Phase III Study of Liquid Formulation of ROTAVIN
Primary Purpose
Diarrhea, Diarrhea Rotavirus
Status
Completed
Phase
Phase 3
Locations
Vietnam
Study Type
Interventional
Intervention
ROTAVIN (liquid formulation)
ROTAVIN-M1 (frozen formulation)
Sponsored by
About this trial
This is an interventional prevention trial for Diarrhea focused on measuring ROTAVIN, Rotavirus vaccine, Rotavirus, Diarrhea
Eligibility Criteria
Inclusion Criteria:
- Healthy infants as established by medical history and clinical examination before entering the study.
- Age: 60-91 days (both days inclusive) at the time of enrollment.
- Parental/legally acceptable representative ability and willingness to provide written informed consent.
- Parent/legally acceptable representative who intends to remain in the area with the child during the study period.
Exclusion Criteria:
- Presence of diarrhea or vomiting in the previous 72 hours or on the day of enrollment (temporary exclusion).
- Presence of fever on the day of enrollment (temporary exclusion).
- Acute disease at the time of enrollment (temporary exclusion).
- Concurrent participation in another clinical trial at any point throughout the entire time frame for this study.
- Presence of significant malnutrition (weight-for-height z-score < -3 SD median)
- Presence of any systemic disorder (cardiovascular, pulmonary, hepatic, renal, gastrointestinal, hematological, endocrine, immunological, dermatological, neurological, cancer, or autoimmune disease) as determined by medical history and / or physical examination which would compromise the participant's health or is likely to result in nonconformance to the protocol.
- History of congenital abdominal disorders, intussusception, or abdominal surgery.
- Known or suspected impairment of immunological function based on medical history and physical examination.
- Household contact with an immunosuppressed individual or pregnant woman.
- Prior receipt of rotavirus or an intent to receive this vaccine from outside of the study center during study participation.
- Prior receipt of Expanded Program on Immunization (EPI) vaccination during past 7 days or plan to receive them within next 7 days.
- A known sensitivity or allergy to any components of the study vaccine.
- History of allergy to antibiotic kanamycin.
- Clinically detectable significant congenital or genetic defect.
- History of persistent diarrhea (defined as diarrhea that lasts 14 days or longer).
- Receipt of immunoglobulin therapy and / or blood products since birth or planned administration during the study period.
- History of chronic administration (defined as more than 14 days) of immunosuppressants including corticosteroids. Infants on inhaled or topical steroids may be permitted to participate in the study.
- Any medical condition in the parent/legally acceptable representative or infant which, in the judgment of the Investigator, would interfere with or serves as a contraindication to protocol adherence.
Sites / Locations
- CDC Nam Dinh
- CDC Quang Ninh
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
ROTAVIN Liquid Formulation
ROTAVIN-M1 Frozen Formulation
Arm Description
Participants received two doses of ROTAVIN liquid formulation vaccine orally 8 weeks apart with the first dose administered at 60-91 days of age.
Participants received two doses of ROTAVIN-M1 frozen formulation vaccine orally 8 weeks apart with the first dose administered at 60-91 days of age.
Outcomes
Primary Outcome Measures
Geometric Mean Concentration (GMC) of Serum Anti-rotavirus Immunoglobulin A (IgA) Antibodies 28 Days After Second Vaccination
Serum anti-rotavirus IgA antibodies were measured using a validated enzyme linked immunosorbent assay (ELISA) at the Cincinnati Children's Hospital Medical Center (CCHMC), Division of Infectious Diseases in Cincinnati, Ohio USA.
Number of Participants With Solicited Reactions Within 7 Days of Vaccination
Solicited post-vaccination reactogenicity included fever, diarrhea, vomiting, decreased appetite, irritability, and decreased activity level during the seven-day period after each vaccination. Parents were asked to record reactions on a post-immunization diary card.
Solicited reactions were graded for severity on a scale from mild to severe based on the level of symptoms.
Secondary Outcome Measures
Percentage of Participants With Seroconversion 28 Days After the Second Vaccination
Seroconversion is defined as a post-vaccination serum anti-rotavirus IgA antibody concentration of at least 20 U/mL if the baseline concentration was < 20 U/mL or a post- vaccination serum anti-rotavirus IgA antibody concentration of ≥ 4-fold baseline level if the baseline concentration was ≥ 20 U/mL.
Percentage of Participants With Seropositivity at Baseline and 28 Days After the Second Vaccination
Seropositivity is defined as serum IgA antibody concentration ≥ 20 U/mL
Number of Participants With Immediate Adverse Events (AEs)
After each vaccination participants were observed at the clinic site for at least 30 minutes to check for any immediate AEs including episodes of vomiting and allergic reaction to vaccine. Immediate AEs include all reactions that occurred within 30 minutes of each vaccination.
Reactions were graded for severity per the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, version 2.1, of the US National Institute of Health:
Grade 1: Mild symptoms causing no or minimal interference with usual social & functional activities; intervention not indicated.
Grade 2: Moderate symptoms causing greater than minimal interference with usual activities; intervention indicated.
Grade 3: Severe symptoms causing inability to perform usual activities; intervention or hospitalization indicated.
Grade 4: Potentially life-threatening symptoms; intervention indicated to prevent permanent impairment, persistent disability, or death
Grade 5: Death
Number of Participants With Unsolicited Adverse Events
An unsolicited AE was any AE that occurred after vaccination, whether or not deemed "related" to the product, that was not solicited, or, any solicited reaction that started after 7 days post-vaccination. Severity of unsolicited AEs was graded per the DAIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, version 2.1.
Grade 1: Mild symptoms causing no or minimal interference with usual social & functional activities; intervention not indicated
Grade 2: Moderate symptoms causing greater than minimal interference with usual activities; intervention indicated
Grade 3: Severe symptoms causing inability to perform usual activities; intervention or hospitalization indicated
Grade 4: Potentially life-threatening symptoms; intervention indicated to prevent permanent impairment, persistent disability, or death
Grade 5: Death
The clinician classified the causality of each AE as related if there was reasonable possibility that the product caused the event.
Number of Participants With Serious Adverse Events Including Intussusception
All Serious adverse events (SAEs), including cases of intussusception, were recorded at all time points between first vaccination and last visit. An SAE was defined as any untoward medical occurrence that:
Resulted in death,
Was life threatening,
Required inpatient hospitalization or prolongation of existing hospitalization,
Resulted in persistent or significant disability / incapacity,
Was a congenital anomaly or a birth defect,
Medically important event
Investigator-confirmed cases of intussusception also qualified as an SAE in this study. Intussusception is the infolding (telescoping) of one segment of the intestine within another, usually resulting in a blockage of the intestine.
Full Information
NCT ID
NCT03703336
First Posted
October 9, 2018
Last Updated
January 5, 2021
Sponsor
Center for Research and Production of Vaccines and Biologicals, Vietnam
Collaborators
PATH, National Institute of Hygiene and Epidemiology, Vietnam, Children's Hospital Medical Center, Cincinnati
1. Study Identification
Unique Protocol Identification Number
NCT03703336
Brief Title
Phase III Study of Liquid Formulation of ROTAVIN
Official Title
A Phase III, Randomized, Partially Double- Blind, Active Control Study to Compare the Immunogenicity and Safety of a Liquid Formulation of ROTAVIN With the Currently Licensed Frozen Formulation of the Vaccine (ROTAVIN-M1), in Healthy Vietnamese Infants
Study Type
Interventional
2. Study Status
Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
March 16, 2019 (Actual)
Primary Completion Date
January 8, 2020 (Actual)
Study Completion Date
January 8, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Center for Research and Production of Vaccines and Biologicals, Vietnam
Collaborators
PATH, National Institute of Hygiene and Epidemiology, Vietnam, Children's Hospital Medical Center, Cincinnati
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
This study is conducted to demonstrate non-inferiority in the immunogenicity of the liquid formulation of ROTAVIN in comparison to currently licensed frozen formulation of the vaccine (ROTAVIN-M1), 28 days after the second vaccination when administered as two dose series starting at 2-3 months of age.
The study will also assess the reactogenicity of the vaccine 7 days after each vaccination and safety from first vaccination up to 4 weeks after the last vaccination.
Detailed Description
The study is designed as a phase III, randomized, partially double-blinded, active controlled study with two groups of infants receiving vaccines at the ratio of 2:1 (liquid formulation of ROTAVIN to frozen formulation ROTAVIN-M1), to compare their immunogenicity and safety. Two doses of vaccine will be administered 8 weeks apart with the first vaccine administration between 60-91 days of age. All childhood vaccines as per the Expanded Program for Immunization of the Government of Vietnam (including Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b and Hepatitis B vaccine (DTwPHib-HepB), and Oral Polio Vaccine at at 2, 3 and 4 months of age) will be allowed as per the immunization schedule.
Active surveillance for vaccine reactogenicity (solicited reactions) over the 7-day period after each vaccination, unsolicited adverse events (AEs) for 4 weeks after each vaccination and serious adverse events (SAEs) including intussusception over the period between first vaccination and four weeks after the last vaccination will be conducted for all infants.
This trial will generate immunogenicity and safety data which would be submitted to Ministry of Health in Vietnam for license of new formulation of ROTAVIN vaccine.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea, Diarrhea Rotavirus
Keywords
ROTAVIN, Rotavirus vaccine, Rotavirus, Diarrhea
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Eligible infants will be randomized to receive either ROTAVIN or ROTAVIN-M1 vaccines in the ratio of 2:1.
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
825 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ROTAVIN Liquid Formulation
Arm Type
Experimental
Arm Description
Participants received two doses of ROTAVIN liquid formulation vaccine orally 8 weeks apart with the first dose administered at 60-91 days of age.
Arm Title
ROTAVIN-M1 Frozen Formulation
Arm Type
Active Comparator
Arm Description
Participants received two doses of ROTAVIN-M1 frozen formulation vaccine orally 8 weeks apart with the first dose administered at 60-91 days of age.
Intervention Type
Biological
Intervention Name(s)
ROTAVIN (liquid formulation)
Intervention Description
Live attenuated human rotavirus vaccine containing ≥ 2x10^6 plaque forming units (PFU) of strain G1P[8] per dose of 2 mL.
Intervention Type
Biological
Intervention Name(s)
ROTAVIN-M1 (frozen formulation)
Intervention Description
Live attenuated human rotavirus vaccine containing ≥ 2x10^6 PFU of strain G1P[8] per dose of 2 mL.
Primary Outcome Measure Information:
Title
Geometric Mean Concentration (GMC) of Serum Anti-rotavirus Immunoglobulin A (IgA) Antibodies 28 Days After Second Vaccination
Description
Serum anti-rotavirus IgA antibodies were measured using a validated enzyme linked immunosorbent assay (ELISA) at the Cincinnati Children's Hospital Medical Center (CCHMC), Division of Infectious Diseases in Cincinnati, Ohio USA.
Time Frame
Day 85 (28 days after the second vaccination)
Title
Number of Participants With Solicited Reactions Within 7 Days of Vaccination
Description
Solicited post-vaccination reactogenicity included fever, diarrhea, vomiting, decreased appetite, irritability, and decreased activity level during the seven-day period after each vaccination. Parents were asked to record reactions on a post-immunization diary card.
Solicited reactions were graded for severity on a scale from mild to severe based on the level of symptoms.
Time Frame
7 days after each vaccination (Days 1 to 8 and 57 to 64)
Secondary Outcome Measure Information:
Title
Percentage of Participants With Seroconversion 28 Days After the Second Vaccination
Description
Seroconversion is defined as a post-vaccination serum anti-rotavirus IgA antibody concentration of at least 20 U/mL if the baseline concentration was < 20 U/mL or a post- vaccination serum anti-rotavirus IgA antibody concentration of ≥ 4-fold baseline level if the baseline concentration was ≥ 20 U/mL.
Time Frame
28 days after the second vaccination (Day 85)
Title
Percentage of Participants With Seropositivity at Baseline and 28 Days After the Second Vaccination
Description
Seropositivity is defined as serum IgA antibody concentration ≥ 20 U/mL
Time Frame
Baseline (Day 1) and at 28 days after the second vaccination (Day 85)
Title
Number of Participants With Immediate Adverse Events (AEs)
Description
After each vaccination participants were observed at the clinic site for at least 30 minutes to check for any immediate AEs including episodes of vomiting and allergic reaction to vaccine. Immediate AEs include all reactions that occurred within 30 minutes of each vaccination.
Reactions were graded for severity per the Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, version 2.1, of the US National Institute of Health:
Grade 1: Mild symptoms causing no or minimal interference with usual social & functional activities; intervention not indicated.
Grade 2: Moderate symptoms causing greater than minimal interference with usual activities; intervention indicated.
Grade 3: Severe symptoms causing inability to perform usual activities; intervention or hospitalization indicated.
Grade 4: Potentially life-threatening symptoms; intervention indicated to prevent permanent impairment, persistent disability, or death
Grade 5: Death
Time Frame
Within 30 minutes after each vaccination on Day 1 and Day 57
Title
Number of Participants With Unsolicited Adverse Events
Description
An unsolicited AE was any AE that occurred after vaccination, whether or not deemed "related" to the product, that was not solicited, or, any solicited reaction that started after 7 days post-vaccination. Severity of unsolicited AEs was graded per the DAIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, version 2.1.
Grade 1: Mild symptoms causing no or minimal interference with usual social & functional activities; intervention not indicated
Grade 2: Moderate symptoms causing greater than minimal interference with usual activities; intervention indicated
Grade 3: Severe symptoms causing inability to perform usual activities; intervention or hospitalization indicated
Grade 4: Potentially life-threatening symptoms; intervention indicated to prevent permanent impairment, persistent disability, or death
Grade 5: Death
The clinician classified the causality of each AE as related if there was reasonable possibility that the product caused the event.
Time Frame
From vaccination through 28 days after each dose (Days 1 to 28 and 57 to 85)
Title
Number of Participants With Serious Adverse Events Including Intussusception
Description
All Serious adverse events (SAEs), including cases of intussusception, were recorded at all time points between first vaccination and last visit. An SAE was defined as any untoward medical occurrence that:
Resulted in death,
Was life threatening,
Required inpatient hospitalization or prolongation of existing hospitalization,
Resulted in persistent or significant disability / incapacity,
Was a congenital anomaly or a birth defect,
Medically important event
Investigator-confirmed cases of intussusception also qualified as an SAE in this study. Intussusception is the infolding (telescoping) of one segment of the intestine within another, usually resulting in a blockage of the intestine.
Time Frame
From first vaccination through 28 days after the last vaccination; 85 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
60 Days
Maximum Age & Unit of Time
91 Days
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Healthy infants as established by medical history and clinical examination before entering the study.
Age: 60-91 days (both days inclusive) at the time of enrollment.
Parental/legally acceptable representative ability and willingness to provide written informed consent.
Parent/legally acceptable representative who intends to remain in the area with the child during the study period.
Exclusion Criteria:
Presence of diarrhea or vomiting in the previous 72 hours or on the day of enrollment (temporary exclusion).
Presence of fever on the day of enrollment (temporary exclusion).
Acute disease at the time of enrollment (temporary exclusion).
Concurrent participation in another clinical trial at any point throughout the entire time frame for this study.
Presence of significant malnutrition (weight-for-height z-score < -3 SD median)
Presence of any systemic disorder (cardiovascular, pulmonary, hepatic, renal, gastrointestinal, hematological, endocrine, immunological, dermatological, neurological, cancer, or autoimmune disease) as determined by medical history and / or physical examination which would compromise the participant's health or is likely to result in nonconformance to the protocol.
History of congenital abdominal disorders, intussusception, or abdominal surgery.
Known or suspected impairment of immunological function based on medical history and physical examination.
Household contact with an immunosuppressed individual or pregnant woman.
Prior receipt of rotavirus or an intent to receive this vaccine from outside of the study center during study participation.
Prior receipt of Expanded Program on Immunization (EPI) vaccination during past 7 days or plan to receive them within next 7 days.
A known sensitivity or allergy to any components of the study vaccine.
History of allergy to antibiotic kanamycin.
Clinically detectable significant congenital or genetic defect.
History of persistent diarrhea (defined as diarrhea that lasts 14 days or longer).
Receipt of immunoglobulin therapy and / or blood products since birth or planned administration during the study period.
History of chronic administration (defined as more than 14 days) of immunosuppressants including corticosteroids. Infants on inhaled or topical steroids may be permitted to participate in the study.
Any medical condition in the parent/legally acceptable representative or infant which, in the judgment of the Investigator, would interfere with or serves as a contraindication to protocol adherence.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Niraj Rathi, MD
Organizational Affiliation
PATH India
Official's Role
Study Director
Facility Information:
Facility Name
CDC Nam Dinh
City
Nam Dinh
ZIP/Postal Code
10000
Country
Vietnam
Facility Name
CDC Quang Ninh
City
Quang Ninh
ZIP/Postal Code
10000
Country
Vietnam
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34218961
Citation
Thiem VD, Anh DD, Ha VH, Hien ND, Huong NT, Nga NT, Thang TC, McNeal MM, Meyer N, Pham HL, Huong NM, Gompana G, Cassels F, Tang Y, Flores J, Rathi N. Safety and immunogenicity of two formulations of rotavirus vaccine in Vietnamese infants. Vaccine. 2021 Jul 22;39(32):4463-4470. doi: 10.1016/j.vaccine.2021.06.056. Epub 2021 Jul 1.
Results Reference
derived
Learn more about this trial
Phase III Study of Liquid Formulation of ROTAVIN
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