This is a phase 1, randomized regimen optimization study of PfSPZ Vaccine in healthy Equatoguinean volunteers to determine if a condensed, rapid immunization regimen is safe and efficacious. Four different regimens 4 weeks or less in duration will be evaluated for safety, tolerability, immunogenicity, and protective efficacy in comparison to a gold standard 16-week regimen.
This double-blind, placebo-controlled clinical trial will be conducted in 104 Equatoguinean healthy men and women 18-45 years of age divided into four groups of 26 subjects receiving one of four dosing regimens. The study is designed to test the hypothesis that 2 or 4 doses of 9x10\^5 PfSPZ of PfSPZ Vaccine administered by direct venous inoculation (DVI) over 6-7 days as the priming immunization, with or without a boosting immunization at 4 or 16 weeks after the last priming dose, will (1) be safe and well tolerated; and (2) induce immunity leading to protection against homologous controlled human malaria infection (CHMI) performed at 8 weeks after the final immunization by DVI injection of PfSPZ Challenge. The first regimen will test the radiation-attenuated whole sporozoite PfSPZ Vaccine in a dose of 9.0x10\^5 administered by DVI with four priming immunizations followed by a boost after 16 weeks. The second regimen will follow the same dosing and administering schedule, but without the boost after 16 weeks to study if a boost may be necessary. The third regimen will follow the first regimen with the interval duration to the boost shortened to only 4 weeks. In the fourth and final regimen, the vaccine will be administered two times instead of four followed by a boost in 4 weeks to evaluate if two priming immunizations will be sufficient to confer protection. In summary: * Group 1: 21 subjects will receive 9.0x10\^5 PfPSZ and 5 subjects will receive normal saline (NS) placebo on Days 1, 3, 5, 7, and 113. * Group 2: 21 subjects will receive 9.0x10\^5 PfPSZ and 5 subjects will receive NS on Days 1, 3, 5, and 7. * Group 3: 21 subjects will receive 9.0x10\^5 PfPSZ and 5 subjects will receive NS on Days 1, 3, 5, 7, and 29. * Group 4: 21 subjects will receive 9.0x10\^5 PfPSZ and 5 subjects will receive NS on Days 1 and 8. The safety and tolerability of each regimen will be measured by recording (1) solicited and unsolicited adverse events, (2) immunogenicity by assessing humoral and cellular immune responses pre- and post-vaccination, and (3) vaccine efficacy (VE) by measuring protection against homologous CHMI administered by DVI of PfSPZ Challenge (NF54) at 8 weeks post-final vaccination.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
104
Metabolically active, non-replicating, radiation attenuated, aseptic, purified, cryopreserved NF54 P. falciparum (Pf) sporozoites (PfSPZ Vaccine)
Normal saline is 0.9% sodium chloride
Live, infectious, aseptic, purified, vialed, cryopreserved, Plasmodium falciparum sporozoites, strain NF54
Baney Clinical Research Center
Santiago de Baney, Bioko Island, Equatorial Guinea
Incidence and type of Adverse Events (AEs)
1. Occurrence of solicited local AEs during priming vaccination and a 3-day surveillance period after priming and boost vaccinations. 2. Occurrence of solicited systemic AEs during priming vaccination and a 7-day surveillance period after priming and boost vaccinations. 3. Occurrence of unsolicited AEs during priming vaccination and a 14-day surveillance period after priming and boost vaccinations. 4. Occurrence of serious adverse events (SAEs) during the study.
Time frame: Day of first immunization until 1 year
Proportion of volunteers who become parasitemic will be recorded, detected by thick blood smear microscopy (TBS) and/ or quantitative real time polymerase chain reaction (qPCR)
1. Development of Pf parasitemia by TBS following CHMI 2. Development of Pf parasitemia by qPCR following CHM
Time frame: Post first immunization uptil 56 days post-CHMI
Level of Antibodies against Pf proteins in volunteer sera
1. Antibody titres to pre-erythrocytic stage and erythrocytic stage antigens\[PfCSP, PfLSA-1, PfEBA-175 , PfMSP-1, PfMSP-5, EXP-1\] by ELISA 2. Antibody titres to Pf sporozoites, asexual and sexual erythrocytic stage parasites by IFA. 3. Analysis of antibodies to proteins in the Pf proteome array chip.
Time frame: Post first immunization uptil 56 days post-CHMI
Inhibitory Capacity of Volunteer Sera against in vitro Sporozoite Invasion of Hepatocytes
Capacity of sera from immunized volunteers to inhibit sporozoite invasion (ISI) of hepatocytes in vitro by ISI assay
Time frame: Post first immunization uptil 56 days post-CHMI
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