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Safety and Immunogenicity Study of Venezuelan Equine Encephalomyelitis (VEE) Vaccine as Booster Vaccine in Adults (VEE)

Primary Purpose

Venezuelan Equine Encephalomyelitis

Status
Not yet recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
0.5 mL Inactivated, Dried, C-84, TSI-GSD 205, Lot 7, Run 1
Sponsored by
U.S. Army Medical Research and Development Command
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Venezuelan Equine Encephalomyelitis

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Be 18 to 65 years old at time of consent
  • Have received VEE TC-83 vaccine
  • Have VEE plaque reduction neutralization 80% titers (PRNT80) <1:20
  • If female of childbearing potential, must agree to have a urine pregnancy test on the same day before each vaccination administration. (Exception: documented hysterectomy or >3 years of menopause). The results must be negative. Females just agree not to become pregnant for 3 months after receipt of the last study treatment (vaccination).
  • Be considered at risk for exposure to VEE virus and who have submitted a Request for IND Vaccines for VDD vaccine.
  • Sign and date the approved informed consent document and HIPAA Authorization.
  • Have in their charts:
  • medical history (including concomitant medications) within 60 days of planned first administration of vaccine
  • physical examination and laboratory tests within 1 year
  • previous chest radiograph results and electrocardiogram
  • Be medically cleared for participation by an investigator (Examinations and/or tests may be repeated at the discretion of the PI).
  • Be willing to return for all follow-up visits.
  • Agree to report any adverse events (AEs) that may or may not be associated with administration of the vaccine for at least 28 days after administration and agree to report all serious adverse events (for example, resulting in hospitalization) for the duration of the subject's participation in the study.
  • Agree to defer blood donation for 1 year after receipt of the vaccine.

Exclusion Criteria:

  • Have completed previous VEE C-84 vaccine study as a non-responder.
  • Have clinically significant abnormal laboratory results (including evidence of hepatitis C, hepatitis B carrier state) or elevated liver function tests (two times the normal range or at the discretion of the PI).
  • Have a personal history of an immunodeficiency or received treatment with an immunosuppressive medication, such as systemically administered glucocorticoids (eg, prednisone) within 1 month before planned administration of the vaccine or with other immunosuppressive therapies within 6 months of planned administration of the vaccine. Other immunosuppressive therapies include all cancer chemotherapeutic agents, drugs to prevent transplant rejection, interferons, monoclonal antibodies, protein kinase inhibitors, methotrexate, TNF (tumor necrosis factor) inhibitors, and any other drug determined to be immunosuppressive by the PI. Current administration of topical, inhalational, or intranasal glucocorticoids is not excluded.
  • Have confirmed HIV infection.
  • Have positive pregnancy test or be a breastfeeding female.
  • Have any known allergies to components of the vaccine:
  • Neomycin sulfate
  • Streptomycin
  • VEE virus, inactivated
  • Formaldehyde
  • Eggs
  • Human serum albumin
  • Guinea pig heart cells
  • Sodium bisulfite
  • Have had a previous serious allergic reaction to guinea pigs or guinea pig products. (Subjects who have known allergies to guinea pigs but whose allergic reactions were not severe may still participate in the study but should be referred to an allergy specialist for assessment and recommendation prior to vaccination).
  • Have received or plan to receive another vaccine or investigational product within 28 days of VEE vaccination.
  • Have any unresolved AE resulting from a previous immunization.
  • Have a medical condition that, in the judgment of the PI, would impact subject safety.

Sites / Locations

  • Special Immunizations Program/USAMRIID

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort A: Initial Non-responders to VEE TC-83 vaccinations

Cohort B: Responders to TC-83 or previous C-84 vaccinations

Arm Description

Venezuelan Equine Encephalomyelitis (VEE) Vaccine, Inactivated, Dried, C-84, TSI-GSD 205, Lot 7, Run 1, to be administered as dose(s) of 0.5 mL given subcutaneously in the upper outer aspect of the triceps area.

Subjects who showed an initial immune response ≥ 1:20 to TC-83 and whose titer decreased over time or who rollover from a previous VEE C-84 protocol will receive a single 0.5 mL booster dose of C-84 vaccine. Subjects who were initial non-responders (< 1:20) to TC-83 will be given subcutaneous 0.5 mL injections on Days 0, 28-35, and 56-63

Outcomes

Primary Outcome Measures

Percentage of Subjects Who Develop titers of >1:20
The primary immunogenicity endpoint measurements will be the percentage of per-protocol subjects who develop titers of ≥ 1:20 as determined by PRNT80 after VEE vaccination at each scheduled time point for which blood samples are drawn and over the entire study period to study completion.

Secondary Outcome Measures

GMT for PRNT80 Titers of Subjects at Each Scheduled Time Point
The geometric mean PRNT80 titers of per-protocol subjects at each scheduled time point for which blood samples are drawn and over the entire study period to study completion.
Percentage of Subjects with Adverse Events (AEs) Following Vaccination
Safety will be evaluated by the nature (body system affected), type [local or systemic], severity, relationship to vaccine, treatment or intervention offered if any, and resolution or outcome) and frequency of AEs for the assessment population
Percentage of Subjects with Each AE Type (local or systemic)
Safety will be evaluated by the nature (body system affected), type [local or systemic], severity, relationship to vaccine, treatment or intervention offered if any, and resolution or outcome) and frequency of AEs for the assessment population

Full Information

First Posted
May 8, 2018
Last Updated
February 10, 2021
Sponsor
U.S. Army Medical Research and Development Command
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1. Study Identification

Unique Protocol Identification Number
NCT03531242
Brief Title
Safety and Immunogenicity Study of Venezuelan Equine Encephalomyelitis (VEE) Vaccine as Booster Vaccine in Adults
Acronym
VEE
Official Title
Phase 2 Open-Label Safety and Immunogenicity Study of the Venezuelan Equine Encephalomyelitis (VEE) Vaccine, Inactivated, Dried, C-84, TSI-GSD 205, Lot 7, Run 1, as Booster Vaccination in Adult Subjects at Risk of Exposure to VEE Virus
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 2021 (Anticipated)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
U.S. Army Medical Research and Development Command

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and immunogenicity of VEE vaccine, C-84, TSI-GSD 205, Lot 7, Run 1, and collect data on the incidence of occupational VEE infection in vaccinated personnel.
Detailed Description
Venezuelan Equine Encephalomyelitis Vaccine, Inactivated, Dried, C-84, TSI-GSD 205, Lot 7, Run 1, to be administered as dose(s) of 0.5 mL given subcutaneously in the upper outer aspect of the triceps area. Subjects who showed an initial immune response ≥ 1:20 to TC-83 and whose titer decreased over time or who rollover from a previous VEE C-84 protocol will receive a single 0.5 mL booster dose of C-84 vaccine. Subjects who were initial non-responders (< 1:20) to TC-83 will be given subcutaneous 0.5 mL injections on Days 0, 28-35, and 56-63. Duration of participation is 12-15 months if the subject demonstrates a PRNT80 of ≥1:20 at 1 year; if not, the vaccination procedure with C-84 will be repeated with a minimum of 28 days between doses. A maximum of four booster doses will be given in a year. If the PRNT80 titer is < 1:20 after four booster doses in any 12-month period, the subject's participation in the study will be placed on hold for 12 months; titers will be repeated at 1 year (± 30 days), and, if required, the subject will be given a booster dose of C-84 vaccine. Safety endpoint measurements will be evaluated for all subjects receiving at least one vaccination under this protocol regardless of compliance with the protocol. Immunogenicity endpoints will be evaluated for subjects who have been vaccinated in compliance with the protocol and who have had blood for titers drawn in compliance with the protocol.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Venezuelan Equine Encephalomyelitis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Subjects who successfully complete screening will be enrolled in the study to receive either (1) a series of booster(s) or (2) one booster vaccination(s). Each vaccination will be administered as 0.5 mL subcutaneous doses in the upper outer aspect of the arm (triceps areas)
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
500 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort A: Initial Non-responders to VEE TC-83 vaccinations
Arm Type
Experimental
Arm Description
Venezuelan Equine Encephalomyelitis (VEE) Vaccine, Inactivated, Dried, C-84, TSI-GSD 205, Lot 7, Run 1, to be administered as dose(s) of 0.5 mL given subcutaneously in the upper outer aspect of the triceps area.
Arm Title
Cohort B: Responders to TC-83 or previous C-84 vaccinations
Arm Type
Experimental
Arm Description
Subjects who showed an initial immune response ≥ 1:20 to TC-83 and whose titer decreased over time or who rollover from a previous VEE C-84 protocol will receive a single 0.5 mL booster dose of C-84 vaccine. Subjects who were initial non-responders (< 1:20) to TC-83 will be given subcutaneous 0.5 mL injections on Days 0, 28-35, and 56-63
Intervention Type
Biological
Intervention Name(s)
0.5 mL Inactivated, Dried, C-84, TSI-GSD 205, Lot 7, Run 1
Intervention Description
administered as dose(s) of 0.5 mL given subcutaneously in the upper outer aspect of the triceps area. Subjects who showed an initial immune response ≥ 1:20 to TC-83 and whose titer decreased over time or who rollover from a previous VEE C-84 protocol will receive a single 0.5 mL booster dose of C-84 vaccine. Subjects who were initial non-responders (< 1:20) to TC-83 will be given subcutaneous 0.5 mL injections on Days 0, 28-35, and 56-63
Primary Outcome Measure Information:
Title
Percentage of Subjects Who Develop titers of >1:20
Description
The primary immunogenicity endpoint measurements will be the percentage of per-protocol subjects who develop titers of ≥ 1:20 as determined by PRNT80 after VEE vaccination at each scheduled time point for which blood samples are drawn and over the entire study period to study completion.
Time Frame
Month 12-15
Secondary Outcome Measure Information:
Title
GMT for PRNT80 Titers of Subjects at Each Scheduled Time Point
Description
The geometric mean PRNT80 titers of per-protocol subjects at each scheduled time point for which blood samples are drawn and over the entire study period to study completion.
Time Frame
Month 12-15
Title
Percentage of Subjects with Adverse Events (AEs) Following Vaccination
Description
Safety will be evaluated by the nature (body system affected), type [local or systemic], severity, relationship to vaccine, treatment or intervention offered if any, and resolution or outcome) and frequency of AEs for the assessment population
Time Frame
Month 12-15
Title
Percentage of Subjects with Each AE Type (local or systemic)
Description
Safety will be evaluated by the nature (body system affected), type [local or systemic], severity, relationship to vaccine, treatment or intervention offered if any, and resolution or outcome) and frequency of AEs for the assessment population
Time Frame
Month 12-15

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Be 18 to 65 years old at time of consent Have received VEE TC-83 vaccine Have VEE plaque reduction neutralization 80% titers (PRNT80) <1:20 If female of childbearing potential, must agree to have a urine pregnancy test on the same day before each vaccination administration. (Exception: documented hysterectomy or >3 years of menopause). The results must be negative. Females just agree not to become pregnant for 3 months after receipt of the last study treatment (vaccination). Be considered at risk for exposure to VEE virus and who have submitted a Request for IND Vaccines for VDD vaccine. Sign and date the approved informed consent document and HIPAA Authorization. Have in their charts: medical history (including concomitant medications) within 60 days of planned first administration of vaccine physical examination and laboratory tests within 1 year previous chest radiograph results and electrocardiogram Be medically cleared for participation by an investigator (Examinations and/or tests may be repeated at the discretion of the PI). Be willing to return for all follow-up visits. Agree to report any adverse events (AEs) that may or may not be associated with administration of the vaccine for at least 28 days after administration and agree to report all serious adverse events (for example, resulting in hospitalization) for the duration of the subject's participation in the study. Agree to defer blood donation for 1 year after receipt of the vaccine. Exclusion Criteria: Have completed previous VEE C-84 vaccine study as a non-responder. Have clinically significant abnormal laboratory results (including evidence of hepatitis C, hepatitis B carrier state) or elevated liver function tests (two times the normal range or at the discretion of the PI). Have a personal history of an immunodeficiency or received treatment with an immunosuppressive medication, such as systemically administered glucocorticoids (eg, prednisone) within 1 month before planned administration of the vaccine or with other immunosuppressive therapies within 6 months of planned administration of the vaccine. Other immunosuppressive therapies include all cancer chemotherapeutic agents, drugs to prevent transplant rejection, interferons, monoclonal antibodies, protein kinase inhibitors, methotrexate, TNF (tumor necrosis factor) inhibitors, and any other drug determined to be immunosuppressive by the PI. Current administration of topical, inhalational, or intranasal glucocorticoids is not excluded. Have confirmed HIV infection. Have positive pregnancy test or be a breastfeeding female. Have any known allergies to components of the vaccine: Neomycin sulfate Streptomycin VEE virus, inactivated Formaldehyde Eggs Human serum albumin Guinea pig heart cells Sodium bisulfite Have had a previous serious allergic reaction to guinea pigs or guinea pig products. (Subjects who have known allergies to guinea pigs but whose allergic reactions were not severe may still participate in the study but should be referred to an allergy specialist for assessment and recommendation prior to vaccination). Have received or plan to receive another vaccine or investigational product within 28 days of VEE vaccination. Have any unresolved AE resulting from a previous immunization. Have a medical condition that, in the judgment of the PI, would impact subject safety.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Anthony P Cardile, DO, MAJ
Phone
301-619-8833
Email
anthony.p.cardile.mil@mail.mil
First Name & Middle Initial & Last Name or Official Title & Degree
Jennifer L Kalapaca, RN, BSN, CCRC
Phone
301-619-1962
Email
jennifer.l.kalapaca.mil@mail.mil
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anthony P Cardile, DO, MAJ
Organizational Affiliation
USAMRIID
Official's Role
Principal Investigator
Facility Information:
Facility Name
Special Immunizations Program/USAMRIID
City
Fort Deterick
State/Province
Maryland
ZIP/Postal Code
21702
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anthony P Cardile, DO, MAJ
Phone
301-619-8833
Email
anthony.p.cardile.mil@mail.mil

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
4383416
Citation
Rossi AL. Rural epidemic encephalitis in Venezuela caused by a group A arbovirus (VEE). Prog Med Virol. 1967;9:176-203. No abstract available.
Results Reference
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19871301
Citation
Casals J, Curnen EC, Thomas L. VENEZUELAN EQUINE ENCEPHALOMYELITIS IN MAN. J Exp Med. 1943 Jun 1;77(6):521-30. doi: 10.1084/jem.77.6.521.
Results Reference
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PubMed Identifier
7565549
Citation
Centers for Disease Control and Prevention (CDC). Venezuelan equine encephalitis--Colombia, 1995. MMWR Morb Mortal Wkly Rep. 1995 Oct 6;44(39):721-4.
Results Reference
background
PubMed Identifier
528788
Citation
Edelman R, Ascher MS, Oster CN, Ramsburg HH, Cole FE, Eddy GA. Evaluation in humans of a new, inactivated vaccine for Venezuelan equine encephalitis virus (C-84). J Infect Dis. 1979 Nov;140(5):708-15. doi: 10.1093/infdis/140.5.708.
Results Reference
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PubMed Identifier
5453912
Citation
Franck PT, Johnson KM. An outbreak of Venezuelan encephalitis in man in the Panama Canal Zone. Am J Trop Med Hyg. 1970 Sep;19(5):860-5. doi: 10.4269/ajtmh.1970.19.860. No abstract available.
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PubMed Identifier
5101138
Citation
Hinman AR, McGowan JE Jr, Henderson BE. Venezuelan equine encephalomyelitis: surveys of human illness during an epizootic in Guatemala and El Salvador. Am J Epidemiol. 1971 Feb;93(2):130-6. doi: 10.1093/oxfordjournals.aje.a121233. No abstract available.
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Johnson KM, Martin DH. Venezuelan equine encephalitis. Adv Vet Sci Comp Med. 1974;18(0):79-116. No abstract available.
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PubMed Identifier
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Citation
Pittman PR, Makuch RS, Mangiafico JA, Cannon TL, Gibbs PH, Peters CJ. Long-term duration of detectable neutralizing antibodies after administration of live-attenuated VEE vaccine and following booster vaccination with inactivated VEE vaccine. Vaccine. 1996 Mar;14(4):337-43. doi: 10.1016/0264-410x(95)00168-z.
Results Reference
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PubMed Identifier
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Citation
Rivas F, Diaz LA, Cardenas VM, Daza E, Bruzon L, Alcala A, De la Hoz O, Caceres FM, Aristizabal G, Martinez JW, Revelo D, De la Hoz F, Boshell J, Camacho T, Calderon L, Olano VA, Villarreal LI, Roselli D, Alvarez G, Ludwig G, Tsai T. Epidemic Venezuelan equine encephalitis in La Guajira, Colombia, 1995. J Infect Dis. 1997 Apr;175(4):828-32. doi: 10.1086/513978.
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SANMARTIN-BARBERI C, GROOT H, OSORNO-MESA E. Human epidemic in Colombia caused by the Venezuelan equine encephalomyelitis virus. Am J Trop Med Hyg. 1954 Mar;3(2):283-93. doi: 10.4269/ajtmh.1954.3.283. No abstract available.
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Citation
Weaver SC, Bellew LA, Rico-Hesse R. Phylogenetic analysis of alphaviruses in the Venezuelan equine encephalitis complex and identification of the source of epizootic viruses. Virology. 1992 Nov;191(1):282-90. doi: 10.1016/0042-6822(92)90190-z.
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Young NA, Johnson KM. Antigenic variants of Venezuelan equine encephalitis virus: their geographic distribution and epidemiologic significance. Am J Epidemiol. 1969 Mar;89(3):286-307. doi: 10.1093/oxfordjournals.aje.a120942. No abstract available.
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Results Reference
result

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Safety and Immunogenicity Study of Venezuelan Equine Encephalomyelitis (VEE) Vaccine as Booster Vaccine in Adults

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