Solid Organ Transplant SHINGRIX

Emory University2 enrolled

Overview

This study will assess the immune responses to the recombinant, AS01-adjuvanted varicella zoster virus subunit (HZ/su) vaccine or SHINGRIX in immunosuppressed patients, particularly those who have received a renal transplant, and aim to better understand if the vaccine and perhaps other adjuvanted vaccines are safe in these patients. 30 participants will be divided into 2 groups, one group will receive the 1st out of 2 doses of the vaccine 3-6 months after transplant per standard of care and the second group will receive the 1st out of 2 doses of the vaccine 12-36 months after the transplant per standard of care.The duration of the study is 180 days.

Shingles is a viral illness caused by the same virus that causes the chicken pox. Reactivation of this virus leads to shingles which is a painful blistering rash. Around 10% of organ transplant patients get shingles. This study will help us assess the safety and efficacy of a new shingles vaccine, SHINGRIX in Kidney Transplant patients. SHINGRIX is FDA approved for the prevention of shingles. In this study, participants will be divided into 2 groups, one group will receive the 1st out of 2 doses of the vaccine 3-6 months after transplant per standard of care and the second group will receive the 1st out of 2 doses of the vaccine 12-36 months after the transplant per standard of care. This research is conducted at the Emory University Hospital and Emory Clinics. Additionally follow up visits might also be conducted at the Emory Hope Clinic, the clinical arm of the Emory Vaccine Center. Subjects will be identified through review of medical records or by referral from their healthcare providers. Subjects may also self-refer from the IRB approved recruitment flyers. Following identification/referral, a coordinator or recruiter will contact the subject and tell them about the study and see if he/she is interested. If the potential subject is interested, the recruiter will obtain an oral consent and prescreen them for the study using a screening checklist. Qualified subjects will be scheduled to come into the clinic and be fully consented and proceed with screening/enrollment. Blood specimens will be collected and stored for the research study and for future use. Subjects can opt to have their information stored in a Hope Clinic database in order to contact them for other studies they may qualify for in the future. There are no other optional studies planned at this time.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Kidney Transplant; Complications

Interventions

SHINGRIXBIOLOGICAL

A single intramuscular injection of the FDA-approved recombinant glycoprotein E herpes zoster (HZ/su) vaccine will be administered in the deltoid muscle of the preferred arm

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Capable of informed consent and provision of written informed consent before any study procedures. 2. Capable of attending study visits according to the study schedule 3. Males or females greater than or equal to 50 years of age. 4. Oral temperature less than 38 C. 5. Are in general good health, as determined by medical history and targeted physical exam related to this history 6. Recent renal transplant (either 3-6 months or 12-36 months prior) 7. Have received maintenance immunosuppressive therapy for prevention of allograft rejection for a minimum of 30 days prior to the first vaccination 8. Have received an ABO compatible allogeneic renal transplant 9. Male subjects should agree not to contribute to conception of a child, including sperm donation, for the duration of the study. Exclusion Criteria: 1. Have received any transplant in addition to renal transplant 2. Have an acute illness within 72 hours prior to vaccination 3. Have a severe medical condition as determined by the investigators 4. Have kidney disease related to any known immune/autoimmune phenomena including, but not limited to: systemic lupus erythematosus, glomerulonephritis (post-streptococcal, Goodpasture syndrome, granulomatosis with polyangitis, polyarteritis nodosa, etc.). 5. Be on systemic immunosuppressive agents aside from those related to their renal transplant 6. Have known HIV or primary immune deficiency 7. Have a known potential immune-mediated disorder (pIMD) 8. Have planned receipt of any unlicensed or investigational medications, biologics, or vaccines for the duration of subject study participation 9. Have a history of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine 10. Have donated blood or blood products within 56 days before study vaccination and for the duration of the study 11. Have received the Shingrix or Zostavax injection previously 12. Have had Shingles in the past 13. Be of child-bearing potential 14. Have known recent exposure to wild-type varicella in the past 4 weeks 15. Have a history of severe reactions following other vaccinations

Locations (4)

Hope Clinic

Atlanta, Georgia, United States

Emory University Hospital Clinical Research Network

Atlanta, Georgia, United States

Emory Clinic

Atlanta, Georgia, United States

Emory University Hospital

Atlanta, Georgia, United States

Outcomes

Primary Outcomes

Change in levels of Anti-gE antibody concentrations

Anti-gE antibody concentrations will be obtained via enzyme-linked immunosorbent assay (ELISA)

Time frame: Day 1, Day 61, Day 180

Change in number of subjects with a vaccine response for anti-gE antibody

Vaccine response is defined as: * For initially seronegative subjects, antibody concentration at post-vaccination greater than or equal to (≥) 4 fold the cut-off for Anti-gE (4x97 milli-international units per milliliter \[mIU/ml\]) * For initially seropositive subjects (defined as ≥ 97 mIU/ml), antibody concentration at post-vaccination ≥ 4 fold the pre-vaccination antibody concentration.

Time frame: Day 61, Day 180

Secondary Outcomes

Number of subjects with any related severe adverse events (SAEs)

Number of participants with SAEs from first vaccination until the end of the trial

Time frame: Day 180

Number of subjects with any grade 3 related adverse events (AEs)

Number of subjects with any grade 3 related AEs from each vaccination and until 15 days after each vaccination

Time frame: Day 91

Number of subjects with renal allograft rejection

Number of subjects with renal allograft rejection from first vaccination until the end of the trial

Time frame: Day 180

Number of subjects with changes in allograft function

Number of subjects with changes in allograft function from first vaccination until the end of the trial. Allograft function will be defined as increase in serum creatinine levels (≥ 1.25, ≥ 1.50, ≥ 1.75 or ≥ 2 fold increase)

Time frame: Day 180

Data from ClinicalTrials.gov

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