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| Name | Class |
|---|---|
| Bill and Melinda Gates Foundation | OTHER |
| PT Bio Farma | INDUSTRY |
| Centers for Disease Control and Prevention | FED |
| DiagnoSearch Life Sciences Pvt. Ltd. |
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The purpose of this clinical trial is to assess the safety and tolerability (primary objective), immunogenicity (primary and secondary objectives), fecal shedding of vaccine viruses (secondary objective) and the potential for neurovirulence of shed virus (secondary objective) of a novel oral polio type 1 vaccine, nOPV1, as compared to Sabin monovalent type 1 vaccine controls (mOPV1), in healthy young children (192 subjects), infants (720 subjects), and neonates (1320 subjects).
This single-center trial is the first clinical assessment of nOPV1 in a pediatric population. It will be a 15-arm, randomized, observer-blind, controlled trial, with Sabin monovalent type 1 vaccine (mOPV1) serving as the control. Enrollment in this pediatric study will be staggered into three age-descending cohorts, Cohort 1 composed of 192 healthy young children 1 to less than 5 years of age who have completed their full routine polio immunization series, Cohort 2 composed of 720 healthy infants 6 weeks of age (+6 days) who will receive only one dose of inactivated poliomyelitis vaccine (IPV) on Day 1, and finally Cohort 3, composed of 1320 healthy poliomyelitis unvaccinated neonates (day of birth +3 days). Participants will receive two or three doses of either nOPV1 at dose levels of 10^5.5 CCID50, 10^6.0 CCID50, 10^6.5 CCID50, 10^7.0 CCID50 or 10^7.5 CCID50 or the mOPV control vaccine. The second and third doses of vaccine will be given 28 days following the prior dose. In order to demonstrate the vaccine's ability to reduce fecal shedding following a challenge with the Sabin type 1 strain, the infant cohort will be challenged with mOPV 8 weeks after their last dose of nOPV. Participants will be followed until 28 weeks (young children and neonates) or 32 weeks (infants) after their Day 1 vaccination.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1: Young Children, nOPV1 10^5.5 CCID50 | Experimental | 48 young children aged 1 to <5 years will receive 2 doses of nOPV1 at a dose level of 10^5.5 CCID50 on Day 1 and Day 29 |
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| Group 3: Young Children, nOPV1 10^6.0 CCID50 | Experimental | 48 young children aged 1 to <5 years will receive 2 doses of nOPV1 at a dose level of 10^6.0 CCID50 on Day 1 and Day 29 |
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| Group 5: Young Children, nOPV1 10^6.5 CCID50 | Experimental | 48 young children aged 1 to <5 years will receive 2 doses of nOPV1 at a dose level of 10^6.5 CCID50 on Day 1 and Day 29 |
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| Groups 2, 4 and 6: Young Children, mOPV1 | Active Comparator | 48 young children aged 1 to <5 years will receive 2 doses of mOPV1 at a dose level of ≥ 10^6.0 CCID50 on Day 1 and Day 29 |
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| Group 7: Infants, nOPV1 10^5.5 CCID50 | Experimental | 96 infants aged 6 weeks (+6 days) will receive 1 dose of IPV on Day 1, then 2 doses of nOPV1 at a dose level of 10^5.5 CCID50 on Day 29 and Day 57, and a challenge dose of mOPV on Day 113. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Novel Live Attenuated Type 1 Oral Poliomyelitis Vaccine (nOPV1) | Biological | Drop counts of nOPV vaccine will be varied to achieve approximately 10^5.5, 10^6.0, 10^6.5 CCID50 or 10^7.0, 10^7.5 dose levels. |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of serious adverse events (SAEs) from the time of first study vaccination through the end of the study | Serious adverse event is any adverse event that results in any of the following outcomes:
| From Day 1 to end of study, up to Day 197 (young children and neonates) or Day 225 (infants) |
| Frequency of solicited adverse events (AEs) for 7 days (day of vaccination and 6 following days) after each vaccination | Solicited AEs are pre-specific AEs that are common or known to be associated with vaccination that are actively monitored as potential indicators of vaccine reactogenicity. The following specific solicited AEs will be monitored for this trial:
| From vaccination to 7 days post vaccination |
| Frequency of unsolicited AEs for 28 days (day of vaccination and 27 following days) after each vaccination | Unsolicited AEs are any AEs reported spontaneously by the participant's parent, observed by the study personnel during study visits or identified during review of medical records or source documents. In the absence of a diagnosis, abnormal physical examination findings or abnormal clinical safety laboratory test results that are assessed by the investigator to be clinically significant will be reported as an AE. | From vaccination to 28 days post vaccination |
| Measure | Description | Time Frame |
|---|---|---|
| Post-vaccination frequency of seroconversion of type 1 anti-polio serum NAb. | To assess the seroconversion rate elicited by nOPV1 at dose levels of 10^6.5, 10^7.0 and 10^7.5 CCID50/dose following one and three doses in healthy neonates compared to mOPV1. To assess the seroconversion rate elicited by nOPV1 at dose levels of 10^5.5, 10^6.0 and 10^6.5 CCID50/dose following one or two doses in healthy young children compared to mOPV1. To assess the seroconversion rate elicited by nOPV1 at dose levels of 10^5.5 and 10^6.0 CCID50/dose following one or two doses in healthy infants compared to mOPV1. |
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Inclusion Criteria for all participants:
Inclusion Criteria for Cohort 1 (young children) participants only:
Inclusion Criteria for Cohort 2 (infants) participants only:
Inclusion Criteria for Cohort 3 (neonates) participants only:
Exclusion Criteria for all participants:
Exclusion Criteria for Cohort 2 & 3 participants only:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tushar Tewari, MD | Contact | +91 11 4064 0005 | ttewari@path.org |
| Name | Affiliation | Role |
|---|---|---|
| K. Zaman, MBBS, MPH, PhD, FRCP | International Centre for Diarrhoeal Disease Research, Bangladesh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) | Recruiting | Dhaka | 1212 | Bangladesh |
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| ID | Term |
|---|---|
| D011051 | Poliomyelitis |
| ID | Term |
|---|---|
| D009187 | Myelitis |
| D002494 | Central Nervous System Infections |
| D007239 | Infections |
| D004769 | Enterovirus Infections |
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| UNKNOWN |
A 15-arm, randomized, observer-blind, controlled, age de-escalation, dosage escalation study.
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| Group 9: Infants, nOPV1 10^6.0 CCID50 | Experimental | 96 infants aged 6 weeks (+6 days) will receive 1 dose of IPV on Day 1, then 2 doses of nOPV1 at a dose level of 10^6.0 CCID50 on Day 29 and Day 57, and a challenge dose of mOPV on Day 113. |
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| Group 11: Infants, nOPV1 10^6.5 CCID50 | Experimental | 48 infants aged 6 weeks (+6 days) will receive 1 dose of IPV on Day 1, then 2 doses of nOPV1 at a dose level of 10^6.5 CCID50 on Day 29 and Day 57, and a challenge dose of mOPV on Day 113. |
|
| Group 11b: Infants, nOPV1 10^6.5 CCID50 | Experimental | 96 infants aged 6 weeks (+6 days) will receive 1 dose of IPV on Day 1, then 3 doses of nOPV1 at a dose level of 10^6.5 CCID50 on Day 29, Day 57 and Day 85, and a challenge dose of mOPV on Day 141. |
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| Group 13: Infants, nOPV1 10^7.0 CCID50 | Experimental | 96 infants aged 6 weeks (+6 days) will receive 1 dose of IPV on Day 1, then 3 doses of nOPV1 at a dose level of 10^7.0 CCID50 on Day 29, Day 57 and Day 85, and a challenge dose of mOPV on Day 141. |
|
| Group 15: Infants, nOPV1 10^7.5 CCID50 | Experimental | 96 infants aged 6 weeks (+6 days) will receive 1 dose of IPV on Day 1, then 3 doses of nOPV1 at a dose level of 10^7.5 CCID50 on Day 29, Day 57 and Day 85, and a challenge dose of mOPV on Day 141. |
|
| Groups 8, 10, 12, 12b, 14, 16: Infants mOPV1 | Active Comparator | 192 infants aged 6 weeks (+6 days) will receive 1 dose of IPV on Day 1 then 2 to 3 doses of mOPV1 at a dose level of ≥10^6.0 CCID50 on Day 29, Day 57, Day 85 (groups 12b, 14 & 16 only) and a challenge dose of mOPV on Day 113 (groups 8, 10 & 12) on Day 141 (groups 12b, 14 & 16) |
|
| Group 17: Neonates, nOPV1 10^6.5 CCID50 | Experimental | 330 neonates (day of birth +3 days) will receive 3 doses of nOPV1 at a dose level of 10^6.5 CCID50 on Day 1, Day 29 & Day 57 |
|
| Group 19: Neonates, nOPV1 10^7.0 CCID50 | Experimental | 330 neonates (day of birth +3 days) will receive 3 doses of nOPV1 at a dose level of 10^7.0 CCID50 on Day 1, Day 29 & Day 57 |
|
| Group 21: Neonates, nOPV1 10^7.5 CCID50 | Experimental | 330 neonates (day of birth +3 days) will receive 3 doses of nOPV1 at a dose level of 10^7.5 CCID50 on Day 1, Day 29 & Day 57 |
|
| Groups 18, 20 & 22: Neonates, mOPV1 | Active Comparator | 330 neonates (day of birth +3 days) will receive 3 doses of mOPV1 at a dose level of ≥ 10^6.0 CCID50 on Day 1, Day 29 & Day 57 |
|
| Sabin Monovalent Oral Poliomyelitis Vaccine Type 1 (mOPV1) | Biological | The Sabin Monovalent Oral Poliomyelitis Vaccine Type 1 control and challenge vaccine (mOPV1) contains ≥ 10^6.0 CCID50 per 0.1 mL (2 drops) dose. |
|
| Post-vaccination frequency of seroconversion of type 1 anti-polio serum neutralizing antibody (NAb). | Following two doses of nOPV1, at dose levels of 10^6.5 and 10^7.0 CCID50/dose, compared to mOPV1, in healthy neonates. For unvaccinated neonates, seroconversion will be defined as either a minimum 4-fold higher antibody titer relative to the expected level of maternal antibody and seropositivity (reciprocal titer ≥ 8) at the post-vaccination time point among those initially seropositive, or post-vaccination seropositivity among those initially seronegative. | 28 days post second vaccination |
| Baseline and 28 days post vaccination (Day 1 and Day 29 for young children, Day 1, Day 29 and Day 57 for neonates and Day 29, Day 57 and Day 85 for infants) |
| Median type 1 anti-polio serum NAb titers. | Elicited by nOPV1, compared to that of mOPV1, following one or two doses in healthy young children, and one, two or three doses in infants and neonates. | Baseline and 28 days post vaccination (Day 1 and Day 29 for young children, Day 1, Day 29 and Day 57 for neonates and Day 29, Day 57 and Day 85 for infants) |
| Type 1 anti-polio serum NAb Geometric Mean Titer (GMT). | Elicited by nOPV1, compared to that of mOPV1, following one or two doses in healthy young children, and one, two or three doses in infants and neonates. | Baseline and 28 days post vaccination (Day 1 and Day 29 for young children, Day 1, Day 29 and Day 57 for neonates and Day 29, Day 57 and Day 85 for infants) |
| Post-vaccination GMT ratios of type 1 anti-polio serum NAb, adjusted for baseline immunity. | Elicited by nOPV1, compared to that of mOPV1, following one or two doses in healthy young children, and one, two or three doses in infants and neonates. | Baseline and 28 days post vaccination (Day 1 and Day 29 for young children, Day 1, Day 29 and Day 57 for neonates and Day 29, Day 57 and Day 85 for infants) |
| Seroprotection rate, defined as type 1 anti-polio serum NAb reciprocal titer ≥ 8. | Elicited by nOPV1, compared to that of mOPV1, following one or two doses in healthy young children, and one, two or three doses in infants and neonates. | Baseline and 28 days post vaccination (Day 1 and Day 29 for young children, Day 1, Day 29 and Day 57 for neonates and Day 29, Day 57 and Day 85 for infants) |
| Geometric mean fold rise (GMFR) in NAb titer relative to baseline | Elicited by nOPV1, compared to that of mOPV1, following one or two doses in healthy young children, and one, two or three doses in infants and neonates. | Baseline and 28 days post vaccination (Day 1 and Day 29 for young children, Day 1, Day 29 and Day 57 for neonates and Day 29, Day 57 and Day 85 for infants) |
| Proportion of participants shedding type 1 poliovirus at any and at each post-vaccination stool collection, as assessed by polymerase chain reaction (PCR) in infants and neonates. | 28 days after the initial dose of nOPV1, compared to mOPV1. | Baseline through to 28 days post initial vaccination (Day 29 through to Day 57 for infants; Day 1 through to Day 29 for neonates) |
| Proportion of participants shedding type 1 poliovirus at any and at each post-challenge stool collection, as assessed by PCR in infants. | 28 days after mOPV challenge compared to mOPV1 | Day of challenge through to 28 days post challenge (Day 113 through to Day 141 or 169, for infants) |
| Neurovirulence of shed study vaccine virus from select stool samples as measured by a transgenic mouse neurovirulence test in a subset of infants. | Within 28 days of an initial nOPV dose and compared to that of mOPV1. | Baseline through to 28 days post initial vaccination (Day 29 through 57 for infants) |
| D010850 |
| Picornaviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D013118 | Spinal Cord Diseases |
| D000090862 | Neuroinflammatory Diseases |
| D009468 | Neuromuscular Diseases |