulceration OR secondary infection OR phlebitis OR sterile abscess OR drainage Grade 4: potentially life-threatening consequences Injection site pain/tenderness were graded as follows: Grade 1: causing no or minimal limitation in use of limb Grade 2: causing greater than minimal limitation of use of limb Grade 3: causing inability to perform usual social or functional activities Grade 4: inability to perform basic self-care OR hospitalization indicated.
    Number of Participants With Solicited Systemic Reactions Occurring Within 7 Days of Booster Vaccination
    Participants were monitored for systemic reactions from 30 minutes through 7 days post booster vaccination. Systemic reactions (general signs / symptoms) included the following: Fever Change in eating habits Diarrhea Sleepiness Irritability Unusual crying Vomiting Fever was graded as follows: Grade 1: 37.5 ℃ to 37.9 ℃ Grade 2: 38.0 ℃ to 38.4 ℃ Grade 3: 38.5 ℃ to 40.0 ℃ Grade 4: > 40.0 ℃ Change in eating habits, diarrhea, sleepiness, irritability, unusual crying, vomiting were graded as follows: Grade 1: causing no or minimal interference with usual social or functional activities Grade 2: causing greater than minimal interference with usual social or functional activities Grade 3: causing inability to perform usual social or functional activities OR hospitalization indicated Grade 4: inability to perform basic self-care OR medical or operative intervention indicated to prevent permanent impairment, persistent disability, or death.
    Number of Participants With Unsolicited Adverse Events (AEs) and Serious Adverse Events (SAEs) Within 28 Days Following Booster Vaccination
    AEs were graded for severity according to the following: Grade 1 (Mild): Symptoms causing no or minimal interference with usual social and functional activities Grade 2 (Moderate): Symptoms causing greater than minimal interference with usual social and functional activities Grade 3 (Severe): Symptoms causing inability to perform usual social and functional activities with intervention or hospitalization indicated Grade 4 (Potentially life-threatening): Symptoms causing inability to perform basic self-care functions OR medical or operative intervention indicated to prevent permanent impairment, persistent disability, or death. Relationship to study vaccine was based on the Clinician's assessment. A serious adverse event is defined as an AE that meets 1 of the following criteria: Death Life-threatening Requires hospitalization or prolongation of existing hospitalization Results in persistent disability Important medical event based on medical judgement

    Full Information

    First Posted
    July 15, 2015
    Last Updated
    September 24, 2020
    Sponsor
    PATH
    Collaborators
    International Centre for Diarrhoeal Disease Research, Bangladesh
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02514746
    Brief Title
    Long-term Immunogenicity After Receipt of JE Vaccine and Antibody Response and Safety to a Booster Dose
    Official Title
    Assessment of Long Term Immunogenicity of Japanese Encephalitis Live Attenuated SA-14-14-2 Vaccine in Previously Vaccinated Bangladeshi Children and Antibody Response and Safety to a Booster Dose
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2020
    Overall Recruitment Status
    Completed
    Study Start Date
    July 30, 2015 (Actual)
    Primary Completion Date
    December 15, 2016 (Actual)
    Study Completion Date
    January 12, 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    PATH
    Collaborators
    International Centre for Diarrhoeal Disease Research, Bangladesh

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This study aims to understand the persistence of the Japanese encephalitis (JE) antibody response in previously vaccinated children. The proposed study will enrol Bangladeshi children who had previously participated in a lot to lot consistency study (JEV05; NCT01567865) of JE live attenuated SA 14-14-2 vaccine (CD-JEV).
    Detailed Description
    Study participants previously immunized with CD-JEV (Clinical Trials identifier: NCT01567865, JEV05) will have serum collected three and four years after initial vaccination to assess long-term immunogenicity. Four years after receiving the initial dose of CD-JEV, eligible participants will be vaccinated with a second subcutaneous dose of CD-JEV to assess the antibody response. Participants will be monitored for safety for 28 days following receipt of the booster dose.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Encephalitis, Japanese
    Keywords
    Japanese Encephalitis Vaccines, Flavivirus Infections

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    561 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Live Attenuated JE SA-14-14-2 Vaccine (CD-JEV)
    Arm Type
    Experimental
    Arm Description
    Participants previously vaccinated with CD-JEV will receive a booster dose of live, attenuated Japanese encephalitis SA-14-14-2 vaccine four years after initial vaccination.
    Intervention Type
    Biological
    Intervention Name(s)
    Live Attenuated Japanese Encephalitis SA-14-14-2 Vaccine
    Other Intervention Name(s)
    CD-JEV, CD.JEVAX®, RS.JEV®
    Intervention Description
    0.5 mL subcutaneous injection
    Primary Outcome Measure Information:
    Title
    Seroprotection Rate Three and Four Years After Initial Vaccination With CD-JEV
    Description
    Seroprotection rate is defined as the percentage of participants with an anti-Japanese encephalitis (JE) neutralizing antibody titer ≥ 1:10 as measured using a 50% plaque reduction neutralization test (PRNT-50). Seroprotection was assessed at 3 and 4 years after the initial vaccination in Study JEV05, prior to participants receiving a booster vaccination in the current study.
    Time Frame
    3 years after initial vaccination (Study Day 1) and 4 years after initial vaccination (Study Day 365)
    Title
    Geometric Mean Titer of Anti-JE Neutralizing Antibodies Three and Four Years After Initial Vaccination With CD-JEV
    Description
    The geometric mean titer (GMT) of anti-JE neutralizing antibodies 3 and 4 years after initial vaccination with CD-JEV in Study JEV05 and prior to receiving the booster vaccination in the current study, measured using PRNT-50.
    Time Frame
    3 years after initial vaccination (Study Day 1) and 4 years after initial vaccination (Study Day 365)
    Secondary Outcome Measure Information:
    Title
    Seroprotection Rate 7 Days and 28 Days After Booster Dose
    Description
    Seroprotection rate is defined as the percentage of study participants with an anti-JE neutralizing antibody titer ≥1:10 assessed using PRNT-50.
    Time Frame
    7 days and 28 days following booster vaccination (Study Days 372 and 393)
    Title
    GMT of Anti-JE Neutralizing Antibodies 7 Days and 28 Days After Booster Dose
    Description
    Geometric mean titer of anti-JE neutralizing antibodies measured using PRNT-50.
    Time Frame
    7 days and 28 days following booster vaccination (Study Days 372 and 393)
    Title
    Seroconversion Rate 7 Days and 28 Days After Booster Dose
    Description
    Seroconversion rate is defined as the percentage of study participants with either: For participants who were seronegative at Baseline (defined as anti-JE neutralizing antibody titer of < 1:10 assessed using PRNT-50 at Year 4, prior to booster vaccination): A change in serostatus from seronegative (anti-JE neutralizing antibody titer of < 1:10) to positive (anti-JE neutralizing antibody titer ≥ 1:10) For participants who were seropositive at Baseline (defined as an anti-JE neutralizing antibody titer ≥1:10 assessed using PRNT-50 at Year 4, prior to booster vaccination): a 4-fold increase in anti-JE neutralizing antibody titer relative to Baseline anti-JE neutralizing antibody titer
    Time Frame
    7 days and 28 days following booster vaccination (Study Days 372 and 393)
    Title
    GMT Ratio of Anti-JE Neutralizing Antibody Titers Between Post-Booster and Pre-Booster Vaccination
    Description
    To evaluate the magnitude of the increase in GMTs, the GMT ratio of anti-JE neutralizing antibody titers between post-booster vaccination and pre-booster vaccination was calculated for the following: GMT of anti-JE neutralizing antibodies at 7 days after booster vaccination to the Year 4, pre-booster GMT of anti-JE neutralizing antibodies GMT of anti-JE neutralizing antibodies at 28 days after booster vaccination to the Year 4, pre-booster GMT of anti-JE neutralizing antibodies
    Time Frame
    4 years after the initial vaccination (Study Day 365, pre-booster vaccination) and 7 and 28 days following booster vaccination (Study Days 372 and 393)
    Title
    Number of Participants With Immediate Reactions 30 Minutes Following Booster Vaccination
    Description
    The number of participants with at least one occurrence of an immediate reaction, including local, systemic, or unsolicited adverse event that occurred within 30 minutes of the booster vaccination.
    Time Frame
    30 minutes following booster vaccination (Study Day 365)
    Title
    Number of Participants With Solicited Local Reactions Occurring Within 7 Days of Booster Vaccination
    Description
    Participants were monitored for local reactions from 30 minutes through 7 days post booster vaccination. Local reactions (at the injection site) included the following: Ecchymosis (bruising) Erythema (redness) Edema (swelling) Induration (hardness) Pain/tenderness Local ecchymosis, erythema, edema, and induration were graded as follows: Grade 1: ≤ 2.5 cm in diameter Grade 2: > 2.5 cm in diameter with < 50% surface area of extremity involved Grade 3: ≥ 50% surface area of extremity involved OR ulceration OR secondary infection OR phlebitis OR sterile abscess OR drainage Grade 4: potentially life-threatening consequences Injection site pain/tenderness were graded as follows: Grade 1: causing no or minimal limitation in use of limb Grade 2: causing greater than minimal limitation of use of limb Grade 3: causing inability to perform usual social or functional activities Grade 4: inability to perform basic self-care OR hospitalization indicated.
    Time Frame
    From 30 minutes to 7 days following booster vaccination (Study Day 365 to 372)
    Title
    Number of Participants With Solicited Systemic Reactions Occurring Within 7 Days of Booster Vaccination
    Description
    Participants were monitored for systemic reactions from 30 minutes through 7 days post booster vaccination. Systemic reactions (general signs / symptoms) included the following: Fever Change in eating habits Diarrhea Sleepiness Irritability Unusual crying Vomiting Fever was graded as follows: Grade 1: 37.5 ℃ to 37.9 ℃ Grade 2: 38.0 ℃ to 38.4 ℃ Grade 3: 38.5 ℃ to 40.0 ℃ Grade 4: > 40.0 ℃ Change in eating habits, diarrhea, sleepiness, irritability, unusual crying, vomiting were graded as follows: Grade 1: causing no or minimal interference with usual social or functional activities Grade 2: causing greater than minimal interference with usual social or functional activities Grade 3: causing inability to perform usual social or functional activities OR hospitalization indicated Grade 4: inability to perform basic self-care OR medical or operative intervention indicated to prevent permanent impairment, persistent disability, or death.
    Time Frame
    From 30 minutes to 7 days following booster vaccination (Study Day 365 to 372)
    Title
    Number of Participants With Unsolicited Adverse Events (AEs) and Serious Adverse Events (SAEs) Within 28 Days Following Booster Vaccination
    Description
    AEs were graded for severity according to the following: Grade 1 (Mild): Symptoms causing no or minimal interference with usual social and functional activities Grade 2 (Moderate): Symptoms causing greater than minimal interference with usual social and functional activities Grade 3 (Severe): Symptoms causing inability to perform usual social and functional activities with intervention or hospitalization indicated Grade 4 (Potentially life-threatening): Symptoms causing inability to perform basic self-care functions OR medical or operative intervention indicated to prevent permanent impairment, persistent disability, or death. Relationship to study vaccine was based on the Clinician's assessment. A serious adverse event is defined as an AE that meets 1 of the following criteria: Death Life-threatening Requires hospitalization or prolongation of existing hospitalization Results in persistent disability Important medical event based on medical judgement
    Time Frame
    28 days following booster vaccination (Study Days 365 to 393)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    43 Months
    Maximum Age & Unit of Time
    51 Months
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Participant in JEV05 study (NCT01567865) and received one dose of CD-JEV. Resides in the Matlab or Mirpur study area. At least one parent or guardian willing to provide written informed consent. Exclusion Criteria: Received a second dose of Japanese encephalitis vaccine within the past three years. Received immunoglobulins and/or any blood products within 90 days prior to enrollment. Been diagnosed with a primary or acquired immunodeficiency, including human immunodeficiency virus (HIV) infection within the past three years.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    K Zaman, PhD, MPH, MBBS
    Organizational Affiliation
    International Centre for Diarrhoeal Disease Research, Bangladesh
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    25239483
    Citation
    Zaman K, Naser AM, Power M, Yaich M, Zhang L, Ginsburg AS, Luby SP, Rahman M, Hills S, Bhardwaj M, Flores J. Lot-to-lot consistency of live attenuated SA 14-14-2 Japanese encephalitis vaccine manufactured in a good manufacturing practice facility and non-inferiority with respect to an earlier product. Vaccine. 2014 Oct 21;32(46):6061-6. doi: 10.1016/j.vaccine.2014.09.012. Epub 2014 Sep 18.
    Results Reference
    result
    PubMed Identifier
    35243320
    Citation
    Zaman K, Yunus M, Aziz AB, Feser J, Mooney J, Tang Y, Ellison DW, Thaisomboonsuk B, Zhang L, Neuzil KM, Marfin AA, Letson GW. Antibody persistence and immune memory response following primary vaccination and boosting with live attenuated SA 14-14-2 Japanese encephalitis vaccine (CD-JEV) in Bangladesh: A phase 4 open-label clinical trial. Vaccine X. 2022 Feb 5;10:100143. doi: 10.1016/j.jvacx.2022.100143. eCollection 2022 Apr.
    Results Reference
    derived

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    Long-term Immunogenicity After Receipt of JE Vaccine and Antibody Response and Safety to a Booster Dose

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