This is a phase II, randomized, two-armed, double-blind, placebo-controlled trial designed to evaluate the safety, tolerability, and immunogenicity of a candidate adjuvanted recombinant SARS-CoV-2 spike (S) protein subunit vaccine (SpikoGen) produced by CinnaGen Co. 400 adult individuals receive either SARS-CoV-2 recombinant spike protein (25 µg) with Advax-SM adjuvant (15 mg) or saline placebo in a 3:1 ratio. The injection is given in two doses with a 21-day interval in the deltoid muscle of the non-dominant arm. The randomization was stratified by age (\<65 or ≥65) and health conditions of potential risk for severe COVID-19. Participants will be visited at two weeks and will be followed up for six months after the second dose of the study intervention. Study hypotheses include: 1. The adjuvanted COVID-19 vaccine candidate is safe and tolerable in adult subjects. 2. The adjuvanted COVID-19 vaccine candidate induces strong immunogenicity against SARS-CoV-2 in adult subjects.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
400
SARS-CoV-2 recombinant spike protein (25 µg) with Advax-SM adjuvant (15 mg) in two doses with a 21-day interval administered with intramuscular injections in the non-dominant arm
0.9% sodium chloride (1 mL) injection in two doses with a 21-day interval administered with intramuscular injections in the non-dominant arm
Espinas Palace Hotel
Tehran, Iran
Incidence of solicited adverse events
Injection site pain, erythema, swelling, and induration, axillary swelling or tenderness ipsilateral to the side of injection, fever (oral temperature), headache, fatigue, myalgia, arthralgia, nausea, vomiting, and chills, as reported by the study participants on electronic diaries, and as defined using system organ classes and preferred terms of the Medical Dictionary for Regulatory Activities (MedDRA)
Time frame: For 7 days after each dose
Incidence of unsolicited adverse events
As reported by the study participants on electronic diaries, and as defined using system organ classes and preferred terms of the Medical Dictionary for Regulatory Activities (MedDRA)
Time frame: For 28 days after each dose
Percentage of participants with seroconversion for S1 binding IgG antibodies after the first injection
As measured by ELISA
Time frame: 21 days after the first dose (on the day of the second dose)
Percentage of participants with seroconversion for S1 binding IgG antibodies after the second injection
As measured by ELISA
Time frame: 14 days after the second dose
Change in geometric mean concentration (GMC) for S1 binding IgG antibodies from baseline to 21 days after the first injection
As measured by ELISA
Time frame: On the day of the first dose and 21 days after the first dose (on the day of the second dose)
Change in geometric mean concentration (GMC) for S1 binding IgG antibodies from baseline to 14 days after the second injection
As measured by ELISA
Time frame: On the day of the first dose and 14 days after the second dose
Percentage of participants with seroconversion for SARS-CoV-2 neutralizing antibodies after the first injection
As measured by ELISA (sVNT)
Time frame: 21 days after the first dose (on the day of the second dose)
Percentage of participants with seroconversion for SARS-CoV-2 neutralizing antibodies after the first injection
As measured by cVNT
Time frame: 21 days after the first dose (on the day of the second dose)
Percentage of participants with seroconversion for SARS-CoV-2 neutralizing antibodies after the second injection
As measured by ELISA (sVNT)
Time frame: 14 days after the second dose
Percentage of participants with seroconversion for SARS-CoV-2 neutralizing antibodies after the second injection
As measured by cVNT
Time frame: 14 days after the second dose
Percentage of participants with seroconversion for receptor-binding domain (RBD) binding IgA antibodies after the first injection
As measured by ELISA
Time frame: 21 days after the first dose (on the day of the second dose)
Percentage of participants with seroconversion for receptor-binding domain (RBD) binding IgA antibodies after the second injection
As measured by ELISA
Time frame: 14 days after the second dose
Percentage of participants with seroconversion for S1 binding IgA antibodies after the first injection
As measured by ELISA
Time frame: 21 days after the first dose (on the day of the second dose)
Percentage of participants with seroconversion for S1 binding IgA antibodies after the second injection
As measured by ELISA
Time frame: 14 days after the second dose
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Percentage of participants with seroconversion for receptor-binding domain (RBD) binding IgG antibodies after the first injection
As measured by ELISA
Time frame: 21 days after the first dose (on the day of the second dose)
Percentage of participants with seroconversion for receptor-binding domain (RBD) binding IgG antibodies after the second injection
As measured by ELISA
Time frame: 14 days after the second dose
Change in geometric mean concentration (GMC) for receptor-binding domain (RBD) binding IgG antibodies from baseline to 21 days after the first injection
As measured by ELISA
Time frame: On the day of the first dose and 21 days after the first dose (on the day of the second dose)
Change in geometric mean concentration (GMC) for receptor-binding domain (RBD) binding IgG antibodies from baseline to 14 days after the second injection
As measured by ELISA
Time frame: On the day of the first dose and 14 days after the second dose
Geometric mean fold rise (GMFR) for S1 binding IgG antibodies after the first injection
As measured by ELISA
Time frame: 21 days after the first dose (on the day of the second dose)
Geometric mean fold rise (GMFR) for S1 binding IgG antibodies after the second injection
As measured by ELISA
Time frame: 14 days after the second dose
Geometric mean fold rise (GMFR) for receptor-binding domain (RBD) binding IgG antibodies after the first injection
As measured by ELISA
Time frame: 21 days after the first dose (on the day of the second dose)
Geometric mean fold rise (GMFR) for receptor-binding domain (RBD) binding IgG antibodies after the second injection
As measured by ELISA
Time frame: 14 days after the second dose
Geometric mean fold rise (GMFR) for SARS-CoV-2 neutralizing antibodies after the first injection
As measured by ELISA (sVNT)
Time frame: 21 days after the first dose (on the day of the second dose)
Geometric mean fold rise (GMFR) for SARS-CoV-2 neutralizing antibodies after the second injection
As measured by ELISA (sVNT)
Time frame: 14 days after the second dose
Change in geometric mean concentration (GMC) for SARS-CoV-2 neutralizing antibodies from baseline to 21 days after the first injection
As measured by ELISA (sVNT)
Time frame: On the day of the first dose and 21 days after the first dose (on the day of the second dose)
Change in geometric mean concentration (GMC) for SARS-CoV-2 neutralizing antibodies from baseline to 14 days after the second injection
As measured by ELISA (sVNT)
Time frame: On the day of the first dose and 14 days after the second dose
Change in geometric mean concentration (GMC) for S1 binding IgA antibodies from baseline to 21 days after the first injection
As measured by ELISA
Time frame: On the day of the first dose and 21 days after the first dose (on the day of the second dose)
Change in geometric mean concentration (GMC) for S1 binding IgA antibodies from baseline to 14 days after the second injection
As measured by ELISA
Time frame: On the day of the first dose and 14 days after the second dose
Geometric mean fold rise (GMFR) for S1 binding IgA antibodies after the first injection
As measured by ELISA
Time frame: 21 days after the first dose (on the day of the second dose)
Geometric mean fold rise (GMFR) for S1 binding IgA antibodies after the second injection
As measured by ELISA
Time frame: 14 days after the second dose
Incidence of serious adverse events (SAEs) and suspected unexpected serious adverse reaction (SUSARs)
As defined using system organ classes and preferred terms of the Medical Dictionary for Regulatory Activities (MedDRA)
Time frame: For 6 months after the second dose
Change in T-cell proliferation responses from baseline to 21 days after the first injection
Evaluation of CD4+ and CD8+ T-cell proliferation responses as measured by flow cytometry
Time frame: On the day of the first dose and 21 days after the first dose (on the day of the second dose)
Change in T-cell proliferation responses from baseline to 14 days after the second injection
Evaluation of CD4+ and CD8+ T-cell proliferation responses as measured by flow cytometry
Time frame: On the day of the first dose and 14 days after the second dose
Change in T-cell IFN-γ secretion from baseline to 21 days after the first injection
As measured by IGRA
Time frame: On the day of the first dose and 21 days after the first dose (on the day of the second dose)
Change in T-cell IFN-γ secretion from baseline to 14 days after the second injection
As measured by IGRA
Time frame: On the day of the first dose and 14 days after the second dose