This is an observer-blinded Phase 3 study to evaluate the safety and immunogenicity of a single booster dose of the Novavax severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recombinant (r) spike (S) protein nanoparticle vaccine adjuvanted with Matrix-MTM (NVX-CoV2373) in adults previously vaccinated with the BBIBP-CorV vaccine. The study will enroll approximately1,000 participants \>18 years of age. All participants will be randomized in a 1:1 ratio to receive a single booster dose of NVX-CoV2373 or the BBIBP-CorV vaccine. All participants will receive the booster dose on Day 0 and remain on study for immunogenicity and safety data collection through Day 180. An interim analysis will be performed of safety and immunogenicity data gathered through Day 28.
Novavax, Inc., is developing recombinant vaccines adjuvanted with the saponin-based Matrix-M for the prevention of disease caused by SARS-CoV-2. Both nonclinical and clinical data to date (Liu 2011; Keech 2020; Formica 2021; Heath 2021) support continued clinical development of SARS-CoV-2 rS vaccines combined with Matrix-M adjuvant as potential vaccines against SARS-CoV-2. Due to waning immunity following primary vaccination against SARS-CoV-2 as well as the emergence of SARS-CoV-2 variants (eg, Alpha, Beta, Gamma, Delta and Omicron), a number of countries have administered or are planning to administer booster doses of vaccine to either specific subgroups or to their general population. As part of this effort, both homologous boosting (boosting with the same vaccine used for the primary vaccination series) or heterologous boosting (boosting with a vaccine that differs from that used for the primary vaccination series) are being evaluated. The present study aims to investigate the safety and immunogenicity of a single booster of NVX-CoV2373 administered to participants who have already been immunized with BBIBP-CorV vaccine. The NVX-CoV2373 booster will be administered \> 180 days after the second dose of BBIBP-CorV vaccine, and the ability of the vaccine to increase antibody titers against the prototype SARS-CoV-2 strain as well as the ability to induce cross-neutralizing antibodies to variant strains will be evaluated. If favorable immunogenicity and safety profiles are observed following a booster dose of NVX-CoV2373, this option would add flexibility to the global COVID-19 vaccination effort and potentially decrease the need to develop variant-specific vaccines.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
1,000
A single booster injection of NVX-CoV2373 with Matrix-M adjuvant. 0.5 mL injection volume at a dose of 5μg of antigen with 50 μg Matrix-M adjuvant
BBIBP-CorV vaccine administered per manufacturer instructions.
Cleveland Clinic Abu Dhabi
Abu Dhabi, United Arab Emirates
Sheikh Khalifa Medical City (SKMC)
Abu Dhabi, United Arab Emirates
Utilizing ratio of IgG GMTs and difference in seroconversion rates to compare IgG antibody responses between the vaccines.
Comparative IgG antibody responses on Day 14, summarized in terms of the ratio of IgG GMTs and difference in seroconversion rates (SCR; defined as ≥ 4-fold increase from baseline booster dose) between the vaccines. Non-inferiority will be demonstrated if: * The lower bound of the two-sided 95% CI on the ratio of the GMTS (GMTNVX-CoV2373/GMTBBIBP-CorV) is ≥ 0.6667, AND * The lower bound of the two-sided 95% CI on the difference between the SCRs (SCRNVX-CoV2373 - SCR BBIBP-CorV) is ≥ 10%.
Time frame: On Day 14.
Utilizing Case Report Forms and safety follow up via telephone to measure and assess incidence, duration, and severity of solicited local and systemic adverse events (AEs)
All safety analyses will be summarized descriptively by vaccine group using the Safety Analysis Set. To compare the overall safety, the two-sided 95% CIs for the difference of incidence of solicited AEs for 7 days following each vaccination. Recording of solicited and unsolicited AEs may be conducted by electronic data capture (EDC)/reporting. All AEs will be followed until resolution or until clinically stable.
Time frame: For 7 days following each vaccination.
Utilizing Case Report Forms to measure and assess Incidence, duration, severity, and relationship of unsolicited AEs
All safety analyses will be summarized descriptively by vaccine group using the Safety Analysis Set. 1085BUnsolicited AEs will be coded by preferred term and system organ class using MedDRA and summarized by vaccine group as well as by severity and relationship to booster vaccine. Unsolicited AEs through 28 days after the booster vaccination. Recording of solicited and unsolicited AEs may be conducted by electronic data capture (EDC)/reporting. All AEs will be followed until resolution or until clinically stable.
Time frame: Through 28 days after the last vaccination.
Utilizing Case Report Forms to measure incidence and relationship of medically attended adverse events (MAAEs), adverse events of special interest (AESIs) (predefined list), and serious adverse events (SAEs) throughout the study.
To compare the overall safety of a single booster injection of NVX-CoV2373 with Matrix-M adjuvant with a single booster injection of BBIBP-CorV in participants previously vaccinated with a primary two-dose series of the BBIBP-CorV vaccine. Recording of solicited and unsolicited AEs may be conducted by electronic data capture (EDC)/reporting. All AEs will be followed until resolution or until clinically stable.
Time frame: Throughout the study. Note: Beginning on Day 29, only MAAEs related to the vaccine will be recorded.
Utilizing Plaque Reduction Neutralization Tests (PRNT) to compare neutralizing antibody responses
Objective: Utilize Plaque Reduction Neutralization Tests (PRNT) to compare neutralizing antibody responses to the SARS-CoV-2 rS with Matrix M adjuvant vaccine to antibody responses to the BBIBP-CorV vaccine, both administered as single booster doses, in adult participants ≥18 years of age who were previously vaccinated with a primary two-dose series of BBIBP-CorV.
Time frame: • PRNT GMTs to the SARS-CoV-2 S protein at Days 0, 14, 28, and 180. • GMFRPost/Pre, defined as the ratio of post-vaccination to pre-vaccination (Day 0) PRNT GMTs within the same treatment arm at Days 14, 28, and 180.
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