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Assessing Immunogenicity of Intramuscular Sabin Inactivated Poliovirus Vaccine and Non-inferiority of Intradermal Fractional Inactivated Poliovirus Vaccine

Phase 4
Completed
Conditions
Poliomyelitis
Interventions
Biological: Full dose Sabin Inactivated Poliovirus Vaccine produced by BIBP
Biological: Fractional (1/5) Dose Sabin Inactivated Poliovirus Vaccine produced by IMBCAMS
Biological: Fractional (1/5) dose Sabin Inactivated Poliovirus Vaccine produced by BIBP
Biological: Full dose Sabin Inactivated Poliovirus Vaccine produced by IMBCAMS
Registration Number
NCT05460377
Lead Sponsor
Centers for Disease Control and Prevention
Brief Summary

This is an open label and off label, phase IV, randomized clinical trial that will compare the immune response among infants that receive either two full doses of Sabin IPV intramuscularly or two fractional (1/5) dose of Sabin IPV intradermally at 14 weeks and 9 months of age from two different manufacturers.

Detailed Description

After OPV cessation, which is expected within a year of polio eradication certification, IPV will be the only polio vaccine used in essential immunization programs. SAGE has recommended a two-dose intramuscular IPV or intradermal fractional IPV (fIPV) schedule after OPV cessation. While it is expected that there shall be sufficient IPV available - in large part because of several manufacturers establishing production of IPV using Sabin strains (sIPV) - it is dependent on these manufacturers being able to meet promised product development and manufacturing timeline and meet WHO prequalification. It is likely that countries that have introduced intradermal fIPV pre-eradication will continue to use intradermal fIPV post-eradication. Therefore, it is important to generate evidence on immunogenicity of intradermal fractional sIPV in addition to intramuscular sIPV for the schedule recommended by SAGE.

This clinical trial assesses and compares the immunogenicity of full and fractional (1/5) dose Sabin IPV given at 14 weeks and 9 months of age from two different manufacturers. Healthy infants 6 weeks of age will be enrolled in Dhaka, Bangladesh, and randomized to one of four arms:

A. IMBCAMS full dose sIPV at 14 weeks and 9 months B. IMBCAMS fractional dose sIPV at 14 weeks and 9 months C. BIBP full dose sIPV at 14 weeks and 9 months D. BIBP fractional dose sIPV at 14 weeks and 9 months

Participants will be followed until 10 months of age through clinic visits. Blood samples will be collected for measuring immune response.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1224
Inclusion Criteria
  • Healthy infants 6 weeks of age (range: 42-48 days).
  • Parents that consent for participation in the full length of the study (i.e., 34 weeks).
  • Parents that are able to understand and comply with planned study procedures.
Exclusion Criteria
  • A diagnosis or suspicion of immunodeficiency disorder either in the infant or in an immediate family member.
  • A diagnosis or suspicion of bleeding disorder that would contraindicate parenteral administration of sIPV or collection of blood by venepuncture.
  • Acute diarrhoea, infection or illness at the time of enrollment (6 weeks of age) that would require infant's admission to a hospital.
  • Acute vomiting and intolerance to liquids within 24 hours before the enrollment visit (6 weeks of age).
  • Evidence of a chronic medical condition identified by a study medical officer during physical exam.
  • Receipt of any polio vaccine (OPV or IPV) before enrollment based upon documentation or parental recall.
  • Known allergy/sensitivity or reaction to polio vaccine, or its contents.
  • Infants from multiple births. Infants from multiple births will be excluded because the infant(s) who is/are not enrolled would likely receive OPV through routine immunization and transmit vaccine poliovirus to the enrolled infant.
  • Infants from premature births (<37 weeks of gestation).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BIBP Sabin IPV full dose at 14 weeks and 9 monthsFull dose Sabin Inactivated Poliovirus Vaccine produced by BIBPParticipants will receive two full doses of Sabin IPV intramuscularly at 14 weeks and 9 months produced by Beijing Bio Institute Biological Products (BIBP).
IMBCAMS Sabin IPV fractional dose at 14 weeks and 9 monthsFractional (1/5) Dose Sabin Inactivated Poliovirus Vaccine produced by IMBCAMSParticipants will receive two fractional (1/5) doses of Sabin IPV intradermally at 14 weeks and 9 months produced by Institute of Medical Biology Chinese Academy of Medical Sciences, Kunming (IMBCAMS).
BIBP Sabin IPV fractional dose at 14 weeks and 9 monthsFractional (1/5) dose Sabin Inactivated Poliovirus Vaccine produced by BIBPParticipants will receive two fractional (1/5) doses of Sabin IPV intradermally at 14 weeks and 9 months produced by Beijing Bio Institute Biological Products (BIBP).
IMBCAMS Sabin IPV full dose at 14 weeks and 9 monthsFull dose Sabin Inactivated Poliovirus Vaccine produced by IMBCAMSParticipants will receive two full doses of Sabin IPV intramuscularly at 14 weeks and 9 months produced by Institute of Medical Biology Chinese Academy of Medical Sciences, Kunming (IMBCAMS).
Primary Outcome Measures
NameTimeMethod
Vaccine responseMeasured 4 weeks after administration of study vaccine

Dichotomous (yes/no) variable defined as participants who are either seronegative (\<1:8 titers) at baseline who become seropositive (≥1:8) after vaccination (seroconversion) or participants who demonstrate a four-fold rise in titers after vaccination between two specimens, e.g. a change from 1:8 to 1:32, after adjusting for expected decay in maternal antibodies. Antibody titers at 14 weeks of age will be the starting point for the expected decline in maternal antibodies, assuming at half-life of 28 days.

Secondary Outcome Measures
NameTimeMethod
PrimingMeasured 7 days after challenge dose (e.g. 9 months + 7 days)

Dichotomous (yes/no) variable defined as participants who are either seronegative (\<1:8 titers) at baseline who become seropositive (≥1:8) after vaccination (seroconversion) or participants who demonstrate a four-fold rise in titers after vaccination between two specimens, e.g. a change from 1:8 to 1:32, after adjusting for expected decay in maternal antibodies. Antibody titers at 14 weeks of age will be the starting point for the expected decline in maternal antibodies, assuming at half-life of 28 days.

Reciprocal antibody titersMeasured 4 weeks after administration of study Vaccine

Variable of the observed reciprocal antibody titer results.

Trial Locations

Locations (1)

Icddr,B Study Clinics

🇧🇩

Dhaka, Bangladesh

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