Enterovirus 71 (EV71), a major pathogen that is responsible for causing hand-foot-and-mouth disease (HFMD) worldwide, is a member of the Human Enterovirus species A, family Picornaviridae. Since the late 1990s, a series of large HFMD epidemics caused by EV71 have been reported in the Asia-Pacific region. Notably, there is evidence that the most severe cases from these epidemic outbreaks are associated with neurological disorders with CNS involvement caused by EV71 infection. Because of these EV71 infection-related public health issues, the research and development of EV71 vaccine candidates have been heavily promoted. Recently, several EV71 vaccine candidates have been evaluated in animals but no final results of clinical trials, including inactivated vaccine, attenuated vaccine, subunit vaccine, DNA vaccine, epitope peptide vaccine, virus-like particles (VLPs). Basing on the previous studies of elicited protection in mice and rhesus monkeys, a formalin-inactivated EV71 vaccine (Human Diploid cell, KMB-17 Cell) has been licensed by SFDA in China, Dec. 2010. The phase I clinical trial has been carried out, during four months, in Guangxi Province, China. The purpose of this study is to evaluate the safety, tolerability and immunogenicity of the formalin-inactivated EV71 vaccine in Chinese adults (from 18 to 49 years old), children (from 3 to 11 years old) and infants (from 6 to 35 months old).
Hand-foot-and-mouth disease (HFMD) is a significant cause of death, usually characterized by vesicular lesions on the skin and oral mucosa and high morbidity rates in children. Additionally, occasional fatal cases have been reported involving brainstem encephalitis and myelitis associated with cardiopulmonary collapse. Pulmonary edema/hemorrhage and respiratory failure are the major causes of death among children less than five years old. Enterovirus 71 (EV71), a major pathogen that is responsible for causing HFMD worldwide, is a member of the Human Enterovirus species A, family Picornaviridae. Since the late 1990s, a series of large HFMD epidemics caused by EV71 have been reported in the Asia-Pacific region. Notably, there is evidence that the most severe cases from these epidemic outbreaks are associated with neurological disorders with CNS involvement caused by EV71 infection. Because of these EV71 infection-related public health issues, the research and development of EV71 vaccine candidates have been heavily promoted. Recently, several EV71 vaccine candidates have been evaluated in animals but no final results of clinical trials, including heat-inactivated or formalin-inactivated vaccine, live-attenuated vaccine, recombinant viral protein 1 (VP1) vaccine, VP1 DNA vaccine, VP1 epitope peptide vaccine, EV71 virus-like particles (VLPs) and bacterial or viral vector expressing VP1. Overall, the inactivated whole-virus vaccines seem to be more immunogenic than recombinant VP1 and DNA vaccines. Basing on the previous studies of elicited protection in mice and rhesus monkeys (Ying Zhang, et al. Pathogenesis study of Enterovirus 71 Infection in Rhesus Monkeys. Lab Invest, 2011, doi:10.1038/labinest.2011.82; Longding Liu, et al. Neonatal Rhesus Monkey is a Potential Animal Model for Studying Pathogenesis of EV71 Infection. Virology, 2011, 412:91-100; Chenghong Dong, et al. Immunoprotection Elicited by an Enterovirus Type 71 Experimental Inactivated Vaccine in Mice and Rhesus Monkeys. Vaccine, 2011, doi: 10.1016/j.vaccine.2011.06.044.), a formalin-inactivated EV71 vaccine (Human Diploid cell, KMB-17 Cell) has been licensed by SFDA in China, Dec. 2010. The phase I clinical trial has been carried out, during four months, in Guangxi Province, China. The purpose of this study is to evaluate the safety, tolerability and immunogenicity of the formalin-inactivated EV71 vaccine in Chinese adults (from 18 to 49 years old), children (from 3 to 11 years old) and infants (from 6 to 35 months old).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
288
inactivated EV71 vaccine (KMB-17) of 160Eu/0.5ml in 12 adults aged 18-49 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 320Eu/0.5ml in 12 adults aged 18-49 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 640Eu/0.5ml in 12 adults aged 18-49 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 1280Eu/0.5ml (without adjuvant) in 12 adults aged 18-49 years old on day 0, 14.
0Eu/0.5ml placebo in 24 adults aged 18-49 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 160Eu/0.5ml in 12 children aged 3-11 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 320Eu/0.5ml in 12 children aged 3-11 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 640Eu/0.5ml in 12 children aged 3-11 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 1280Eu/0.5ml (without adjuvant) in 12 children aged 3-11 years old on day 0, 14.
0Eu/0.5ml placebo in 24 children aged 3-11 years old on day 0, 14.
inactivated EV71 vaccine (KMB-17) of 160Eu/0.5ml in 24 infants aged 6-35 months old on day 0, 28.
inactivated EV71 vaccine (KMB-17) of 320Eu/0.5ml in 24 infants aged 6-35 months old on day 0, 28.
inactivated EV71 vaccine (KMB-17) of 640Eu/0.5ml in 24 infants aged 6-35 months old on day 0, 28.
inactivated EV71 vaccine (KMB-17) of 1280Eu/0.5ml (without adjuvant) in 24 infants aged 6-35 months old on day 0, 28.
0Eu/0.5ml placebo in 48 infants aged 6-35 months old on day 0, 28.
Guangxi Provincial Center for Diseases Control and Prevention
Nanning, Guangxi, China
Evaluate the Safety of Inactivated EV 71 Vaccine (Human Diploid Cell, KMB-17) in Chinese Adults.
Adverse reactions associated with vaccine were observed in Chinese Adults (from 18 to 49 years old) after the first vaccination.
Time frame: within the first 14 days after the first vaccination
Evaluate the Safety of Inactivated EV 71 Vaccine (Human Diploid Cell, KMB-17) in Chinese Adults.
Adverse reactions associated with vaccine were observed in Chinese Adults (from 18 to 49 years old) after the second vaccination.
Time frame: within the first 4 days after the second vaccination
Evaluate the Safety of Inactivated EV 71 Vaccine (Human Diploid Cell, KMB-17) in Chinese Children.
Adverse reactions associated with vaccine were observed in Chinese Children (from 3 to 11 years old) after the first vaccination.
Time frame: within the first 14 days after the first vaccination
Evaluate the Safety of Inactivated EV 71 Vaccine (Human Diploid Cell, KMB-17) in Chinese Children.
Adverse reactions associated with vaccine were observed in Chinese Children (from 3 to 11 years old) after the second vaccination.
Time frame: within the first 4 days after the second vaccination
Evaluate the safety of Inactivated EV 71 Vaccine (Human Diploid Cell, KMB-17) in Chinese Infants.
Adverse reactions associated with vaccine were observed in Chinese Infants (from 6 to 35 months old) after the first vaccination.
Time frame: within the first 28 days after the first vaccination
Evaluate the safety of Inactivated EV 71 Vaccine (Human Diploid Cell, KMB-17) in Chinese Infants.
Adverse reactions associated with vaccine were observed in Chinese Infants (from 6 to 35 months old) after the second vaccination.
Time frame: within the first 28 days after the second vaccination
Evaluate the seroconversion rate of anti-EV71 antibodies in serum of adults, children and infant, after first vaccination.
The seroconversion rate of anti-EV71 antibodies was evaluated in serum of adults within the first 14 days after first vaccination. The seroconversion rate of anti-EV71 antibodies was evaluated in serum of children within the first 14 days after first vaccination. The seroconversion rate of anti-EV71 antibodies was evaluated in serum of infant, within the first 28 days after first vaccination.
Time frame: within the first 14 or 28 days after the first vaccination
Evaluate the seroconversion rate of anti-EV71 antibodies in serum of adults, children and infant, after second vaccination.
The seroconversion rate of anti-EV71 antibodies was evaluated in serum of adults within the first 4 days after second vaccination. The seroconversion rate of anti-EV71 antibodies was evaluated in serum of children within the first 4 days after second vaccination. The seroconversion rate of anti-EV71 antibodies was evaluated in serum of infant, within the first 28 days after second vaccination.
Time frame: within the first 4 or 28 days after the second vaccination
Evaluate the seroconversion rate of antinuclear antibodies in serum of adults, children and infant, after first vaccination.
The seroconversion rate of antinuclear antibodies was evaluated in serum of adults within the first 14 days after first vaccination. The seroconversion rate of antinuclear antibodies was evaluated in serum of children within the first 14 days after first vaccination. The seroconversion rate of antinuclear antibodies was evaluated in serum of infant, within the first 28 days after first vaccination.
Time frame: within the first 14 or 28 days after the first vaccination
Evaluate the seroconversion rate of antinuclear antibodies in serum of adults, children and infant, after second vaccination.
The seroconversion rate of antinuclear antibodies was evaluated in serum of adults within the first 4 days after the second vaccination. The seroconversion rate of antinuclear antibodies was evaluated in serum of children within the first 4 days after the second vaccination. The seroconversion rate of antinuclear antibodies was evaluated in serum of infant, within the first 28 days after the second vaccination.
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Time frame: within the first 4 or 28 days after the second vaccination
Evaluate the abnormity change of live and kidney function indexes in serum of adults, children and infant, after first vaccination.
The abnormity change of live and kidney function indexes were evaluated in serum of adults within the first 14 days after first vaccination. The abnormity change of live and kidney function indexes were evaluated in serum of children within the first 14 days after first vaccination. The abnormity change of live and kidney function indexes were evaluated in serum of infant, within the first 28 days after first vaccination.
Time frame: within the first 14 or 28 days after the first vaccination
Evaluate the abnormity change of live and kidney function indexes in serum of adults, children and infant, after second vaccination.
The abnormity change of live and kidney function indexes were evaluated in serum of adults within the first 4 days after the second vaccination. The abnormity change of live and kidney function indexes were evaluated in serum of children within the first 4 days after the second vaccination. The abnormity change of live and kidney function indexes were evaluated in serum of infant, within the first 28 days after the second vaccination.
Time frame: within the first 4 or 28 days after the second vaccination
Evaluate the vaccine-induced cellular immune responses in infant after first vaccination.
The vaccine-induced cellular immune responses were evaluated in serum of infant, within the first 28 days after the first vaccination.
Time frame: within the first 28 days after the first vaccination
Evaluate the vaccine-induced cellular immune responses in infant after second vaccination.
The vaccine-induced cellular immune responses were evaluated in serum of infant, within the first 28 days after the second vaccination.
Time frame: within the first 28 days after the second vaccination