This randomized, double-blind, three parallel-group, multicenter, phase 3b trial evaluates the safety and immunogenicity of Butantan-DV. The study compares two primary immunization regimens (Butantan-DV/Butantan-DV vs. Butantan-DV/Placebo) across both the 2-11 and 12-17 age cohorts. It also evaluates the manufacturing facility transition for the Butantan-DV dengue vaccine, by comparing the open-label arm WuXi Biologics (Butantan-DV group) to both double-blinded Butantan-DV/Butantan-DV and Butantan-DV/Placebo arms, in adolescents aged 12 to 17.
This randomized three parallel-group trial (one open-label, two double-blinded) evaluates the safety and humoral immunogenicity of a 0.5 mL dose (subcutaneously) of the tetravalent Butantan-DV vaccine against four dengue virus serotypes (DENV-1-4). It will address the two-dose primary immunization regimen superiority in children (2-11 years) or adolescents (12-17 years), in comparison to the one dose regimen versus placebo on Day 29 post second vaccination. The manufacturing facility transition for the Butantan-DV dengue vaccine will evaluate the non-inferiority of humoral immunogenicity between WuXi Biologics formulation (Butantan-DV WuXi) against both Butantan-DV (IB) arms, on Day 29 post first vaccination, in adolescents (12-17 years). Safety endpoint consists in local or systemic solicited and unsolicited adverse events, in children and adolescents up to Day 22 after each vaccine dose.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
1,765
Butantan-DV manufactured at the Instituto Butantan - Butantan-DV (IB), mean 10³ PFU (per dose), subcutaneously, in the deltoid region.
Butantan-DV manufactured at the WuXi Biologics CRDMO - Butantan-DV (WuXi),mean 10³ PFU (per dose), subcutaneously, in the deltoid region.
Placebo manufactured at the Instituto Butantan - Placebo (IB), mean 0 PFU (per dose), subcutaneously, in the deltoid region.
Immunogenicity - 1
Geometric Mean Fold-Rise ratio of neutralizing antibodies measured by PRNT50 against the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) in participants in the Butantan-DV (IB) + Butantan-DV (IB) group, compared to participants in the Butantan-DV (IB) + Placebo (IB) group, in children aged 2 to 11 years.
Time frame: Group Butantan-DV (IB) + Butantan-DV (IB) on Day 302 and Group Butantan-DV (IB) + Placebo (IB) on Day 29 post vaccination.
Immunogenicity - 2
Geometric Mean Fold-Rise ratio of neutralizing antibodies measured by PRNT50 against the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) in participants of the Butantan-DV (IB) + Butantan-DV (IB) group at Day 302, compared to participants of the Butantan-DV (IB) + Placebo (IB) group at Day 29, in adolescents aged 12 to 17 years.
Time frame: Group Butantan-DV (IB) + Butantan-DV (IB) on Day 302 and Group Butantan-DV (IB) + Placebo (IB) on Day 29 post vaccination.
Immunogenicity - 3
Geometric Mean Fold-Rise ratio of neutralizing antibodies measured by PRNT50 against the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) in participants of the Butantan-DV (WuXi) Group compared to participants of the other two Butantan-DV (IB) groups, in adolescents aged 12 to 17 years.
Time frame: Day 29 post vaccination.
Safety - 1
Frequency of solicited and unsolicited adverse reactions in participants in the Butantan-DV + Butantan-DV group and in participants in the Butantan-DV (IB) + Placebo (IB) group, among children aged 2 to 11 years.
Time frame: First 21 days after each vaccine dose (up to Day 22 and from Day 273 to Day 294).
Safety - 2
Frequency of solicited and unsolicited adverse reactions after each vaccine dose in participants in the Butantan-DV (IB) + Butantan-DV (IB) group and in participants in the Butantan-DV (IB) + Placebo (IB) group, among adolescents aged 12 to 17 years.
Time frame: First 21 days after each vaccine dose (up to Day 22 and from Day 273 to Day 294).
Safety - 3
Frequency of solicited and unsolicited adverse reactions in participants in the Butantan-DV (WuXi) Group and in participants in the other two Butantan-DV (IB) groups who received the first dose of the primary immunization series, among adolescents aged 12 to 17 years.
Time frame: First 21 days after each vaccine dose (up to Day 22).
Immunogenicity - 4
Geometric Mean Fold-Rise ratio (rGMFR) in neutralizing antibody titers measured by PRNT50, for each dengue virus serotype (DENV-1, DENV-2, DENV-3, and DENV-4), postvaccination, for participants in the Butantan-DV (IB) + Butantan-DV (IB) group compared to participants in the Butantan-DV (IB) + Placebo (IB) group, among children aged 2 to 11 years and adolescents aged 12 to 17 years.
Time frame: Day 29 postvaccination.
Immunogenicity - 5
Geometric Mean Fold-Rise ratio (rGMFR) of neutralizing antibody titers measured by PRNT50-for each dengue virus serotype (DENV-1, DENV-2, DENV-3, and DENV-4)-comparing the Butantan-DV (WuXi) Group to the other Butantan-DV (IB) groups that received only the first vaccination.
Time frame: Day 182 postvaccination.
Immunogenicity - 6
Difference between proportions of seroconversion (95% CI) in the Butantan-DV (IB) + Butantan-DV (IB) group and seroconversion in the Butantan-DV (IB) + Placebo (IB) group, for the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). Seroconversion defined as ≥1:10 from a baseline titer \<1:10 post-vaccination or a fourfold increase relative to baseline for a baseline titer ≥1:10.
Time frame: Day 302 in the Butantan-DV (IB) + Butantan-DV (IB) Group and Day 29 in the Butantan-DV (IB) + Placebo (IB) Group.
Immunogenicity - 7
Cellular immune response in a cohort of 50 consecutive participants from the Butantan-DV (IB) + Butantan-DV (IB) group and the Butantan-DV (IB) + Placebo (IB) group, against the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). The immune response will consist of the proportion (%) of DENV-1- through DENV-4-specific CD4+ and CD8+ T cells (producing IFN-γ) following vaccine stimulation.
Time frame: Days 1, 29, 182, 302, and 456 post vaccination.
Safety - 4
Frequency (95% CI and p-value) for the difference in proportions of participants with solicited (local and systemic) and unsolicited adverse reactions comparing the Butantan-DV (IB) + Butantan-DV (IB) group with the Butantan-DV (IB) + Placebo (IB) group, in children aged 2 to 11 years and adolescents aged 12 to 17 years.
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Time frame: Period between the second dose and Day 294.
Safety - 5
Frequency (95% CI and p-value) for the difference in proportions of participants with solicited (local and systemic) and unsolicited adverse reactions, among participants in the Butantan-DV (WuXi) Group and participants in the other Butantan-DV (IB) groups who received the first dose of the primary immunization series, in adolescents aged 12 to 17 years.
Time frame: Period between the first dose and Day 22.
Safety - 6
Frequency (95% CI) of the difference in proportions of participants with adverse events requiring medical attention (AERMA) post-vaccination across the three groups, in children aged 2 to 11 years and adolescents aged 12 to 17 years.
Time frame: Day 1 to Day 43 and Day 273 to Day 315
Safety - 7
Frequency (95% CI and p-value) of the difference between proportions, of participants with serious adverse events (SAEs) post-vaccination across the three groups, among children aged 2 to 11 and adolescents aged 12 to 17 years.
Time frame: Throughout the entire study period, an average of 1 year.
Safety - 8
Frequency (95% CI and p-value) of the difference in proportions of participants with adverse events of special interest (AESI) post-vaccination, across the three groups, in children aged 2 to 11 years and adolescents aged 12 to 17 years.
Time frame: Throughout the entire study period, an average of 1 year.
Safety - 9
Frequency (95% CI and p-value) of the difference in proportions of participants with adverse events of special interest (AESI) post-vaccination, across the three groups, in children aged 2 to 11 years and adolescents aged 12 to 17 years.
Time frame: Throughout the entire study period, an average of 1 year.
Safety - 10
Frequency of viremia after each dose of the primary immunization and laboratory changes at visits on in a cohort of 50 adolescent participants aged 12 to 17 years from the Butantan-DV (IB) + Butantan-DV (IB) group and the Butantan-DV (IB) + Placebo (IB) group, for all dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) and by valence.
Time frame: Days 1, 6, 9, 12, 22, 273, 279, 282, 285, and 294.