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Non-specific Effects of a Modified Measles Vaccination Schedule to Prevent Allergy and Unrelated Infection in Children (NEMAU)

Primary Purpose

Respiratory Tract Infections, Infections, Allergy

Status
Recruiting
Phase
Phase 4
Locations
Switzerland
Study Type
Interventional
Intervention
Measles-Mumps-Rubella vaccine (MMR)
Sponsored by
Laure Pittet, MD-PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Respiratory Tract Infections focused on measuring Non-specific/off-target effect of vaccine

Eligibility Criteria

6 Months - 6 Months (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Informed Consent as documented by signature 6-month-old children In overall good health, without any clinically significant concomitant disease states (e.g., renal failure, hepatic dysfunction, cardiovascular disease, etc.) and no clinically significant abnormal finding on history and/or physical examination Fully immunised for age according to the Swiss vaccination schedule with at least 2 doses of DTP-containing vaccine the last dose of vaccine received at least 2 weeks prior to enrolment Exclusion Criteria: Contra-indications to MMR, including immunosuppression (i.e. proven, suspected, or planned) allergy to a component of the vaccine receipt of a live-attenuated vaccine in the four weeks prior to inclusion Vaccine refusal Indication for an early MMR vaccination, including Measles outbreak Planned immunosuppression (indication to an accelerated schedule to be completed before starting an immunosuppressive treatment) Travel to a region with a high risk of measles outbreak Indication for vaccination with MMR-varicella (MMRV) instead of MMR, including severe eczema parental will Parental inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, known/suspected non-compliance, substance abuse, etc. Plan to move out of the country or have prolong absence during the trial Other sibling included in the trial (in the case of multiple pregnancy, only one child can be randomised) Any temporary contra-indication to MMR, including child being sick (active significant illness, inclusion can be delayed a few days until the illness resolves)

Sites / Locations

  • University Hospitals of GenevaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Experimental

Experimental

Experimental

Arm Label

C.C. : Both MMR doses given on current schedule (9 months and 12 months)

M.C. : 1st MMR on modified schedule (6 months) and 2nd MMR on current schedule (12 months)

C. M. : 1st MMR on current schedule (9 months) and 2nd MMR on modified schedule (13 months)

M.M. : Both MMR doses given on modified schedule (6 months and 13 months)

Arm Description

Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 9 months (= current Swiss schedule) 12 months, concomitant with other vaccines (= current Swiss schedule)

Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 6 months (= modified schedule) 12 months, concomitant with other vaccines (= current Swiss schedule)

Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 9 months (= current Swiss schedule) 13 months, distant from other vaccines (= modified schedule)

Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 6 months (= modified schedule) 13 months, distant from other vaccines (= modified schedule)

Outcomes

Primary Outcome Measures

Incidence of respiratory infection within the 3 months following randomisation
Incidence of parent-reported respiratory infections between 6 months and 9 months of age using fortnightly REDCap questionnaires, with validation of data by confirmation with treating paediatrician and medical records.

Secondary Outcome Measures

Infection: Time to first infection within the 3 months following randomisation
Calculated as: For participants who have an event: Date of event onset - date of randomisation For participants who did not have an event: Earliest censoring date - date of randomisation
Infection: Time to first infection within the 18 months following randomisation
Calculated as: For participants who have an event: Date of event onset - date of randomisation For participants who did not have an event: Earliest censoring date - date of randomisation
Infection: Prevalence of infection within the 3 months following randomisation
Calculated as: number of participants who have an event / total number of participants
Infection: Prevalence of infection within the 18 months following randomisation
Calculated as: number of participants who have an event / total number of participants
Infection: Incidence of infection within the 3 months following randomisation
Calculated as: number of events / total time of follow-up
Infection: Incidence of infection within the 18 months following randomisation
Calculated as: number of events / total time of follow-up
Infection: Number of days free of infection within the 3 months following randomisation
Calculated as: number of days free of event / total days of follow-up of participants
Infection: Number of days free of infection within the 18 months following randomisation
Calculated as: number of days free of event / total days of follow-up of participants
Infection severity: Duration of infection within the 3 months following randomisation
Per event, calculated as: date of recovery - date of onset
Infection severity: Duration of infection within the 18 months following randomisation
Per event, calculated as: date of recovery - date of onset
Infection severity: Antibiotic use for infection within the 3 months following randomisation
Per event, defined as a binary variable (yes/no)
Infection severity: Antibiotic use for infection within the 18 months following randomisation
Per event, defined as a binary variable (yes/no)
Infection severity: Hospitalisation for infection within the 3 months following randomisation
Per event, defined as a binary variable (yes/no)
Infection severity: Hospitalisation for infection within the 18 months following randomisation
Per event, defined as a binary variable (yes/no)
Infection severity: Outcome of infection within the 3 months following randomisation
Per event, defined as a categorical variable (uneventful/complication or sequel/death)
Infection severity: Outcome of infection within the 18 months following randomisation
Per event, defined as a categorical variable (uneventful/complication or sequel/death)
Incidence of respiratory infection within the 18 months following randomisation
Incidence of parent-reported respiratory infections between 6 months and 24 months of age using fortnightly REDCap questionnaires, with validation of data by confirmation with treating paediatrician and medical records.

Full Information

First Posted
February 10, 2023
Last Updated
March 22, 2023
Sponsor
Laure Pittet, MD-PhD
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1. Study Identification

Unique Protocol Identification Number
NCT05758532
Brief Title
Non-specific Effects of a Modified Measles Vaccination Schedule to Prevent Allergy and Unrelated Infection in Children
Acronym
NEMAU
Official Title
Harnessing the Beneficial Non-specific Effects of Measles-mumps-rubella Vaccine in Children on Infection With Unrelated Pathogens and Allergic Diseases - a Single-centre Phase IV RCT With a Factorial Design
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 17, 2023 (Actual)
Primary Completion Date
April 2026 (Anticipated)
Study Completion Date
December 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Laure Pittet, MD-PhD

4. Oversight

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

5. Study Description

Brief Summary
The goal of this clinical trial is to evaluate the off-target/non-specific effects of the measles-mumps-rubella (MMR) vaccine in children.
Detailed Description
The overall objective of this project is to assess, in a randomised control trial (RCT), the effects of a "modified" MMR schedule in children, by an in-depth characterisation of both the clinical effects and the underlying immunomodulatory changes. The current Swiss administration schedule of giving MMR at 9 and 12 months of age ("current schedule") will be compared with a "modified schedule". This is expected to maximise the beneficial non-specific effects of MMR by giving it at 6 and 13 months of age, separately from other vaccines ("modified schedule"). Factorial analysis will enable assessment of the benefit of the intervention on each of the two doses of MMR separately or in combination. The clinical aims are to determine whether a modified schedule of MMR administration reduces both the risk and severity of: (i) infections with unrelated pathogens and (ii) atopic and allergic diseases. The laboratory aims are to: (i) quantify and characterise the immunological non-specific effects of MMR, and (ii) identify the biological pathways and molecular mechanisms that are altered by MMR vaccination.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Respiratory Tract Infections, Infections, Allergy, Eczema
Keywords
Non-specific/off-target effect of vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Factorial Assignment
Model Description
Phase IV, single-centre, 4-group, open-label, randomised controlled trial with a factorial design (primary outcome analysed as a 2-group trial)
Masking
None (Open Label)
Allocation
Randomized
Enrollment
500 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
C.C. : Both MMR doses given on current schedule (9 months and 12 months)
Arm Type
Active Comparator
Arm Description
Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 9 months (= current Swiss schedule) 12 months, concomitant with other vaccines (= current Swiss schedule)
Arm Title
M.C. : 1st MMR on modified schedule (6 months) and 2nd MMR on current schedule (12 months)
Arm Type
Experimental
Arm Description
Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 6 months (= modified schedule) 12 months, concomitant with other vaccines (= current Swiss schedule)
Arm Title
C. M. : 1st MMR on current schedule (9 months) and 2nd MMR on modified schedule (13 months)
Arm Type
Experimental
Arm Description
Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 9 months (= current Swiss schedule) 13 months, distant from other vaccines (= modified schedule)
Arm Title
M.M. : Both MMR doses given on modified schedule (6 months and 13 months)
Arm Type
Experimental
Arm Description
Measles-mumps-rubella (MMR) vaccine 0.5 ml injected intramuscularly, at: 6 months (= modified schedule) 13 months, distant from other vaccines (= modified schedule)
Intervention Type
Biological
Intervention Name(s)
Measles-Mumps-Rubella vaccine (MMR)
Intervention Description
0.5 ml of MMR vaccine injected intramuscularly in the deltoid region or in the anterolateral area of the thigh
Primary Outcome Measure Information:
Title
Incidence of respiratory infection within the 3 months following randomisation
Description
Incidence of parent-reported respiratory infections between 6 months and 9 months of age using fortnightly REDCap questionnaires, with validation of data by confirmation with treating paediatrician and medical records.
Time Frame
Measured over the 3 months following randomisation
Secondary Outcome Measure Information:
Title
Infection: Time to first infection within the 3 months following randomisation
Description
Calculated as: For participants who have an event: Date of event onset - date of randomisation For participants who did not have an event: Earliest censoring date - date of randomisation
Time Frame
Measured over the 3 months following randomisation
Title
Infection: Time to first infection within the 18 months following randomisation
Description
Calculated as: For participants who have an event: Date of event onset - date of randomisation For participants who did not have an event: Earliest censoring date - date of randomisation
Time Frame
Measured over the 18 months following randomisation
Title
Infection: Prevalence of infection within the 3 months following randomisation
Description
Calculated as: number of participants who have an event / total number of participants
Time Frame
Measured over the 3 months following randomisation
Title
Infection: Prevalence of infection within the 18 months following randomisation
Description
Calculated as: number of participants who have an event / total number of participants
Time Frame
Measured over the 18 months following randomisation
Title
Infection: Incidence of infection within the 3 months following randomisation
Description
Calculated as: number of events / total time of follow-up
Time Frame
Measured over the 3 months following randomisation
Title
Infection: Incidence of infection within the 18 months following randomisation
Description
Calculated as: number of events / total time of follow-up
Time Frame
Measured over the 18 months following randomisation
Title
Infection: Number of days free of infection within the 3 months following randomisation
Description
Calculated as: number of days free of event / total days of follow-up of participants
Time Frame
Measured over the 3 months following randomisation
Title
Infection: Number of days free of infection within the 18 months following randomisation
Description
Calculated as: number of days free of event / total days of follow-up of participants
Time Frame
Measured over the 18 months following randomisation
Title
Infection severity: Duration of infection within the 3 months following randomisation
Description
Per event, calculated as: date of recovery - date of onset
Time Frame
Measured over the 3 months following randomisation
Title
Infection severity: Duration of infection within the 18 months following randomisation
Description
Per event, calculated as: date of recovery - date of onset
Time Frame
Measured over the 18 months following randomisation
Title
Infection severity: Antibiotic use for infection within the 3 months following randomisation
Description
Per event, defined as a binary variable (yes/no)
Time Frame
Measured over the 3 months following randomisation
Title
Infection severity: Antibiotic use for infection within the 18 months following randomisation
Description
Per event, defined as a binary variable (yes/no)
Time Frame
Measured over the 18 months following randomisation
Title
Infection severity: Hospitalisation for infection within the 3 months following randomisation
Description
Per event, defined as a binary variable (yes/no)
Time Frame
Measured over the 3 months following randomisation
Title
Infection severity: Hospitalisation for infection within the 18 months following randomisation
Description
Per event, defined as a binary variable (yes/no)
Time Frame
Measured over the 18 months following randomisation
Title
Infection severity: Outcome of infection within the 3 months following randomisation
Description
Per event, defined as a categorical variable (uneventful/complication or sequel/death)
Time Frame
Measured over the 3 months following randomisation
Title
Infection severity: Outcome of infection within the 18 months following randomisation
Description
Per event, defined as a categorical variable (uneventful/complication or sequel/death)
Time Frame
Measured over the 18 months following randomisation
Title
Incidence of respiratory infection within the 18 months following randomisation
Description
Incidence of parent-reported respiratory infections between 6 months and 24 months of age using fortnightly REDCap questionnaires, with validation of data by confirmation with treating paediatrician and medical records.
Time Frame
Measured over the 18 months following randomisation
Other Pre-specified Outcome Measures:
Title
Allergic/atopic diseases: time to first allergic/atopic disease flare within the 3 months following randomisation
Description
Calculated as: For participants who have a flare: Date of event onset - date of randomisation For participants who did not have a flare: Earliest censoring date - date of randomisation
Time Frame
Measured over the 3 months following randomisation
Title
Allergic/atopic diseases: time to first allergic/atopic disease flare within the 18 months following randomisation
Description
Calculated as: For participants who have a flare: Date of event onset - date of randomisation For participants who did not have a flare: Earliest censoring date - date of randomisation
Time Frame
Measured over the 18 months following randomisation
Title
Allergic/atopic diseases: Prevalence of allergic/atopic disease within the 3 months following randomisation
Description
Calculated as: number of participants who have a flare / total number of participants
Time Frame
Measured over the 3 months following randomisation
Title
Allergic/atopic diseases: Prevalence of allergic/atopic disease within the 18 months following randomisation
Description
Calculated as: number of participants who have a flare / total number of participants
Time Frame
Measured over the 18 months following randomisation
Title
Allergic/atopic diseases: Incidence of allergic/atopic disease flare within the 3 months following randomisation
Description
Calculated as: number of flares / total time of follow-up
Time Frame
Measured over the 3 months following randomisation
Title
Allergic/atopic diseases: Incidence of allergic/atopic disease flare within the 18 months following randomisation
Description
Calculated as: number of flares / total time of follow-up
Time Frame
Measured over the 18 months following randomisation
Title
Allergic/atopic diseases: Days free of allergic/atopic disease flare within the 3 months following randomisation
Description
Calculated as: number of days free of flare / total days of follow-up of participants
Time Frame
Measured over the 3 months following randomisation
Title
Allergic/atopic diseases: Days free of allergic/atopic disease flare within the 18 months following randomisation
Description
Calculated as: number of days free of flare / total days of follow-up of participants
Time Frame
Measured over the 18 months following randomisation
Title
Eczema severity: Difference in eczema severity as assessed by SCORAD at 3 months following randomisation
Description
Calculated as the difference in SCORAD score
Time Frame
Measured at 3 months after randomisation
Title
Eczema severity: Difference in eczema severity as assessed by SCORAD at 18 months following randomisation
Description
Calculated as the difference in SCORAD score
Time Frame
Measured at 18 months after randomisation
Title
Eczema severity: Difference in eczema severity as assessed by POEM at 3 months following randomisation
Description
Calculated as the difference in POEM score
Time Frame
Measured at 3 months after randomisation
Title
Eczema severity: Difference in eczema severity as assessed by POEM at 18 months following randomisation
Description
Calculated as the difference in POEM score
Time Frame
Measured at 18 months after randomisation
Title
Eczema severity: Difference in eczema impact on quality of life at 3 months following randomisation
Description
Assessed by IDQOL score
Time Frame
Measured at 3 months after randomisation
Title
Eczema severity: Difference in eczema impact on quality of life at 18 months following randomisation
Description
Assessed by IDQOL score
Time Frame
Measured at 18 months after randomisation
Title
Eczema severity: Topical steroid use for eczema within 3 months following randomisation
Description
Per event, defined as a binary variable (yes/no)
Time Frame
Measured over the 3 months following randomisation
Title
Eczema severity: Topical steroid use for eczema within the 18 months following randomisation
Description
Per event, defined as a binary variable (yes/no)
Time Frame
Measured over the 18 months following randomisation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
6 Months
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Informed Consent as documented by signature 6-month-old children In overall good health, without any clinically significant concomitant disease states (e.g., renal failure, hepatic dysfunction, cardiovascular disease, etc.) and no clinically significant abnormal finding on history and/or physical examination Fully immunised for age according to the Swiss vaccination schedule with at least 2 doses of DTP-containing vaccine the last dose of vaccine received at least 2 weeks prior to enrolment Exclusion Criteria: Contra-indications to MMR, including immunosuppression (i.e. proven, suspected, or planned) allergy to a component of the vaccine receipt of a live-attenuated vaccine in the four weeks prior to inclusion Vaccine refusal Indication for an early MMR vaccination, including Measles outbreak Planned immunosuppression (indication to an accelerated schedule to be completed before starting an immunosuppressive treatment) Travel to a region with a high risk of measles outbreak Indication for vaccination with MMR-varicella (MMRV) instead of MMR, including severe eczema parental will Parental inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, known/suspected non-compliance, substance abuse, etc. Plan to move out of the country or have prolong absence during the trial Other sibling included in the trial (in the case of multiple pregnancy, only one child can be randomised) Any temporary contra-indication to MMR, including child being sick (active significant illness, inclusion can be delayed a few days until the illness resolves)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Laure F Pittet, MD-PhD
Phone
+41 22 372 33 11
Email
laure.pittet@hcuge.ch
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Laure F Pittet, MD-PhD
Organizational Affiliation
University Hospitals of Geneva
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospitals of Geneva
City
Geneva
ZIP/Postal Code
1211
Country
Switzerland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laure F Pittet, MD-PhD
First Name & Middle Initial & Last Name & Degree
Laure F Pittet, MD-PhD

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Under the terms of the funding agreement with the Swiss National Science Foundation, the NEMAU trial has a data sharing agreement in place. An anonymised Individual Participant Data (IPD) dataset and a data dictionary will be provided to a FAIR platform after database lock.
IPD Sharing Time Frame
After database lock, a 12-month embargo period will be in place, to allow adequate time for analyses and publication outputs. Data transfer to a FAIR plateform will occur during the embargo period.
IPD Sharing Access Criteria
Researchers from a recognised research institution can approach the PI for access of data. The researcher will need to provide evidence that the proposed use of the data has been ethically reviewed and approved by an Institutional Review Board (IRB)/ Human Research Ethics Committee(HREC), and accept HUG's conditions, under a collaborator agreement.

Learn more about this trial

Non-specific Effects of a Modified Measles Vaccination Schedule to Prevent Allergy and Unrelated Infection in Children

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