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A Study to Evaluate the Safety and Immunogenicity of 4 Doses of MenACWY Conjugate Vaccine, Administered Concomitantly With Routine Vaccines, Among Infants Aged 2 Months

Phase 3
Completed
Conditions
Meningococcal Disease
Interventions
Biological: MenACWY-CRM
Biological: DTaP-IPV/Hib
Biological: HBV
Biological: PCV
Biological: MMR
Registration Number
NCT01000311
Lead Sponsor
Novartis Vaccines
Brief Summary

This Phase 3 study is designed to demonstrate the safety and immunogenicity of MenACWY and non-interference of concomitant routine vaccines by MenACWY in an infant age group.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
529
Inclusion Criteria
  1. Two month-old infants, born after a full-term pregnancy with an estimated gestational age ≥37 weeks and a birth weight ≥2.5 kg.

  2. Documented written informed consent provided by the parent/legal representative after the nature of the study had been explained.

  3. Parent/legal representative was available for all visits scheduled in the study.

  4. Subjects were in good health as determined by:

    1. medical history
    2. physical assessment
    3. clinical judgment of the investigator
Exclusion Criteria
  1. Subjects who previously received any meningococcal vaccines or vaccines against diphtheria, tetanus, pertussis, polio (IPV or OPV), H. influenzae type b (Hib) or pneumococcus. Exceptions: prior doses HBV vaccination (one or two doses) are permitted.
  2. Subjects who had a previous confirmed or suspected disease caused by N. meningitidis, C. diphtheriae, C. tetani, poliovirus, Hepatitis B, Hib, pneumococcus or B. pertussis (history of laboratory confirmed, or clinical condition of paroxysmal cough for a period of longer than or equal to 2 weeks associated with apnea or whooping).
  3. Subjects who had household contact with and/or intimate exposure to an individual with laboratory confirmed N. meningitidis, B. pertussis, Hib, C. diphtheriae, polio, or pneumococcal infection at any time since birth.
  4. Subjects who had a history of anaphylactic shock, asthma, urticaria or other allergic reaction after previous vaccinations or known hypersensitivity to any vaccine component.
  5. Subjects who had experienced significant acute or chronic infection within the previous 7 days or have experienced fever (temperature ≥ 38.0°C [100.4°F]) within the previous 3 days.
  6. Subjects who had any serious acute or chronic disease, neurological disease including seizures, congenital defects, or cytogenic disorders (e.g., Down syndrome).
  7. Subjects who had a known or suspected autoimmune disease or persistent impairment/alteration of immune function.
  8. Subjects who had a suspected or known HIV infection or were born to a mother known to be HIV positive.
  9. Subjects who had ever received blood, blood products and/or plasma derivatives or any parenteral immunoglobulin preparation (including Hepatitis B immune globulin).
  10. Subjects who had a known bleeding diathesis, or any condition that may be associated with a prolonged bleeding time.
  11. Subjects who with their parents/legal representatives were planning to leave the area of the study site before the end of the study period.
  12. Subjects who had any condition which, in the opinion of the investigator, might interfere with the evaluation of the study objectives.
  13. Subjects who received any investigational agents or vaccines since birth or who expect to receive an investigational agent or vaccine prior to the completion of the study.
  14. Subjects who were relatives of site research staff working on this study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MenACWY-CRM + Routine VaccinesMenACWY-CRMInfants received 3 doses of MenACWY-CRM at 2, 4 and 6 months as a infant series vaccination and a toddler dose at 12 months of age. Infants also received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months.
MenACWY-CRM + Routine VaccinesDTaP-IPV/HibInfants received 3 doses of MenACWY-CRM at 2, 4 and 6 months as a infant series vaccination and a toddler dose at 12 months of age. Infants also received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months.
MenACWY-CRM + Routine VaccinesHBVInfants received 3 doses of MenACWY-CRM at 2, 4 and 6 months as a infant series vaccination and a toddler dose at 12 months of age. Infants also received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months.
MenACWY-CRM + Routine VaccinesPCVInfants received 3 doses of MenACWY-CRM at 2, 4 and 6 months as a infant series vaccination and a toddler dose at 12 months of age. Infants also received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months.
MenACWY-CRM + Routine VaccinesMMRInfants received 3 doses of MenACWY-CRM at 2, 4 and 6 months as a infant series vaccination and a toddler dose at 12 months of age. Infants also received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months.
Routine VaccinesDTaP-IPV/HibInfants received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months. In addition subjects were offered a dose of MenACWY-CRM at 18 months as a benefit of participating in this study. However, blood was not drawn for immunogenicity analysis after this dose.
Routine VaccinesHBVInfants received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months. In addition subjects were offered a dose of MenACWY-CRM at 18 months as a benefit of participating in this study. However, blood was not drawn for immunogenicity analysis after this dose.
Routine VaccinesPCVInfants received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months. In addition subjects were offered a dose of MenACWY-CRM at 18 months as a benefit of participating in this study. However, blood was not drawn for immunogenicity analysis after this dose.
Routine VaccinesMMRInfants received routine vaccines - 3 doses each of DTaP-IPV/Hib, HBV and PCV at 2, 4 and 6 months; and 1 dose each of PCV and MMR at 12 months. In addition subjects were offered a dose of MenACWY-CRM at 18 months as a benefit of participating in this study. However, blood was not drawn for immunogenicity analysis after this dose.
Primary Outcome Measures
NameTimeMethod
Percentage of Subjects With hSBA Titer ≥1:8 Against Serogroup A, C, W and Y One Month After Toddler Vaccination of MenACWY-CRMBaseline and one month after fourth-dose of MenACWY-CRM

Immunogenicity was measured as the percentage of subjects who achieved hSBA titer ≥1:8 against meningococcal serogroup A, C, W and Y, evaluated by serum bactericidal assay using human complement (hSBA), at baseline and one month after toddler dose of MenACWY-CRM administered at 12 months of age.

The immune response was considered sufficient if the lower limit of the two-sided 95% confidence intervals (CIs) for the percentage of subjects with hSBA titer ≥1:8, at one month after toddler vaccination, was greater than 85% for the serogroup C, W, or Y and greater than 80% for the serogroup A.

Secondary Outcome Measures
NameTimeMethod
Percentage of Subjects With hSBA Titers ≥1:8, and Four-Fold Increase in hSBA Titers Against Serogroup A, C, W and Y One Month After Three Dose Infant Series Vaccination of MenACWY-CRMBaseline and one month after third infant dose of MenACWY-CRM

Immunogenicity was measured as the percentage of subjects with hSBA titers ≥1:8 against meningococcal serogroup A, C, W and Y, before (baseline) and one month after 3 infant doses of MenACWY-CRM administered at 2, 4 and 6 months of age.

Percentage of subjects who achieved at least four-fold rise in hSBA titers against serogroup A, C, W and Y was measured one month after 3 infant doses of MenACWY-CRM.

hSBA Geometric Mean Titers Against Serogroup A, C, W and Y One Month After Toddler Vaccination of MenACWY-CRMBaseline and one month after fourth-dose of MenACWY-CRM

Immunogenicity was measured as the hSBA geometric mean titers (GMTs) directed against meningococcal serogroup A, C, W and Y, at baseline and one month after toddler dose of MenACWY-CRM administered at 12 months of age.

hSBA Geometric Mean Titers Against Serogroup A, C, W and Y One Month After Three Dose Infant Series Vaccination of MenACWY-CRMBaseline and one month after third infant dose of MenACWY-CRM

Immunogenicity was measured as the hSBA GMTs directed against meningococcal serogroups A, C, W and Y before (baseline) and one month after 3 infants doses of MenACWY-CRM administered at 2, 4 and 6 months of age.

Percentage of Subjects With Seroresponse to Routine Concomitant Vaccinations One Month After Infant Series, When Routine Vaccines Are Administered With MenACWY-CRM Compared With When Routine Vaccines Are Given AloneOne month after third dose of routine infant series vaccination

The immune seroresponse to routine concomitant vaccination was measured as the percentages of subjects with pre-specified cut-off limit of ≥0.1 IU/mL (Diphtheria and Tetanus); ≥0.15 μg/mL (Hib); ≥0.35 μg/mL (Pneumococcal antigens, PnC); and ≥10 mIU/mL (Hepatitis B), evaluated using enzyme-linked immunosorbent assay (ELISA) at one month after 3 doses of infant series vaccination administered at 2, 4 and 6 months of age.

The immune response to pertussis antigens (PT, FHA, Pertactin, FIM) was measured as percentage of subjects with seroresponse (in initially seronegative infants, ≥4 times the lower limit of quantification (LLQ); in initially seropositive infants, at least 4 times prevaccination concentration) by ELISA and percentage of subjects with titer ≥1:8 (Polio types 1, 2, and 3) by neutralization test (NT) one month after 3 doses of infant series vaccination administered at 2, 4 and 6 months of age.

Geometric Mean Concentrations Of Antibodies Against Routine Concomitant Vaccinations One Month After Infant Series, When Routine Vaccines Are Administered With MenACWY-CRM Compared With When Routine Vaccines Are Given AloneOne month after third dose of routine infant series vaccination

The immune response was measured as the geometric mean concentrations (GMCs) of antibodies directed against diphtheria, tetanus, pertussis (PT, FHA, Pertactin, FIM), hepatitis B, Hib, polio (type 1, 2 and 3) and pneumococcal (PnC 4, 6B, 9V, 14, 18C, 19F and 23F) antigens when routine vaccines are administered concomitantly with MenACWY-CRM compared with when routine vaccines are given alone, one month after 3 doses of infant series vaccination at 2, 4 and 6 months of age.

Geometric Mean Concentrations Of Antibodies Against Pneumococcal Antigens One Month After Toddler Vaccination With PCV Administered With MenACWY-CRM Compared With PCV Given AloneOne month after PCV toddler vaccination

Immunogenicity was measured as the GMCs of anti-pneumococcal antibodies against pneumococcal antigens PnC 4, 6B, 9V, 14, 18C, 19F and 23F, one month after toddler dose of PCV at 12 months of age administered concomitantly with MenACWY-CRM compared with PCV given alone.

Percentage of Subjects With Anti-pneumococcal Antigen Antibodies ≥0.35 μg/mL One Month After Toddler Vaccination With PCV Administered With MenACWY-CRM Compared With PCV Given AloneOne month after PCV toddler vaccination

The immune seroresponse was measured as the percentage of subjects with anti-pneumococcal antigen antibodies ≥0.35 μg/mL against pneumococcal antigens PnC 4, 6B, 9V, 14, 18C, 19F and 23F, one month after toddler dose of PCV at 12 months of age when administered concomitantly with MenACWY-CRM compared with PCV given alone.

Antibody Persistence by Percentage of Subjects With hSBA Titers ≥1:8 Against Serogroup A, C, W and Y, Six Months After Third Infant Vaccination, Prior to MenACWY-CRM Toddler VaccinationBaseline and Six months after third infant dose of MenACWY-CRM

The antibody persistence was measured as the percentage of subjects with hSBA titers ≥1:8 against meningococcal serogroup A, C, W and Y, at baseline and six months after third infant dose of MenACWY-CRM administered at 6 months (12 months of age), before administration of the toddler dose of MenACWY-CRM.

Persistence of hSBA Geometric Mean Titers Against Serogroup A, C, W and Y, Six Months After Third Infant Vaccination, Prior to MenACWY-CRM Toddler VaccinationBaseline and Six months after third infant dose of MenACWY-CRM

The antibody persistence was measured as the hSBA GMTs directed against meningococcal serogroup A, C, W and Y, at baseline and six months after third infant dose of MenACWY-CRM administered at 6 months (12 months of age), before administration of the toddler dose of MenACWY-CRM.

Percentage of Subjects With Four-fold Increase in hSBA Titers Against Serogroup A, C, W and Y One Month After Toddler Vaccination of MenACWY-CRMOne month after MenACWY-CRM toddler vaccination

The immune response was measured as the percentage of subjects who achieved four-fold increase in hSBA titers against meningococcal serogroup A, C, W and Y one month after toddler dose of MenACWY-CRM administered at 12 months of age as compared to hSBA titers before the toddler vaccination.

Safety of MenACWY-CRM Vaccinations When Administered Concomitantly With Routine VaccinationsFrom day 1 to 18 months

Safety of the study vaccines (MenACWY-CRM and other routine vaccines) was assessed in terms of the number of subjects who reported adverse events (AEs) and/or serious AEs per vaccine group at the following time points: entire study period, after infants vaccination (up to 7 months), between 2- and 4-months, between 4- and 6-months, between 6- and 12-months, between 7- and 12-months, 28 days after 12-month vaccination, and between 29 days after 12-month vaccination and study termination.

Solicited reactions were not collected during this study. The safety analyses also included any AEs observed by study personnel within 15 minutes following vaccination. All AEs and SAEs were judged by the investigator as whether probably related, possibly related, or not related to vaccine.

Trial Locations

Locations (46)

17 Edinger Medical Group Research Center 9900 Talbert Avenue Suite 204

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Fountain Valley, California, United States

24 University Of Louisville 555 South Floyd Street

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Louisville, Kentucky, United States

34 Primary Physicians Research Inc. 1580 McLaughlin Run Road

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Pittsburgh, Pennsylvania, United States

35 Southwestern Medical Clinic P.C. 2002 S 11th Street

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Niles, Michigan, United States

13 Willis Knighton Physician Network- Portico Pediatrics 7847 Youree Drive

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Shreveport, Louisiana, United States

5 Dayton Clinical Research 1100 Salem Ave.

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Dayton, Ohio, United States

44 Wee Care Pediatrics 5991 S. 3500 W Suite 100 Rock Run Plaza

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Roy, Utah, United States

48 Cotton O'Neil Clinical Research Center 4100 SW 15th Street

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Topeka, Kansas, United States

3 Sydney Children's Hospital Strasser Lab. Level 3 High Street

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Randwick, New South Wales, Australia

9 San Fernando Valley Research Associates 7111 Winnetka Avenue Suite 14

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Canoga Park, California, United States

22 Ohio Pediatrics Research Association 1775 Delco Park Drive

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Kettering, Ohio, United States

45 Oklahoma State University Physicians 635 W 11th St

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Tulsa, Oklahoma, United States

31 Senders Pediatrics 2054 South Green Road

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Cleveland, Ohio, United States

33 Primary Physicians Research Inc. 1580 McLaughlin Run Road

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Pittsburgh, Pennsylvania, United States

15 Northwest Arkansas Pediatric Clinic 3383 N. Mana Court Suite 101

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Fayetteville, Arkansas, United States

47 Cotton O'Neil Clinical Research Center 6725 SW 29th Street

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Topeka, Kansas, United States

4 Nassim McMonigle Mescia and Associates 5512 Bardstown Road Suite 2

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Louisville, Kentucky, United States

38 Center for Clinical Trials LLC 16660 Paramount Blvd Suite 301

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Paramount, California, United States

6 Children's Clinic of Jonesboro AR 800 South Church Street Suite 400 and 204

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Jonesboro, Arkansas, United States

28 Madera Family Medical Group 1111 West 4th Street

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Madera, California, United States

25 Center for Pharmaceutical Research 1010 Carondelet Drive Suite 426

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Kansas City, Missouri, United States

19 Pediatric Care 1675 North Freedom Blvd Building 3

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Provo, Utah, United States

27 Ark-La-Tex Children's Clinic 1025 Highway 80 E

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Haughton, Louisiana, United States

29 Kentucky Pediatric/Adult Research 201 South 5th Street

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Bardstown, Kentucky, United States

2 Royal Children's Hospital Herston Road

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Herston, Queensland, Australia

7 Amarillo Children's Clinical Research #17 Care Circle

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Amarillo, Texas, United States

30 Kentucky Pediatric/Adult Research 102 West Depot Street

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Springfield, Kentucky, United States

14 Ohio Pediatrics Research Association 7371 Brandt Pike Suite C

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Huber Heights, Ohio, United States

16 Westside Medical 1477 North 2000 West

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Clinton, Utah, United States

10 Holston Medical Group 105 W. Stone Drive Suite 3B

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Kingsport, Tennessee, United States

43 Wee Care Pediatrics 1580 W. Antelope Drive Suite 100

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Layton, Utah, United States

36 Dominion Medical Associates 304 East Leigh Street

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Richmond, Virginia, United States

18 Copperview Medical Center 3556 West 9800 South

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South Jordan, Utah, United States

41 Wee Care Pediatrics 1792 W. 1700 S. Suite 102

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Syracuse, Utah, United States

20 Medicor Research Inc 359 Riverside Suite 200

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Sudbury, Ontario, Canada

1 Murdoch Childrens Research Institute C/- School of Population Health The University of Melbourne

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Carlton, Victoria, Australia

21 CAMC Health Education and Research Institute 3100 McCorkle Ave. S.E. Suite 806

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Charleston, West Virginia, United States

46 Pediatric Healthcare of Northwest Houston P.A. 12015 Louetta Road Suite 100

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Houston, Texas, United States

8 Pharmax Research Clinic 7200 NW 7th Street Suite 350

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Miami, Florida, United States

37 Alabama Clinical Therapeutics LLC 52 Medical Park East Drive Suite 203

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Birmingham, Alabama, United States

39 Dixie Pediatrics 1240 E 100 S Suite 14

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St. George, Utah, United States

40 Brownsboro Park Pediatrics 5512 Bardstown Road Suite 2

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Louisville, Kentucky, United States

26 University Of Louisville 230 East Broadway

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Louisville, Kentucky, United States

12 Pediatric Healthcare of Northwest Houston P.A. 13406 Medical Complex Drive Suite 200

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Tomball, Texas, United States

42 Wee Care Pediatrics 934 S. Main Street Suite 8

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Layton, Utah, United States

23 Focus Research Group 201 Signature Place

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Lebanon, Tennessee, United States

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