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Since acceptable safety, tolerability, and immunogenicity was demonstrated at the highest dose tested (group 3, fully recruited), there was no scientific or ethical justification to recruit more participants into the mid-dose group (group 2).
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This is a first-in-human, open-label, dose escalation, phase I clinical trial to assess the safety and immunogenicity of the candidate ChAdOx2 RabG vaccine in healthy UK volunteers aged 18-65. The vaccine will be administered intramuscularly (IM).
Volunteers will be recruited and vaccinated at the Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), Oxford. There will be 3 study groups and it is anticipated that a total of 12 volunteers will be enrolled. Staggered enrolment will apply between study groups and for the first three volunteers within each group.
The study includes an optional extended follow-up period, lasting one month and starting one year after vaccination. Volunteers will receive a complete pre-exposure prophylactic course of an existing rabies vaccine, allowing study of the immunological memory (recall response) induced by ChAdOx2 RabG. A second optional element of the study is the collection of saliva samples at each visit for the study of shedding of EBV and CMV.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 5 x 10^9 vp of ChAdOx2 RabG | Experimental | Volunteers will receive a standalone dose of ChAdOx2 RabG 5 x 10^9 vp vaccination intramuscularly. Optional extended follow-up, volunteers will receive a complete pre-exposure prophylactic course of an existing rabies vaccine. |
|
| 2.5 x 10^10 vp of ChAdOx2 RabG | Experimental | Volunteers will receive a standalone dose of ChAdOx2 RabG 2.5 x 10^10 vp vaccination intramuscularly. Optional extended follow-up, volunteers will receive a complete pre-exposure prophylactic course of an existing rabies vaccine. |
|
| 5 x 10^10 vp of ChAdOx2 RabG | Experimental | Volunteers will receive a standalone dose of ChAdOx2 RabG 5 x 10^10 vp vaccination intramuscularly. Optional extended follow-up, volunteers will receive a complete pre-exposure prophylactic course of an existing rabies vaccine. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ChAdOx2 RabG | Biological | Single dose of ChAdOx2 RabG at different concentrations: 5 x 10^9 vp, 2.5 x 10^10 vp, 5 x 10^10 vp |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety and tolerability of ChAdOx2 RabG in healthy volunteers given as a standalone vaccine at different doses assessed by the occurrence of solicited adverse events. | Occurrence of solicited local and systemic adverse events (i.e: pain, redness, swelling and pruritus at injection site and temperature, feverishness, myalgia, arthralgia, malaise, headache, fatigue and nausea). | Assessment of solicited AEs in the first 7 days post vaccination |
| Safety and tolerability of ChAdOx2 RabG in healthy volunteers given as a standalone vaccine at different doses assessed by the occurrence of solicited adverse events. | Occurrence of unsolicited local and systemic adverse events | Unsolicited AEs to be assessed up to 28 days post vaccination. |
| Safety and tolerability of ChAdOx2 RabG in healthy volunteers given as a standalone vaccine at different doses assessed by the occurrence of serious adverse events. | Occurrence of serious adverse events | SAEs will be collected from enrolment until the end of the follow-up period.(8 weeks) |
| Safety and tolerability of ChAdOx2 RabG in healthy volunteers given as a standalone vaccine at different doses assessed by the occurrence of solicited adverse events. | Occurrence of laboratory adverse events defined as clinically significant changes from baseline. Haematology (Full Blood Count) and Biochemistry (Kidney and Liver Function Tests) will be assessed. | At Day 0 (baseline), day 2, day 7, day 28 and day 56 post vaccination |
| Measure | Description | Time Frame |
|---|---|---|
| Immunogenicity of the ChAdOx2 RabG vaccine | Rapid fluorescent focus inhibition test (RFFIT) of virus neutralising antibody | Day 365 |
| Measure | Description | Time Frame |
|---|---|---|
| Immunological memory induced by ChAdOx2 RabG | Virus neutralizing antibody will be measured before and in the course of immunisation with IRVs during an optional extended follow-up. | Between days 365 and 386 |
| Timecourse of EBV and CMV shedding |
Inclusion Criteria:
Exclusion Criteria:
13. Individuals who have previously experienced episodes of capillary leak syndrome.
14. History of confirmed major thrombotic event (including cerebral venous sinus thrombosis, deep vein thrombosis, pulmonary embolism).
15. History of antiphospholipid syndrome. 16. History of prior receipt of unfractionated heparin. 17. History of heparin induced thrombocytopenia. 18. Any other serious chronic illness requiring hospital specialist supervision.
19. Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 42 units every week. 20. Suspected or known injecting drug abuse in the 5 years preceding enrolment. 21. Detectable circulating hepatitis B surface antigen (HBsAg). 22. Seropositive for hepatitis C virus (antibodies to HCV). 23. Any clinically significant abnormal finding on screening biochemistry or haematology blood tests or urinalysis. 24. Any other significant disease, disorder or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data.
25. Inability of the study team to contact the volunteer's GP to confirm medical history and safety to participate. 26. Receipt of any prior rabies vaccine, including an incomplete course. 27. Require or will require rabies vaccination during the first 8 weeks of the study period (e.g. through planned travel to high risk enzootic areas of through work which may lead to exposure and for which rabies vaccination is usually required/recommended).
Exclusion criteria for optional follow-up
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| Name | Affiliation | Role |
|---|---|---|
| Alexander D Douglas | Jenner Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CCVTM, University of Oxford, Churchill Hospital | Oxford | OX3 7LE | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35907430 | Derived | Jenkin D, Ritchie AJ, Aboagye J, Fedosyuk S, Thorley L, Provstgaad-Morys S, Sanders H, Bellamy D, Makinson R, Xiang ZQ, Bolam E, Tarrant R, Ramos Lopez F, Platt A, Poulton I, Green C, Ertl HCJ, Ewer KJ, Douglas AD. Safety and immunogenicity of a simian-adenovirus-vectored rabies vaccine: an open-label, non-randomised, dose-escalation, first-in-human, single-centre, phase 1 clinical trial. Lancet Microbe. 2022 Sep;3(9):e663-e671. doi: 10.1016/S2666-5247(22)00126-4. Epub 2022 Jul 27. |
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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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| Inactivated Rabies Vaccine | Biological | A complete pre-exposure prophylactic course of an existing rabies vaccine, ≥2.5 international units. |
|
| ChAdOx2 RabG | Biological | Single dose of ChAdOx2 RabG at different concentrations: 5 x 10^9 vp, 2.5 x 10^10 vp, 5 x 10^10 vp |
|
| ChAdOx2 RabG | Biological | Single dose of ChAdOx2 RabG at different concentrations: 5 x 10^9 vp, 2.5 x 10^10 vp, 5 x 10^10 vp. |
|
| Inactivated Rabies Vaccine | Biological | A complete pre-exposure prophylactic course of an existing rabies vaccine, ≥2.5 international units. |
|
| Inactivated Rabies Vaccine | Biological | A complete pre-exposure prophylactic course of an existing rabies vaccine, ≥2.5 international units. |
|
Measured by quantitative PCR.
| Study Duration (386 days) |
| Level of EBV and CMV shedding | Measured by quantitative PCR. | Study Duration (386 days) |
| D007239 | Infections |