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| Name | Class |
|---|---|
| Walter Reed Army Institute of Research (WRAIR) | FED |
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The purpose of this study is to compare the effectiveness of a two dose versus a three dose schedule and intramuscular versus intradermal injection for pre-exposure prophylaxis.
This is an exploratory vaccine trial to evaluate immunogenicity of a non-licensed dosing schedule and route of administration for a currently FDA licensed rabies vaccine for pre-exposure prophylaxis against rabies infection. The goal of this study is to characterize the immune response and persistence of immunity to a shortened dose schedule and intradermal (ID) administration, relative to the current licensed dosing schedule of the rabies vaccine (3 dose (0, 7, 21 days) IM). Rabies virus is endemic throughout the world due to high rates of both wild and domestic animal rabies and the risk to deployed military in endemic areas is considerable. Currently the commonly supported pre-exposure prophylaxis regimen for rabies, in the United States is comprised of three, 1.0 ml intramuscular (IM) injections of the human diploid cell vaccine (HDCV) or purified chick embryo cell (PCEC) rabies vaccine on days 0, 7, and 21 or 28. Modified, two and three dose schedules of intradermal (ID) injections of 0.1 ml of HDCV and PCEC are utilized outside the US. These two and three dose intradermal schedules share a similar safety and immunogenicity profile to intramuscular vaccinations and are easily boosted at one year after vaccination. A death, from rabies, of a US Soldier returned from Afghanistan underscores the importance of rabies pre-exposure prophylaxis for soldiers and the need to evaluate the safest, most effective means of vaccinating large deploying forces. While the current three dose, 1 ml IM rabies series is effective, a shortened, equally effective vaccination series with significantly smaller dose per injection would greatly improve the logistics and cost associated with universal or even targeted coverage of deploying soldiers. Evaluation of a shorter, smaller-dose, pre-exposure vaccination series for rabies is the goal of this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rabies vaccine IM 3 dose | Active Comparator | Intramuscular injection: 1mL at 0, 7 and 21 days. An additional 1 mL intramuscular dose at day 365 |
|
| Rabies vaccine ID 3 dose | Experimental | Intradermal injection: 0.1mL at 0, 7 and 21 days. A single intramuscular 1 mL dose at day 365 |
|
| Rabies vaccine IM 2 dose | Experimental | Intramuscular injection: 1mL at 0, 7 days. An additional 1 mL intramuscular dose at day 365 |
|
| Rabies vaccine ID 2 dose | Experimental | Intradermal injection: 0.1mL at 0, 7 days. A single intramuscular 1 mL dose at day 365 |
|
| Placebo IM 1 dose | Placebo Comparator | Albumin and saline comparator, Intramuscular injection: 1mL |
|
| Placebo ID 1 dose | Placebo Comparator |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rabies vaccine | Drug | Compare dose schedule and route of administration |
|
| Measure | Description | Time Frame |
|---|---|---|
| Protective Humoral Immune Response at 1 Month Post First Vaccination. | Percentage of subjects achieving the protective titer of ≥ 0.5 IU/ml against rabies virus | 1 month post first vaccination |
| Protective Humoral Immune Response 12 Months Post First Vaccination. | Percentage of subjects achieving the protective titer of ≥ 0.5 IU/ml against rabies virus 12 months post vaccinations (prior to boost). | 12 months post first vaccination |
| Measure | Description | Time Frame |
|---|---|---|
| Protective Humoral Immune Response 7 Days Post Booster at 12 Months Post First Vaccination. | Percentage of subjects achieving the protective titer of ≥ 0.5 IU/ml against rabies virus at 7 days post boost. | up to 13 months post first vaccination |
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Inclusion Criteria:
Male and non-pregnant females aged ≥ 18 to ≤ 60 years on the day of inclusion Able to comprehend and give informed consent Able to attend all scheduled visits and to comply with all trial procedures Subject in good health, based on medical history and physical examination
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mark Polhemus, MD | State University of New York - Upstate Medical University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| State University of New York, Upstate Medical University (SUNY-UMU) | Syracuse | New York | 13210 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31802120 | Result | Endy TP, Keiser PB, Wang D, Jarman RG, Cibula D, Fang H, Ware L, Abbott M, Thomas SJ, Polhemus ME. Serologic Response of 2 Versus 3 Doses and Intradermal Versus Intramuscular Administration of a Licensed Rabies Vaccine for Preexposure Prophylaxis. J Infect Dis. 2020 Apr 7;221(9):1494-1498. doi: 10.1093/infdis/jiz645. |
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One subject in group 4 was lost to follow up prior to receiving vaccine.
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| ID | Title | Description |
|---|---|---|
| FG000 | Rabies Vaccine IM 3 Dose | Rabies vaccine: 1.0 ml delivered Intramuscularly (IM) on day 0, 7, 21 and 365. |
| FG001 | Rabies Vaccine ID 3 Dose | Rabies vaccine: 0.1 ml of rabies vaccine delivered intradermal (ID) on days 0, 7, and 21 with a 1.0ml boost delivered IM on day 365. |
| FG002 | Rabies Vaccine IM 2 Dose | Rabies vaccine: 1.0ml delivered IM on day 0, 7 and 365. |
| FG003 | Rabies Vaccine ID 2 Dose | Rabies vaccine: 0.1ml delivered on day 0 and 7 with a 1.0ml IM boost on day 365 |
| FG004 | Placebo IM 1 Dose | Placebo: 1.0ml delivered IM on day 0 |
| FG005 | Placebo ID 1 Dose | Placebo: 0.1ml delivered on day 0 |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Subjects who received at least one dose of rabies vaccine or placebo
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| ID | Title | Description |
|---|---|---|
| BG000 | Rabies Vaccine IM 3 Dose | This is standard FDA approved schedule Rabies vaccine: Compare dose schedule and route of administration |
| BG001 | Rabies Vaccine ID 3 Dose | This is using alternative administration method Rabies vaccine: Compare dose schedule and route of administration |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| 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 | Protective Humoral Immune Response at 1 Month Post First Vaccination. | Percentage of subjects achieving the protective titer of ≥ 0.5 IU/ml against rabies virus | Placebo groups were used for adverse event data collection only. It was not expected that placebo group would elicit any antibody titer to rabies. Samples in groups 5 and 6 were not analyzed for primary or secondary outcome measures. | Posted | Count of Participants | Participants | 1 month post first vaccination |
|
372 days for all groups (1-4) receiving rabies vaccine; 7 days for groups 5-6 receiving control
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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 | Rabies Vaccine IM 3 Dose | Intramuscular injection: 1mL at 0, 7 and 21 days. An additional 1 mL intramuscular dose at day 365 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Injection site reaction | General disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Timothy Endy | SUNY Upstate Medical University | 315-464-7692 | endyt@upstate.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jun 2, 2016 | May 10, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Dec 5, 2016 | May 10, 2021 | SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | Mar 26, 2015 | Jun 10, 2022 | ICF_002.pdf |
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| ID | Term |
|---|---|
| D011818 | Rabies |
| ID | Term |
|---|---|
| D018353 | Rhabdoviridae Infections |
| D018701 | Mononegavirales Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
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| ID | Term |
|---|---|
| D011819 | Rabies Vaccines |
| D000418 | Albumins |
| ID | Term |
|---|---|
| D014765 | Viral Vaccines |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
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Albumin and saline comparator, Intradermal injection: 0.1mL |
|
|
| Placebo | Drug | Placebo |
|
|
| Withdrawal by Subject |
|
| BG002 | Rabies Vaccine IM 2 Dose | This is using alternative dose schedule Rabies vaccine: Compare dose schedule and route of administration |
| BG003 | Rabies Vaccine ID 2 Dose | This is using alternative dose schedule and administration Rabies vaccine: Compare dose schedule and route of administration |
| BG004 | Placebo IM 1 Dose | Albumin and saline comparator Placebo: Placebo |
| BG005 | Placebo ID 1 Dose | Albumin and saline comparator Placebo: Placebo |
| BG006 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | Years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
Rabies vaccine:
Intradermal injection: 0.1mL at 0, 7 and 21 days. A single intramuscular 1 mL dose at day 365.
| OG002 | Rabies Vaccine IM 2 Dose | Rabies vaccine: Intramuscular injection: 1mL at 0, 7 days. An additional 1 mL intramuscular dose at day 365. |
| OG003 | Rabies Vaccine ID 2 Dose | Rabies vaccine: Intradermal injection: 0.1mL at 0, 7 days. A single intramuscular 1 mL dose at day 365. |
| OG004 | Placebo IM 1 Dose | Albumin and saline comparator Placebo: A single 1mL intramuscular injection at day 0 |
| OG005 | Placebo ID 1 Dose | Albumin and saline comparator Placebo: A single intradermal injection of 0.1mL at day 0 |
|
|
| Primary | Protective Humoral Immune Response 12 Months Post First Vaccination. | Percentage of subjects achieving the protective titer of ≥ 0.5 IU/ml against rabies virus 12 months post vaccinations (prior to boost). | One subject in each of groups 1, 2, and 4 were lost to follow up prior to vaccination boost. Placebo groups were used for adverse event data collection only. It was not expected that placebo group would elicit any antibody titer to rabies. Samples in groups 5 and 6 were not analyzed for primary or secondary outcome measures. | Posted | Count of Participants | Participants | 12 months post first vaccination |
|
|
|
| Secondary | Protective Humoral Immune Response 7 Days Post Booster at 12 Months Post First Vaccination. | Percentage of subjects achieving the protective titer of ≥ 0.5 IU/ml against rabies virus at 7 days post boost. | One subject in group 3 and one in 4 withdrew consent not due to adverse events. Placebo groups were used for adverse event data collection only. It was not expected that placebo group would elicit any antibody titer to rabies. Samples in groups 5 and 6 were not analyzed for primary or secondary outcome measures. | Posted | Count of Participants | Participants | up to 13 months post first vaccination |
|
|
|
| 0 |
| 12 |
| 0 |
| 12 |
| 10 |
| 12 |
| EG001 | Rabies Vaccine ID 3 Dose | Intradermal injection: 0.1mL at 0, 7 and 21 days. A single intramuscular 1 mL dose at day 365 | 0 | 12 | 0 | 12 | 12 | 12 |
| EG002 | Rabies Vaccine IM 2 Dose | Intramuscular injection: 1mL at 0, 7 days. An additional 1 mL intramuscular dose at day 365 | 0 | 12 | 0 | 12 | 8 | 12 |
| EG003 | Rabies Vaccine ID 2 Dose | Intradermal injection: 0.1mL at 0, 7 days. A single intramuscular 1 mL dose at day 365 | 0 | 11 | 0 | 11 | 11 | 11 |
| EG004 | Placebo IM 1 Dose | Albumin and saline comparator Intramuscular injection: 1ml | 0 | 6 | 0 | 6 | 1 | 6 |
| EG005 | Placebo ID 1 Dose | Albumin and saline comparator Intradermal injection: 0.1ml | 0 | 6 | 0 | 6 | 0 | 6 |
| Fatigue | General disorders | Systematic Assessment |
|
| Flu-like symptoms | General disorders | Systematic Assessment |
|
| Malaise | General disorders | Systematic Assessment |
|
| Fever | General disorders | Systematic Assessment |
|
| Upper respiratory infection | Infections and infestations | Systematic Assessment |
|
| Myalgia | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Rash | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| Dizziness | Nervous system disorders | Systematic Assessment |
|
| Headache | Nervous system disorders | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | Systematic Assessment |
|
| Abdominal Pain | Gastrointestinal disorders | Systematic Assessment |
|
| Lymph node pain | Blood and lymphatic system disorders | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
|
| Menorrhagia | Reproductive system and breast disorders | Systematic Assessment |
|
| Tinnitus | Ear and labyrinth disorders | Systematic Assessment |
|
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| D007239 | Infections |
| D011506 |
| Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |