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Seasonal Influenza DNA Vaccine & Seasonal Influenza Trivalent Inactivated Vaccine (TIV) in Children & Adolescents

Primary Purpose

Influenza

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Seasonal Influenza DNA vaccine
TIV
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Influenza focused on measuring Influenza A (H1), Influenza A (H3), Influenza B, DNA Vaccine, Trivalent Inactivated Vaccine (TIV), Healthy Adolescents, Healthy Children

Eligibility Criteria

6 Years - 17 Years (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Children/adolescents aged 6 to 17 years inclusive and at least 20 kg in weight.
  • Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process.
  • Willing to have blood drawn 5 times over 42 weeks, including blood stored for research purposes.
  • In good general health as assessed by medical history, vital signs and targeted physical examination; stable medical conditions that, in the opinion of the investigator, will not compromise the subject's participation in the study are acceptable.
  • Capability of the legal adult representative of the minor to understand and comply with planned study procedures.
  • Capability of the legal adult representative of the minor to provide written informed consent; assent will be obtained from the child/adolescent per requirements of the site institutional review board (IRB).
  • For female adolescent of child-bearing potential (as defined by onset of menses): agrees to avoid becoming pregnant and to use effective method of contraception or practice abstinence for at least 21 day prior to the first study vaccine administration, until at least 4 weeks after the second study vaccination.
  • Within 70 days prior to enrollment, hemoglobin within institutional normal limits, creatinine less than the upper limit of normal (ULN) and ALT ≤1.5 X ULN for respective age group.

Exclusion Criteria:

  • History of Guillain-Barré syndrome.
  • Active neoplasm or history of cancer.
  • On-going immunosuppressive therapy or known to be immunosuppressed at the time of enrollment.
  • Immunoglobulin (or similar blood product) therapy within 3 months prior to enrollment.
  • Known to have HIV, hepatitis B or hepatitis C infection.
  • Acute or chronic illness that, in the opinion of the investigator, precludes participation in the study.
  • Developmental delay, neurologic disorder, or seizure disorder requiring ongoing medical management (note: history of febrile seizure is not an exclusion).
  • Acute febrile and/or respiratory illness within one week prior to enrollment.
  • Idiopathic urticaria within the year prior to enrollment.
  • Allergy treatment with antigen injections, unless on maintenance schedule and allergy shots could be staggered with the study vaccinations, within 14 days (2 weeks) prior to enrollment.
  • Asthma that is severe, unstable or required emergent care, urgent care, hospitalization or intubation during the previous two years or that is expected to require the use of oral, intravenous or high dose inhaled corticosteroids.
  • Vaccination of any type within 2 weeks prior to enrollment or receipt of the 2012/2013 seasonal TIV any time prior to enrollment.
  • Participating in or planning to begin participation in another investigational study during the projected time during which the subject would be in this study.
  • Factors related to the legal representative that in the judgment of the investigator may affect the objective decision-making of the legal representative.
  • For a female adolescent of child-bearing potential: breast-feeding, known pregnancy or positive urine or serum pregnancy test on day of study enrollment.

Sites / Locations

  • Emory Children's Center
  • Saint Louis University - Doisy Research Center
  • Dartmouth Hitchcock Medical Center
  • The Gamble Program for Clinical Studies, Cincinnati Children's Hospital Medical Center
  • Vanderbilt University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Active Comparator

Active Comparator

Arm Label

Group 1A (12-17yrs):1 mg DNA vaccine+TIV

Group 1B (6-11yrs):1 mg DNA vaccine+TIV

Group 2A (12-17yrs):4 mg DNA vaccine+TIV

Group 2B (6-11yrs):4 mg DNA vaccine+TIV

Group 3A: (12-17yrs): TIV+TIV

Group 3B: (6-11yrs): TIV+TIV

Arm Description

2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks

2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks

2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks

2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks

Licensed 2012/13 TIV at Day 0 and Week 18±2 wks

Licensed 2012/13 TIV at Day 0 and Week 18±2 wks

Outcomes

Primary Outcome Measures

Incidence of solicited and unsolicited adverse events
Incidence is reported for solicited events for 7 days after each injection, for unsolicited adverse event (AE) of any severity for 28 days after each injection, and for serious adverse events or new chronic medical conditions through 24 weeks after the 2nd injection.
Mean change from baseline in safety laboratory measures
At day 28 (+/- 7 days) blood will be drawn prior to receiving the second injection to measure hemoglobin, creatinine, and alanine transaminase (ALT).
Number of subjects with influenza or influenza-like illnesses
Participants who experience at least one influenza or influenza-like illness will be counted.

Secondary Outcome Measures

Proportion of subjects with either a baseline hemagglutination inhibition (HAI) titer <1:10 and post-vaccination HAI titer ≥1:40 or baseline HAI titer ≥1:10 and a minimum 4-fold rise in HAI titer for each of the 3 strains in the 2012/13 TIV at Week 22.
Blood is collected from all subjects at baseline and at 4 weeks after TIV boost(Week 22 +/- 7 days) for testing in an HAI assay for each of the 3 strains of influenza in the 2012/2013 TIV.
Proportion of subjects with a four-fold or greater rise from baseline (Day 0) and Week 22 in 2012/13 TIV specific H1, H3 and B neutralizing antibodies
Blood is collected from all subjects at baseline (Day 0) and 4 weeks after TIV boost (Week 22 +/- 7 days) for testing in a neutralizing antibody assays for 2012/13 strain-specific H1, H3 and B antigens.

Full Information

First Posted
May 30, 2012
Last Updated
December 4, 2018
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
The Emmes Company, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01609998
Brief Title
Seasonal Influenza DNA Vaccine & Seasonal Influenza Trivalent Inactivated Vaccine (TIV) in Children & Adolescents
Official Title
Open-Label, Dose-Escalation, Phase I Study of the Prime-Boost Investigational 2012/13 Seasonal Influenza DNA Vaccine, VRC-FLUDNA063-00-VP, Followed by the 2012/2013 Seasonal TIV Compared to TIV Prime-Boost in Children/Adolescents Ages 6-17
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Completed
Study Start Date
June 2012 (undefined)
Primary Completion Date
July 2013 (Actual)
Study Completion Date
July 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
The Emmes Company, LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Phase I, dose escalation study in healthy adolescents and children (6-17 years) to evaluate the safety, tolerability, and immunogenicity of a prime-boost regimen of the 2012/2013 seasonal influenza DNA vaccine (HA DNA) followed by licensed 2012/2013 TIV vaccine. The comparator groups will receive licensed 2012/2013 TIV as prime and boost. The hypothesis is that the 2012/2013 HA DNA prime-TIV boost regimen will be safe and result in a broader and more durable immune response than is observed in age-matched comparator TIV-TIV groups.
Detailed Description
Vaccines are an effective way to prevent influenza infection. Each year the World Health Organization (WHO) and the U.S FDA recommend the influenza strains to include in the seasonal influenza vaccines. The licensed seasonal influenza vaccines are directed against 3 influenza virus strains: an influenza A H1N1, an influenza A H3N2, and an influenza B. The currently approved vaccines depend upon labor-intensive methods that limit manufacturing speed and capacity. Influenza vaccines that can be more rapidly produced and that induce stronger, broader and more persistent immune responses are a recognized public health need. In this protocol we will evaluate an investigational seasonal influenza (HA DNA) vaccine in healthy adolescents and children (6-17 years). Some participants will receive HA DNA vaccine "prime" followed by licensed trivalent influenza vaccine (TIV) "boost" 18 weeks later. Other participants will receive two TIV injections 18 weeks apart. The results will be compared. The HA DNA vaccine and TIV are both directed at the 3 influenza strains selected for the 2012/2013 vaccines. Prior studies in adults of avian and seasonal influenza DNA vaccines have been completed. The DNA vaccinations were assessed as safe and well tolerated in adults. The immune response to avian influenza is augmented by DNA vaccine priming compared to two vaccinations with the inactivated avian influenza (H5N1)vaccine when the prime-boost interval is 12-24 weeks, but not when the prime-boost interval is 4 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Influenza
Keywords
Influenza A (H1), Influenza A (H3), Influenza B, DNA Vaccine, Trivalent Inactivated Vaccine (TIV), Healthy Adolescents, Healthy Children

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
75 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1A (12-17yrs):1 mg DNA vaccine+TIV
Arm Type
Experimental
Arm Description
2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks
Arm Title
Group 1B (6-11yrs):1 mg DNA vaccine+TIV
Arm Type
Experimental
Arm Description
2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks
Arm Title
Group 2A (12-17yrs):4 mg DNA vaccine+TIV
Arm Type
Experimental
Arm Description
2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks
Arm Title
Group 2B (6-11yrs):4 mg DNA vaccine+TIV
Arm Type
Experimental
Arm Description
2012/13 seasonal influenza DNA Vaccine (VRC-FLUDNA063-00-VP) at Day 0 and licensed 2012/13 TIV at Week 18±2 wks
Arm Title
Group 3A: (12-17yrs): TIV+TIV
Arm Type
Active Comparator
Arm Description
Licensed 2012/13 TIV at Day 0 and Week 18±2 wks
Arm Title
Group 3B: (6-11yrs): TIV+TIV
Arm Type
Active Comparator
Arm Description
Licensed 2012/13 TIV at Day 0 and Week 18±2 wks
Intervention Type
Biological
Intervention Name(s)
Seasonal Influenza DNA vaccine
Other Intervention Name(s)
VRC-FLUDNA063-00-VP, HA DNA Vaccine, Seasonal influenza trivalent DNA vaccine
Intervention Description
VRC-FLUDNA063-00-VP is composed of 3 closed-circular DNA plasmids that encode for the hemagglutinin (HA) from the following 3 strains: A/California/04/2009 (H1); A/Victoria/361/2011 (H3), and B/Wisconsin/2010. DNA vaccine vials will be supplied at 4 mg/mL in single use vials. The 1 mg dosage is administered as 0.25 mL volume and the 4 mg dosage as a 1 mL volume.
Intervention Type
Biological
Intervention Name(s)
TIV
Other Intervention Name(s)
2012/13 Seasonal Influenza Trivalent Inactivated Vaccine
Intervention Description
2012/13 Seasonal Influenza Trivalent Inactivated Vaccine (TIV)
Primary Outcome Measure Information:
Title
Incidence of solicited and unsolicited adverse events
Description
Incidence is reported for solicited events for 7 days after each injection, for unsolicited adverse event (AE) of any severity for 28 days after each injection, and for serious adverse events or new chronic medical conditions through 24 weeks after the 2nd injection.
Time Frame
7 days after injection for solicited events; from 1st injection to study completion for unsolicited events
Title
Mean change from baseline in safety laboratory measures
Description
At day 28 (+/- 7 days) blood will be drawn prior to receiving the second injection to measure hemoglobin, creatinine, and alanine transaminase (ALT).
Time Frame
Day 28
Title
Number of subjects with influenza or influenza-like illnesses
Description
Participants who experience at least one influenza or influenza-like illness will be counted.
Time Frame
Day 0 through 24 weeks post TIV boost (Day 294)
Secondary Outcome Measure Information:
Title
Proportion of subjects with either a baseline hemagglutination inhibition (HAI) titer <1:10 and post-vaccination HAI titer ≥1:40 or baseline HAI titer ≥1:10 and a minimum 4-fold rise in HAI titer for each of the 3 strains in the 2012/13 TIV at Week 22.
Description
Blood is collected from all subjects at baseline and at 4 weeks after TIV boost(Week 22 +/- 7 days) for testing in an HAI assay for each of the 3 strains of influenza in the 2012/2013 TIV.
Time Frame
Week 22 (4 weeks after TIV boost)
Title
Proportion of subjects with a four-fold or greater rise from baseline (Day 0) and Week 22 in 2012/13 TIV specific H1, H3 and B neutralizing antibodies
Description
Blood is collected from all subjects at baseline (Day 0) and 4 weeks after TIV boost (Week 22 +/- 7 days) for testing in a neutralizing antibody assays for 2012/13 strain-specific H1, H3 and B antigens.
Time Frame
Week 22 (4 weeks after TIV boost)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Children/adolescents aged 6 to 17 years inclusive and at least 20 kg in weight. Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process. Willing to have blood drawn 5 times over 42 weeks, including blood stored for research purposes. In good general health as assessed by medical history, vital signs and targeted physical examination; stable medical conditions that, in the opinion of the investigator, will not compromise the subject's participation in the study are acceptable. Capability of the legal adult representative of the minor to understand and comply with planned study procedures. Capability of the legal adult representative of the minor to provide written informed consent; assent will be obtained from the child/adolescent per requirements of the site institutional review board (IRB). For female adolescent of child-bearing potential (as defined by onset of menses): agrees to avoid becoming pregnant and to use effective method of contraception or practice abstinence for at least 21 day prior to the first study vaccine administration, until at least 4 weeks after the second study vaccination. Within 70 days prior to enrollment, hemoglobin within institutional normal limits, creatinine less than the upper limit of normal (ULN) and ALT ≤1.5 X ULN for respective age group. Exclusion Criteria: History of Guillain-Barré syndrome. Active neoplasm or history of cancer. On-going immunosuppressive therapy or known to be immunosuppressed at the time of enrollment. Immunoglobulin (or similar blood product) therapy within 3 months prior to enrollment. Known to have HIV, hepatitis B or hepatitis C infection. Acute or chronic illness that, in the opinion of the investigator, precludes participation in the study. Developmental delay, neurologic disorder, or seizure disorder requiring ongoing medical management (note: history of febrile seizure is not an exclusion). Acute febrile and/or respiratory illness within one week prior to enrollment. Idiopathic urticaria within the year prior to enrollment. Allergy treatment with antigen injections, unless on maintenance schedule and allergy shots could be staggered with the study vaccinations, within 14 days (2 weeks) prior to enrollment. Asthma that is severe, unstable or required emergent care, urgent care, hospitalization or intubation during the previous two years or that is expected to require the use of oral, intravenous or high dose inhaled corticosteroids. Vaccination of any type within 2 weeks prior to enrollment or receipt of the 2012/2013 seasonal TIV any time prior to enrollment. Participating in or planning to begin participation in another investigational study during the projected time during which the subject would be in this study. Factors related to the legal representative that in the judgment of the investigator may affect the objective decision-making of the legal representative. For a female adolescent of child-bearing potential: breast-feeding, known pregnancy or positive urine or serum pregnancy test on day of study enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Barney Graham, S Graham, M.D., Ph.D.
Organizational Affiliation
Chief, Clinical Trials Core Vaccine Research Center, NIAID, NIH
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Julie Ledgerwood, D.O.
Organizational Affiliation
Deputy Chief, Clinical Trials Core Vaccine Research Center, NIAID, NIH
Official's Role
Study Chair
Facility Information:
Facility Name
Emory Children's Center
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Saint Louis University - Doisy Research Center
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63104
Country
United States
Facility Name
Dartmouth Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
The Gamble Program for Clinical Studies, Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Vanderbilt University
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21975270
Citation
Ledgerwood JE, Wei CJ, Hu Z, Gordon IJ, Enama ME, Hendel CS, McTamney PM, Pearce MB, Yassine HM, Boyington JC, Bailer R, Tumpey TM, Koup RA, Mascola JR, Nabel GJ, Graham BS; VRC 306 Study Team. DNA priming and influenza vaccine immunogenicity: two phase 1 open label randomised clinical trials. Lancet Infect Dis. 2011 Dec;11(12):916-24. doi: 10.1016/S1473-3099(11)70240-7. Epub 2011 Oct 3.
Results Reference
background
PubMed Identifier
19779298
Citation
Ledgerwood JE, Graham BS. DNA vaccines: a safe and efficient platform technology for responding to emerging infectious diseases. Hum Vaccin. 2009 Sep;5(9):623-6. doi: 10.4161/hv.8627. No abstract available.
Results Reference
background
PubMed Identifier
30388160
Citation
Houser KV, Yamshchikov GV, Bellamy AR, May J, Enama ME, Sarwar U, Larkin B, Bailer RT, Koup R, Paskel M, Subbarao K, Anderson E, Bernstein DI, Creech B, Keyserling H, Spearman P, Wright PF, Graham BS, Ledgerwood JE; VRC 702 study team. DNA vaccine priming for seasonal influenza vaccine in children and adolescents 6 to 17 years of age: A phase 1 randomized clinical trial. PLoS One. 2018 Nov 2;13(11):e0206837. doi: 10.1371/journal.pone.0206837. eCollection 2018.
Results Reference
result

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Seasonal Influenza DNA Vaccine & Seasonal Influenza Trivalent Inactivated Vaccine (TIV) in Children & Adolescents

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