The primary goal of this clinical trial is to demonstrate non-inferiority of 30 µg of Hecolin® in healthy children, compared to healthy adults as measured by seroresponse rates (SR) of anti-HEV IgG titers, 4 weeks after 3 doses (0, 1 and 6 months) and to assess and descriptively compare safety profile data intra and inter age Strata. As secondary objectives, Geometric Mean Concentration (GMC) of anti-HEV IgG ELISA will be evaluated 4 weeks after 3 doses (0, 1 and 6 months) and 4 weeks after 2 doses (0- and 6-months dose) in healthy children. SR and GMC will also be evaluated 24 weeks after 3 doses and 2 doses. The immune response will be compared among adult participants between HIV positive and HIV negative individuals and between virally suppressed and virally unsuppressed HIV positive individuals
The primary objective of the study is to demonstrate immune non-inferiority of 30 µg Hecolin® when given to healthy children (2-17 years) as compared to healthy adults (18-45 years) as measured by seroresponse rates (SR) of anti- HEV IgG ELISA antibody titers, 4 weeks after the 3 doses given at 0, 1- \& 6-months. Co-primary objective is to assess safety in each age cohort and descriptively compare lower age cohorts with higher age cohorts. Other immune parameters would be assessed as secondary objectives. Healthy children and adolescents collectively (2-17 years) will be compared for immune non-inferiority with healthy adults (18-45 years) as measured by geometric mean concentration (GMC) of anti-HEV IgG ELISA antibody titers, 4 weeks after the 3 doses given at 0, 1- \& 6-months. Among children (2-17 years) 3 doses of Hecolin® given at 0, 1 and 6 months will be compared with 2 doses of Hecolin® given at 1 and 6 months in terms of immune non-inferiority of SR and GMC of anti-HEV IgG ELISA antibody titers. The immune response will be compared between HIV positive and HIV negative adults in terms of SR and GMC as measured by anti-HEV IgG ELISA antibody titers at 4 weeks after completing 3 doses of Hecolin® (0, 1 and 6 months). A total of 860 participants will be enrolled in the main study and will be divided into 4 age strata; 18-45 years (Cohort A), 12-17 years (Cohort B), 6-11 years (Cohort C) and 2-5 years (Cohort D) having 410, 175, 175 and 100 participants respectively. Cohort A will be further divided into Arm A1 and A2 having 232 HIV -ve and 178 HIV +ve participants respectively. All participants in cohort A will receive intramuscular injection of 3 doses of 30 µg Hecolin® at 0, 1 and 6 months. Cohort B will be further divided into Arm B1, B2 and B3 having 70, 70 and 35 participants respectively. Arm B1 will receive intramuscular injection of 3 doses of 30 µg Hecolin® at 0, 1 and 6 months. Arm B2 will receive intramuscular injection of 2 doses of 30 µg Hecolin® at 0 and 6 months while Arm B3 will receive intramuscular injection of comparator (placebo) intramuscularly at 0, 1 and 6 months. Similarly, Cohort C will be further divided into Arm C1, C2 and C3 having 70, 70 and 35 participants respectively. Arm C1 will receive intramuscular injection of 3 doses of 30 µg Hecolin® at 0, 1 and 6 months. Arm C2 will receive intramuscular injection of 2 doses of 30 µg Hecolin® at 0 and 6 months while Arm C3 will receive intramuscular injection of comparator (placebo) intramuscularly at 0, 1 and 6 months. Cohort D will be further divided into Arm D1, D2 and D3 having 40, 40 and 20 participants respectively. Arm D1 will receive intramuscular injection of 3 doses of 30 µg Hecolin® at 0, 1 and 6 months. Arm D2 will receive intramuscular injection of 2 doses of 30 µg Hecolin® at 0 and 6 months while Arm D3 will receive intramuscular injection of comparator (placebo) intramuscularly at 0,1 and 6 months. In the main study a total of 6 blood samples for immunogenicity will be collected from all participants at Day 0 (baseline), one month after first vaccination, one month after second vaccination, 6 months after first vaccination, one month after third vaccination, and at 6 months after third vaccination. Blood samples will be collected at screening and one month after third vaccination from the HIV + arm to document CD4 T cells and HIV Viral load. Out of the 860 participants enrolled in the main study, 2 additional blood samples after reconsent for the 2-year long term follow up period will be collected at V8 (12 months after 3rd dose) and V9 (24 months after 3rd dose) from any 100 HIV negative adults in Cohort A and from participants in Hecolin arms in Cohorts B, C and D (B1, B2, C1, C2, D1, and D2) for immunogenicity assessment. In the additional 0-1-month dose schedule component/arm, a total of 4 blood samples will be collected from all participants at V2 (Day 0), V3 (28 days after 1st dose), V4 (28 days after 2nd dose), V5 (6 months after 2nd dose), and 2 additional samples will be collected from participants in Hecolin arms in Cohorts B, C and D (B4, C4, and D4) at V6 (12months after 2nd dose), and V7 (24 months after 2nd dose) for immunogenicity assessment. All participants will be observed at the study site for 30 minutes after each Investigational Product (IP) injection for any reactogenicity events. Local and systemic solicited adverse events will be recorded in a diary card during 7 days after each IP dose while unsolicited adverse events will be recorded during the 4 weeks after each IP injection. Serious adverse events (SAEs), Medically attended adverse events (MAAEs) and Adverse of special interest (AESI) will be recorded during the entire study period i.e., until 6 months post last dose.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
1,040
30㎍/dose, 0.5mL administered intramuscularly
0.5mL administered intramuscularly
MeCRU Clinical Research Unit
Ga-Rankuwa, South Africa
RECRUITINGNewtown Clinical Research Centre
Johannesburg, South Africa
RECRUITINGBe Part Research
Paarl, South Africa
RECRUITINGSeroresponse rate
Seroresponse rate (antibody response greater than four times or more increase of anti-HEV IgG in paired sera) at 4 weeks post third dose of Hecolin® administered at 0, 1 and 6 months to healthy children (2-17 years) as compared to healthy adults (18-45 years)
Time frame: 4 weeks post third dose of Hecolin®
Proportion of immediate adverse events
Proportion of immediate adverse events within 30 minutes post each dose of vaccination in all study participants
Time frame: Within 30 minutes post each dose of vaccination
Proportion of solicited local and systemic adverse events
Proportion of solicited local and systemic adverse events within 7 days post each dose of vaccination in all study participants
Time frame: Within 7 days post each dose
Proportion of unsolicited adverse events
Proportion of unsolicited adverse events within 28 days post each dose of vaccination in all study participants
Time frame: Within 28 days post each dose
Proportion of SAEs, MAAEs and AESIs
Proportion of Serious adverse events (SAEs), Medically attended adverse events (MAAEs) and Adverse events of special interest (AESIs) post dose 1 until 6 months post last dose of vaccination
Time frame: Post dose 1 until 6 months post last dose
GMC of anti-HEV IgG
GMC of anti-HEV IgG at 4 weeks post third dose of Hecolin® administered at 0, 1 and 6 months to healthy children (2-17 years) as compared to healthy adults (18-45 years)
Time frame: 4 weeks post third dose
SR
SR (antibody response greater than four times or more increase of anti-HEV IgG in paired sera) 4 weeks post two doses of Hecolin® administered at 0, and 6 months as compared to three doses of Hecolin® administered at 0, 1 and 6 months to healthy children (2-17 years)
Time frame: 4 weeks post two doses of Hecolin®
GMC of anti-HEV IgG
GMC of anti-HEV IgG at 4 weeks post two doses of Hecolin® administered at 0, and 6 months as compared to three doses of Hecolin® administered at 0, 1 and 6 months to healthy children (2-17 years)
Time frame: 4 weeks post two doses of Hecolin®
SR and GMC of anti-HEV IgG
SR and GMC of anti-HEV IgG at 4 weeks post third dose of Hecolin® administered at 0, 1 and 6 months in healthy older children (6-17 years) and healthy adults (18-45 years)
Time frame: 4 weeks post third dose of Hecolin®
SR
SR (antibody response greater than four times or more increase of anti-HEV IgG in paired sera) at 24 weeks post two doses of Hecolin® administered at 0, and 6 months as compared to three doses of Hecolin® administered at 0, 1 and 6 months to healthy child
Time frame: 24 weeks post two doses of Hecolin®
GMC of anti-HEV IgG
GMC of anti-HEV IgG at 24 weeks post two doses of Hecolin® administered at 0, and 6 months as compared to three doses of Hecolin® administered at 0, 1 and 6 months to healthy children (2-17 years)
Time frame: 24 weeks post two doses of Hecolin®
SR
SR (antibody response greater than four times or more increase of anti-HEV IgG in paired sera) at 4 weeks post third dose of Hecolin® administered at 0, 1 and 6 months to HIV-positive adults as compared to HIV-negative healthy adults (18-45 years)
Time frame: 4 weeks post third dose of Hecolin®
GMC of anti-HEV IgG
GMC of anti-HEV IgG at 4 weeks post third dose of Hecolin® administered at 0, 1 and 6 months to HIV-positive adults as compared to HIV-negative healthy adults (18-45 years)
Time frame: 4 weeks post third dose of Hecolin®
SR
SR (antibody response greater than four times or more increase of anti-HEV IgG in paired sera) at 4 weeks post third dose of Hecolin® administered at 0, 1 and 6 months to virally suppressed (CD4 count \< 350) and virally unsuppressed (CD4 count ≥ 350) HIV-positive adults (18-45 years)
Time frame: 4 weeks post third dose of Hecolin®
GMC of anti-HEV IgG
MC of anti-HEV IgG at 4 weeks post third dose of Hecolin® administered at 0, 1 and 6 months to virally suppressed (CD4 count \< 350) and virally unsuppressed (CD4 count ≥ 350) HIV-positive adults (18-45 years)
Time frame: 4 weeks post third dose of Hecolin®
SR
SR (antibody response greater than four times or more increase of anti-HEV IgG in paired sera) at 4 weeks post first, second and third dose of Hecolin® /Placebo administered at 0, 1 and 6 months in healthy children (12-17 years), (6-11 years), (2-5 years) and adults (18-45 years) individually
Time frame: 4 weeks post first, second and third dose of Hecolin® /Placebo
GMC of anti-HEV IgG
GMC of anti-HEV IgG at 4 weeks post first, second and third dose of Hecolin® /Placebo administered at 0, 1 and 6 months in healthy children (12-17 years), (6-11 years), (2-5 years) and adults (18-45 years) individually
Time frame: 4 weeks post first, second and third dose of Hecolin® /Placebo
SR and GMC of anti-HEV IgG
SR and GMC of anti-HEV IgG at 4 weeks post first, second and third dose of Hecolin® /Placebo administered at 0, 1 and 6 months in healthy children (12-17 years), (6-11 years), (2-5 years) and adults (18-45 years) collectively and individually as per sero- status at baseline.
Time frame: 4 weeks post first, second and third dose of Hecolin® /Placebo
GMC of anti-HEV IgG for additional 0-1 dose schedule
GMC of anti-HEV IgG at 4 weeks post two doses of Hecolin® administered at 0 and 1 months as compared to three doses of Hecolin® administered at 0, 1 and 6 months to healthy children (2-17 years)
Time frame: 4 weeks post first, second of Hecolin
GMC of anti-HEV IgG for additional 0-1 dose schedule
SR and GMC of anti-HEV IgG in paired sera at 4 weeks post each dose of Hecolin® /Placebo when administered two doses at 0 and 1 months or at 0 and 6 months or three doses at 0, 1 and 6 months in individual age groups in healthy children (12 - 17 years, 6 - 11 years, and 2 - 5 years) or three doses at 0, 1 and 6 months in adults (18 - 45 years).
Time frame: 4 weeks post first, second and third dose of Hecolin® /Placebo
SR and GMC of anti-HEV IgG for additional 0-1 dose schedule
SR and GMC of anti-HEV IgG in paired sera at 4 weeks post each dose of Hecolin® /Placebo when administered two doses at 0 and 1 months or at 0 and 6 months or three doses at 0, 1 and 6 months in individual age groups in healthy children (12 - 17 years, 6 - 11 years, and 2 - 5 years) or three doses at 0, 1 and 6 months in adults (18 - 45 years).
Time frame: 4 weeks post first, second and third dose of Hecolin® /Placebo
SR and GMC of anti-HEV IgG for additional 0-1 dose schedule
SR (antibody response greater than four times or more increase of anti-HEV IgG in paired sera) at 24 weeks post two doses of Hecolin® administered at 0-, and 1- month in healthy children (2-17 years).
Time frame: 24 weeks post two doses of Hecolin®
SR and GMC of anti-HEV IgG for additional long-term follow up component
SR and GMC (defined as the percentage of participants with anti-HEV IgG antibodies above the detection limit, assessed at 1 year and 2 years post two doses of Hecolin® administered in healthy children (2-17 years) at 0- \& 6-months or at 0- \& 1-month or post 3 doses (0, 1 \& 6 month) in healthy children (2-17 years) and healthy adults (18-45 years)
Time frame: 1 and 2 years post two doses of Hecolin®
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