A Study of a Seasonal Trivalent Split, Inactivated Influenza Vaccine

Overview

This is a phase I, double-blind, randomized, placebo-controlled trial with two groups of participants to receive seasonal trivalent split, inactivated influenza vaccine (A/H1N1; A/H3N2 and B) or placebo (phosphate buffered saline). A total of 60 healthy male and female adults 18 through 45 years of age will be randomized to receive vaccine (30) or placebo (30).

Full Title of Study: “A Phase 1 Double Blinded, Randomized, Placebo-Controlled Study to Examine the Safety and Immunogenicity of a Seasonal Trivalent Split, Inactivated Influenza Vaccine Produced by Torlak in Healthy Adult Volunteers in Serbia”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: March 2016

Detailed Description

This is a phase 1, double blinded, randomized, placebo-controlled study. The study will be conducted at 1 site in Serbia. Sixty (60) healthy male and female adults, 18 to 45 years of age, will be enrolled into the trial. Subjects will be randomized 1:1 to one of two treatment allocations: 30 to vaccine, 30 to placebo. The study will utilize a "randomized block design" to assure a balance of 1:1 vaccine and placebo when all subjects are enrolled. The study will be double blinded, meaning the study subjects, investigators, and the sponsor will be unaware of the treatment allocated to each subject until the clinical trial database is declared final and locked. The study should take about 5 months to complete, with each subject involved for 3 months from the day of injection. The justification for the 3 month follow up, rather than 6 month follow up is that this is an inactivated vaccine that follows very standard manufacturing practices with standard antigens. The safety of inactivated influenza vaccines is well-established. Adding length to the follow up results in delays in future testing of the vaccine for licensure.

Interventions

  • Biological: Influenza vaccine, split inactivated
    • Seasonal trivalent inactivated influenza vaccine (TIV), inactivated split virion, purified by sucrose gradient ultracentrifugation. The vaccine is produced in hen’s eggs, and inactivated with beta-propiolactone.
  • Other: Placebo
    • 0.5 mL of phosphate buffered saline

Arms, Groups and Cohorts

  • Experimental: Vaccine
    • 0.5 mL of influenza vaccine, split, inactivated with 15 mcg of haemagglutination (HA) of each of 3 strains: NYMC BX-51B reassortant of B/Massachusetts/2/2012 X-181 reassortant of H1/A/California/7/2009 X-223A reassortant of H3/A/Texas/50/2012.
  • Placebo Comparator: Placebo
    • 0.5 mL of phosphate buffered saline

Clinical Trial Outcome Measures

Primary Measures

  • Number of Subjects With Immediate Adverse Events
    • Time Frame: 30-minute post-vaccination period.
    • Number of subjects with observed immediate adverse events, including allergic reaction or anaphylaxis, following administration of the study product.
  • Number and Percentage of Subjects With Solicited Local Reactogenicity
    • Time Frame: 7-day period (Days 0-6) post-vaccination.
    • Number of subjects reporting solicited local reactions (redness, swelling, induration, pain and tenderness) at the injection site post-vaccination with study vaccine or placebo
  • Number and Percentage of Subjects With Solicited Systemic Reactogenicity
    • Time Frame: 7-day period (Days 0-6) post-vaccination.
    • Number of subjects reporting solicited systemic reactions (fever, fatigue/malaise, muscle aches, joint aches, chills, nausea, vomiting, and headache) post-vaccination with study vaccine or Placebo
  • Number and Percentage of Subjects With Occurrence of Unsolicited Adverse Events
    • Time Frame: Within 21 days post vaccination
    • These data are presented broadly as number per group for the study. Please see AE reporting section for more specific details on AEs.
  • Number and Percentage of Subjects With Occurrence of Serious Adverse Events (SAE)
    • Time Frame: Over the entire study period (Day 90).

Secondary Measures

  • Number and Percentage of Seroconverted Subjects Against 3 Strains of Influenza Vaccine.
    • Time Frame: Day 21
    • Seroconversion is defined as a serum HAI titer meeting the following criteria: pre-vaccination titer <1:10 and a post-vaccination titer ≥ 1:40 or pre-vaccination titer ≥ 1:10 and at least a four-fold increase in post-vaccination measured on Day 21. The 3 influenza strains assessed were B/Massachusetts, H1/A/California and H3/A/Texas
  • Number and Percentage of Seroprotected Subjects Against 3 Strains of Influenza Vaccine
    • Time Frame: Day 0 and Day 21 post vaccination
    • A seroprotected subject was defined as a vaccinated subject who had a serum Hemagluttination Inhibition (HAI) titer ≥ 1:40. The 3 influenza strains assessed were B/Massachusetts, H1/A/California an d H3/A/Texas
  • Geometric Mean Titers (GMTs) of Serum Hemagglutination Inhibition (HAI) Antibodies Pre- (Day 0) and Post-vaccination (Day 21) for Each of the 3 Antigens
    • Time Frame: Pre- (Day 0) and post-vaccination (Day 21)
    • The 3 influenza strains assessed were B/Massachusetts, H1/A/California an d H3/A/Texas
  • Geometric Mean Fold Rises (GMFRs) of Serum (HAI) Antibodies (Post-vaccination / Pre-vaccination) for Each of the 3 Antigens.
    • Time Frame: Pre- (Day 0) and post-vaccination (Day 21)
    • The 3 influenza strains assessed were B/Massachusetts, H1/A/California an d H3/A/Texas
  • Geometric Mean Neutralization Titers of Neutralizing Antibodies (MNT) Pre- (Day 0) and Post-vaccination (Day 21) for Each of the 3 Antigens.
    • Time Frame: Pre- (Day 0) and post-vaccination (Day 21)
  • Geometric Mean Fold Rises (GMFRs) of MNT (Post-vaccination / Pre-vaccination) for Each of the 3 Antigens.
    • Time Frame: Pre- (Day 0) and post-vaccination (Day 21)
    • The 3 influenza strains assessed were B/Massachusetts, H1/A/California an d H3/A/Texas

Participating in This Clinical Trial

Inclusion Criteria

  • Healthy male or female adult 18 through 45 years of age at the enrollment visit. – Literate (by self-report) and willing to provide written informed consent. – Healthy, as established by the medical history, physical examination, and screening laboratory evaluations. – Capable and willing to complete Memory Aids and willing to return for all follow-up visits. – For females, willing to utilize reliable birth control measures (e.g., intrauterine device, hormonal contraception, condoms) from Day 0 through the Day 21 visit. Exclusion Criteria:

  • Participation in another clinical trial involving any therapy within the previous three months or planned enrollment in such a trial during the period of this study. – Receipt of any non-study vaccine within 4 weeks prior to enrollment or refusal to postpone receipt of such vaccines until after the Day 21 visit. – Current or recent (within 2 weeks of vaccination) acute illness with or without fever. – Receipt of immune globulin or other blood products within 3 months prior to study enrollment or planned receipt of such products prior to the Day 21 visit. – Chronic administration (defined as more than 14 consecutively-prescribed days) of immunosuppressants or other immune-modulating therapy within six months prior to study vaccination. (For corticosteroids, this means prednisone or equivalent, equal or more than 0.5 mg per kg per day; topical steroids are allowed.) – History of asthma. – Hypersensitivity after previous administration of any vaccine. – Suspected or known hypersensitivity to any of the study vaccine components, including chicken or egg protein. – Acute or chronic clinically significant pulmonary, cardiovascular, hepatobiliary, metabolic, neurologic, psychiatric or renal functional abnormality, as determined by medical history, physical examination or clinical laboratory screening tests, which in the opinion of the investigator, might interfere with the study objectives. – History of any blood or solid organ cancer. – History of thrombocytopenic purpura or known bleeding disorder. – History of seizures. – Known or suspected immunosuppressed or immunodeficient condition of any kind. – Confirmed hepatitis B virus (HBV) or hepatitis C virus (HCV) infection – Known HIV infection (self-report). – Known active tuberculosis or symptoms of active tuberculosis, regardless of cause (self-report). – History of chronic alcohol abuse and/or illegal drug use. – Pregnancy or lactation. (A negative pregnancy test will be required before administration of study product for all women of childbearing potential.) – History of Guillain-Barré Syndrome – Any condition that, in the opinion of the investigator, would increase the health risk to the subject if he/she participates in the study or would interfere with the evaluation of the study objectives.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 45 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Institute of Virology, Vaccines and Sera, Torlak
  • Collaborator
    • Department of Health and Human Services
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Goran Stevanovic, PhD, Principal Investigator, Clinic for Infectious and Tropical Diseases

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