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The goal of this clinical trial is to assess the immune response to the yellow fever vaccine 17D in adults with prior 17D vaccination. The main questions this study aims to answer are:
Participants will:
In this study the investigators use 17D revaccination as a live-virus challenge to test the hypothesis that neutralizing antibody titers correlate with YFV protection. The investigators will prospectively characterize pre-boost antibodies titers, vaccine viremia, acute immune responses and post-boost titers in vaccinees receiving boost 17D vaccinations. The investigators expect to identify neutralizing antibody titers above which sterilizing immunity is conferred and titers below which it is not. These Aims will set a foundation for future studies to further dissect determinants of 17D and other live-attenuated vaccine induced immunity and establish metrics that could allow efficient prioritization of 17D vaccination and optimize 17D use in the face of current and future outbreaks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vaccination arm | Experimental | Participants will receive a standard dose of of the yellow fever vaccine 17D (YFVax(r)), 0.5mL suspension in normal saline administered subcutaneously once. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 17D | Biological | Vaccine administration in subjects previously vaccinated with 17D. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Neutralizing antibody titer boost following vaccination | four-fold rise in neutralization antibody titer before and after vaccinatioin | 28 days |
| vaccine viremia following vaccination | detection of vaccine virus in subject blood | 14 days |
| Measure | Description | Time Frame |
|---|---|---|
| CD4+ immune cell response to vaccination | Frequency of CD4+ cell populations on day 0, 2, 8, 14, and 28 post vaccination | 28 days |
| Measure | Description | Time Frame |
|---|---|---|
| CD8+ immune cell response to vaccination | Frequency of CD8+ cell populations on day 0, 2, 8, 14, and 28 post vaccination | 28 days |
| cytokine response to vaccination | Cytokine levels measured on days 0, 1, 2, 8, 14, and 28 days post vaccination |
Inclusion Criteria:
Exclusion Criteria:
A clinically active infection or self-reported body temperature ≥38°C (100.4°F) within 3 days of scheduled date of vaccination (consider whether the finding is an exclusion criterion or criterion for delay of vaccination see Section 8.3).
A known hypersensitivity or allergy to any of the trial vaccine components including eggs.
Behavioral/cognitive impairment that, in the investigator's opinion, may interfere with the subject's ability to participate safely in the trial.
Any history of neurologic disorder, seizure disorder or neuro-inflammatory disease.
Any illness, or history of any illness that, in the investigator's opinion, could interfere with the trial or pose an additional risk to the subject during the trial period.
Known or suspected impairment/alteration of immune function, including:
History of splenic or thymic dysfunction.
Any serious chronic or progressive disease as assessed by the investigator (eg, neoplasm, hematologic malignancies, insulin dependent diabetes; cardiac, renal, or hepatic disease).
Body Mass Index (BMI) greater than or equal to 35 kg/m2.
Concurrent participation in any clinical trial with another investigational product 30 days prior to or during the conduct of this trial.
Vaccination within 14 days (for inactivated vaccines) or 28 days (for live vaccines) prior to enrollment or plans to receive any vaccine within 28 days of trial vaccine administration (consider whether applicable as an exclusion criterion or criterion for delay of trial vaccine administration).
Use of antipyretics and/or analgesic medications within 24 hours prior to vaccination. Trial entry should be delayed to allow for a full 24-hours to have passed since last use of antipyretics and/or analgesic medications (consider whether applicable as an exclusion criterion or criterion for delay of trial vaccine administration).
Subjects with history of substance or alcohol abuse within the past 2 years.
Subjects who are pregnant or breastfeeding.
Subjects of childbearing potential who are sexually active with men and have not used "acceptable contraceptive methods" for at least 2 months prior to enrollment.
Subjects of childbearing potential who are sexually active with men and refuse acceptable contraceptive method up to 28 days after the vaccination.
Any positive or indeterminate pregnancy test.
Planned vaccination (during the trial conduct) against any other vaccine preventable disease.
Planned travel (during the trial) to any YFV endemic area.
Screening serology consistent with prior history of dengue, zika, West Nile or Japanese encephalitis virus infection.
It may occur that a prospective subject meets all entry criteria except one that relates to short term clinical condition (e.g., fever, recent use of excluded medications). Under these circumstances, eligibility for delayed trial enrollment may be considered after inclusion/exclusion criteria have been rechecked, and if the subject is confirmed to be eligible.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| William Messer, MD PhD | Contact | 503-494-2185 | messer@ohsu.edu | |
| Sarah Siegel, PhD | Contact | 541-60-0798 | siegels@ohsu.edu |
| Name | Affiliation | Role |
|---|---|---|
| William Messer, MD PhD | Oregon Health and Science University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oregon Health & Science University | Recruiting | Portland | Oregon | 97239 | United States |
Coded samples and/or data will be made available to other researchers.
For up to 5 years after the completion of the study.
The PI will review all sample and data requests. A request will include a scope of work and justification for the work. All approved requests will be conducted under an M/DTA.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 21, 2023 | Apr 21, 2023 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Feb 24, 2023 | Apr 5, 2023 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D015004 | Yellow Fever |
| D007239 | Infections |
| ID | Term |
|---|---|
| D000096724 | Mosquito-Borne Diseases |
| D000079426 | Vector Borne Diseases |
| D001102 | Arbovirus Infections |
| D014777 | Virus Diseases |
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All subjects receive the same intervention.
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| 28 days |
| vaccine virus titer | quantity of vaccine virus in vaccine vial on vaccination day 0 | 1 day |
| Memory B cell response to vaccination | YFV specific memory B cell frequency on days 1, 2, 8, 14 and 28 days post vaccination | 28 days |
| D018177 | Flavivirus Infections |
| D018178 | Flaviviridae Infections |
| D012327 | RNA Virus Infections |
| D006482 | Hemorrhagic Fevers, Viral |