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| ID | Type | Description | Link |
|---|---|---|---|
| VRC 701 | Other Grant/Funding Number | HHSN272201000049I |
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| Name | Class |
|---|---|
| The Emmes Company, LLC | INDUSTRY |
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This is a Phase 1b, randomized study in healthy younger (18-50 years) and older (51-70 years) adults to evaluate the safety, tolerability, and immunogenicity of a prime-boost vaccination regimen with an investigational plasmid DNA vaccine directed towards the 2011/12 influenza vaccine strains as a prime followed 36 weeks later by the 2012/13 influenza trivalent inactivated vaccine (TIV) as the booster injection, as compared to placebo prime followed by the 2012/13 seasonal TIV. The hypothesis is that the DNA vaccine will be safe for human administration and that the DNA vaccine prime-TIV boost schedule will elicit a better immune response than the seasonal TIV alone.
Vaccines are an effective way of preventing influenza infection and transmission in humans. Although licensed influenza vaccines are available, ways to improve influenza vaccines continue to be studied. Annually, the World Health Organization (WHO) and the U.S FDA make recommendations on the composition of the seasonal influenza vaccine, with recommendations for the Northern Hemisphere (NH) and for the Southern Hemisphere (SH) considered at different times based on epidemiology data. The annually licensed influenza vaccines consist of 3 components: an Influenza A (H1N1) strain, an Influenza A (H3N2) strain, and an influenza B strain. The current U.S. FDA-licensed influenza vaccines depend upon labor-intensive methods that limit manufacturing capacity and which do not induce broad immune responses to various strains of influenza. The vaccine composition requires frequent adjustment for emerging influenza strains.
The need for influenza vaccines that are more immunogenic and able to induce a more universal immune response against a broad spectrum of influenza strains is well recognized. Earlier laboratory and clinical studies together suggest that an investigational DNA vaccine encoding for the influenza hemagglutinin protein(HA DNA vaccine) administered as a prime, followed by a boost with a traditional inactivated influenza vaccine, may induce a stronger immune response against various influenza strains and with improved durability. The interval of time between the prime vaccination and the boost vaccination is important for the strength of the immune response.
This clinical trial will evaluate the safety, tolerability and immune responses to the investigational HA DNA vaccine prime-TIV boost schedule compared to a placebo prime-TIV boost schedule when the time between the prime and boost is 36 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1A (18-50 yrs): DNA vaccine + TIV | Experimental | HA DNA Vaccine (VRC-FLUDNA061-00-VP) at Day 0 and licensed TIV at Week 36 |
|
| Group 2A (51-70 yrs): DNA vaccine + TIV | Experimental | HA DNA Vaccine (VRC-FLUDNA061-00-VP) at Day 0 and licensed TIV at Week 36 |
|
| Group 1B (18-50 yrs): TIV only | Placebo Comparator | Phosphate buffered saline (PBS) on Day 0 + TIV at Week 36 |
|
| Group 2B (51-70 yrs): TIV only | Placebo Comparator | Phosphate buffered saline (PBS) on Day 0 + TIV at Week 36 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DNA vaccine | Biological | VRC-FLUDNA061-00-VP is composed of 3 closed-circular DNA plasmids that encode for the hemagglutinin (HA) from the following 3 strains: A/California/04/2009 (H1N1); A/Perth/16/2009 (H3N2), and B/Brisbane/60/2008. DNA vaccine vials will be supplied at 4 mg/mL and each dose will be 1 mL. |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of subjects per Group of serious adverse events (SAEs) | Serious adverse events included any untoward medical occurrence that resulted in death; was life threatening; was a persistent/significant disability/incapacity; required non-elective in-patient hospitalization or prolongation thereof; resulted in a congenital anomaly/birth defect; may have jeopardized the subject or required intervention to prevent one of these outcomes. Association to vaccination was determined by a study clinician licensed to make medical diagnoses. | Day 0 (after injection) to Week 60 (Visit 07) |
| Frequency of Subjects per Group of Solicited Local Reactions After First Study Injection | Frequency and severity of solicited injection site reactions following first study injection (vaccine group compared to placebo group). | Within 7 days after first vaccination |
| Frequency of Subjects per Group Reporting Solicited Local Reactions After TIV injection | Frequency and severity of solicited injection site reactions following the TIV booster injection by Group. | Within 7 days after TIV injection |
| Frequency of Subjects per Group Reporting Solicited Systemic Reactions After First Study Injection | Frequency and severity of solicited systemic reactions following first study injection (vaccine group compared to placebo group). | Within 7 days after first study injection |
| Frequency of Subjects per Group Reporting Solicited Systemic Reactions After TIV injection | Frequency and severity of solicited systemic reactions following TIV injection. | Within 7 days after TIV injection |
| Frequency by group of all unsolicited adverse events (AEs) after first study injection. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects per group with an Hemagglutination Inhibition (HAI) titer ≥ 1:40 or four-fold greater than baseline (Day 0) compared to those who received the seasonal influenza TIV alone. | Blood is collected from all subjects at baseline and at 4 weeks after TIV (Week 40) for testing in an HAI assay for each of the 3 strains of influenza in the vaccine. A positive response is 1:40 or greater (or a 4-fold increase over baseline if positive at baseline). Groups are compared for statistically significant differences. |
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Inclusion Criteria:
Laboratory Criteria within 70 days prior to enrollment:
Criteria applicable to women of childbearing potential:
Exclusion Criteria:
Women Specific:
• Breast-feeding or planning to become pregnant during the 12 weeks after enrollment in the study
Subject has received any of the following substances:
History of any of the following clinically significant conditions:
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| Name | Affiliation | Role |
|---|---|---|
| Julie Ledgerwood, D.O. | Deputy Chief, Clinical Trials Core Vaccine Research Center, NIAID, NIH | Study Chair |
| Barney S Graham, M.D., Ph.D. | Chief, Clinical Trials Core Vaccine Research Center, NIAID, NIH | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hope Clinic of the Emory Vaccine Center | Decatur | Georgia | 30030 | United States | ||
| St. Louis University - Doisy Research Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21975270 | Background | Ledgerwood JE, Wei CJ, Hu Z, Gordon IJ, Enama ME, Hendel CS, McTamney PM, Pearce MB, Yassine HM, Boyington JC, Bailer R, Tumpey TM, Koup RA, Mascola JR, Nabel GJ, Graham BS; VRC 306 Study Team. DNA priming and influenza vaccine immunogenicity: two phase 1 open label randomised clinical trials. Lancet Infect Dis. 2011 Dec;11(12):916-24. doi: 10.1016/S1473-3099(11)70240-7. Epub 2011 Oct 3. | |
| 19779298 |
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| ID | Term |
|---|---|
| D007251 | Influenza, Human |
| D009976 | Orthomyxoviridae Infections |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
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| ID | Term |
|---|---|
| D019444 | Vaccines, DNA |
| ID | Term |
|---|---|
| D000087504 | Nucleic Acid-Based Vaccines |
| D014614 | Vaccines, Synthetic |
| D011994 | Recombinant Proteins |
| D011506 | Proteins |
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|
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| TIV | Biological | 2012/13 Seasonal Influenza Trivalent Inactivated Vaccine (TIV) |
|
|
Frequency of adverse events (AEs) during 28 days after first study injection (vaccine as compared to placebo groups). |
| Through Day 28 after first injection |
| Frequency by group of all unsolicited adverse events (AEs) after TIV vaccination. | Frequency of unsolicited adverse events (AEs) during 28 days after TIV vaccination by group. | Through Day 28 after second vaccincation |
| Week 40 (4 weeks after TIV) |
| Proportion of subjects by group with a four-fold or greater rise from baseline (Day 0) and Week 40 in specific H1, H3 and B neutralizing antibodies | Blood is collected from all subjects at baseline (Day 0) and at Week 40 (4 weeks after TIV) for testing in a neutralizing antibody assay for strain-specific H1, H3 and B antigens. A positive response is a four-fold rise or greater from baseline. | Week 40 (4 weeks after TIV) |
| St Louis |
| Missouri |
| 63104 |
| United States |
| Cincinnati Children's Hospital Medical Center | Cincinnati | Ohio | 45229 | United States |
| Baylor College of Medicine | Houston | Texas | 77030 | United States |
| Background |
| Ledgerwood JE, Graham BS. DNA vaccines: a safe and efficient platform technology for responding to emerging infectious diseases. Hum Vaccin. 2009 Sep;5(9):623-6. doi: 10.4161/hv.8627. No abstract available. |
| 20647428 | Background | Wei CJ, Boyington JC, McTamney PM, Kong WP, Pearce MB, Xu L, Andersen H, Rao S, Tumpey TM, Yang ZY, Nabel GJ. Induction of broadly neutralizing H1N1 influenza antibodies by vaccination. Science. 2010 Aug 27;329(5995):1060-4. doi: 10.1126/science.1192517. Epub 2010 Jul 15. |
| 25950433 | Derived | Ledgerwood JE, Bellamy AR, Belshe R, Bernstein DI, Edupuganti S, Patel SM, Renehan P, Zajdowicz T, Schwartz R, Koup R, Bailer RT, Yamshchikov GV, Enama ME, Sarwar U, Larkin B, Graham BS; VRC 701 study team. DNA priming for seasonal influenza vaccine: a phase 1b double-blind randomized clinical trial. PLoS One. 2015 May 7;10(5):e0125914. doi: 10.1371/journal.pone.0125914. eCollection 2015. |
| D012140 |
| Respiratory Tract Diseases |
| D000602 |
| Amino Acids, Peptides, and Proteins |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
| D000941 | Antigens |
| D001685 | Biological Factors |