This is a phase 1, research study is looking at the safety and acceptability of a new vaccine adjuvant (immune booster) called PAL when combined with the seasonal flu vaccine (Fluviral) to test the safety and effectiveness of new vaccines and medications on healthy volunteers. The study will enroll approximately 48 healthy adult participants, and occur over 3 years. In the first six months/180 days of the study participants will have visits to the study site during which safety and immunogenicity outcomes will be measured. From Day 181 to Year 3, participants will be contacted by telephone or email to collect information on any adverse events.
This is a phase 1, dose-ranging, randomized (5:1), observer-blind, controlled study of the safety and immune response to intramuscular injection of PapMV (Papaya Mosaic Virus) rVLP (Recombinant Virus-Like Particles) which is PAL adjuvant, or "PAL" combined with Trivalent Influenza Vaccines (TIV) at one of four dose levels of PAL, combined with one of two dose levels of TIV, or active control (TIV). The study will enroll approximately 48 healthy adult participants, and occur over 3 years. In the first six months/180 days (Epoch 1) of the study participants will have visits to the study site during which safety and immunogenicity outcomes will be measured. In Epoch 2 (Day 181 to Year 3) participants will be contacted by telephone or email to collect unsolicited adverse events. This is a controlled clinical trial. The control group will receive the standard dose of TIV, 0.5 mL, which consists of 15 μg haemagglutinin (HA) of each influenza strain recommended by the World Health Organization (WHO) for the 2013-2014 influenza season in the northern hemisphere. An active control is used so that the attributable risk of adverse events can be estimated, and so that outcome measures can be assessed in a blinded fashion. Only adults in stable health will be eligible in order to minimize participant risk. Only non-pregnant females of childbearing age are eligible, and they must agree to continue adequate contraception for 180 days after injection. Study holding rules and a safety evaluation by a Safety Review Committee (SRC) will be in place. The study will follow a staggered dose-escalation design, with each of four steps introducing a new dose of the adjuvant (30, 60, 120 and 240 μg respectively). The first dose level of PAL adjuvant FB-631 is 0.5 X 60 µg (i.e., 30 µg), which is half the dose that was found to be most immunogenic in animal studies. The adjuvant is co-administered with 0.25 mL of TIV, which is half the dose of TIV that is routinely administered to adults (i.e. 7.5 μg of each of the three influenza subtypes contained in the vaccine). The next dose level is 60µg of FB-631 combined with 0.25 mL TIV. The third dose level is 120 μg of FB-631 with 0.25 mL TIV. In the fourth and final step the dose of adjuvant is 240 μg of PAL adjuvant combined with 0.25 mL TIV (8 participants) or 0.125 mL TIV (i.e. 3.75 μg HA of each influenza subtype contained in the vaccine) (8 participants). Any safety signal observed in the study will lead to a hold until the decision of Safety Review Committee to continue, modify or suspend the conduct of the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
48
Canadian Center for Vaccinology
Halifax, Nova Scotia, Canada
Safety
The occurrence of adverse events from injection to Day 1095 (36 months/three years, in all participants, in all groups:
Time frame: 3 years
Immunogenicity
Evaluate the immunogenicity of influenza antigens contained in TIV when combined with PAL adjuvant as measured by haemagglutination inhibition (HAI) titres, pre-injection (Day 0) and post-injection (Days 28, 120 and 180).
Time frame: 6 months
Immunogenicity of TIV combined with PAL
Immunogenicity of the influenza antigens contained in TIV when combined with PAL adjuvant as measured by IgG and IgG1 antibody directed to influenza A viral nucleoproteins on Days 0, 28, 120 and 180.
Time frame: 6 months
Immune responses
Describe cellular immune responses to the investigational products as assessed by antigen-secreted interferon-gamma secretion, and interferon-gamma to IL-10 ratio, pre-injection (Day 0) and post-injection (Day 28, Day 120 and Day 180).
Time frame: 6 months
Induced immune responses
Describe immune responses induced by PAL adjuvant combined with TIV as measured by Granzyme B levels in Peripheral Blood Mononuclear Cells (PBMC), pre-injection (Day 0) and post-injection (Day 28, Day 120 and Day 180).
Time frame: 6 months
Solicited and General Adverse Events
The occurrence of each solicited local and general AE (adverse event), during a 7-day follow-up period after injection (i.e. the day of injection and 6 subsequent days).
Time frame: up to 6 months
Hematological laboratory values
The occurrence of any hematological (hemoglobin level, WBC (white blood cells), lymphocyte, neutrophil, eosinophil and platelet count) and biochemical (ALT, AST(angiotensin sensitivity test) and creatinine) laboratory abnormality at Day 0 and at Day 7.
Time frame: up to 6 months
Unsolicited Adverse Events
The occurrence of any unsolicited AE, during a 28-day follow-up period after injection (i.e. the day of injection and 27 subsequent days), and through to Day 1095. The occurrence of any SAE through to Day 1095.
Time frame: 3 years
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