This randomized, double-blinded, placebo-controlled Phase 3 study is designed to evaluate the efficacy and safety of maternal immunization with RSVpreF against medically attended lower respiratory tract illness (MA-LRTI) in infants.
This is a Phase 3, multicenter, randomized, double-blinded, placebo-controlled study to assess the efficacy, safety, and immunogenicity of RSVpreF or placebo (1:1 randomization) in infants born to healthy women vaccinated during pregnancy, as well as the safety and immunogenicity in the pregnant women. This will be a global study which will span multiple RSV seasons.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
14,727
Percentage of Infant Participants With Medically Attended Lower Respiratory Tract Illness (MA-LRTI) Cases Due to RSV Occurring Within 90 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. MA-LRTI case: infant with an MA-RTI visit with age related fast breathing (respiratory rate \[RR\] more than or equal to \[\>=\] 60 breaths per minute \[bpm\] for less than \[\<\] 2 months of age \[\<60 days of age\], \>=50 bpm for \>=2 months to \<12 months of age, or \>=40 bpm for \>=12 months to 24 months of age) or oxygen saturation (SpO2) \<95 percent (%) or chest wall indrawing and RSV positive test results by reverse transcription-polymerase chain reaction (RT-PCR) testing of midturbinate nasal swab samples.
Time frame: Within 90 days after birth
Percentage of Infant Participants With MA-LRTI Cases Due to RSV Occurring Within 120 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. MA-LRTI case: Infant with an MA-RTI visit with age related fast breathing (RR \>=60 bpm for \<2 months of age \[\<60 days of age\], \>=50 bpm for \>=2 months to \<12 months of age, or \>=40 bpm for \>=12 months to 24 months of age) or SpO2 \<95% or chest wall indrawing and RSV positive test results by RT-PCR testing of midturbinate nasal swab samples.
Time frame: Within 120 days after birth
Percentage of Infant Participants With MA-LRTI Cases Due to RSV Occurring Within 150 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. MA-LRTI case: Infant with an MA-RTI visit with age related fast breathing (RR \>=60 bpm for \<2 months of age \[\<60 days of age\], \>=50 bpm for \>=2 months to \<12 months of age, or \>=40 bpm for \>=12 months to 24 months of age) or SpO2 \<95% or chest wall indrawing and RSV positive test results by RT-PCR testing of midturbinate nasal swab samples.
Time frame: Within 150 days after birth
Percentage of Infant Participants With MA-LRTI Cases Due to RSV Occurring Within 180 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. MA-LRTI case: Infant with an MA-RTI visit with age related fast breathing (RR \>=60 bpm for \<2 months of age \[\<60 days of age\], \>=50 bpm for \>=2 months to \<12 months of age, or \>=40 bpm for \>=12 months to 24 months of age) or SpO2 \<95% or chest wall indrawing and RSV positive test results by RT-PCR testing of midturbinate nasal swab samples.
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Central Research Associates, Inc.
Birmingham, Alabama, United States
Endocrinology and Internal Medicine Associates, PC
Birmingham, Alabama, United States
OB/GYN Associates of Alabama, PC
Birmingham, Alabama, United States
Sharp and Stone OB/GYN PC
Birmingham, Alabama, United States
St Vincent's Hospital
Birmingham, Alabama, United States
Children's of Alabama
Birmingham, Alabama, United States
UAB Women & Infants Center - UAB Medicine
Birmingham, Alabama, United States
University of Alabama at Birmingham/Center for Women's Reproductive Health
Birmingham, Alabama, United States
Cullman Clinical Research, Inc
Cullman, Alabama, United States
Cullman Primary Care, PC
Cullman, Alabama, United States
...and 454 more locations
Time frame: Within 180 days after birth
Percentage of Infant Participants With Severe MA-LRTI Cases Due to RSV Occurring Within 90 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. Severe MA-LRTI cases were a subset of MA-LRTI cases, and all severe MA-LRTI cases included MA-LRTI cases. Severe MA-LRTI case was an RSV positively adjudicated event which met the following defined criteria: an infant with an MA-RTI visit and aged associated fast breathing (RR \>=70 bpm for \<2 months of age \[\<60 days of age\], \>=60 bpm for \>=2 months to \<12 months of age, or \>=50 bpm for \>=12 months to 24 months of age) or SpO2 \<93% or high-flow nasal cannula or mechanical ventilation (i.e., invasive or non-invasive) or intensive care unit (ICU) admission for more than (\>) 4 hours or failure to respond/unconscious.
Time frame: Within 90 days after birth
Percentage of Infant Participants With Severe MA-LRTI Cases Due to RSV Occurring Within 120 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. Severe MA-LRTI cases were a subset of MA-LRTI cases, and all severe MA-LRTI cases were included MA-LRTI cases. Severe MA-LRTI case was an RSV positively adjudicated event which met the following defined criteria: an infant with an MA-RTI visit and aged associated fast breathing (RR \>=70 bpm for \<2 months of age \[\<60 days of age\], \>=60 bpm for \>=2 months to \<12 months of age, or \>=50 bpm for \>=12 months to 24 months of age) or SpO2 \<93% or high-flow nasal cannula or mechanical ventilation (i.e., invasive or non-invasive) or ICU admission for \>4 hours or failure to respond/unconscious.
Time frame: Within 120 days after birth
Percentage of Infant Participants With Severe MA-LRTI Cases Due to RSV Occurring Within 150 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. Severe MA-LRTI cases were a subset of MA-LRTI cases, and all severe MA-LRTI cases were included MA-LRTI cases. Severe MA-LRTI case was an RSV positively adjudicated event which met the following defined criteria: an infant with an MA-RTI visit and aged associated fast breathing (RR \>=70 bpm for \<2 months of age \[\<60 days of age\], \>=60 bpm for \>=2 months to \<12 months of age, or \>=50 bpm for \>=12 months to 24 months of age) or SpO2 \<93% or high-flow nasal cannula or mechanical ventilation (i.e., invasive or non-invasive) or ICU admission for \>4 hours or failure to respond/unconscious.
Time frame: Within 150 days after birth
Percentage of Infant Participants With Severe MA-LRTI Cases Due to RSV Occurring Within 180 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. Severe MA-LRTI cases were a subset of MA-LRTI cases, and all severe MA-LRTI cases were included MA-LRTI cases. Severe MA-LRTI case was an RSV positively adjudicated event which met the following defined criteria: an infant with an MA-RTI visit and aged associated fast breathing (RR \>=70 bpm for \<2 months of age \[\<60 days of age\], \>=60 bpm for \>=2 months to \<12 months of age, or \>=50 bpm for \>=12 months to 24 months of age) or SpO2 \<93% or high-flow nasal cannula or mechanical ventilation (i.e., invasive or non-invasive) or ICU admission for \>4 hours or failure to respond/unconscious.
Time frame: Within 180 days after birth
Percentage of Infant Participants With Adverse Events of Special Interest (AESI) (Safety)
AESI are a subset of targeted medical events based on review of known pharmacology, toxicology findings, possible class effects, published literature, and signals arising from safety data assessments, and on population under study. AESIs were based on targeted medical events associated with pregnant maternal participants and their infants prior to/during delivery and at birth. For infant participants the following were considered as protocol defined AESIs: Preterm birth (born at \<37 weeks gestation); birth weight 1001-2500 grams; developmental delay; positive viral (polymerase chain reaction \[PCR\] or antigen-based) testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when not reported during MA-RTI visit, were reported as SARS-CoV-2 test positive. Extremely preterm birth (\<28 weeks) and extremely low birth weight (=\<1000 grams \[g\]) were reported as serious AESIs.
Time frame: From birth to 24 months of age
Percentage of Infant Participants With Neonatal Deaths (Safety)
Neonatal death was defined as the death of a live-born infant that occurred within a month after birth.
Time frame: Within 1 Month after birth
Percentage of Infant Participants With Congenital Malformations/Anomalies (Safety)
Congenital malformations/ anomalies were defined as structural or functional anomalies that occurred during intrauterine life and could be identified prenatally, at birth or later in life.
Time frame: At birth
Percentage of Infant Participants With Other Neonatal Events (Safety)
Other Neonatal problem included dysmaturity, neonatal illness, hospitalization, drug therapies, and neonatal death.
Time frame: Within 1 Month after birth
Number of Infant Participants According to Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) Score at 1 Minute After Birth (Safety)
APGAR was a fast evaluation technique used to evaluate a newborn baby's overall health. APGAR stands for (A) Appearance (skin coloration), (P) Pulse (heart rate), (G) Grimace (reflex response), (A) Activity (muscle tone) and (R) Respiration (breathing). Each component was given a score of 0, 1, or 2; after summing up scores for each component a total possible score was of 0 (worst condition) to 10 (best condition), where higher scores indicate better health. A score of 7 to 10 was good, 4 to \<7 was moderate, and \<4 was poor.
Time frame: 1 minute after birth
Number of Infant Participants According to APGAR Score at 5 Minutes After Birth (Safety)
APGAR was a fast evaluation technique used to evaluate a newborn baby's overall health. APGAR stands for (A) Appearance (skin coloration), (P) Pulse (heart rate), (G) Grimace (reflex response), (A) Activity (muscle tone) and (R) Respiration (breathing). Each component was given a score of 0, 1, or 2; after summing up scores for each component a total possible score was of 0 (worst condition) to 10 (best condition), where higher scores indicate better health. A score of 7 to 10 was good, 4 to \<7 was moderate, and \<4 was poor.
Time frame: 5 minutes after birth
Number of Infant Participants According to APGAR Score at 10 Minutes After Birth (Safety)
APGAR was a fast evaluation technique used to evaluate a newborn baby's overall health. APGAR stands for (A) Appearance (skin coloration), (P) Pulse (heart rate), (G) Grimace (reflex response), (A) Activity (muscle tone) and (R) Respiration (breathing). Each component was given a score of 0, 1, or 2; after summing up scores for each component a total possible score was of 0 (worst condition) to 10 (best condition), where higher scores indicate better health. A score of 7 to 10 was good, 4 to \<7 was moderate, and \<4 was poor.
Time frame: 10 minutes after birth
Percentage of Infant Participants With Adverse Events (AEs) From Birth to 1 Month of Age (Safety)
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
Time frame: From birth to 1 month of age
Percentage of Infant Participants With Serious Adverse Events (SAEs) and Newly Diagnosed Chronic Medical Conditions (NDCMCs) From Birth Through 6 Months of Age (Safety)
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An SAE was any untoward medical occurrence that at any dose: resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly/birth defect or that was considered an important medical event. An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or otherwise long-lasting in its effects.
Time frame: From birth to 6 months of age
Percentage of Infant Participants With SAEs and NDCMCs From Birth Through 12 Months of Age (Safety)
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An SAE was any untoward medical occurrence that at any dose: resulted in death, was life threatening required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly/birth defect or that was considered an important medical event. An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or otherwise long-lasting in its effects.
Time frame: From birth to 12 months of age
Percentage of Infant Participants With SAEs and NDCMCs From Birth Through 24 Months of Age (Safety)
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An SAE was any untoward medical occurrence that at any dose: resulted in death, was life threatening required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly/birth defect or that was considered an important medical event. An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or otherwise long-lasting in its effects.
Time frame: From birth to 24 months of age
Percentage of Maternal Participants With Prespecified Local Reactions Within 7 Days After Vaccination (Safety)
Local reactions included redness, swelling, and pain at injection site and were recorded in electronic diary (e-diary). Redness and swelling were measured and recorded in measuring device units. 1 measuring device unit= 0.5 centimetre (cm). Redness and swelling were graded as mild (\>2.0 to 5.0 cm), moderate (\>5.0 to 10.0 cm), severe (\>10.0 cm) and grade 4 (necrosis or exfoliative dermatitis for redness and necrosis for swelling). Pain at injection site was graded as mild (did not interfere with activity), moderate (interfered with activity), severe (prevented daily activity) and grade 4 (emergency room visit or hospitalization for the severe pain at the injection site). Grade 4 reactions were classified by the investigator or medically qualified person.
Time frame: From Day 1 to Day 7 after vaccination
Percentage of Maternal Participants With Prespecified Systemic Events Within 7 Days After Vaccination (Safety)
Systemic events included: fever, fatigue, headache, nausea, muscle pain, joint pain, vomiting and diarrhea and were recorded by participants in an e-diary. Fever was defined as an oral temperature \>=38.0 degree Celsius \[C\]) and classified as mild (38.0 to 38.4), moderate (38.5 to 38.9), severe (39.0 to 40.0) and grade 4 (\>40.0 degree C). Headache, nausea, fatigue, muscle pain and joint pain were graded as mild (did not interfere with activity), moderate (some interference with activity), severe (prevented daily activity). Vomiting: mild (1-2 times in 24 hours \[H\]), moderate (\>2 times in 24 H), severe (required intravenous \[IV\] hydration). Diarrhea: mild (2-3 loose stools in 24 H), moderate (4-5 loose stools in 24 H), severe (\>=6 in 24 H). For all systemic events except fever, Grade 4= emergency room visit or hospitalization. Grade 4 events were classified by investigator or medically qualified person.
Time frame: From Day 1 to Day 7 after vaccination
Percentage of Maternal Participants With AEs From the Time of Vaccination Through 1 Month After Vaccination (Safety)
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention Only AEs collected by non-systematic assessment (i.e. excluding local reactions and systemic events) were included in this outcome measure.
Time frame: From vaccination on Day 1 up to 1 month after vaccination
Percentage of Maternal Participants With SAEs Throughout the Study Period (Safety)
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An SAE was any untoward medical occurrence that at any dose: resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly/birth defect or that was considered an important medical event.
Time frame: From vaccination on Day 1 up to 6 months after delivery (maximum up to 10 months)
Percentage of Infant Participants With Cases of Hospitalization Due to RSV Within 90, 120, 150, 180 and 360 Days After Birth (Efficacy)
Results are reported as confirmed by endpoint adjudication committee.
Time frame: Within 90, 120, 150, 180 and 360 days after birth
Percentage of Infant Participants With MA-LRTI Cases Due to Any Cause With Protocol Defined Criteria Occurring Within 90, 120, 150, 180 and 360 Days After Birth (Efficacy)
MA-LRTI cases due to any cause was defined as an infant with a MA-RTI visit with age related fast breathing (RR \>=60 bpm for \<2 months of age \[\<60 days of age\], \>=50 bpm for \>=2 months to \<12 months of age, or \>=40 bpm for \>=12 months to 24 months of age) or SpO2 \<95% or chest wall indrawing.
Time frame: Within 90, 120, 150, 180 and 360 days after birth
Percentage of Infant Participants With MA-LRTI Cases Due to RSV Occurring Within 210, 240, 270 and 360 Days After Birth (Efficacy)
Results are presented as confirmed by endpoint adjudication committee. MA-LRTI case: Infant with an MA-RTI visit with age related fast breathing (RR \>=60 bpm for \<2 months of age \[\<60 days of age\], \>=50 bpm for \>=2 months to \<12 months of age, or \>=40 bpm for \>=12 months to 24 months of age) or SpO2 \<95% or chest wall indrawing and RSV positive test results by RT-PCR testing of midturbinate nasal swab samples.
Time frame: Within 210, 240, 270 and 360 days after birth