The hemorrhagic fever resulting from Ebola infection is frequently fatal; the current Ebola outbreak, still in its ascendant phase, has a mortality rate over 50%. There is no proven therapy or prevention available at this time. The vaccine candidate VSV-ZEBOV (BPSC1001) has shown promising safety and efficacy in preventing Ebola Zaire infections in non-human primates (NHP). Before it can be assessed in large Phase IIb/3 trials in affected areas, safety data from phase 1 first-in-human trials are needed. To accelerate this process, the World Health Organization (WHO) has constituted a consortium of Clinical Research Centers in Switzerland, Germany, and Africa that will use similar protocols to collectively include roughly 250 volunteers, the sample size required to identify a 2-fold difference in anti-ZEBOV IgG antibody titers following immunization with 2 different doses of BPSC1001. The joint primary objectives of this single-center, double-blind, randomized placebo-controlled phase 1 dose-finding study are to assess the safety and tolerability of the VSV-ZEBOV vaccine when administered to healthy volunteers at a lower or higher vaccine dose and to define whether seroresponses differ significantly following immunization with the lower or higher vaccine dose.
This single-center, double-blind, randomized placebo-controlled phase 1 dose-finding study will have two randomization schemes. Volunteers who could later be exposed to Ebolavirus while working in epidemic areas ("deployable subjects") will be randomized to receive one of two vaccine doses. Non-deployable volunteers, with no identified risk of Ebola exposure in the near term, will be allocated to one of three groups and receive the lower or higher vaccine dose, or a placebo. A single immunization will be performed. All subjects will be observed in the clinical trials unit (CTU) for 1.5 hours after vaccine/placebo injection. Subjects will complete post-injection diaries for 7 days after injection, as well as post-injection follow-up visits (see below). On-site visits at the CTU will occur on days -90 to -1, 0, 1, 3, 7, 14, 28, 84, 168. Some subjects with a positive serologic response at 24 weeks may be requested to return for immune durability testing at 12 months. One or more interim analyses will be undertaken to guide decisions on 1) the potential use of the vaccine in Ph2/3 trials in affected countries and 2) potential modification of the trial(s) through an amendment to evaluate a higher dose, if immunogenicity is poor, or a lower dose if the dosage levels selected are not safe and reasonably well tolerated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
115
See arm/group descriptions.
University Hospitals of Geneva
Geneva, Switzerland
Titers of ZEBOV-specific IgG Antibodies
Primary immunogenicity outcome (required for dose selection)
Time frame: Day 0 - 28
Number of Participants With Solicited Local and Systemic Reactogenicity Signs and Symptoms
Number of participants with solicited local and systemic reactogenicity signs and symptoms. Day 0 is the day of the study intervention.
Time frame: Days 0 - 14
Number of Participants With Unsolicited Adverse Events
Number of participants with unsolicited adverse events in the 28 days following injection
Time frame: Days 0 - 28
Number of Participants With a Serious Adverse Event (SAE)
Number of participants with a serious adverse event (SAE) in the 365 days (1 year) following injection.
Time frame: Days 0 - 365
Magnitude (Copies/ml) of VSVΔG-ZEBOV Viremia
Magnitude (copies/ml) of VSVΔG-ZEBOV viremia as expressed by median VSV RNA concentrations after vaccination.
Time frame: Days 1, 3 and 7
Persistence of Titers of ZEBOV-specific IgG Antibodies
The percentage of participants maintaining positive ZEBOV-specific IgG antibody titers at 168 days after vaccination.
Time frame: Day 168
Titers of Neutralizing ZEBOV-specific IgG Antibodies
Geometric mean titers of neutralizing ZEBOV-specific IgG antibodies.
Time frame: Days 0, 28 and 168
Duration of VSVΔG-ZEBOV Viremia
Percentage of participants with any detectable viremia on days 1, 3 and 7
Time frame: Days 1, 3 and 7
Number of Participants in Whom Shedding of VSVΔG-ZEBOV Was Detected in Urine and/or Saliva.
This outcome was evaluated in a subset of vaccinees.
Time frame: Days 1, 3 and 7
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