The aim of the current clinical study is to evaluate, for the first time in humans (FTIH), the safety and immunogenicity of the altSonflex1-2-3 candidate vaccine against S. sonnei and S. flexneri serotypes 1b, 2a, and 3a. The vaccine will be first administered in adults 18 to 50 years of age in Europe. Subsequently, the vaccine will be administered to a shigellosis-endemic population in Africa, first in adults 18 to 50 years of age, then in children 24 to 59 months of age, finally in infants 9 months of age. Infants will also receive a third vaccination. Three different doses of the vaccine \[low (Dose A), medium (Dose B), and high (Dose C) amounts of antigen\] will be evaluated using an age de-escalation approach (from least vulnerable adult population to most vulnerable paediatric population). The results of this study will allow the selection of the most appropriate dose for further vaccine development in infants 9 months of age, which is the main target age group for this vaccine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
551
2 doses of altSonflex Placebo, administered intramuscularly, in the non-dominant arm, either at Day 1 and Day 85 or at Day 1 and Day 169 (depending on the vaccination schedule) to adults in the ST1\_Adults\_Placebo\_GR1 and ST1\_Adults\_Placebo\_GR2 groups in Stage 1 (Europe).
2 doses of altSonflex1-2-3 Dose C administered intramuscularly, in the non-dominant arm, at Day 1 and Day 85 to adults in the ST1\_Adults\_Dose C\_GR1 and ST2\_Adults\_Dose C groups in Stage 1 and 2 (Europe and Africa) and children in the ST2\_Children\_Dose C group in Stage 2 (Africa), and at Day 1 and Day 169 to adults in the ST1\_Adults\_Dose C\_GR2 group in Stage 1 (Europe); 3 doses of altSonflex1-2-3 Dose C administered intramuscularly, in the non-dominant arm, at Day 1, Day 85 and Day 253 to infants in the ST2\_Infants\_Dose C\_Safety and ST2\_Infants\_Dose C\_Dose find groups in Stage 2 (Africa).
2 doses of altSonflex1-2-3 Dose B administered intramuscularly, in the non-dominant arm, at Day 1 and Day 85 to children in the ST2\_Children\_Dose B group in Stage 2 (Africa); 3 doses of altSonflex1-2-3 Dose B administered intramuscularly, in the non-dominant arm, at Day 1, Day 85 and Day 253 to infants in the ST2\_Infants\_Dose B\_Safety and ST2\_Infants\_Dose B\_Dose find groups in Stage 2 (Africa).
3 doses of altSonflex1-2-3 Dose A administered intramuscularly, in the non-dominant arm, at Day 1, Day 85 and Day 253 to infants in the ST2\_Infants\_Dose A\_Safety and ST2\_Infants\_Dose A\_Dose find groups in Stage 2 (Africa).
1 dose of GSK's Meningococcal A, C, Y and W-135 conjugate vaccine administered intramuscularly, in the non-dominant arm, at Day 1 to adults in the ST2\_Adults\_Control C group and children in the ST2\_Children\_Control B and ST2\_Children\_Control C groups in Stage 2 (Africa); 2 doses of GSK's Meningococcal A, C, Y and W-135 conjugate vaccine administered intramuscularly, in the non-dominant arm, at Day 1 and Day 85 to infants in the ST2\_Infants\_Control A\_Safety, ST2\_Infants\_Control B\_Safety, ST2\_Infants\_Control C\_Safety and ST2\_Infants\_Control\_Dose find groups in Stage 2 (Africa).
1 dose of GSK's Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine administered intramuscularly, in the non-dominant arm, at Day 85 to adults in the ST2\_Adults\_Control C group in Stage 2 (Africa).
1 dose of GSK's Diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis (inactivated), and Haemophilus influenzae type b vaccine administered intramuscularly, in the non-dominant arm, at Day 253 to infants in the ST2\_Infants\_Control A\_Safety, ST2\_Infants\_Control B\_Safety, ST2\_Infants\_Control C\_Safety and ST2\_Infants\_Control\_Dose find groups in Stage 2 (Africa).
1 dose of Sanofi Pasteur's Typhoid Vi polysaccharide vaccine administered intramuscularly, in the non-dominant arm, at Day 85 to children in the ST2\_Children\_Control B and ST2\_Children\_Control C groups in Stage 2 (Africa).
2 doses of Serum Institute of India's Measles and rubella vaccine administered subcutaneously, in the non-dominant arm, at Day 29 and Day 281 to infants in the safety groups, and at Day 1 and Day 253 to infants in the dose-finding groups, in Stage 2 (Africa).
GSK Investigational Site
Ghent, Belgium
GSK Investigational Site
Kericho, Kenya
Anti-serotype specific Shigella lipopolysaccharide (LPS)/O-Antigen (OAg) serum immunoglobulin G (IgG) geometric mean concentrations (GMCs) in infants 9 months of age in Africa
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs are measured by GSK Vaccines Institute for Global Health (GVGH) enzyme-linked immunosorbent assay (ELISA) and expressed in ELISA units per milliliter (EU/mL) of serum.
Time frame: At Day 281 (28 days after the third study intervention administration)
Number of adults 18 to 50 years of age in Europe with solicited administration site events
The solicited administration site events are pain, redness, and swelling.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1 and Day 85/Day 169)
Number of adults 18 to 50 years of age in Europe with solicited systemic events
The solicited systemic event is fever. Fever is defined as temperature equal to or above (≥) 38.0°C. The preferred location for measuring temperature is the axilla for all participants.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1 and Day 85/Day 169)
Number of adults 18 to 50 years of age in Europe with unsolicited adverse events (AEs)
An unsolicited AE is an AE reported in addition to those solicited during the clinical study. Also, any 'solicited' symptom with onset outside the specified period of follow-up for solicited symptoms is reported as an unsolicited adverse event.
Time frame: During 28 days after each study intervention administration (study interventions administered at Day 1 and Day 85/Day 169)
Number of adults 18 to 50 years of age in Europe with serious adverse events (SAEs)
An SAE is defined as any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect in the offspring of a study participant, results in abnormal pregnancy outcomes or any other situation based on appropriate medical or scientific judgement.
Time frame: During the entire study participation period [Day 1 to Day 113 (for ST1_Adults_Placebo_GR1 and ST1_Adults_Dose C_GR1 groups)/Day 197 (for ST1_Adults_Placebo_GR2 and ST1_Adults_Dose C_GR2 groups)
Number of adults 18 to 50 years of age in Europe with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 (7 days after the first study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, aspartate aminotransferase (AST) and alanine aminotransferase (ALT).
Time frame: At Day 8 (7 days after the first study intervention administration)
Number of adults 18 to 50 years of age in Europe with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92/Day 176 (7 days after the second study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, aspartate aminotransferase (AST) and alanine aminotransferase (ALT).
Time frame: At Day 92 (for ST1_Adults_Placebo_GR1 and ST1_Adults_Dose C_GR1 groups)/Day 176 (for ST1_Adults_Placebo_GR2 and ST1_Adults_Dose C_GR2 groups) (7 days after the second study intervention administration)
Number of adults 18 to 50 years of age in Africa with solicited administration site events
The solicited administration site events are pain, redness, and swelling.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1 and Day 85)
Number of adults 18 to 50 years of age in Africa with solicited systemic events
The solicited systemic event is fever. Fever is defined as temperature ≥ 38.0°C. The preferred location for measuring temperature is the axilla for all participants.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1 and Day 85)
Number of adults 18 to 50 years of age in Africa with unsolicited AEs
An unsolicited AE is an AE reported in addition to those solicited during the clinical study. Also, any 'solicited' symptom with onset outside the specified period of follow-up for solicited symptoms is reported as an unsolicited adverse event.
Time frame: During 28 days after each study intervention administration (study interventions administered at Day 1 and Day 85)
Number of adults 18 to 50 years of age in Africa with SAEs
An SAE is defined as any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect in the offspring of a study participant, results in abnormal pregnancy outcomes or any other situation based on appropriate medical or scientific judgement.
Time frame: During the entire study participation (Day 1 to Day 113)
Number of adults 18 to 50 years of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 (7 days after the first study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, AST, and ALT.
Time frame: At Day 8 (7 days after the first study intervention administration)
Number of adults 18 to 50 years of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92 (7 days after the second study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, AST, and ALT.
Time frame: At Day 92 (7 days after the second study intervention administration)
Number of children 24 to 59 months of age in Africa with solicited administration site events
The solicited administration site events are pain, redness, and swelling.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1 and Day 85)
Number of children 24 to 59 months of age in Africa with solicited systemic events
The solicited systemic event is fever. Fever is defined as temperature ≥ 38.0°C. The preferred location for measuring temperature is the axilla for all participants.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1 and Day 85)
Number of children 24 to 59 months of age in Africa with unsolicited AEs
An unsolicited AE is an AE reported in addition to those solicited during the clinical study. Also, any 'solicited' symptom with onset outside the specified period of follow-up for solicited symptoms is reported as an unsolicited adverse event.
Time frame: During 28 days after each study intervention administration (study interventions administered on Day 1 and Day 85)
Number of children 24 to 59 months of age in Africa with SAEs
An SAE is defined as any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in disability/incapacity or any other situation based on appropriate medical or scientific judgement.
Time frame: During the entire study participation period (Day 1 to Day 113)
Number of children 24 to 59 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 (7 days after the first study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, AST, and ALT.
Time frame: At Day 8 (7 days after the first study intervention administration)
Number of children 24 to 59 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92 (7 days after the second study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, AST, and ALT.
Time frame: At Day 92 (7 days after the second study intervention administration)
Number of infants 9 months of age in Africa with solicited administration site events
The solicited administration site events are pain, redness and swelling.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1, Day 85 and Day 253)
Number of infants 9 months of age in Africa with solicited systemic events
The solicited systemic event is fever. Fever is defined as temperature ≥ 38.0°C. The preferred location for measuring temperature is the axilla for all participants.
Time frame: During 7 days after each study intervention administration (study interventions administered at Day 1, Day 85 and Day 253)
Number of infants 9 months of age in Africa with unsolicited AEs
An unsolicited AE is an AE reported in addition to those solicited during the clinical study. Also, any 'solicited' symptom with onset outside the specified period of follow-up for solicited symptoms is reported as an unsolicited adverse event.
Time frame: During 28 days after each study intervention administration (study intervention administered at Day 1, Day 85 and Day 253)
Number of infants 9 months of age in Africa with SAEs
An SAE is defined as any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in disability/incapacity or any other situation based on appropriate medical or scientific judgement.
Time frame: During the entire study participation period (Day 1 to Day 281)
Number of infants 9 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 (7 days after the first study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, AST, and ALT.
Time frame: At Day 8 (7 days after the first study intervention administration)
Number of infants 9 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92 (7 days after the second study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, AST, and ALT.
Time frame: At Day 92 (7 days after the second study intervention administration)
Number of infants 9 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 260 (7 days after the third study intervention administration)
Panel tests include measures of leukocytes, erythrocytes, haemoglobin, haematocrit, platelets, eosinophils, basophils, neutrophils, monocytes, lymphocytes, creatinine, blood urea, sodium, potassium, AST, and ALT.
Time frame: At Day 260 (7 days after the third study intervention administration)
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs in adults 18 to 50 years of age in Europe
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs are measured by GVGH ELISA and expressed in EU/mL of serum.
Time frame: At Day 1 and Day 85/Day 169 (before each study intervention administration), at Day 15 (14 days after the first study intervention administration) and at Day 29 and Day 113/Day197 (28 days after each study intervention administration)
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs in adults 18 to 50 years of age in Africa
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs are measured by GVGH ELISA and expressed in EU/mL of serum.
Time frame: At Day 1 and Day 85 (before each study intervention administration) and at Day 29 and Day 113 (28 days after each study intervention administration)
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs in children 24 to 59 months of age in Africa
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs are measured by GVGH ELISA and expressed in EU/mL of serum.
Time frame: At Day 1 and Day 85 (before each study intervention administration) and at Day 29 and Day 113 (28 days after each study intervention administration)
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs in infants 9 months of age in Africa
Anti-serotype specific Shigella LPS/OAg serum IgG GMCs are measured by GVGH ELISA and expressed in EU/mL of serum.
Time frame: At Day 1, Day 85 and Day 253 (before each study intervention administration) and at Day 29, Day 113 and Day 281 (28 days after each study intervention administration)
Number of adults 18 to 50 years of age in Europe achieving a GVGH ELISA level equivalent to ≥1:800 titer against S. sonnei LPS/OAg
Time frame: At Day 1 and Day 85/Day 169 (before each study intervention administration), at Day 15 (14 days after the first study intervention administration) and at Day 29 and Day 113/Day 197 (28 days after each study intervention administration)
Number of adults 18 to 50 years of age in Africa achieving a GVGH ELISA level equivalent to ≥1:800 titer against S. sonnei LPS/OAg
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Time frame: At Day 1 and Day 85 (before each study intervention administration) and at Day 29 and Day 113 (28 days after each study intervention administration)
Number of children 24 to 59 months of age in Africa achieving a GVGH ELISA level equivalent to ≥1:800 titer against S. sonnei LPS/OAg
Time frame: At Day 1 and Day 85 (before each study intervention administration) and at Day 29 and Day 113 (28 days after each study intervention administration)
Number of infants 9 months of age in Africa achieving a GVGH ELISA level equivalent to ≥1:800 titer against S. sonnei LPS/OAg
Time frame: At Day 1, Day 85 and Day 253 (before each study intervention administration) and at Day 29, Day 113 and Day 281 (28 days after each study intervention administration)
Number of adults 18 to 50 years of age in Europe achieving a GVGH ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS/OAg
Time frame: At Day 1 and Day 85/Day 169 (before each study intervention administration), at Day 15 (14 days after the first study intervention administration) and at Day 29 and Day 113/Day 197 (28 days after each study intervention administration)
Number of adults 18 to 50 years of age in Africa achieving a GVGH ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS/OAg
Time frame: At Day 1 and Day 85 (before each study intervention administration) and at Day 29 and Day 113 (28 days after each study intervention administration)
Number of children 24 to 59 months of age in Africa achieving a GVGH ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS/OAg
Time frame: At Day 1 and Day 85 (before each study intervention administration) and at Day 29 and Day 113 (28 days after each study intervention administration)
Number of infants 9 months of age in Africa achieving a GVGH ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS/OAg
Time frame: At Day 1, Day 85 and Day 253 (before each study intervention administration) and at Day 29, Day 113 and Day 281 (28 days after each study intervention administration)
Number of adults 18 to 50 years of age in Europe showing at least a 4-fold increase in anti-serotype specific Shigella LPS/OAg serum IgG concentrations, as measured by GVGH ELISA
Time frame: At Day 15 (14 days after first study intervention administration) and at Day 29 and Day 113/197 (28 days after each study intervention administration) compared to Day 1 and Day 85/Day 169 (baseline)
Number of adults 18 to 50 years of age in Africa showing at least a 4-fold increase in anti-serotype specific Shigella LPS/OAg serum IgG concentrations, as measured by GVGH ELISA
Time frame: At Day 29 and Day 113 (28 days after each study intervention administration) compared to Day 1 and Day 85 (baseline)
Number of children 24 to 59 months of age in Africa showing at least a 4-fold increase in anti-serotype specific Shigella LPS/OAg serum IgG concentrations, as measured by GVGH ELISA
Time frame: At Day 29 and Day 113 (28 days after each study intervention administration) compared to Day 1 and Day 85 (baseline)
Number of infants 9 months of age in Africa showing at least a 4-fold increase in anti-serotype specific Shigella LPS/OAg serum IgG concentrations, as measured by GVGH ELISA
Time frame: At Day 29, Day 113 and Day 281 (28 days after each study intervention administration) compared to Day 1, Day 85 and Day 253 (baseline)
Anti-measles IgG concentrations in infants 9 months of age in the dose-finding groups in Africa
Time frame: At Day 1 (before the first MR-VAC dose administration) and Day 281 (28 days after the second MR-VAC dose administration)
Anti-rubella IgG concentrations in infants 9 months of age in the dose-finding groups in Africa
Time frame: At Day 1 (before the first MR-VAC dose administration) and Day 281 (28 days after the second MR-VAC dose administration)
Number of infants 9 months of age in the dose-finding groups in Africa achieving anti-measles IgG concentrations of ≥150 mIU/mL and ≥200 mIU/mL
Time frame: At Day 281 (28 days after the second MR-VAC dose administration)
Number of infants 9 months of age in the dose-finding groups in Africa achieving anti-rubella IgG concentrations of ≥4 IU/mL and ≥10 IU/mL
Time frame: At Day 281 (28 days after the second MR-VAC dose administration)