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This study is a combination of a Phase I and Phase III study design. The Phase I portion is an open-label, controlled study to evaluate the safety of 7vPnC in healthy Chinese infants. The Phase III portion is an open-label, controlled, randomized study to evaluate the safety and immunogenicity of 7-Valent Pneumococcal Conjugate Vaccine (7vPnC)in healthy Chinese infants. Both phases include a Primary Series which includes the primary 3 doses of 7vPnC and /or Diptheria and tetanus toxoids and accelular pertussis vaccine (DTaP) at about 3, 4, and 5 months of age; and a Booster Dose which includes the 4th dose of 7vPnC at 12-15 months of age.
This study is a combination of a Phase I and Phase III study design. The Phase I portion is an open-label, controlled study to evaluate the safety of 7vPnC in healthy Chinese infants. The Phase III portion is an open-label, controlled, randomized study to evaluate the safety and immunogenicity of 7vPnC in healthy Chinese infants. Both phases include a Primary Series which includes the primary 3 doses of 7vPnC and/or DTaP at about 3, 4, and 5 months of age; and a Booster Dose which includes the 4th dose of 7vPnC at 12-15 months of age. A total of 822 healthy Chinese infants will be enrolled. The study will be conducted in 2 phases: Phase I and Phase III.
Phase I: 22 healthy infants will be enrolled first and receive a dose of 7vPnC at least 7 days prior to receiving DTaP and followed up on safety for 30 days post the immunization. If there are no adverse events of specific concern considered, in the opinion of the principal investigator, related to the study vaccine (including, though not limited to, infectious and allergic reactions as described in the China Immunization Handbook) within 4 days after the first dose immunization and no serious adverse event possibly, probably or definitely related to the study vaccine within 30 days after the first dose of immunization, Phase III can be initiated and the infants in Phase I will proceed to the next dose of the Primary Series. If such events occur, a medical review will be conducted by both the investigator and the Sponsor to decide if the study can proceed.
Phase III: 800 infants will be enrolled and randomized to one of 3 groups according to the administration regimen. Group 1: 300 infants will receive the primary 3 doses of 7vPnC separately at 3, 4 and 5 months of age. Group 2: 300 infants will receive the primary 3 doses of 7vPnC concurrently with DTaP at 3, 4 and 5 months of age. Group 3: 200 infants will receive DTaP only at 3, 4 and 5 months of age. The injection site is the left upper arm deltoid for 7vPnC and the right upper arm deltoid for DTaP.
Safety Evaluation: Each infant will have an initial physical examination and history obtained at the enrollment visit and a brief physical evaluation at each subsequent visit. Following immunization, each subject will be observed in the clinic for 30 minutes and evaluated for signs or symptoms of anaphylaxis and reactions at the injection sites. The parent or legal guardian will be required to take the infant's axillary temperature on the evening of immunization and for 3 consecutive evenings following the immunization. In addition, if the parent suspects that the infant may have a fever at any time in the four days following immunization, the temperature is to be taken and recorded. Thermometers for axillary temperature use and diary cards will be supplied by Wyeth for distribution to the parents.
The parent or legal guardian of each subject will be instructed to complete a diary card for 4 days [day of immunization (day 0) and next 3 days] following each immunization. Information collected will include: the subject's axillary temperature, local reactions at the 7vPnC injection site (All subjects in Phase I of the study and Group 1 and Group 2 of Phase III) and DTaP injection site (Group 2 and Group 3 of Phase III) (tenderness, presence and size of erythema and induration/swelling) and any systemic reactions (disrupted sleep, drowsiness, decreased appetite, irritability, vomiting, diarrhea and rash not limited to the injection site) occurring days 0-3. The subject will return to clinic or be visited at home on the day after immunization (Day 1) for local and systemic reaction observation by study personnel. The parent or legal guardian will be contacted by telephone or home visit at 2 and 3 days post-immunization to collect information on local and systemic events and the information will be recorded on the source data sheet by study personnel. On, or after, the fourth day after each immunization, the study personnel will collect the diary card. The data in the diary card will be reconciled with the data in the source data sheet. If there is discrepancy, it should be clarified with the parents and recorded.
At the visit of next immunization, the interim medical history since Day 4 post last immunization will be reviewed with the parent/legal guardian. If there is any adverse event, it should be collected and recorded in the case report form. The primary source of data on adverse events will be the parent or legal guardian of each subject, as well as any medical records from a health care provider sought as a result of an adverse event. The parent/legal guardian is instructed to contact the investigators immediately for any serious adverse events.
Assessment of Immunogenicity: Up to 3ml venous blood will be collected from 55 infants in Group 1, 55 infants in Group 2 and 55 infants in Group 3 of Phase III, immediately prior to the first dose and 30-40 days after the 3rd dose to assess the immunogenicity.
Booster Dose: All infants in Phase I and Group 1 and Group 2 of Phase III will receive the booster dose of 7vPnC at 12-15 months of age. Local/systemic reactions will be observed in the same way as after the primary dose.
Assessment of Immunogenicity: Up to 3ml venous blood will be collected from the same 55 infants in Group 1 and 55 infants in Group 2 as in the Primary Series of Phase III, immediately prior to the forth dose and 30-40 days after the 4th dose to assess the immunogenicity.
The statistical analysis of the two phases will be conducted separately. The statistical analysis of the primary series is planned when all subjects have received the 1st, 2nd and 3rd dose of 7vPnC and 3 doses of DTaP or 3 doses of DTaP alone and the 30-day safety follow-up period has terminated. The analysis of the booster dose is planned when all subjects have received the 4th dose of 7vPnC and the 30-day safety follow-up period has terminated.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 7-valent pneumococcal conjugate vaccine | Biological | |||
| Diptheria and tetanus toxoids and accelular pertussis vaccine (DTaP) | Biological |
| Measure | Description | Time Frame |
|---|---|---|
| Concentration of Serotype-Specific IgG Antibodies | Vaccine efficacy can be assessed by measuring the levels of antibodies to the specific types (or serotypes) of bacteria covered by the vaccine. IgG antibodies for the 7 pneumococcal serotypes in 7vPnC (4, 6B, 9V, 14, 18C, 19F, 23F) were assessed 30-50 days after the third dose of vaccine. Antibody levels were measured by standardized enzyme-linked immunosorbent assay (ELISA). The minimum level of antibodies required to confer protection has been defined as 0.15 ug/ml by the Northern California Kaiser Permanente (NCKP) study, and as 0.35 ug/ml by the World Health Organization (WHO). | 7 months |
| Measure | Description | Time Frame |
|---|---|---|
| Concentration of Serotype-Specific IgG Antibodies | Vaccine efficacy can be assessed by measuring the levels of antibodies to the specific types (or serotypes) of bacteria covered by the vaccine. IgG antibodies for the 7 pneumococcal serotypes in 7vPnC (4, 6B, 9V, 14, 18C, 19F, 23F) were assessed 30-50 days after the third dose of vaccine. Antibody levels were measured by standardized enzyme-linked immunosorbent assay (ELISA). The minimum level of antibodies required to confer protection has been defined as 0.15 ug/ml by the Northern California Kaiser Permanente (NCKP) study and as 0.35 ug/ml by the World Health Organization (WHO). |
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Inclusion Criteria:
Exclusion Criteria:'
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| Name | Affiliation | Role |
|---|---|---|
| Medical Monitor | Wyeth is now a wholly owned subsidiary of Pfizer | Study Director |
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Subjects were enrolled into study according to inclusion/exclusion criteria without a screening period.
Subjects were recruited in China from September 2006 to May 2007.
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| ID | Title | Description |
|---|---|---|
| FG000 | 7vPnC Separately | 7-valent pneumococcal conjugate vaccine (7vPnC) administered at 3, 4, and 5 months of age. Diphtheria and tetanus toxoids and accelular pertussis vaccine (DTaP) administered at least 7 days after 7vPnC at 3, 4, and 5 months of age. |
| FG001 | 7vPnC + DTaP Concurrently | 7vPnC adminstered concurrently with DTaP at 3, 4, and 5 months of age. |
| FG002 | DTaP Alone | DTaP administered at 3, 4, and 5 months of age. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | 7vPnC Separately | 7-valent pneumococcal conjugate vaccine (7vPnC) administered at 3, 4, and 5 months of age. Diphtheria and tetanus toxoids and accelular pertussis vaccine (DTaP) administered at least 7 days after 7vPnC at 3, 4, and 5 months of age. |
| BG001 | 7vPnC + DTaP Concurrently |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Concentration of Serotype-Specific IgG Antibodies | Vaccine efficacy can be assessed by measuring the levels of antibodies to the specific types (or serotypes) of bacteria covered by the vaccine. IgG antibodies for the 7 pneumococcal serotypes in 7vPnC (4, 6B, 9V, 14, 18C, 19F, 23F) were assessed 30-50 days after the third dose of vaccine. Antibody levels were measured by standardized enzyme-linked immunosorbent assay (ELISA). The minimum level of antibodies required to confer protection has been defined as 0.15 ug/ml by the Northern California Kaiser Permanente (NCKP) study, and as 0.35 ug/ml by the World Health Organization (WHO). | Population analyzed was available immunogenicity population (all subjects who completed the primary series of 7vPnC or DTaP and had the post-third dose serum available for assessment) and were in either the "7vPnC separately" or "DTaP alone" group. The "7vPnC + DTaP" group was not part of the primary objective; no statistical testing was done. | Posted | Dec 2008 | Geometric Mean | 95% Confidence Interval | ug/ml | 7 months |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 7vPnC Separately | 7-valent pneumococcal conjugate vaccine (7vPnC) administered at 3, 4, and 5 months of age. Diphtheria and tetanus toxoids and accelular pertussis vaccine (DTaP) administered at least 7 days after 7vPnC at 3, 4, and 5 months of age. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Bronchopneumonia | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| U. S. Contact Center | Wyeth | clintrialresults@wyeth.com |
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| ID | Term |
|---|---|
| D011008 | Pneumococcal Infections |
| ID | Term |
|---|---|
| D013290 | Streptococcal Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
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| ID | Term |
|---|---|
| D000069443 | Heptavalent Pneumococcal Conjugate Vaccine |
| D013745 | Tetanus Toxoid |
| ID | Term |
|---|---|
| D022242 | Pneumococcal Vaccines |
| D022541 | Streptococcal Vaccines |
| D001428 | Bacterial Vaccines |
| D014612 | Vaccines |
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| 7 months |
| Adverse Event |
|
| Lost to Follow-up |
|
| Protocol Deviations |
|
7vPnC adminstered concurrently with DTaP at 3, 4, and 5 months of age. |
| BG002 | DTaP Alone | DTaP administered at 3, 4, and 5 months of age. |
| BG003 | Total | Total of all reporting groups |
| months |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| OG000 |
| 7vPnC Separately |
7-valent pneumococcal conjugate vaccine (7vPnC) administered at 3, 4, and 5 months of age. Diphtheria and tetanus toxoids and accelular pertussis vaccine (DTaP) administered at least 7 days after 7vPnC at 3, 4, and 5 months of age. |
| OG001 | 7vPnC + DTaP Concurrently | 7vPnC adminstered concurrently with DTaP at 3, 4, and 5 months of age. |
| OG002 | DTaP Alone | DTaP administered at 3, 4, and 5 months of age. |
|
|
|
| Secondary | Concentration of Serotype-Specific IgG Antibodies | Vaccine efficacy can be assessed by measuring the levels of antibodies to the specific types (or serotypes) of bacteria covered by the vaccine. IgG antibodies for the 7 pneumococcal serotypes in 7vPnC (4, 6B, 9V, 14, 18C, 19F, 23F) were assessed 30-50 days after the third dose of vaccine. Antibody levels were measured by standardized enzyme-linked immunosorbent assay (ELISA). The minimum level of antibodies required to confer protection has been defined as 0.15 ug/ml by the Northern California Kaiser Permanente (NCKP) study and as 0.35 ug/ml by the World Health Organization (WHO). | The population analyzed was all the available immunogenicity population (all subjects who completed the primary series of 7vPnC or DTaP and had the post third dose serum available for assessment) and were in either "7vPnC+DTaP Concurrently" or "DTaP Alone" group. The "7vPnC Separately" group was not included as part of this objective. | Posted | Dec 2008 | Geometric Mean | 95% Confidence Interval | ug/ml | 7 months |
|
|
|
|
| 3 |
| 206 |
| EG001 | 7vPnC + DTaP Concurrently | 7vPnC adminstered concurrently with DTaP at 3, 4, and 5 months of age. | 7 | 263 |
| EG002 | DTaP Alone | DTaP administered at 3, 4, and 5 months of age. | 1 | 137 |
| Pneumonia | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Enteritis | Gastrointestinal disorders | Non-systematic Assessment |
|
| Tachypnea | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Acute Bronchitis | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Upper respiratory infection | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Pyrexia | General disorders | Non-systematic Assessment |
|
| Nasopharyngitis | Infections and infestations | Non-systematic Assessment |
|
| Upper respiratory tract infection | Infections and infestations | Non-systematic Assessment |
|
| Cough | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
The PIs agreed to allow the sponsor 60 days to review and require changes to presentations or publications but only to protect confidential information and intellectual property, and for the sponsor to file a patent application, as applicable. The PIs also agreed for data to be presented first as a joint, multi-center publication.
| D007239 | Infections |
| D001688 |
| Biological Products |
| D045424 | Complex Mixtures |
| D017778 | Vaccines, Combined |
| D014121 | Toxoids |
| Serotype 9V |
|
| Serotype 14 |
|
| Serotype 18C |
|
| Serotype 19F |
|
| Serotype 23F |
|
The ratio of the "7vPnC + DTaP Concurrently" group to "DTaP Alone" group geometric mean comparisons (GMC) was provided with a corresponding 90% confidence interval. |
P-Values were not calculated. |
| Geometric mean ratio |
| 22.2 |
| 90 |
| 13.99 |
| 31.77 |
This analysis is for Serotype 6B. |
| No |
| Superiority or Other |
| The ratio of the "7vPnC + DTaP Concurrently" group to "DTaP Alone" group geometric mean comparisons (GMC) was provided with a corresponding 90% confidence interval. | P-Values were not calculated. | Geometric mean ratio | 73.7 | 90 | 56.41 | 103.6 | This analysis is for Serotype 9V. | No | Superiority or Other |
| The ratio of the "7vPnC + DTaP Concurrently" group to "DTaP Alone" group geometric mean comparisons (GMC) was provided with a corresponding 90% confidence interval. | P-Values were not calculated. | Geometric mean ratio | 99.48 | 90 | 61.09 | 147.5 | This analysis is for Serotype 14. | No | Superiority or Other |
| The ratio of the "7vPnC + DTaP Concurrently" group to "DTaP Alone" group geometric mean comparisons (GMC) was provided with a corresponding 90% confidence interval. | P-Values were not calculated. | Geometric mean ratio | 164 | 90 | 114.9 | 232.9 | This analysis is for Serotype 18C. | No | Superiority or Other |
| The ratio of the "7vPnC + DTaP Concurrently" group to "DTaP Alone" group geometric mean comparisons (GMC) was provided with a corresponding 90% confidence interval. | P-Values were not calculated. | Geometric mean ratio | 81.45 | 90 | 57.98 | 119.1 | This analysis is for Serotype 19F. | No | Superiority or Other |
| The ratio of the "7vPnC + DTaP Concurrently" group to "DTaP Alone" group geometric mean comparisons (GMC) was provided with a corresponding 90% confidence interval. | P-Values were not calculated. | Geometric mean ratio | 44.7 | 90 | 29.48 | 68.71 | This analysis is for Serotype 23F. | No | Superiority or Other |