A First-in-human, Phase 1, Randomized, Observer-blind, Controlled Study to Assess the Safety and Immunogenicity of Novel Live Attenuated Type 1 and Type 3 Oral Poliomyelitis Vaccines in Healthy Adults
Overview
- Phase
- Phase 1
- Intervention
- Novel Oral Polio Vaccine Type 1 (nOPV1)
- Conditions
- Poliomyelitis
- Sponsor
- PATH
- Enrollment
- 205
- Locations
- 4
- Primary Endpoint
- Number of Participants With Serious Adverse Events (SAEs)
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The purpose of this study is to assess the safety (primary objective) and immunogenicity (secondary objective) and fecal shedding of vaccine viruses (secondary objective) of two novel oral polio vaccines, nOPV1 and nOPV3, as compared to Sabin monovalent vaccine controls, in 150-230 healthy adults.
Detailed Description
This multicenter trial is the first-in-human assessment of two novel oral polio vaccines for poliovirus type 1 and type 3. It will be an 8-arm, randomized, observer-blind, controlled trial, with Sabin monovalent vaccines serving as the control for each type. One hundred and fifty to 230 healthy, adult participants will be recruited, 70-80 participants with an exclusive inactivated poliovirus vaccine (IPV) prior vaccination history and 120-150 participants with an oral poliomyelitis vaccine (OPV)-containing prior vaccination history.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Males or females, from 18 to 45 years of age (inclusive) at the time of enrollment
- •Healthy, as defined by the absence of any clinically significant medical conditions, either acute or chronic, as determined by medical history, physical examination, screening laboratory test results, and clinical assessment of the investigator
- •Willing and able to provide written informed consent prior to performance of any study-specific procedure
- •If female and of childbearing potential\*, be not breastfeeding and not pregnant (based on a negative serum pregnancy test at screening and a negative urine pregnancy test during the 24 hours prior to any study vaccination), agreeing to have repeated pregnancy tests prior to any study vaccination, and having practiced adequate contraception\*\* for 30 days prior to first study vaccination and willing to continue using adequate contraception consistently for at least 90 days after the last study vaccination and until cessation of vaccine virus shedding is confirmed \* Females can be considered not of childbearing potential if they are with current bilateral tubal ligation, occlusion or removal, or post-total hysterectomy, or post-bilateral ovariectomy \*\* Adequate contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly and when applicable, in accordance with the product label, for example:
- •Abstinence from penile-vaginal intercourse
- •Combined estrogen and progesterone oral contraceptives
- •Hormonal (e.g., progestogen) injections
- •Hormonal (e.g., etonogestrel or levonorgestrel) implants
- •Contraceptive vaginal ring
- •Percutaneous contraceptive patches
Exclusion Criteria
- •Have any condition (medical, psychiatric or behavioral) that, in the opinion of the investigator, would increase the participant's health risks in study participation or would increase the risk of not achieving the study's objectives (e.g., would compromise adherence to protocol requirements or interfere with planned safety and immunogenicity assessments)
- •Receipt of polio vaccine within 12 months before the start of the study
- •Having Crohn's disease or ulcerative colitis or having had major surgery of the gastrointestinal tract involving significant loss or resection of the bowel
- •A known allergy, hypersensitivity, or intolerance to any components of the study vaccines, including all macrolide and aminoglycoside antibiotics (e.g., erythromycin and kanamycin)
- •Any confirmed or suspected immunosuppressive or immunodeficiency condition (human immunodeficiency virus \[HIV\] infection, or total serum immunoglobulin A (IgA) or immunoglobulin G (IgG) level below the testing laboratory's lower limit of normal \[LLN\])
- •Administration of any long-acting immune-modifying drugs (e.g., infliximab or rituximab) or the chronic administration (i.e., longer than 14 days) of immunosuppressant drugs (e.g., oral or systemic steroids) or other immune-modifying drugs within 6 months prior to the first vaccine dose or planned use during the study (inhaled and topical steroids are allowed whereas intraarticular and epidural injection/administration of steroids are not allowed)
- •Will have household direct or close professional contact during the study with individuals expected to be immunosuppressed (due to underlying condition or treatments) or individuals who have not yet completed their primary infant polio immunization series (i.e., three doses)
- •Will have household direct or close professional contact during the study with pregnant women
- •Will have household direct or close professional (e.g., neonatal nurses) contact during the study with children less than 2 years of age or with individuals who are encopretic (i.e., infants/toddlers who are not yet toilet trained or other individuals, including adults, with fecal incontinence)
- •Will have professional handling of food, catering, or food production activities during the study
Arms & Interventions
Group1: nOPV1 (IPV History)
Healthy adults fully vaccinated against polio exclusively by IPV were administered 1 vaccination of novel OPV type 1 (nOPV1) containing 10\^6.5 cell culture infectious dose 50% (CCID50) on Day 1.
Intervention: Novel Oral Polio Vaccine Type 1 (nOPV1)
Group 2: mOPV1 (IPV History)
Healthy adults fully vaccinated against polio exclusively by IPV were administered 1 vaccination of mOPV1 containing 10\^6.0 CCID50 on Day 1.
Intervention: Sabin Monovalent Oral Polio Vaccine Type 1 (mOPV1)
Group 3: nOPV1 (OPV History)
Healthy adults fully vaccinated against polio with an OPV-containing vaccine history were administered 2 vaccinations of nOPV1 containing 10\^6.5 CCID50/dose, given 28 days apart.
Intervention: Novel Oral Polio Vaccine Type 1 (nOPV1)
Group 4: mOPV1 (OPV History)
Healthy adults fully vaccinated against polio with an OPV-containing vaccine history were administered 2 doses of mOPV1 containing ≥ 10\^6.0 CCID50/dose, given 28 days apart.
Intervention: Sabin Monovalent Oral Polio Vaccine Type 1 (mOPV1)
Group 5: nOPV3 (IPV History)
Healthy adults fully vaccinated against polio exclusively by IPV were administered 1 vaccination of nOPV3 containing 10\^6.5 CCID50 on Day 1.
Intervention: Novel Oral Polio Vaccine Type 3 (nOPV3)
Group 6: mOPV3 (IPV History)
Healthy adults fully vaccinated against polio by exclusively IPV were administered 1 vaccination of mOPV3 containing ≥ 10\^5.8 CCID50 on Day 1.
Intervention: Sabin Monovalent Oral Polio Vaccine Type 3 (mOPV3)
Group 7: nOPV3 (OPV History)
Healthy adults fully vaccinated against polio with an OPV-containing vaccine history were administered 2 vaccinations of nOPV3 in a dose of 10\^6.5 CCID50/dose, given 28 days apart.
Intervention: Novel Oral Polio Vaccine Type 3 (nOPV3)
Group 8: mOPV3 (OPV History)
Healthy adults fully vaccinated against polio with an OPV-containing vaccine history were administered 2 vaccinations of mOPV3 containing ≥ 10\^5.8 CCID50/dose, given 28 days apart.
Intervention: Sabin Monovalent Oral Polio Vaccine Type 3 (mOPV3)
Outcomes
Primary Outcomes
Number of Participants With Serious Adverse Events (SAEs)
Time Frame: From Day 1 to end of study, up to 169 days
A serious adverse event is any adverse event that resulted in any of the following outcomes: * Death * Was life-threatening * Required inpatient hospitalization or prolongation of existing hospitalization * Resulted in persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions * Congenital anomaly or birth defect * Important medical event that may not result in one of the above outcomes but may jeopardize the health of the study participant and/or require medical or surgical intervention to prevent one of the outcomes listed above
Number of Participants With Solicited Adverse Events (AEs) 7 Days After First Dose of Study Vaccine
Time Frame: From vaccination to 7 days post vaccination (Days 1-7)
Solicited AEs are pre-specified AEs that are common or known to be associated with vaccination that are actively monitored as potential indicators of vaccine reactogenicity. Solicited AEs for this study included: * Fever (oral temperature ≥ 38.0°C or 100.4°F) * Chills * Fatigue * Headache * Muscle aches/myalgias * Joint aches/arthralgias * Nausea * Vomiting * Abdominal pain * Diarrhea
Number of Participants With Solicited Adverse Events 7 Days After Second Dose of Study Vaccine
Time Frame: From Day 29 to Day 35
Solicited AEs are pre-specified AEs that are common or known to be associated with vaccination that are actively monitored as potential indicators of vaccine reactogenicity. Solicited AEs for this study included: * Fever (oral temperature ≥ 38.0°C or 100.4°F) * Chills * Fatigue * Headache * Muscle aches/myalgias * Joint aches/arthralgias * Nausea * Vomiting * Abdominal pain * Diarrhea
Number of Participants With Unsolicited Adverse Events (AEs) up to 28 Days Post Vaccination
Time Frame: From vaccination to 28 days post vaccination (Day 1-28 for 1st vaccination and Day 29-56 for the 2nd vaccination)
Unsolicited AEs are any AEs reported spontaneously by the participant, observed by the study personnel during study visits or those 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 were reported as an AE.
Secondary Outcomes
- Median Anti-poliovirus Type 1 Serum Neutralizing Antibody Titers at Baseline and Post-vaccination Among Participants With a Vaccine History of IPV(Baseline and Day 29 (28 days post-vaccination))
- Median Anti-poliovirus Type 1 Serum Neutralizing Antibody Titers at Baseline and Post-vaccination Among Participants With a Vaccine History of OPV(Baseline, Day 29 (28 days post-vaccination) and Day 57 (28 days after 2nd vaccination))
- Median Anti-poliovirus Type 3 Serum Neutralizing Antibody Titers at Baseline and Post-vaccination Among Participants With a Vaccine History of IPV(Baseline and Day 29 (28 days post-vaccination))
- Median Anti-poliovirus Type 3 Serum Neutralizing Antibody Titers at Baseline and Post-vaccination Among Participants With a Vaccine History of OPV(Baseline, Day 29 (28 days after the 1st vaccination) and Day 57 (28 days after 2nd vaccination))
- Geometric Mean Titer (GMT) of Anti-poliovirus Type 1 Serum Neutralizing Antibodies at Baseline and Post-vaccination Among Participants With a Vaccine History of IPV(Baseline and Day 29 (28 days post-vaccination))
- Geometric Mean Titer of Anti-poliovirus Type 1 Serum Neutralizing Antibodies at Baseline and Post-vaccination Among Participants With a Vaccine History of OPV(Baseline, Day 29 (28 days after 1st vaccination) and Day 57 (28 days after 2nd vaccination))
- Geometric Mean Titer of Anti-poliovirus Type 3 Serum Neutralizing Antibodies at Baseline and Post-vaccination Among Participants With a Vaccine History of IPV(Baseline and Day 29 (28 days post-vaccination))
- Geometric Mean Titer of Anti-poliovirus Type 3 Serum Neutralizing Antibodies at Baseline and Post-vaccination Among Participants With a Vaccine History of OPV(Baseline, Day 29 (28 days after 1st vaccination) and Day 57 (28 days after 2nd vaccination))
- Percentage of Participants With Any-Fold Rise, 2-fold Rise and 4-fold Rise in Anti-poliovirus Type 1 Serum Neutralizing Antibody Titers From Baseline to 28 Days After Vaccination Among Participants With a Vaccine History of IPV(Baseline (pre-vaccination) and Day 29 (28 days post-vaccination))
- Percentage of Participants With Any-Fold Rise, 2-fold Rise and 4-fold Rise in Anti-poliovirus Type 1 Serum Neutralizing Antibody Titers From Baseline to 28 Days After Each Vaccination Among Participants With a Vaccine History of OPV(Baseline, Day 29 (28 days post-vaccination) and Day 57 (28 days after 2nd vaccination))
- Percentage of Participants With Any-Fold Rise, 2-fold Rise and 4-fold Rise in Anti-poliovirus Type 3 Serum Neutralizing Antibody Titers From Baseline to 28 Days After Vaccination Among Participants With a Vaccine History of IPV(Baseline and Day 29 (28 days post-vaccination))
- Percentage of Participants With Any-Fold Rise, 2-fold Rise and 4-fold Rise in Anti-poliovirus Type 3 Serum Neutralizing Antibody Titers From Baseline to 28 Days After Each Vaccination Among Participants With a Vaccine History of OPV(Baseline, Day 29 (28 days after 1st vaccination) and Day 57 (28 days after 2nd vaccination))
- Time to Cessation of Fecal Shedding of Vaccine Virus in Participants With IPV Vaccination History(Up to Day 57)
- Time to Cessation of Fecal Shedding of Vaccine Virus in Participants With OPV Vaccination History(From vaccination through 28 days after each vaccination)
- Percentage of Participants Shedding Type 1 Vaccine Virus at Each Post-vaccination Stool Collection in Participants With IPV Vaccination History(Days 3, 5, 8, 10, 15, 22, 29, 36, 43, 50, and 57)
- Percentage of Participants Shedding Type 3 Vaccine Virus at Each Post-vaccination Stool Collection in Participants With IPV Vaccination History(Days 3, 5, 8, 10, 15, 22, 29, 36, 43, 50, and 57)
- Amount of Type 1 Vaccine Virus in Each Stool Sample Positive for Virus in Participants With IPV Vaccination History(Days 3, 5, 8, 10, 15, 22, 29, 36, 43, 50, and 57)
- Amount of Type 3 Vaccine Virus in Each Stool Sample Positive for Virus in Participants With IPV Vaccination History(Days 3, 5, 8, 10, 15, 22, 29, 36, 43, 50, and 57)
- Shedding Index of Vaccine Virus Shedding in Stool in Participants With IPV Vaccination History(Days 8, 15, 22, and 29)
- Area Under the Curve From Vaccination to 28 Days After Vaccination (AUC₀-₂₈) of Vaccine Virus Shed in Stool in Participants With an IPV Vaccination History(Days 3, 5, 8, 10, 15, 22, and 29)