H7N9 viruses have caused a recent outbreak of severe illness in humans in China. The purpose of this study is to evaluate the safety and immune response of an H7N9 A/Anhui/13 ca influenza virus vaccine followed by an inactivated subvirion H7N9 vaccine at varying intervals.
H7N9 avian influenza (AI) viruses have been responsible for a recent outbreak of illness in humans in China, which was associated with severe respiratory illnesses resulting in acute respiratory distress syndrome (ARDS) and intensive care unit (ICU) admissions. The purpose of this study is to evaluate the safety, infectivity, and immunogenicity of a live attenuated H7N9 A/Anhui/13 cold adapted (ca) influenza virus vaccine followed by a boost with an inactivated subvirion H7N9 vaccine at varying intervals. This study will enroll participants into five cohorts. Participants in Cohorts 1, 2, 3, and 4 will be admitted to an isolation unit on Study Day -2. On Study Day 0, participants will receive one dose of the H7N9 A/Anhui/13 ca influenza virus vaccine via a nose spray device. While in the isolation unit, participants will undergo a physical examination and nasal wash each day, and a blood collection on select days. Participants will remain in the isolation unit for at least 9 days after receiving the vaccine, but possibly longer, depending on their test results. Participants in Cohorts 1 and 2 will return to the isolation unit 4 to 8 weeks after receiving the first vaccine (at approximately Day 28). They will receive the second dose of the H7N9 A/Anhui/13 ca influenza virus vaccine and repeat all of the same procedures that occurred after the first vaccination. Participants will then receive one dose of the inactivated subvirion H7N9 vaccine 1 month (Cohort 1) or 2 months (Cohort 2) after receiving the second vaccine. Participants in Cohorts 3 and 4 will receive the inactivated subvirion H7N9 vaccine either 1 month (Cohort 4) or 2 months (Cohort 3) after receiving one dose of the live attenuated vaccine. For Cohorts 1-4, participants study visits will occur 7, 14, 28, and 90 days after receiving the vaccine and will include a medical history review, physical examination, and blood collection at select visits. Participants in Cohort 5 will receive one dose of the inactivated subvirion H7N9 vaccine at Day 0 and one dose at Day 28. Study visits will occur on Days 0, 7, 28, 35, 42, 56, and 118, and will include blood collections and physical examinations. Participants in Cohort 5 will not be admitted to the isolation unit.
Study Type
INTERVENTIONAL
Allocation
Participants will receive approximately 10\^7.0 fluorescent focus units (FFU) of the vaccine; the vaccine will be administered with a nose spray device.
Participants will receive a dose of 30 mcg of the vaccine; the vaccine will be administered as an injection.
Johns Hopkins Bayview Medical Center
Baltimore, Maryland, United States
Measurement of the ability of the pLAIV vaccine to induce priming by assessing the response to a subsequent dose of pIIV
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
Measurement of the optimal interval between the priming with pLAIV and the subsequent boost with pIIV
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
Determination of whether 1 dose or 2 doses of pLAIV followed by a pIIV boost is sufficient to induce an optimal immune response
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
Frequency of vaccine-related reactogenicity events (REs) for 2 doses of pLAIV vaccine followed by a single dose of inactivated pIIV and compare to 2 doses of pIIV alone
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
Frequency of other adverse events (AEs) for 2 doses of pLAIV vaccine followed by a single dose of inactivated pIIV and compare to 2 doses of pIIV alone
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
Number of vaccinees infected with the H7N9 Anhui 2013/AA ca recombinant vaccine candidate
Infection is defined as recovery of vaccine virus from nasal wash, detection of virus in nasal wash by rRT-PCR, and/or a greater than or equal to 4-fold rise in antibody titer.
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
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NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
100
Measurement of the amount of vaccine virus shed by each recipient
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
Measurement of amount of serum and nasal wash antibody induced by the vaccine
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)
Capacity of the H7N9 Anhui 2013/AA ca recombinant vaccine candidate to elicit HAI and neutralizing antibodies to future H7 influenza viruses
Includes the development of a serum bank
Time frame: Measured through participants' last study visit: 90 days after receiving the last vaccine (Cohorts 1-4) or Day 118 (Cohort 5)