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Trial to Evaluate the Immunogenicity of Dose Reduction Strategies of the MVA-BN Monkeypox Vaccine

Primary Purpose

Monkeypox

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
JYNNEOS
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 Monkeypox focused on measuring Dose Reduction, Immunogenicity, JYNNEOS, Monkeypox, MVA-BN, Open-Label, Randomized, Vaccine

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Individuals 18 - 50 years of age inclusive at the time of consent.
  2. Able to read the written informed consent, states willingness to comply with all study procedures, and is anticipated to be available for all study visits.
  3. Agreement to adhere to Lifestyle Considerations during the study.
  4. Females of reproductive potential who have sexual intercourse with males must agree to use highly effective contraception for at least 1 month prior to signing ICF and through Day 57.
  5. In good general health as evidenced by medical history, physical examination, and clinical judgement of the investigator to be in stable state of health.

    *Participants with pre-existing stable chronic medical conditions defined as conditions not requiring significant change in therapy or hospitalization for worsening disease in the 4 weeks prior to enrollment can be included at the discretion of the investigator. This includes stable, well-controlled HIV positive individuals.

  6. If HIV infected individual, they must be on suppressive Antiretroviral therapy (ART) for at least 6 months, report a cluster of differentiation 4 (CD4) count of greater than 350 cells/uL and no Acquired Immune Deficiency Syndrome (AIDS)-defining illness in the last year.

Exclusion Criteria:

  1. Ever received a licensed or an investigational smallpox or monkeypox vaccine.

    *This includes Dryvax, Acam2000, LC 16 m8, Modified Vaccinia Ankara (MVA)-based vaccine candidate or licensed vaccines, and Jynneos, Imvamune or Imvanex).

  2. Any history of monkeypox, cowpox, or vaccinia infection.
  3. Close contact of anyone known to have monkeypox in the 3 weeks prior to signing Informed Consent Form (ICF).
  4. Immunocompromised as determined by the investigator.
  5. Recent or current use of any immunosuppressing medications in the 4 weeks prior to signing ICF.

    **Topical, ophthalmic, inhaled, intranasal and intraarticular corticosteroids are acceptable, but receipt of >/= 20 mg/day of prednisone or equivalent for >/= 14 consecutive days in the 4 weeks prior to signing ICF is exclusionary.

  6. Pregnant or breast feeding.
  7. Received or plans to receive a live vaccine in the 4 weeks prior to signing ICF and 4 weeks after each vaccination.
  8. Received or plans to receive any other vaccine in the 2 weeks prior to signing ICF through Day 43.
  9. Received experimental therapeutic agent or vaccine in the 3 months prior to signing ICF.
  10. Has known allergy or history of anaphylaxis or other serious adverse reaction to a vaccine or vaccine products.

    ***This includes individuals with history of severe allergic reaction to gentamicin, ciprofloxacin, chicken or egg protein.

  11. Has tattoos, scars, or other marks which would, in the opinion of the investigator, interfere with assessment of the vaccination site.
  12. Has any medical disease or condition that, in the opinion of the participating site Principal Investigator (PI) or appropriate sub-investigator, precludes study participation.

    • This includes acute, subacute, intermittent, or chronic medical disease or condition that would place the participant at an unacceptable risk of injury, render the participant unable to meet the requirements of the protocol, or may interfere with the evaluation of responses or the participant's successful completion of this trial.

Sites / Locations

  • University of California, San Diego (UCSD) - Antiviral Research Center (AVRC)
  • George Washington University Medical Faculty Associates
  • The Hope Clinic of Emory University
  • NIH Clinical Research Center, Investigational Drug Management and Research Section
  • Brigham and Women's Hospital
  • Saint Louis University Center for Vaccine Development
  • Vanderbilt University Medical Center
  • Baylor College of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Arm 1

Arm 2

Arm 3

Arm Description

0.1 mL of 2 x 10^7 (50% Tissue Culture Infectious Dose (TCID50) JYNNEOS (Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN)) administered intradermally on Days 1 and 29. N=70

0.05 mL of 1 x 10^7 (50% Tissue Culture Infectious Dose (TCID50) JYNNEOS (Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN)) administered intradermally on Days 1 and 29. N=70

0.5 mL of 1 x 10^8 (50% Tissue Culture Infectious Dose (TCID50) JYNNEOS (Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN)) administered subcutaneously on Days 1 and 29. N=70

Outcomes

Primary Outcome Measures

Change from baseline in Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) Geometric Mean Titers (GMT)
To determine if peak humoral immune responses following an ID regimen of 1 x 10^7 TCID50 MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC
Change from baseline Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) Geometric Mean Titers (GMT)
To determine if peak humoral immune responses following an ID regimen of 2 x 10^7 TCID50 MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC

Secondary Outcome Measures

Change from baseline in peak Geometric Mean Titers (GMT)
Change from baseline in Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) Geometric Mean Titers (GMT)
Frequency of withdrawals or discontinuation of vaccination
Frequency in each study arm
Occurrence of Medically Attended Events (MAAE)
Frequency and relatedness in each study arm
Occurrence of serious Adverse Events (SAE)
Frequency and relatedness in each study arm
Occurrence of solicited Adverse Events (AE)
Frequency, severity, and relatedness of solicited systemic and local Adverse Events for 14 days after each vaccination
Occurrence of unsolicited Adverse Events (AE)
Frequency, severity, and relatedness of unsolicited Adverse Events for 28 days after each vaccination; in each study arm
Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) half-life (t ½)

Full Information

First Posted
August 20, 2022
Last Updated
October 24, 2023
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT05512949
Brief Title
Trial to Evaluate the Immunogenicity of Dose Reduction Strategies of the MVA-BN Monkeypox Vaccine
Official Title
A Phase 2 Randomized, Open-Label, Multisite Trial to Evaluate the Immunogenicity of Dose Reduction Strategies of the MVA-BN Vaccine
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 7, 2022 (Actual)
Primary Completion Date
October 13, 2023 (Actual)
Study Completion Date
March 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This study is a Phase 2 randomized, open-label, non-placebo controlled, multi-site clinical trial that will evaluate two intradermal (ID) regimens for Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccine compared to the standard subcutaneous (SC) regimen in healthy, vaccinia-naïve adults 18 to 50 years of age, inclusive. At least 210 participants will be enrolled and randomized to one of three study arms. The two dose sparing strategies include one-fifth (2 x 10^7) and one-tenth (1 x 10^7) of the standard dose of MVA-BN administered ID on Day 1 and 29 (Arm 1 and 2, respectively). The comparator arm (Arm 3) will be the 2-dose standard (1 x 10^8) MVA-BN SC regimen. The study will enroll a 1:1:1 randomization allocation. Participants will not be stratified by clinical trial site, demographic characteristics or human immunodeficiency virus (HIV) infection status; however, these data will be collected during screening and enrollment. Each participant may be screened either in a separate visit in the 7 days prior to Day 1 or on Day 1. The primary hypothesis involves a two-step hierarchical process. The study will first test non-inferiority of the 2 x 10^7 ID regimen relative to 1 x 10^8 SC (standard dose regimen). If the 2 x 10^7 ID regimen is non-inferior to the standard dose regimen, hypothesis testing will proceed to test non-inferiority of the 1 x 10^7 ID regimen relative to the standard dose regimen. The primary objectives are: 1) to determine if peak humoral immune responses following an ID regimen of 2 x 10^7 50% Tissue Culture Infectious Dose (TCID50) MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC; 2) to determine if peak humoral immune responses following an ID regimen of 1 x 10^7 TCID50 MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC.
Detailed Description
This study is a Phase 2 randomized, open-label, non-placebo controlled, multi-site clinical trial that will evaluate two intradermal (ID) regimens for Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccine compared to the standard subcutaneous (SC) regimen. This study will enroll healthy, non-pregnant, non-breastfeeding adults 18 to 50 years old inclusive. Participants with stable medical conditions and well-controlled human immunodeficiency virus (HIV) infection can participate. At least 210 participants will be enrolled and randomized to one of three study arms. The two dose sparing strategies include one-fifth (2 x 10^7) and one-tenth (1 x 10^7) of the standard dose of MVA-BN administered ID on Day 1 and 29 (Arm 1 and 2, respectively). The comparator arm (Arm 3) will be the 2-dose standard (1 x 10^8) MVA-BN SC regimen. The study will enroll a 1:1:1 randomization allocation. Participants will not be stratified by clinical trial site, demographic characteristics or HIV infection status; however, these data will be collected during screening and enrollment. Each participant may be screened either in a separate visit in the 7 days prior to Day 1 or on Day 1. The primary hypothesis involves a two-step hierarchical process. The study will first test non-inferiority of the 2 x 10^7 ID regimen relative to 1 x 10^8 SC (standard dose regimen). If the 2 x 10^7 ID regimen is non-inferior to the standard dose regimen, hypothesis testing will proceed to test non-inferiority of the 1 x 10^7 ID regimen relative to the standard dose regimen. The primary objectives are: 1) to determine if peak humoral immune responses following an ID regimen of 2 x 10^7 50% Tissue Culture Infectious Dose (TCID50) MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC; 2) to determine if peak humoral immune responses following an ID regimen of 1 x 10^7 TCID50 MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC. The secondary objectives are: 1) to determine if individual peak humoral immune responses following each ID regimen are non-inferior to the licensed regimen administered SC; 2) to evaluate humoral immune responses of each ID regimen (separately) compared to licensed SC regimen each study day; 3) to evaluate the kinetics of the humoral immune responses of each ID regimen (separately) compared to licensed SC regimen through Day 365; 4) To compare relative safety among study arms as assessed by systemic and local reactogenicity for 14 days after each vaccination, unsolicited adverse events for 28 days after each vaccination, and serious adverse events (SAE) and medically attended events (MAAE) from Day 1 through Day 57, and related SAE/MAAEs through Day 181.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Monkeypox
Keywords
Dose Reduction, Immunogenicity, JYNNEOS, Monkeypox, MVA-BN, Open-Label, Randomized, Vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
229 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
0.1 mL of 2 x 10^7 (50% Tissue Culture Infectious Dose (TCID50) JYNNEOS (Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN)) administered intradermally on Days 1 and 29. N=70
Arm Title
Arm 2
Arm Type
Experimental
Arm Description
0.05 mL of 1 x 10^7 (50% Tissue Culture Infectious Dose (TCID50) JYNNEOS (Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN)) administered intradermally on Days 1 and 29. N=70
Arm Title
Arm 3
Arm Type
Active Comparator
Arm Description
0.5 mL of 1 x 10^8 (50% Tissue Culture Infectious Dose (TCID50) JYNNEOS (Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN)) administered subcutaneously on Days 1 and 29. N=70
Intervention Type
Biological
Intervention Name(s)
JYNNEOS
Intervention Description
JYNNEOS is FDA-approved and licensed as a smallpox and monkeypox vaccine in the United States. JYNNEOS is a live vaccine produced from the strain Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN), an attenuated, non-replicating orthopoxvirus. Each 0.5 mL dose is formulated to contain 0.5 x 10^8 to 3.95 x 10^8 infectious units of MVA-BN live virus in 10 mM Tris (tromethamine), 140 mM sodium chloride at pH 7.7. Subcutaneous is administered in the deltoid region, intradermal is administered in the volar aspect (inner side) of the forearm.
Primary Outcome Measure Information:
Title
Change from baseline in Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) Geometric Mean Titers (GMT)
Description
To determine if peak humoral immune responses following an ID regimen of 1 x 10^7 TCID50 MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC
Time Frame
Day 1 through Day 43
Title
Change from baseline Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) Geometric Mean Titers (GMT)
Description
To determine if peak humoral immune responses following an ID regimen of 2 x 10^7 TCID50 MVA-BN are non-inferior to the licensed regimen of 1 x 10^8 MVA-BN administered SC
Time Frame
Day 1 through Day 43
Secondary Outcome Measure Information:
Title
Change from baseline in peak Geometric Mean Titers (GMT)
Time Frame
Day 1 through Day 365
Title
Change from baseline in Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) Geometric Mean Titers (GMT)
Time Frame
Day 1, 15, 29, 43, 57, 90, 181 365
Title
Frequency of withdrawals or discontinuation of vaccination
Description
Frequency in each study arm
Time Frame
Day 1 through Day 181
Title
Occurrence of Medically Attended Events (MAAE)
Description
Frequency and relatedness in each study arm
Time Frame
Day 1 through Day 181
Title
Occurrence of serious Adverse Events (SAE)
Description
Frequency and relatedness in each study arm
Time Frame
Day 1 through Day 181
Title
Occurrence of solicited Adverse Events (AE)
Description
Frequency, severity, and relatedness of solicited systemic and local Adverse Events for 14 days after each vaccination
Time Frame
Day 1 through Day 43
Title
Occurrence of unsolicited Adverse Events (AE)
Description
Frequency, severity, and relatedness of unsolicited Adverse Events for 28 days after each vaccination; in each study arm
Time Frame
Day 1 through Day 57
Title
Vaccinia virus specific plaque reduction neutralizing antibody (PRNT) half-life (t ½)
Time Frame
Day 1 through Day 365

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Individuals 18 - 50 years of age inclusive at the time of consent. Able to read the written informed consent, states willingness to comply with all study procedures, and is anticipated to be available for all study visits. Agreement to adhere to Lifestyle Considerations during the study. Females of reproductive potential who have sexual intercourse with males must agree to use highly effective contraception for at least 1 month prior to signing ICF and through Day 57. In good general health as evidenced by medical history, physical examination, and clinical judgement of the investigator to be in stable state of health. *Participants with pre-existing stable chronic medical conditions defined as conditions not requiring significant change in therapy or hospitalization for worsening disease in the 4 weeks prior to enrollment can be included at the discretion of the investigator. This includes stable, well-controlled HIV positive individuals. If HIV infected individual, they must be on suppressive Antiretroviral therapy (ART) for at least 6 months, report a cluster of differentiation 4 (CD4) count of greater than 350 cells/uL and no Acquired Immune Deficiency Syndrome (AIDS)-defining illness in the last year. Exclusion Criteria: Ever received a licensed or an investigational smallpox or monkeypox vaccine. *This includes Dryvax, Acam2000, LC 16 m8, Modified Vaccinia Ankara (MVA)-based vaccine candidate or licensed vaccines, and Jynneos, Imvamune or Imvanex). Any history of monkeypox, cowpox, or vaccinia infection. Close contact of anyone known to have monkeypox in the 3 weeks prior to signing Informed Consent Form (ICF). Immunocompromised as determined by the investigator. Recent or current use of any immunosuppressing medications in the 4 weeks prior to signing ICF. **Topical, ophthalmic, inhaled, intranasal and intraarticular corticosteroids are acceptable, but receipt of >/= 20 mg/day of prednisone or equivalent for >/= 14 consecutive days in the 4 weeks prior to signing ICF is exclusionary. Pregnant or breast feeding. Received or plans to receive a live vaccine in the 4 weeks prior to signing ICF and 4 weeks after each vaccination. Received or plans to receive any other vaccine in the 2 weeks prior to signing ICF through Day 43. Received experimental therapeutic agent or vaccine in the 3 months prior to signing ICF. Has known allergy or history of anaphylaxis or other serious adverse reaction to a vaccine or vaccine products. ***This includes individuals with history of severe allergic reaction to gentamicin, ciprofloxacin, chicken or egg protein. Has tattoos, scars, or other marks which would, in the opinion of the investigator, interfere with assessment of the vaccination site. Has any medical disease or condition that, in the opinion of the participating site Principal Investigator (PI) or appropriate sub-investigator, precludes study participation. This includes acute, subacute, intermittent, or chronic medical disease or condition that would place the participant at an unacceptable risk of injury, render the participant unable to meet the requirements of the protocol, or may interfere with the evaluation of responses or the participant's successful completion of this trial.
Facility Information:
Facility Name
University of California, San Diego (UCSD) - Antiviral Research Center (AVRC)
City
San Diego
State/Province
California
ZIP/Postal Code
92103-8208
Country
United States
Facility Name
George Washington University Medical Faculty Associates
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20037
Country
United States
Facility Name
The Hope Clinic of Emory University
City
Decatur
State/Province
Georgia
ZIP/Postal Code
30030
Country
United States
Facility Name
NIH Clinical Research Center, Investigational Drug Management and Research Section
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1504
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115-6110
Country
United States
Facility Name
Saint Louis University Center for Vaccine Development
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63104-1015
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37212
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-3411
Country
United States

12. IPD Sharing Statement

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Trial to Evaluate the Immunogenicity of Dose Reduction Strategies of the MVA-BN Monkeypox Vaccine

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