This was a dose-escalation, Phase I/II study evaluating the safety, tolerability, reactogenicity and immunogenicity of the investigational RNA-based multivalent vaccine candidate BNT166a for active immunization against monkeypox (mpox). This study was originally planned to include four substudies, i.e., substudy A (SSA), substudy B (SSB), substudy C (SSC), and substudy D (SSD). Sponsor decided not to conduct SSC, thus three substudies (SSA, SSB, and SSD) were conducted. In SSA and SSB, dosing started with an initial sentinel group, followed by the expansion cohort. In SSD, dosing was initiated after the interim analysis of SSA and SSB 1-month post-Dose 2 safety, reactogenicity, and immunogenicity data was received. This study was initially planned to investigate two vaccine candidates (the quadrivalent BNT166a and the trivalent BNT166c). The sponsor decided to not activate the groups with BNT166c.
Substudy A was an open-label, dose-escalation, Phase I substudy to assess the reactogenicity, safety, and immunogenicity of up to three dose levels of the multivalent vaccine candidate BNT166a in 48 healthy participants with no prior history of known or suspected smallpox vaccination (vaccinia-naïve participants). Substudy B was a one group, open-label, Phase I substudy to assess the reactogenicity, safety and immunogenicity of the multivalent vaccine candidate BNT166a in 16 healthy participants with prior history of smallpox vaccination (vaccinia-experienced). Substudy D was a one group, open-label, Phase IIa substudy to assess the reactogenicity, safety, and immunogenicity of one dose level of BNT166a in \~32 healthy participants with no prior history of known or suspected smallpox vaccination (i.e., vaccinia-naïve participants). SSD was initiated after the interim analysis of SSA and SSB safety, reactogenicity, and immunogenicity data. The duration of study participation was \~ 14 months per participant in all of the substudies.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
96
Multivalent ribonucleic acid (RNA)-based vaccine for active immunization against monkeypox administered as intramuscular injection.
California Research Foundation
San Diego, California, United States
Alliance for Multispecialty Research, LLC
Kansas City, Missouri, United States
Alliance for Multispecialty Research, LLC
Knoxville, Tennessee, United States
University of Washington Virology Research Clinic
Seattle, Washington, United States
Addenbrooke's Hospital - Cambridge University Hospitals NHS Foundation Trust
Cambridge, United Kingdom
Royal Surrey County Hospital Foundation Trust, NIHR Royal Surrey Clinical Research Facility
Guildford, United Kingdom
Guy's and St Thomas' NHS Foundation Trust of St Thomas' Hospital
London, United Kingdom
Medicine Evaluation Unit Ltd, The Langley Building, Wythenshawe Hospital
Manchester, United Kingdom
University Hospital Southampton
Southampton, United Kingdom
Number of Participants Reporting Solicited Local Reactions At the Injection Site
All reactogenicity events information recorded via the participant e-diaries or solicited by the investigator were considered as solicited events. Solicited local reactions were: pain at the injection site, erythema/redness, and induration/swelling. Any local reaction indicates participants with any reactions, including reactions that do not qualify for Grade 1 (\<2.5 cm for erythema/redness or induration/swelling). The intensity of local reaction was assessed by the participant and may be confirmed or corrected by the investigator; grades were defined as Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially life-threatening.
Time frame: Up to 7 days post any vaccination, and up to 7 days post each vaccination dose (that is, post-dose 1 [up to Day 8]) and post-dose 2 [up to Day 38])
Number of Participants Reporting Solicited Systemic Events
All reactogenicity events information recorded via the participant e-diaries or solicited by the investigator were considered as solicited events. Solicited systemic reactions were: fever, chills, fatigue/tiredness, headache, muscle pain/myalgia, joint pain/arthralgia, vomiting, and diarrhea. Any systemic reaction indicated participants with any Grade \>=1 reactions. The intensity of systemic events was assessed by the participants and may be confirmed or corrected by the investigator; grades were defined as Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Potentially life-threatening.
Time frame: Up to 7 days post any vaccination, and up to 7 days post each vaccination dose (that is, post Dose 1 [up to Day 8] and post Dose 2 [up to Day 38])
Number of Participants With At Least One Unsolicited Adverse Event (AE)
An AE was defined as any untoward medical occurrence in a participant administered with a pharmaceutical product, and which did not necessarily have a causal relationship with this treatment. All AE information or safety data including solicited events persisting beyond 7 days that were voluntarily communicated by the participant or collected by the investigator (that is, ECG or laboratory results etc.) were considered unsolicited events. The intensity of AEs was graded by the investigator. Grades were defined as: Grade 1 - Mild; does not interfere with the trial participant's usual function; Grade 2 - Moderate; interferes to some extent with the trial participant's usual function Grade 3 - Severe; interferes significantly with the trial participant's usual function; and Grade 4 - Potentially life-threatening; life-threatening consequences, urgent intervention required.
Time frame: Up to 28 days post any vaccination, and up to 28 days post each vaccination dose (that is, post-dose 1 [up to Day 29] and post-Dose 2 [up to Day 59])
Number of Participants With At Least One Serious Adverse Event (SAE)
An SAE was defined as any untoward medical occurrence that, at any dose, resulted in death and was life-threatening. It also included any event requiring hospitalization or prolongation of existing hospitalization, resulted in persistent disability/incapacity, caused a congenital anomaly or birth defect, or any other event determined as SAE as per medical or scientific judgment.
Time frame: From Dose 1 up to Day 201
Number of Participants With At Least One Adverse Event of Special Interest (AESI)
An AESI, serious or non-serious, was one of scientific and medical concern specific to the sponsor's product or program, for which monitoring and rapid communication by the investigator to the sponsor was appropriate.
Time frame: From Dose 1 up to Day 201
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