Given the recent circulation of avian influenza A(H5N1) clade 2.3.4.4b strains in birds and mammals in North America, Canada procured a supply of Arepanrix™ H5N1 for potential use in persons at high risk of highly pathogenic avian influenza exposure. This vaccine received regulatory approval in 2013, to be given in two doses at least 3 weeks apart. There is limited data on the effect of various intervals between the two doses on immunogenicity and tolerability. In this study two intervals between doses will be compared (3 vs. 8 weeks apart).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
312
The H5N1 (Arepanrix) vaccine will be administered according to the Product Monograph.
Normal saline will be administered as a placebo according to the Product Monograph.
Vaccine Evaluation Center
Vancouver, British Columbia, Canada
Canadian Center for Vaccinology
Halifax, Nova Scotia, Canada
Vaccine Study Centre of the McGill University Health Centre
Pierrefonds, Quebec, Canada
CHU de Québec
Québec, Quebec, Canada
Percentages of participants with seroprotection against the H5N1 2.3.4.4b clade vaccine given 3 vs. 8 weeks apart
Percentages of participants with seroprotection against the H5N1 2.3.4.4b clade 28 days following administration of 2 doses of avian influenza A(H5N1) vaccine given 3 vs. 8 weeks apart based on serologic outcomes at visit 4 (approximately week 12). Seroprotection is defined as the proportion of subjects who were either seronegative prior to vaccination and have a protective post-vaccination HI titre of ≥ 1:40 or who were seropositive prior to vaccination and have at least a 4-fold increase in HI titre post-vaccination.
Time frame: 28 days post-administration of 2 doses of avian influenza A (H5N1 (Approximately week 12).
Immunogenicity - Percentages of participants with seroconversion and the geometric mean fold rise against the H5N1 2.3.4.4b clade vaccine given 3 vs. 8 weeks apart.
Definition of Seroconversion rate: the proportion of subjects who were either seronegative prior to vaccination and have a protective post-vaccination HI titre of ≥ 1:40 or who were seropositive prior to vaccination and have at least a 4-fold increase in HI titre post-vaccination) as acceptable by regulators for approval of a Pandemic influenza Vaccine (22). Definition of Geometric mean fold rise: the ratio of the post-vaccination geometric mean HI titre divided by the pre-vaccination geometric mean HI titre) acceptable by regulators for approval of a Pandemic influenza Vaccine (22).
Time frame: 28 days post-administration of 2 doses of avian influenza A (H5N1)
Immunogenicity - GMT of HI against the H5N1 2.3.4.4b clade vaccine given 3 vs. 8 weeks apart.
GMT of HI against the H5N1 2.3.4.4b clade 28 days following administration of 2 doses of avian influenza A(H5N1) vaccine given 3 vs. 8 weeks apart.
Time frame: 28 days post-administration of 2 doses of avian influenza A (H5N1) vaccine
Immunogenicity - Percentages of participants with seroprotection, seroconversion and the geometric mean fold rise against the H5N1 2.3.4.4b clade
Percentages of participants with seroprotection, seroconversion and the geometric mean fold rise against the H5N1 2.3.4.4b clade following administration of 1 dose of avian influenza A(H5N1) vaccine.
Time frame: at baseline, at 3 weeks, at 8 weeks, 12 weeks, 26 weeks and through study completion (average of 1 year).
Immunogenicity - Percentages of participants with seroprotection, seroconversion and the geometric mean fold rise against the H5N1 2.3.4.4b clade
Percentages of participants with seroprotection, seroconversion and the geometric mean fold rise against the H5N1 2.3.4.4b clade 6 and 12 months after the first dose of avian influenza A(H5N1) vaccine given 3 vs. 8 weeks apart.
Time frame: 6 and 12 months after the first dose of avian influenza A (H5N1) vaccine
Incidence of Grade 3 & 4 Adverse Events
The following AEFIs will be collected in all participants: 1. Grade 3 solicited local and systemic adverse events in the 7 days following vaccine receipt; 2. SAEs at any time after vaccine receipt during the study; 3. MAAE at any time after vaccine receipt during the study, 4. AESI at any time after vaccine receipt during the study; 5. Provincially reportable AEFI at after vaccine receipt; and 6. acceptability as measured by participant questionnaire. Solicited adverse events and grading Grade 3 and 4 solicited local (injection-site) and systemic adverse events occurring during the 7-day follow-up period after each injection will be recorded. Solicited local (injection-site) adverse events (Pain, redness and swelling at injection site). Solicited systemic AEs, grade 3 and 4 will be recorded (Fatigue, fever - recorded, headache, nausea, diarrhea, vomiting, generalized muscle aches, joint pain and chills).
Time frame: Up to 12 months after the first dose of avian influenza A (H5N1) vaccine
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