A phase I prospective, randomized study in healthy adult subjects at a single center. Adult subjects age 18 to 47 years and meeting all enrollment criteria will choose to participate as subjects who receive inactivated vaccine followed by a live vaccine boost at 4 weeks (Group 1), 12 weeks (Group 2), or 24 weeks (Group 3), or to be in an observational group (Group 4) which will not be scheduled for a booster dose but may serve as a roll-over group for subjects who withdraw prior to the second vaccination but agree to remain in follow-up. A fifth group will receive two intramuscular doses of adjuvanted H7N9 pIIV separated by four weeks. The primary objectives of this study are to (1) assess the safety of H7N9 pLAIV administered to individuals who have previously received MF59-adjuvanted or unadjuvanted H7N9 pIIV, (2) evaluate the ability of a single dose of unadjuvanted H7N9 pIIV to prime for enhanced immunogenicity (booster response) to subsequent administration of antigenically-matched H7N9 pLAIV vaccine, and to (3) evaluate the ability of a single dose of MF59-adjuvanted H7N9 pIIV to prime for enhanced immunogenicity (booster response) to subsequent administration of antigenically-matched H7N9 pLAIV vaccine.
The study will be conducted as a Phase I prospective, randomized study in healthy adult subjects at a single center. Adult subjects age 18 to 47 years and meeting all enrollment criteria will choose to participate as subjects who receive unadjuvanted or adjuvanted H7H9 pIIV vaccine followed by a live vaccine boost at 4 weeks (Group 1, n=24), 12 weeks (Group 2, n=24), or 24 weeks (Group 3, n=24), or to be in an observational group (Group 4, n=16) which will not be scheduled for a booster dose but may serve as a roll-over group for subjects who withdraw prior to the second vaccination but agree to remain in follow-up. Within each group, subjects will be randomized at a 1:1 ratio to receive a single dose of either unadjuvanted H7N9 pIIV at 15 mcg (Subgroup A), or the same vaccine adjuvanted with the oil-in-water emulsion, MF59, (Subgroup B) delivered intramuscularly. Finally, a fifth group (Group 5, n=12) will receive two intramuscular doses of adjuvanted H7N9 pIIV separated by four weeks. The total duration of study participation for all subjects will be approximately 13 months. Recruitment, enrollment and administration of study product will be suspended when one of the following occurs in the clinical or research laboratory at the clinical site: at least two respiratory cultures or PCR assays are determined to be positive for influenza or at least 10% diagnostic tests (rapid tests, respiratory cultures or PCR assays) performed for influenza as positive during two consecutive weeks in the clinical or research laboratory at the clinical site. Recruitment, enrollment and administration of study product may be resumed after 2 weeks without a signal that influenza is still circulating in the community, as defined by the same measures that indicate the start of influenza season (i.e., less than 2 respiratory cultures or PCR assays are determined to positive for influenza or less than 10% of diagnostic tests performed or influenza with positive results). The primary objectives of this study are to (1) assess the safety of H7N9 pLAIV administered to individuals who have previously received MF59-adjuvanted or unadjuvanted H7N9 pIIV, (2) evaluate the ability of a single dose of unadjuvanted H7N9 pIIV to prime for enhanced immunogenicity (booster response) to subsequent administration of antigenically-matched H7N9 pLAIV vaccine, and to (3) evaluate the ability of a single dose of MF59-adjuvanted H7N9 pIIV to prime for enhanced immunogenicity (booster response) to subsequent administration of antigenically-matched H7N9 pLAIV vaccine. The secondary objectives of this study are to (1) assess the safety of priming with MF59-adjuvanted H7N9 pIIV or unadjuvanted H7N9 pIIV, (2) assess the immune response in subjects vaccinated with a single dose of MF59-adjuvanted H7N9 pIIV or a single dose of unadjuvanted H7N9 pIIV, and to (3) compare the booster effect seen after intervals of 4 weeks, 12 weeks, or 24 weeks within each priming group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
62
MedImmune supplies pLAIV vaccines as a colorless to pale yellow and clear to slightly cloudy suspension in single, unit-dose, Becton-Dickinson Accuspray™ Nasal Spray Systems sprayer devices. Each filled sprayer device contains a 0.5 mL dose of 10\^7FFU of H7N9 Anhui 2013/AA ca vaccine. Group I receives the IN dose on Day 29, Group 2 on Day 85, and Group 3 on Day 169.
Sanofi supplies the monovalent influenza A/H7N9 virus vaccine as a sterile, clear, and slightly opalescent suspension in single-dose vials containing 15 mcg HA per 0.5 mL. Group 1 through Group5 will receive the IM vaccine on Day 1
Novartis supplies the MF59 adjuvant as an oil-in-water milky emulsion in single-use vials containing a fill volume of 0.7 mL. Group 1 through Group 5 will receive MF59 IM on Day 1.
University of Rochester Medical Center - Vaccine Research Unit
Rochester, New York, United States
Geometric mean titers determined by neuraminidase inhibiting antibody by enzyme-linked lectin assay (ELLA)
Time frame: Day 29
Geometric mean titers determined by neuraminidase inhibiting antibody by enzyme-linked lectin assay (ELLA) for Group 2
Time frame: Day 113
Geometric mean titers determined by neuraminidase inhibiting antibody by enzyme-linked lectin assay (ELLA) for Group 3
Time frame: Day 197
Geometric mean titers determined by neuraminidase inhibiting antibody by enzyme-linked lectin assay (ELLA) for Groups 1, 5
Time frame: Day 57
Occurrence of respiratory reactogenicity following pLAIV vaccination for Group 1
Time frame: Day 29 through Day 39
Occurrence of respiratory reactogenicity following pLAIV vaccination for Group 2
Time frame: Day 85 through Day 95
Occurrence of respiratory reactogenicity following pLAIV vaccination for Group 3
Time frame: Day 169 through Day 179
Occurrence of solicited systemic reactogenicity following pLAIV vaccination for Group 1
Time frame: Day 29 through Day 39
Occurrence of solicited systemic reactogenicity following pLAIV vaccination for Group 2
Time frame: Day 85 through Day 95
Occurrence of solicited systemic reactogenicity following pLAIV vaccination for Group 3
Time frame: Day 169 through Day 179
Occurrence of study vaccine-related serious adverse events following pLAIV vaccination for Group 1
Time frame: Day 29 through Day 209
Occurrence of study vaccine-related serious adverse events following pLAIV vaccination for Group 2
Time frame: Day 85 through Day 265
Occurrence of study vaccine-related serious adverse events following pLAIV vaccination for Group 3
Time frame: Day 169 through Day 349
Occurrence of study vaccine-related unsolicited non-serious adverse events following pLAIV vaccination for Group 1
Time frame: Day 29 through Day 57
Occurrence of study vaccine-related unsolicited non-serious adverse events following pLAIV vaccination for Group 2
Time frame: Day 85 through 113
Occurrence of study vaccine-related unsolicited non-serious adverse events following pLAIV vaccination for Group 3
Time frame: Day 169 through 197
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 2
Time frame: Day 113
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 3
Time frame: Day 197
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Groups 1, 5
Time frame: Day 57
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum four-fold rise in post-vaccination HAI antibody titer) for Group 2
Time frame: Day 113
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum four-fold rise in post-vaccination HAI antibody titer) for Group 3
Time frame: Day 197
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum four-fold rise in post-vaccination HAI antibody titer) for Groups 1,5
Time frame: Day 57
Percentage of subjects shedding vaccine virus as detected by rRT-PCR following pLAIV vaccination for Group 1
Time frame: Day 29 through Day 36
Percentage of subjects shedding vaccine virus as detected by rRT-PCR following pLAIV vaccination for Group 2
Time frame: Day 85 through Day 92
Percentage of subjects shedding vaccine virus as detected by rRT-PCR following pLAIV vaccination for Group 3
Time frame: Day 169 through Day 176
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells
Time frame: Day 29
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Group 2
Time frame: Day 113
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Group 2
Time frame: Day 141
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Group 2
Time frame: Day 265
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Group 3
Time frame: Day 197
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Group 3
Time frame: Day 225
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Group 3
Time frame: Day 349
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Groups 1, 5
Time frame: Day 209
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Groups 1, 5
Time frame: Day 57
Percentage of subjects with positive B cell responses by plasmablast assays on peripheral blood mononuclear cells for Groups 1, 5
Time frame: Day 85
Geometric mean titers of serum HAI antibody
Time frame: Day 1
Geometric mean titers of serum HAI antibody
Time frame: Day 29
Geometric mean titers of serum HAI antibody for Group 2
Time frame: Day 113
Geometric mean titers of serum HAI antibody for Group 2
Time frame: Day 141
Geometric mean titers of serum HAI antibody for Group 2
Time frame: Day 265
Geometric mean titers of serum HAI antibody for Group 3
Time frame: Day 197
Geometric mean titers of serum HAI antibody for Group 3
Time frame: Day 225
Geometric mean titers of serum HAI antibody for Group 3
Time frame: Day 349
Geometric mean titers of serum HAI antibody for Groups 1, 5
Time frame: Day 209
Geometric mean titers of serum HAI antibody for Groups 1, 5
Time frame: Day 57
Geometric mean titers of serum HAI antibody for Groups 1, 5
Time frame: Day 85
Geometric mean titers of serum NtAb antibody
Time frame: Day 1
Geometric mean titers of serum NtAb antibody
Time frame: Day 29
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Geometric mean titers of serum NtAb antibody for Group 2
Time frame: Day 113
Geometric mean titers of serum NtAb antibody for Group 2
Time frame: Day 141
Geometric mean titers of serum NtAb antibody for Group 2
Time frame: Day 265
Geometric mean titers of serum NtAb antibody for Group 3
Time frame: Day 197
Geometric mean titers of serum NtAb antibody for Group 3
Time frame: Day 225
Geometric mean titers of serum NtAb antibody for Group 3
Time frame: Day 349
Geometric mean titers of serum NtAb antibody for Groups 1, 5
Time frame: Day 209
Geometric mean titers of serum NtAb antibody for Groups 1, 5
Time frame: Day 57
Geometric mean titers of serum NtAb antibody for Groups 1, 5
Time frame: Day 85
Occurrence of adverse events of special interest following pIIV vaccination
Time frame: Day 1 through Day 366
Occurrence of adverse events of special interest following pIIV vaccination for Group 5
Time frame: Day 1 through Day 394
Occurrence of local reactogenicity following pIIV vaccination
Time frame: Day 1 through Day 8
Occurrence of local reactogenicity following pIIV vaccination for Group 5
Time frame: Day 29 through Day 36
Occurrence of new-onset chronic medical conditions for Group 2
Time frame: Day 1 through Day 265
Occurrence of new-onset chronic medical conditions for Group 3
Time frame: Day 1 through Day 349
Occurrence of new-onset chronic medical conditions for Group 4
Time frame: Day 1 through Day 181
Occurrence of new-onset chronic medical conditions for Groups 1, 5
Time frame: Day 1 through Day 209
Occurrence of study vaccine-related serious adverse events following pIIV vaccination
Time frame: Day 1 through Day 366
Occurrence of study vaccine-related serious adverse events following pIIV vaccination for Group 5
Time frame: Day 29 through Day 394
Occurrence of study vaccine-related unsolicited non-serious adverse events following pIIV vaccination
Time frame: Day 29
Occurrence of study vaccine-related unsolicited non-serious adverse events following pIIV vaccination for Group 5
Time frame: Day 57
Occurrence of systemic reactogenicity following pIIV vaccination
Time frame: Day 1 through Day 8
Occurrence of systemic reactogenicity following pIIV vaccination for Group 5
Time frame: Day 29 through Day 36
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine
Time frame: Day 1
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine
Time frame: Day 29
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine for Group 1, 5
Time frame: Day 209
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine for Group 1, 5
Time frame: Day 85
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine for Group 2
Time frame: Day 141
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine for Group 2
Time frame: Day 265
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine for Group 3
Time frame: Day 225
Percentage of subjects achieving a serum HAI antibody titer of 1:40 or greater against the H7N9 antigen contained in the study vaccine for Group 3
Time frame: Day 349
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines
Time frame: Day 1
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines
Time frame: Day 29
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 2
Time frame: Day 113
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 2
Time frame: Day 141
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 2
Time frame: Day 265
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 3
Time frame: Day 197
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 3
Time frame: Day 225
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Group 3
Time frame: Day 349
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Groups 1, 5
Time frame: Day 209
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Groups 1, 5
Time frame: Day 57
Percentage of subjects achieving a serum NtAb titer of 1:40 or greater against the H7N9 antigen contained in the study vaccines for Groups 1, 5
Time frame: Day 85
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum 4-fold rise in post-vaccination HAI antibody titer)
Time frame: Day 29
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum 4-fold rise in post-vaccination HAI antibody titer) for Group 2
Time frame: Day 141
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum 4-fold rise in post-vaccination HAI antibody titer) for Group 2
Time frame: Day 265
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum 4-fold rise in post-vaccination HAI antibody titer) for Group 3
Time frame: Day 225
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum 4-fold rise in post-vaccination HAI antibody titer) for Group 3
Time frame: Day 349
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum 4-fold rise in post-vaccination HAI antibody titer) for Groups 1, 5
Time frame: Day 209
Percentage of subjects achieving seroconversion (a pre-vaccination HAI titer <1:10 and a post-vaccination HAI titer = / > 1:40 or a pre-vaccination HAI titer = / > 1:10 and a minimum 4-fold rise in post-vaccination HAI antibody titer) for Groups 1, 5
Time frame: Day 85
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer)
Time frame: Day 29
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Group 2
Time frame: Day 113
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Group 2
Time frame: Day 141
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Group 2
Time frame: Day 265
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Group 3
Time frame: Day 197
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Group 3
Time frame: Day 225
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Group 3
Time frame: Day 349
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Groups 1, 5
Time frame: Day 209
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Groups 1, 5
Time frame: Day 57
Percentage of subjects achieving seroconversion (a pre-vaccination NtAb titer <1:10 and a post-vaccination NtAb titer = / > 1:40 or a pre-vaccination NtAb titer = / > 1:10 and a minimum 4-fold rise in post-vaccination NtAb titer) for Groups 1, 5
Time frame: Day 85