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This study will test two new vaccines, one for Ebola and one for Marburg virus, to see if they are safe, if they have side effects, and if they create an immune response in people who receive them.
The Ebola and Marburg viruses are both filoviruses known to induce hemorrhagic fever-a set of symptoms characterized by sudden onset, aching, fever, and bleeding in the internal organs. Both filoviruses are associated with high mortality rates, and the Centers for Disease Control (CDC) lists them as Category A bioterrorism agents because of their potential for a major public health impact. Vaccines for both viruses are under development using a prime-boost strategy that involves multiple injections over a period of time to confer long-lasting immunity. Preliminary research supports the vaccines' safety. This study will test these experimental vaccines for the Ebola and Marburg viruses, first administered separately and then together, to ensure they are safe and do not have side effects.
Participation in this study will entail 11 study visits over 2 years. The study will have two parts, to be completed sequentially, and three groups. In part one, participants will be randomly assigned to the first group, which will receive the experimental Ebola DNA vaccine, or the second group, which will receive the experimental Marburg DNA vaccine. In part two, the third group will receive both the Ebola and the Marburg vaccines, one shot in each arm. One fifth of the participants in each group will be controls and receive placebo injections. All vaccines and placebos will be delivered via an intramuscular injection at three time points: at study entry, after 4 weeks, and after 8 weeks.
Participants will complete study assessments at 12 points in time: at baseline and at Weeks 2, 4, 6, 8, 10, 12, 24, 32, 52, 78, and 104. At each assessment, changes in health and medications will be recorded and blood will be drawn. Participants will also complete a diary card daily for 5 days after receiving each injection. In it, they will record their temperature and any skin changes at the injection site.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ebola vaccine only | Experimental | Participants will receive only the Ebola vaccine or a placebo injection. |
|
| Marburg vaccine only | Experimental | Participants will receive only the Marburg vaccine or a placebo injection. |
|
| Ebola and Marburg vaccine | Experimental | Participants will receive both the Ebola and Marburg vaccines, one in each arm or placebo injections. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ebola vaccine | Biological | 4 mg of Ebola DNA plasmid vaccine, VRC-EBODNA023-00-VP, delivered via intramuscular injection on Weeks 0, 4, and 8 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety of Ebola vaccine, as seen in local and systemic reactogenicity signs and symptoms, laboratory measures of safety, and adverse and serious adverse experiences | Measured at 11 or more visits over 2 years | |
| Safety of Marburg vaccine, as seen in local and systemic reactogenicity signs and symptoms, laboratory measures of safety, and adverse and serious adverse experiences | Measured at 11 or more visits over 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Immunogenicity of Ebola vaccine, as seen in ELISA antigen-specific assays for antibodies, intracellular cytokine staining (ICS) assay, and an ELISPOT antigen-specific assay for T cell responses | Measured at baseline and Week 12 | |
| Immunogenicity of Marburg vaccine, as seen in ELISA antigen-specific assays for antibodies, intracellular cytokine staining (ICS) assay, and an ELISPOT antigen-specific assay for T cell responses |
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Inclusion Criteria:
Exclusion Criteria:
Pregnant, breast-feeding, or planning to become pregnant during the first 24 weeks after enrollment
History of Ebola or Marburg virus exposure
Occupational health risk of exposure to the Ebola or Marburg virus known to be higher than that of the general population
Has received any of the following substances:
History of serious adverse reactions to vaccines such as anaphylaxis, urticaria (hives), respiratory difficulty, angioedema, or abdominal pain
Presence of idiopathic urticaria within the past 2 years
History of autoimmune disease or immunodeficiency
History of unstable asthma; asthma that required emergent care, urgent care, hospitalization or intubation during the past 2 years; or asthma that requires the use of oral or parenteral corticosteroids
History of diabetes mellitus (type I or II), with the exception of a history of gestational diabetes
History of thyroidectomy or thyroid disease that required medication within the past 12 months
History of hereditary angioedema (HAE), acquired angioedema (AAE), or idiopathic forms of angioedema
History of hypertension that is not well controlled by medication or blood pressure that is more than 145/95 mm Hg at enrollment
Presence of a bleeding disorder diagnosed by a doctor (e.g., factor deficiency, coagulopathy, or platelet disorder requiring special precautions), significant bruising or bleeding difficulties with intramuscular injections or blood draws, or routine use of anticoagulant medications
Presence of active malignancy, treated malignancy for which there is not reasonable assurance of sustained cure, or malignancy that is likely to recur during the period of the study
History of a seizure or seizure disorder
Asplenia, functional asplenia, or any condition resulting in the absence or removal of the spleen
Allergic reaction to aminoglycoside antibiotics
Presence of a psychiatric condition that precludes compliance with the protocol
History of psychoses, bipolar disorder, disorder requiring lithium, or suicide plan or attempt within 5 years prior to enrollment
Any medical, psychiatric, social condition, occupational reason, or other responsibility that, in the judgment of the investigator, is a contraindication to protocol participation or impairs a subject's ability to give informed consent
Evidence of syphilis based on history, exam, and rapid plasma reagin (RPR) test results
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| Name | Affiliation | Role |
|---|---|---|
| Hannah Kibuuka, MBChB, MMed, MPH | Makerere University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Makerere University Walter Reed Project (MUWRP) clinic | Kampala | Uganda |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25540891 | Derived | Kibuuka H, Berkowitz NM, Millard M, Enama ME, Tindikahwa A, Sekiziyivu AB, Costner P, Sitar S, Glover D, Hu Z, Joshi G, Stanley D, Kunchai M, Eller LA, Bailer RT, Koup RA, Nabel GJ, Mascola JR, Sullivan NJ, Graham BS, Roederer M, Michael NL, Robb ML, Ledgerwood JE; RV 247 Study Team. Safety and immunogenicity of Ebola virus and Marburg virus glycoprotein DNA vaccines assessed separately and concomitantly in healthy Ugandan adults: a phase 1b, randomised, double-blind, placebo-controlled clinical trial. Lancet. 2015 Apr 18;385(9977):1545-54. doi: 10.1016/S0140-6736(14)62385-0. Epub 2014 Dec 23. |
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| ID | Term |
|---|---|
| D019142 | Hemorrhagic Fever, Ebola |
| D008379 | Marburg Virus Disease |
| ID | Term |
|---|---|
| D006482 | Hemorrhagic Fevers, Viral |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D046129 | Ebola Vaccines |
| ID | Term |
|---|---|
| D014765 | Viral Vaccines |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
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| Marburg vaccine | Biological | 4 mg of Marburg DNA plasmid vaccine, VRC-MARDNA025-00-VP, delivered via intramuscular injection on Weeks 0, 4, and 8 |
|
| Placebo injection | Other | 4 mg of saline injection delivered at Weeks 0, 4, and 8 |
|
| Measured at baseline and Week 12 |
| D018702 |
| Filoviridae Infections |
| D018701 | Mononegavirales Infections |
| D008992 | Monkey Diseases |
| D018419 | Primate Diseases |
| D000820 | Animal Diseases |