Bundibugyo virus (BDBV) causes severe and often fatal outbreaks of Bundibugyo virus disease (BVD). No vaccine against BDBV is licensed. There is an urgent need to identify vaccines that are safe, immunogenic, and effective in preventing disease among people at highest risk of infection. This is a Phase 2/3 randomized, double-blind, active-controlled adaptive platform trial evaluating candidate BDBV vaccines in contacts of confirmed BVD cases, co-sponsored by the University of Antwerp and the National Institute of Biomedical Research (INRB), Kinshasa. The contacts of each confirmed index case form a "ring". Eligible contacts are individually randomized to a candidate vaccine or an active comparator on Day 1, and on Day 29 all participants receive the crossover intervention, so that every participant is offered a candidate vaccine while the comparison between groups remains blinded. The platform allows additional candidates to enter as they are prioritized and allows evaluation of a candidate to be discontinued for futility, with an independent Data Monitoring Committee reviewing accumulating data throughout. The overall aim is to generate robust evidence to support the use of BDBV vaccines for outbreak response and future epidemic preparedness.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
3,810
Candidate BDBV vaccine - A candidate Bundibugyo virus vaccine recommended for prioritization by the independent WHO Technical Advisory Group on Candidate Vaccines Prioritization. Administered as a single dose. Dose, formulation and route are candidate-specific and are specified in the vaccine-specific appendix for each candidate entering the platform. Additional candidate vaccines may be added to the platform as they become available and meet the inclusion criteria.
Active comparator, Typhoid vaccine. All study interventions are reconstituted and dispensed by an uninvolved third party, such as a trial pharmacist, so that allocation remains masked.
Bunia
Bunia, Ituri, Democratic Republic of the Congo
Phase 2: Proportion of participants experiencing unsolicited Grade 3 or 4 adverse events, serious adverse events, SUSARs, adverse events of special interest, or medically attended adverse events
Proportion of vaccine recipients who experience unsolicited Grade 3 or 4 adverse events (AEs), serious adverse events (SAEs), suspected unexpected serious adverse reactions (SUSARs), adverse events of special interest (AESIs), or medically attended adverse events (MAAEs), assessed using severity and causality assessments. Events are summarized with counts, percentages and exact 95% confidence intervals.
Time frame: Day 1 to Day 181
Phase 3: Vaccine efficacy against PCR-confirmed symptomatic Bundibugyo virus disease with symptom onset 10 to 29 days after vaccination
Vaccine efficacy estimated by comparing the number of PCR-confirmed symptomatic Bundibugyo virus disease cases with symptom onset 10 to 29 days after randomization in each candidate vaccine arm with the comparator arm. The primary analysis is per-protocol.
Time frame: Day 10 to Day 29 after vaccination
Phase 2: Seroconversion rate measured by ELISA for IgM and IgG titres
Seroconversion assessed by ELISA for IgM and IgG titres in an immunogenicity cohort of 50 individuals per candidate vaccine arm and 50 individuals in the comparator group randomized alongside that candidate. Samples are collected from all participants in the cohort at every time point to preserve masking. Analysis is aligned to the timing of candidate vaccine receipt in each group: Days 1, 15, 29 and 181 for candidate vaccine recipients, and Days 29, 43, 57 and 181 for comparator recipients, where Day 29 is the pre-crossover baseline.
Time frame: Days 1, 15, 29, 43, 57 and 181
Phase 3: Number of confirmed Bundibugyo virus disease deaths in each arm
Number of deaths from confirmed Bundibugyo virus disease in each arm, used to compare case fatality rates between each candidate vaccine arm and the comparator arm.
Time frame: Day 0 to Day 29 after vaccination
Phase 3: Number of PCR-confirmed symptomatic Bundibugyo virus disease cases with symptom onset 10 to 29 days after vaccination, modified intention-to-treat
Number of PCR-confirmed symptomatic Bundibugyo virus disease cases with symptom onset 10 to 29 days after vaccination in each arm, analyzed as modified intention-to-treat, to estimate vaccine efficacy between each candidate vaccine arm and the comparator arm.
Time frame: Day 10 to Day 29 after vaccination
Phase 3: Number of PCR-confirmed symptomatic Bundibugyo virus disease cases with symptom onset 0 to 9 days after vaccination
Number of PCR-confirmed symptomatic Bundibugyo virus disease cases with symptom onset 0 to 9 days after vaccination in each arm, used to estimate vaccine efficacy in the period before protection is expected to be established.
Time frame: Day 0 to Day 9 after vaccination
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.