A total of 51 children between the ages of 4 and 9 will be randomized to receive a two dose schedule of either licensed live attenuated A/California/07/09 influenza vaccine (LAIV) or licensed inactivated A/California/07/09 influenza vaccine (IIV) or IIV followed by LAIV separated by 28 days. Children with prior vaccination or natural infection with novel H1N1 influenza will be excluded. Randomization will be stratified by pre-existing HAI titers to the previous winter's seasonal H1N1 A/Brisbane/57/07 reference virus.
The study will be conducted as a randomized, prospective, open-label evaluation of the clinical tolerability, vaccine virus shedding, and serum and mucosal antibody response to vaccination with either live monovalent novel H1N1 influenza vaccine (LAIV) or monovalent inactivated novel H1N1 influenza vaccine (IIV) in healthy children between the ages of 4 and 9 years. Children will be screened for antibody to A/Brisbane/57/07 (H1N1) and A/California/07/09 (H1N1) prior to randomization. Children with evidence of prior exposure to the 2009 pandemic H1N1 virus will be excluded. Those with antibodies to A/Brisbane/57/07 (H1N1) will be stratified by preexisting antibody. Vaccine will be administered on days 0 and 28. Safety of vaccination will be assessed using symptoms collected by parents for 7 days after each dose of vaccine. Serum will be obtained prior to and on day 28 following each dose of vaccine and assessed for antibody by HAI, ELISA, B-cell ELISPOT and neutralization techniques. Nasal secretions will be obtained by nasal aspiration prior to and on day 28 after each dose and assessed for HA-specific IgA antibody by ELISA. Nasal swabs will be obtained on days 2, 4, and 7 after each dose of live vaccine and assessed for the presence and magnitude of vaccine virus shedding of the live attenuated vaccine by rtRT-PCR and TCID50 on MDCK cells.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
0.2 ml dose of live monovalent vaccine delivered through nasal spray, 2 doses given 28 days apart
0.5 ml IM, 2 doses given 28 days apart
0.5 ml IM given X1 with 0.1 ml intranasally given 28 days later
University of Rochester Medical Center, Vaccine Research Unit Room 3-5000
Rochester, New York, United States
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
Time frame: nasal swabs obtained at days 2 post vaccination
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
Time frame: nasal swab at 4 days post vaccination
The primary endpoint for assessment of the live attenuated vaccine take will be the AUC of the live vaccine virus shedding determined by 50% tissue culture infectious dose (TCID ) on MDCK cells at 33 degrees C
Time frame: nasal swab obtained at 7 days post vaccination
The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
Time frame: swabs will be obtained on day 2 post vaccination
The frequency and magnitude of serum hemagglutination-inhibition (HAI), ELISA, and neutralizing antibody response to vaccine
Time frame: at day 28
The frequency and magnitude of hemagglutinin-specific mucosal IgA response assessed by ELISA on nasal secretions
Time frame: day 28
The frequency and magnitude of antibody secreting cell and memory B cells developing after vaccination
Time frame: on day 7
Development of specific local and systemic symptoms occuring after vaccine
Time frame: for 7 days post each vaccination
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The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
Time frame: swab obtained at day 4 post vaccination
The AUC of nasopharyngeal shedding assessed by quantitative rtRT-PCR
Time frame: swab obtained at day 7 post vaccination
The frequency and magnitude of serum hemagglutination-inhibition (HAI), ELISA, and neutralizing antibody response to vaccine
Time frame: at day 56
The frequency and magnitude of hemagglutinin-specific mucosal IgA response assessed by ELISA on nasal secretions
Time frame: at day 56
The frequency and magnitude of antibody secreting cell and memory B cells developing after vaccination
Time frame: on day 35