This study will compare the influenza A/H5N1 virus vaccine given by injection in the muscle versus injection in the skin in healthy adults. The study will look at the safety of the injections, how the body reacts, and what the body's immune response does when the vaccine is given in the muscle versus in the skin. The study will look at 226 healthy volunteers, ages 18-49 years old. Study procedures will include getting 2 doses of vaccine 28 days apart, physical exams, follow-up clinic visits to check the places on the body where each vaccine was given, and blood sample collections. Volunteers will complete a memory aid by writing down temperatures and health changes for 7 days after each vaccination. Volunteers will be involved in the study for up to 241 days.
Influenza A viruses have the potential to cause worldwide epidemics and/or pandemics resulting in significant morbidity and mortality. Two-hundred twenty-six healthy male and female subjects aged 18 to 49 years, inclusive, in the United States (US) will be enrolled into this single-center, randomized, double-blinded, placebo-controlled trial of intradermal (ID) and intramuscular (IM) injection with subvirion (SV) inactivated influenza A/H5N1 vaccine. The study will have two vaccine groups. Vaccine group 1: the subject will receive 0.1 mL of H5 Hemagglutination (HA) by the ID route in one arm and 0.1 mL of saline placebo by the IM route in the other arm. Vaccine group 2: the subject will receive 0.1 mL of H5 HA by the IM route in one arm and 0.1 mL of saline placebo by the ID route in the other arm. All eligible subjects will be enrolled and randomized 1:1 (113 subjects per vaccine group) to either vaccine group 1 or vaccine group 2. All subjects will receive two doses of approximately 30micrograms of H5 HA by their assigned route, either IM or ID, separated by approximately 28 days. At each vaccination visit, all subjects will also receive a saline placebo in the opposite arm by the different route as their vaccine route (i.e. if vaccine is administered by the ID route in one arm, then a saline placebo will be administered by the IM route in the opposite arm). The second vaccine dose will be administered by the same route as per vaccine group assigned at original randomization. Subjects will be observed in the clinic for approximately 15 minutes after each vaccination. Subjects will return on Day 2 for arm check and assessment of adverse events. All subjects will maintain a memory aid recording oral temperature, and systemic and local adverse events for 7 days after each vaccination. They will return to clinic on Day 8 for adverse event (AE) assessment, concomitant medication assessment, a targeted physical exam (if indicated), and review of memory aid. AE data will be captured Day 0 through Day 56. Serious AE data will be captured from Day 0 through the end of each subject's participation in the study (approximately 7 months). The subjects, staff assessing subjects, and lab personnel will be blinded. Serum for immunogenicity evaluations will be obtained prior to the first vaccination, at Day 0; prior to the second vaccination, at Day 28; on Day 56 and approximately Day 208 (7months after dose 1). The primary objectives are to compare the immunogenicity of a similar dosage level of a subvirion inactivated influenza A/H5N1 vaccine given by ID or IM injection one month after receipt of the second dose of vaccine and to compare the safety and reactogenicity of ID and IM immunization at a similar dosage level of a subvirion inactivated influenza A/H5N1 vaccine among healthy young adults. The secondary objective is to evaluate serum antibody responses approximately 1 and 7 months after the first vaccination. This study is linked to Division of Microbiology and Infectious Diseases protocol 07-0022.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
227
Inactivated influenza A/H5N1 vaccine formulated to a concentration of HA greater than or equal to 300 mcg/mL administered via intramuscular (IM) injection. Vaccine will be administered to each subject at Days 0 and 28.
Inactivated influenza A/H5N1 vaccine formulated to a concentration of HA greater than or equal to 300 mcg/mL administered via intradermal (ID) injection. Vaccine will be administered to each subject at Days 0 and 28.
The placebo will be 0.1 mL of saline administered by the IM route.
The placebo will be 0.1 mL of saline administered by the ID route.
Baylor College of Medicine
Houston, Texas, United States
Number of Participants Achieving a 4-fold or Greater Increase in HAI Antibody Titers After Dose 2
Number of participants in each vaccine group achieving a 4-fold or greater increase in serum hemagglutination inhibition (HAI) antibody titers against influenza A/H5N1 virus 28 days after receipt of the second dose of vaccine
Time frame: Approximately Day 56.
Number of Participants Spontaneously Reporting Any Serious Adverse Event.
Any untoward medical occurrence that resulted in death, persistent/significant disability/incapacity, required in-patient hospitalization or prolongation thereof, was life threatening or a congenital anomaly/birth defect in offspring of a study subject; or may have jeopardized the participant or required intervention to prevent one of the outcomes.
Time frame: Through Day 208.
Occurrence of Unsolicited Symptoms During a 28-day Surveillance Period Following Vaccinations at Days 0 and 28.
The number of participants spontaneously reporting any symptom (defined as any Adverse Event considered associated with the product) within 28 days of vaccination. Participants are counted only once but may have experienced events on multiple occasions.
Time frame: Through approximately Day 56
Occurrence of Solicited Systemic Symptoms During a 7-day Surveillance Period (Systematically Collected) Following Vaccinations at Days 0 and 28.
The number of participants reporting fever, feverishness, malaise, myalgia, headache and nausea. Participants are counted only once for each symptom but may have experienced symptoms on multiple occasions.
Time frame: 7 days after each vaccination
Occurrence of Solicited Local Symptoms During a 7-day Surveillance Period (Systematically Collected) Following Vaccinations at Days 0 and 28.
The number of participants reporting pain, tenderness, itching, induration, erythema, and pigmentation. Participants are counted only once for each symptom but may have experienced symptoms on multiple occasions.
Time frame: 7 days after each vaccination
HAI Geometric Mean Titer (GMT) After Dose 2
HAI geometric mean titer (GMT) against influenza A/H5N1 virus in each vaccine group 28 days after receipt of the second dose of vaccine.
Time frame: Approximately Day 56.
Number of Participants Achieving a HAI Titer of Greater Than or Equal to 40 After Dose 2
Number of participants achieving a serum HAI titer of greater than or equal to 40 against influenza A/H5N1 virus in each vaccine group 28 days after receipt of the second dose of vaccine
Time frame: Approximately Day 56
Number of Participants Achieving a 4-fold or Greater Increase in HAI Antibody Titers After Dose 1.
Number of participants achieving a 4-fold or greater increase in HAI antibody titers against influenza A/H5N1 virus in each vaccine group one month after receipt of the first dose.
Time frame: Approximately Day 28
HAI GMT After Dose 1
HAI GMT against influenza A/H5N1 virus one month after receipt of the first dose of vaccine.
Time frame: Approximately Day 28
Number of Participants Achieving a Serum HAI Titer of Greater Than or Equal to 40 After Dose 1.
Number of participants achieving a serum HAI titer of greater than or equal to 40 against influenza A/H5N1 virus in each vaccine group one month after receipt of the first dose of vaccine.
Time frame: Approximately Day 28
Number of Participants Achieving a 4-fold or Greater Increase in HAI Antibody Titers 7 Months After Dose 1.
Number of participants achieving a 4-fold or greater increase in HAI antibody titers against influenza A/H5N1 virus in each vaccine group seven months after receipt of the first dose of vaccine.
Time frame: Approximately Day 208
HAI GMT at 7 Months After Dose 1
HAI GMT against influenza A/H5N1 virus in each vaccine group seven months after receipt of the first dose of vaccine.
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Time frame: Approximately Day 208
Number of Participants Achieving a Serum HAI Titer of Greater Than or Equal to 40 at 7 Months After Dose 1.
Number of participants achieving a serum HAI titer of greater than or equal to 40 against influenza A/H5N1 virus in each vaccine group 7 months after receipt of the first dose of vaccine.
Time frame: Approximately Day 208