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Study of BBIL's ROTAVAC® and ROTAVAC 5CM Vaccines in Zambia (ROTAVAC)

Primary Purpose

Diarrhea, Diarrhea Rotavirus

Status
Completed
Phase
Phase 2
Locations
Zambia
Study Type
Interventional
Intervention
ROTAVAC®
ROTAVAC 5D
Rotarix®
Sponsored by
Centre for Infectious Disease Research in Zambia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Diarrhea focused on measuring diarrhea, Rotavirus, ROTAVAC, Rotavirus vaccine

Eligibility Criteria

6 Weeks - 8 Weeks (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Healthy infant as established by medical history and clinical examination before entering the study.
  2. Age: 6-8 weeks (42-56 days, both days inclusive) confirmed by Immunization Record.
  3. Infants received age-appropriate EPI vaccines till enrolment.
  4. Ability and willingness to provide informed consent as per local consenting procedures.
  5. Parent can be contacted on phone and confirms intention to remain in the study area with the participant during the study period.

Exclusion Criteria:

  1. Presence of diarrhea or vomiting in the previous 72 hours or on the day of enrolment (temporary exclusion).
  2. Presence of fever on the day of enrolment (temporary exclusion).
  3. Acute disease at the time of enrolment (temporary exclusion).
  4. Concurrent participation in another clinical trial throughout the entire timeframe of this study.
  5. Presence of severe malnutrition (weight-for-height z-score < -3SD median).
  6. 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 child's health or is likely to result in non-conformance to the protocol.
  7. History of congenital abdominal disorders, intussusception, abdominal surgery
  8. Known or suspected impairment of immunological function based on medical history and physical examination.
  9. Prior receipt or intent to receive rotavirus and other age specified EPI vaccines outside of the study center and during study participation.
  10. A known sensitivity or allergy to any component of the study vaccine.
  11. Clinically detectable significant congenital or genetic defect.
  12. History of persistent diarrhea (defined as diarrhea more than 14 days).
  13. Participant's parents not able, available or willing to accept active follow-up by the study staff.
  14. Has received any immunoglobulin therapy and/or blood products since birth or planned administration during the study period.
  15. 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.
  16. History of any neurologic disorders or seizures.
  17. Any medical condition in the parents/infants that, in the judgment of the investigator, would interfere with or serves as a contraindication to protocol adherence or a participant's parent's/legally acceptable representative's ability to give informed consent.
  18. Participant is a direct descendant (child or grandchild) of any person employed by the Sponsor, the CRO, the PI or study site personnel.

Sites / Locations

  • George Research Centre

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

ROTAVAC 5D

ROTAVAC®

Rotarix®

Arm Description

Bharat Biotech International Ltd's new Rotavirus vaccine, ROTAVAC 5D is a live, attenuated G9P[11] monovalent vaccine at a dose of 0.5mL containing NLT log 10^5.0 focus forming units (FFU) per dose. 5D is in liquid form.

Bharat Biotech International Ltd's licensed rotavirus vaccine, ROTAVAC® is a live, attenuated G9P[11] monovalent vaccine at a dose of 0.5mL containing NLT log 10^5.0 focus forming units (FFU) per dose. ROTAVAC® is in frozen form and is thawed till fully liquid prior to administration.

GSK Biologicals' licensed rotavirus vaccine, Rotarix® is a live attenuated RIX4414 strain of human rotavirus of the G1P[8] type containing not less than 106.0 CCID50 (cell culture infectious dose 50%) of the RIX 4414 strain of human rotavirus.

Outcomes

Primary Outcome Measures

Geometric Mean Concentration Using WC3 as the Viral Lysate
GMC of serum anti-rotavirus IgA antibodies as measured by enzyme linked immunosorbent assay (ELISA) using WC3 (heterologous to vaccine strain) as the viral lysate. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC 5D® and ROTAVAC®.

Secondary Outcome Measures

Immediate Adverse Events
Percentage of participants reporting immediate adverse events after each vaccination
Solicited Adverse Events
Percentage of participants reporting solicited post-vaccination reactogenicity (fever, diarrhea, vomiting, decreased appetite, irritability, decreased activity level)
Unsolicited Adverse Events
Percentage of participants reporting unsolicited AEs at a rate >5%.
Serious Adverse Events
Percentage of participants reporting SAEs
Seroconversion Rate in Each of the Three Arms as Measured by ELISA Using WC3 as the Viral Lysate
Seroconversion is defined as a post-vaccination serum anti-rotavirus IgA antibody concentration of at least 20 U/mL if a baseline concentration is < 20 U/mL or a post-vaccination serum anti-rotavirus IgA antibody concentration of ≥ 2-fold baseline level if a baseline concentration is ≥ 20 U/mL. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.
Seropositivity Rate in Each of the Three Vaccine Arms as Measured by ELISA Using WC3 as the Viral Lysate
Seropositivity is defined as serum anti-rotavirus IgA antibody concentration ≥ 20 U/mL. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.
Seroresponse Rate in Each of the Three Vaccine Arms as Measured by ELISA Using WC3 as the Viral Lysate
Seroresponse will be assessed as a four-fold, three-fold and two- fold rise in antibody concentration from baseline. Seroresponse will be assessed as a four-fold, three-fold and two-fold rise in antibody concentration from baseline. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.
Geometric Mean Fold Rise (GMFR) in Each of the Three Vaccine Arms as Measured by ELISA Using WC3 as the Viral Lysate
GMFR in each of the ROTAVAC 5D®, ROTAVAC® and Rotarix® vaccine arms. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.

Full Information

First Posted
July 18, 2018
Last Updated
December 17, 2020
Sponsor
Centre for Infectious Disease Research in Zambia
Collaborators
PATH, Christian Medical College, Vellore, India, Children's Hospital Medical Center, Cincinnati, Bharat Biotech International Limited
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1. Study Identification

Unique Protocol Identification Number
NCT03602053
Brief Title
Study of BBIL's ROTAVAC® and ROTAVAC 5CM Vaccines in Zambia
Acronym
ROTAVAC
Official Title
An Open-label, Randomized, Controlled, Single Centre, Phase IIb Study to Assess the Immunogenicity, Reactogenicity and Safety of Three Live Oral Rotavirus Vaccines, ROTAVAC® , ROTAVAC 5CM and Rotarix® in Healthy Zambian Infants
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
January 22, 2019 (Actual)
Primary Completion Date
October 4, 2019 (Actual)
Study Completion Date
October 4, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Centre for Infectious Disease Research in Zambia
Collaborators
PATH, Christian Medical College, Vellore, India, Children's Hospital Medical Center, Cincinnati, Bharat Biotech International Limited

4. Oversight

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

5. Study Description

Brief Summary
The study is being conducted to evaluate and compare the immunogenicity of ROTAVAC® and ROTAVAC 5D 28 days after the last dose of the vaccine, when administered to infants in a three-dose schedule at 6, 10 and 14 weeks 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 with ROTAVAC® and ROTAVAC 5D, and of Rotarix® when administered to infants in a two-dose schedule at 6 and 10 weeks of age.
Detailed Description
This study is designed as a Phase IIb, single center, randomized, controlled, open label study with 3 groups of infants (n=150 per group) receiving either three doses of ROTAVAC® three doses of ROTAVAC 5D or two doses of Rotarix®. 450 participants will be randomized (1:1:1) to receive ROTAVAC®, ROTAVAC 5D or Rotarix®. The three doses of ROTAVAC® and ROTAVAC 5D will be administered at 6, 10 and 14 weeks of age whereas two doses of Rotarix® will be administered at 6 and 10 weeks of age. All vaccines will be administered concomitantly with EPI vaccines including Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b and Hepatitis B vaccine (DTwP-Hib-HepB), Pneumococcal conjugate vaccine and OPV at 6, 10 and 14 weeks and IPV at week 14 (when switched to in Zambia). The participants will be monitored for 30 minutes following vaccine administration for immediate adverse events. A blood sample will be obtained from all the participating infants before first vaccination and four weeks after the last vaccine dose. This would mean that the blood sample will be collected at approximately 14 weeks of age for infants in the Rotarix® arm and 18 weeks for infants in the ROTAVAC® groups. Enhanced passive/Active surveillance for vaccine reactogenicity (solicited reactions) over the 7-day period after each vaccination will be conducted on all infants. In addition, surveillance for unsolicited AEs, SAEs including intussusception will be carried out over the period between first vaccination and four weeks after the last vaccination on all infants. The study will compare the immunogenicity of the two formulations of ROTAVAC® i.e. ROTAVAC® vs. ROTAVAC 5D and will descriptively analyze the immune response to Rotarix®. Primary immunogenicity analysis of all samples will be based on a validated ELISA which uses strain WC3 as a substrate. A subset of the samples (50 pairs/arms) collected will also be tested by a validated ELISA which uses strain 89-12 (G1P8 virus) as a substrate. This trial will generate immunogenicity and safety data on ROTAVAC® and ROTAVAC 5D outside of India. Presentation of data to Zambian Ministry of Health, WHO and in peer reviewed open access publications will be key audiences targeted for communication of results.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea, Diarrhea Rotavirus
Keywords
diarrhea, Rotavirus, ROTAVAC, Rotavirus vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Phase IIb, single center, randomized, controlled, open label study
Masking
None (Open Label)
Allocation
Randomized
Enrollment
450 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ROTAVAC 5D
Arm Type
Experimental
Arm Description
Bharat Biotech International Ltd's new Rotavirus vaccine, ROTAVAC 5D is a live, attenuated G9P[11] monovalent vaccine at a dose of 0.5mL containing NLT log 10^5.0 focus forming units (FFU) per dose. 5D is in liquid form.
Arm Title
ROTAVAC®
Arm Type
Experimental
Arm Description
Bharat Biotech International Ltd's licensed rotavirus vaccine, ROTAVAC® is a live, attenuated G9P[11] monovalent vaccine at a dose of 0.5mL containing NLT log 10^5.0 focus forming units (FFU) per dose. ROTAVAC® is in frozen form and is thawed till fully liquid prior to administration.
Arm Title
Rotarix®
Arm Type
Active Comparator
Arm Description
GSK Biologicals' licensed rotavirus vaccine, Rotarix® is a live attenuated RIX4414 strain of human rotavirus of the G1P[8] type containing not less than 106.0 CCID50 (cell culture infectious dose 50%) of the RIX 4414 strain of human rotavirus.
Intervention Type
Biological
Intervention Name(s)
ROTAVAC®
Intervention Description
0.5 ml of the vaccine will be administered orally thrice at 6, 10 and 14 weeks of age.
Intervention Type
Biological
Intervention Name(s)
ROTAVAC 5D
Intervention Description
0.5 ml of the vaccine will be administered orally thrice at 6, 10 and 14 weeks of age.
Intervention Type
Biological
Intervention Name(s)
Rotarix®
Intervention Description
1.5 ml of the liquid vaccine will be administered orally twice at 6 and 10 weeks of age.
Primary Outcome Measure Information:
Title
Geometric Mean Concentration Using WC3 as the Viral Lysate
Description
GMC of serum anti-rotavirus IgA antibodies as measured by enzyme linked immunosorbent assay (ELISA) using WC3 (heterologous to vaccine strain) as the viral lysate. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC 5D® and ROTAVAC®.
Time Frame
28 day after last dose of the study vaccine
Secondary Outcome Measure Information:
Title
Immediate Adverse Events
Description
Percentage of participants reporting immediate adverse events after each vaccination
Time Frame
within 30 minutes' post-vaccination.
Title
Solicited Adverse Events
Description
Percentage of participants reporting solicited post-vaccination reactogenicity (fever, diarrhea, vomiting, decreased appetite, irritability, decreased activity level)
Time Frame
7 day period after each vaccination.
Title
Unsolicited Adverse Events
Description
Percentage of participants reporting unsolicited AEs at a rate >5%.
Time Frame
From first vaccination through 4 weeks after the last vaccination.
Title
Serious Adverse Events
Description
Percentage of participants reporting SAEs
Time Frame
From first vaccination through 4 weeks after the last vaccination of each study participant. Immunogenicity
Title
Seroconversion Rate in Each of the Three Arms as Measured by ELISA Using WC3 as the Viral Lysate
Description
Seroconversion is defined as a post-vaccination serum anti-rotavirus IgA antibody concentration of at least 20 U/mL if a baseline concentration is < 20 U/mL or a post-vaccination serum anti-rotavirus IgA antibody concentration of ≥ 2-fold baseline level if a baseline concentration is ≥ 20 U/mL. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.
Time Frame
28 days after last dose of study vaccine.
Title
Seropositivity Rate in Each of the Three Vaccine Arms as Measured by ELISA Using WC3 as the Viral Lysate
Description
Seropositivity is defined as serum anti-rotavirus IgA antibody concentration ≥ 20 U/mL. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.
Time Frame
28 days after last dose of study vaccine
Title
Seroresponse Rate in Each of the Three Vaccine Arms as Measured by ELISA Using WC3 as the Viral Lysate
Description
Seroresponse will be assessed as a four-fold, three-fold and two- fold rise in antibody concentration from baseline. Seroresponse will be assessed as a four-fold, three-fold and two-fold rise in antibody concentration from baseline. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.
Time Frame
28 days after last dose of study vaccine
Title
Geometric Mean Fold Rise (GMFR) in Each of the Three Vaccine Arms as Measured by ELISA Using WC3 as the Viral Lysate
Description
GMFR in each of the ROTAVAC 5D®, ROTAVAC® and Rotarix® vaccine arms. WC3 strain of rotavirus used in the ELISA assay was heterologous to the 116E strain contained in the vaccines ROTAVAC® and ROTAVAC 5D®.
Time Frame
At 28 days after last dose of study vaccine in reference to baseline.
Other Pre-specified Outcome Measures:
Title
Geometric Mean Concentrations Using Strain 89-12 as the Viral Lysate
Description
GMCs of serum anti-rotavirus IgA antibodies in each of the three vaccine arms. 89-12 strain of Rotavirus used in the ELISA assay was homologous to Rotarix® and was heterologous to the strain contained in ROTAVAC® and ROTAVAC 5D®.
Time Frame
28 days after the last dose of a study vaccine.
Title
Seroconversion Using Strain 89-12 as the Viral Lysate
Description
Seroconversion rate in three vaccine arms. 89-12 strain of Rotavirus used in the ELISA assay was homologous to Rotarix® and was heterologous to the strain contained in ROTAVAC® and ROTAVAC 5D®.
Time Frame
28 days after the last dose of a study vaccine.
Title
Seropositivity Using Strain 89-12 as the Viral Lysate
Description
Seropositivity rate in three vaccine arms. 89-12 strain of Rotavirus used in the ELISA assay was homologous to Rotarix® and was heterologous to the strain contained in ROTAVAC® and ROTAVAC 5D®.
Time Frame
at baseline and 28 days after last dose of study vaccine
Title
Geometric Mean Fold Rise (GMFR) Using Strain 89-12 as the Viral Lysate
Description
GMFR in the three vaccine arms. 89-12 strain of Rotavirus used in the ELISA assay was homologous to Rotarix® and was heterologous to the strain contained in ROTAVAC® and ROTAVAC 5D®.
Time Frame
at 28 days after last dose of study vaccine in reference to baseline.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Weeks
Maximum Age & Unit of Time
8 Weeks
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy infant as established by medical history and clinical examination before entering the study. Age: 6-8 weeks (42-56 days, both days inclusive) confirmed by Immunization Record. Infants received age-appropriate EPI vaccines till enrolment. Ability and willingness to provide informed consent as per local consenting procedures. Parent can be contacted on phone and confirms intention to remain in the study area with the participant during the study period. Exclusion Criteria: Presence of diarrhea or vomiting in the previous 72 hours or on the day of enrolment (temporary exclusion). Presence of fever on the day of enrolment (temporary exclusion). Acute disease at the time of enrolment (temporary exclusion). Concurrent participation in another clinical trial throughout the entire timeframe of this study. Presence of severe malnutrition (weight-for-height z-score < -3SD median). 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 child's health or is likely to result in non-conformance to the protocol. History of congenital abdominal disorders, intussusception, abdominal surgery Known or suspected impairment of immunological function based on medical history and physical examination. Prior receipt or intent to receive rotavirus and other age specified EPI vaccines outside of the study center and during study participation. A known sensitivity or allergy to any component of the study vaccine. Clinically detectable significant congenital or genetic defect. History of persistent diarrhea (defined as diarrhea more than 14 days). Participant's parents not able, available or willing to accept active follow-up by the study staff. Has received any 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. History of any neurologic disorders or seizures. Any medical condition in the parents/infants that, in the judgment of the investigator, would interfere with or serves as a contraindication to protocol adherence or a participant's parent's/legally acceptable representative's ability to give informed consent. Participant is a direct descendant (child or grandchild) of any person employed by the Sponsor, the CRO, the PI or study site personnel.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Niraj Rathi, MD
Organizational Affiliation
PATH
Official's Role
Study Director
Facility Information:
Facility Name
George Research Centre
City
Lusaka
ZIP/Postal Code
10101
Country
Zambia

12. IPD Sharing Statement

Plan to Share IPD
Undecided
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Links:
URL
https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Rotarix/pdf/ROTARIX-PI-PIL.PDF
Description
Rotarix (Product Information).
URL
https://www.merck.com/product/usa/pi_circulars/r/rotateq/rotateq_ppi.pdf
Description
Rotateq (Product Information).
URL
https://www.path.org/media-center/path-welcomes-new-promising-study-results-for-rotavirus-vaccine-candidate/
Description
PATH welcomes new promising study results for rotavirus vaccine candidate.
URL
http://www.pharmabiz.com/NewsDetails.aspx?aid=108851&sid=2
Description
Bharat Biotech receives National Technology Award for Rotavac from President of India

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Study of BBIL's ROTAVAC® and ROTAVAC 5CM Vaccines in Zambia

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