A Study of an Adenovirus Serotype 26 Pre-fusion Conformation-stabilized F Protein (Ad26. RSV. preF) Based Respiratory Syncytial Virus (RSV) Vaccine in the Prevention of Lower Respiratory Tract Disease in Adults Aged 60 Years and Older

Phase 3

Completed

Conditions: Lower Respiratory Tract Disease
Respiratory Syncytial Viruses

Interventions: Biological: Adenovirus serotype 26 (Ad26)-based respiratory syncytial virus (RSV). preF
Biological: Placebo

Registration Number: NCT04908683

Lead Sponsor: Janssen Vaccines & Prevention B.V.

Brief Summary: The study will enroll up to 27,200 participants in order to demonstrate the efficacy of the active Ad26.RSV.preF-based study vaccine in the prevention of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed Respiratory Syncytial Virus (RSV)-mediated Lower Respiratory Tract Disease (LRTD) when compared to placebo in adults aged 60 years and above.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 25236

Inclusion Criteria

Must be able to work with smartphones/tablets/computers
From the time of vaccination through 3 months after vaccination, participant agrees not to donate blood
Must be willing to provide verifiable identification, has means to be contacted and to contact the investigator during the study
Before randomization, a participant must be: a. postmenopausal (postmenopausal state is defined as no menses for 12 months without an alternative medical cause); and b. not intending to conceive by any methods
Participants must sign an Inform Consent Form (ICF) indicating that the participant understands the purpose, procedures and potential risks and benefits of the study, and is willing to participate in the study

Exclusion Criteria

Has a serious clinically unstable condition, (example, end-stage renal disease with or without dialysis, clinically unstable cardiac disease), Alzheimer's disease, or any other condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (example, compromise well-being) or that could prevent, confound, or limit the protocol specified assessments
History of malignancy within 5 years before screening not in the following categories: a. Participants with squamous and basal cell carcinomas of the skin and carcinoma in situ of the cervix may be enrolled at the discretion of the investigator; b. Participants with a history of malignancy within 5 years, which is considered cured with minimal risk of recurrence per investigator's judgement, can be enrolled
Had major surgery (example, major cardiopulmonary or abdominal operations) as per the investigator's judgment within 4 weeks before vaccination, or will not have fully recovered from surgery, or has major surgery planned during the time the participant is expected to participate in the study
Employee of the investigator or study site, with direct involvement in the proposed study or other studies under the direction of that investigator or study site, as well as family members of the employees or the investigator, or an employee of the sponsor
Contraindication to Intramuscular (IM) injections and blood draws (example, bleeding disorders)
Known or suspected allergy or history of anaphylaxis or other serious adverse reactions to vaccines or vaccine components (including any of the constituents of the study vaccine)

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Group 1: Respiratory Syncytial Virus (RSV) vaccine	Adenovirus serotype 26 (Ad26)-based respiratory syncytial virus (RSV). preF	All participants in the active group will receive a single dose intramuscular (IM) injection of study vaccine on Day 1.
Group 2: Placebo	Placebo	All participants in the placebo group will receive a single IM injection of matching placebo on Day 1.

Primary Outcome Measures

Name	Time	Method
Number of Participants With First Occurrence of Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)-Confirmed Respiratory Syncytial Virus (RSV) Mediated Lower Respiratory Tract Disease (LRTD)	From Baseline (Day 1) up to 12 months	Number of participants with first occurrence of RT-PCR-confirmed RSV mediated LRTD according to protocol defined criteria were reported. A participant was considered to have RT-PCR-confirmed RSV-mediated LRTD if the following criteria were met: new onset or worsening from baseline of 3 or more of the symptoms as captured on the respiratory infection intensity and impact questionnaire (RiiQ, version 2) at the same assessment time point: cough, short of breath, coughing up phlegm (sputum), and wheezing and confirmation of RSV by RT-PCR in one or more of the nasal swabs, or in the sputum sample. RiiQ symptom scale was a 13-item questionnaire rated on a 4-point scale. Each symptom was rated on a scale of 0 to 3 where 0=None, 1=Mild, 2=Moderate, and 3=Severe. Higher scores indicated greater severity. The total LRTD symptom score was calculated as the mean of the 4 lower respiratory scores (cough, short of breath, coughing up phlegm \[sputum\] and wheezing).

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Unsolicited AEs up to 28 Days After Vaccination	Up to 28 days post vaccination on Day 1 (up to Day 29)	Number of participants with unsolicited AEs 28 days post vaccination were reported. An AE was any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. Unsolicited adverse events included all adverse events for which the participant was not specifically questioned in the subject diary.
Number of Participants With First Occurrence of Any RT-PCR-Confirmed RSV-mediated Acute Respiratory Infection (ARI)	From Baseline (Day 1) up to 12 months	A participant was considered to have RT-PCR-confirmed RSV-mediated ARI if the following protocol defined criteria were met: ARI episode initiated by the participant and confirmed by the site with symptoms consistent with an ARI (new symptoms or worsening from baseline of at least one of the symptoms as captured on the RiiQ): sore throat, nasal congestion, cough, short of breath, coughing up phlegm (sputum), wheezing and confirmation of RSV by RT-PCR in one or more of the nasal swabs, or in the sputum sample. RiiQ symptom scale was a 13-items questionnaire rated on a 4-point scale. Each symptom was rated on a scale of 0 to 3 where 0=None, 1=Mild, 2=Moderate, and 3=Severe. Higher scores indicated greater severity. The total ARI symptom score was calculated as the mean of the 4 lower respiratory scores (cough, short of breath, coughing up phlegm \[sputum\] and wheezing).
Number of Participants With First Occurrence of RT-PCR-Confirmed RSV Mediated LRTD During the Second Year	From Month 12 up to Month 24	Number of participants with first occurrence of any RT-PCR-confirmed RSV mediated LRTD during the second year were reported. A participant was considered to have RT-PCR-confirmed RSV-mediated LRTD if the following criteria were met: new onset or worsening from baseline of 3 or more of the symptoms as captured on the RiiQ, version 2 at the same assessment time point: cough, short of breath, coughing up phlegm (sputum), and wheezing and confirmation of RSV by RT-PCR in one or more of the nasal swabs, or in the sputum sample. RiiQ symptom scale was a 13-items questionnaire rated on a 4-point scale. Each symptom was rated on a scale of 0 to 3 where 0=None, 1=Mild, 2=Moderate, and 3=Severe. Higher scores indicated greater severity. The total LRTD symptom score was calculated as the mean of the 4 lower respiratory scores (cough, short of breath, coughing up phlegm \[sputum\] and wheezing).
Number of Participants With Solicited Local Adverse Events (AEs) up to 7 Days After Vaccination	Up to Day 7 post vaccination on Day 1 (up to Day 8)	Number of participants with solicited local AEs 7 days post vaccination were reported. An AE was any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. Solicited local AEs were precisely defined events that participants were specifically asked about and which were noted by participants in the diary. Solicited local AEs included erythema, swelling, and pain/tenderness at the study vaccine injection site, were used to assess the reactogenicity of the study vaccine and were pre-defined local (injection site). All solicited AEs at the injection site (local) were considered related to the study vaccine administration.
Respiratory Syncytial Virus (RSV) A2 Strain Neutralization Antibody Titers at 14 Days Post Vaccination	At 14 Days post vaccination on Day 1 (Day 15)	RSV A2 strain neutralizing antibody titers of the vaccine-induced immune response was assessed through virus neutralization assay.
T-cell Interferon (IFN) Gamma Responses to Respiratory Syncytial Virus (RSV) F Protein Peptides Analyzed by Enzyme-linked Immunospot Assay (ELISpot)	14 days post vaccination on Day 1 (Day 15)	T-cell IFN gamma responses to RSV F protein specific peptides at 14 days after vaccination as measured by ELISpot assay were reported. RSV F specific T-cell IFN gamma ELISpot responses were measured as counts of spot forming cells per million peripheral blood mononuclear cells (SFC/10\^6 PBMCs).
Number of Participants With First Occurrence of Any RT-PCR-Confirmed RSV Mediated ARI During the Second Year	From Month 12 up to Month 24	A participant was considered to have RT-PCR-confirmed RSV-mediated ARI according to protocol defined criteria were reported. A participant was considered to have RT-PCR-confirmed RSV-mediated ARI if the following criteria were met: ARI episode initiated by the participant and confirmed by the site with symptoms consistent with an ARI (new symptoms or worsening from baseline of at least one of the symptoms as captured on the RiiQ): sore throat, nasal congestion, cough, short of breath, coughing up phlegm (sputum), wheezing and confirmation of RSV by RT-PCR in one or more of the nasal swabs, or in the sputum sample. RiiQ symptom scale was a 13-items questionnaire rated on a 4-point scale. Each symptom was rated on a scale of 0 to 3 where 0=None, 1=Mild, 2=Moderate, and 3=Severe. Higher scores indicated greater severity. The total ARI symptom score was calculated as the mean of the 4 lower respiratory scores (cough, short of breath, coughing up phlegm \[sputum\] and wheezing).
Number of Participants With First Occurrence of Predefined Clinically Relevant Disease Associated With RT-PCR-Confirmed RSV-Mediated ARI Over the Whole Study	Baseline (Day 1) up to 24 months	A participant was considered to have clinically relevant disease with specific parameters associated with an RT-PCR-confirmed RSV-mediated ARI if the following criteria were met: the participant had an RT-PCR-confirmed RSV-mediated ARI: ARI episode initiated by the participant and confirmed by the site with symptoms consistent with an ARI (new symptoms or worsening from baseline of at least one of the symptoms as captured on the RiiQ): sore throat, nasal congestion, cough, short of breath, coughing up phlegm (sputum), wheezing and confirmation of RSV by RT-PCR in one or more of the nasal swabs, or in the sputum sample; any of the following associated with ARI: hospitalization, emergency department visit, per clinical judgement of complications, decreased oxygen saturation, tachypnea, need of supplemental oxygen, hypotension, pulmonary function test and arterial blood gas result.
Number of Participants With Serious Adverse Events (SAEs)	28 days post vaccination on Day 1 (Day 29); First year follow-up (from Day 29 up to 6 months, that is, up to Day 154)	Number of participants with SAEs were reported. An adverse event (AE) is any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. An SAE is any untoward medical occurrence that at any dose may result in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is a suspected transmission of any infectious agent via a medicinal product.
Number of Participants With Potential Adverse Events of Special Interest (AESIs)	28 days post vaccination on Day 1 (Day 29); First year follow-up (from Day 29 up to 6 months, that is, up to Day 154)	Number of participants with potential AESIs were reported. AESIs were significant AEs that were judged to be of special interest because of clinical importance, known or suspected class effects, or based on nonclinical signals. AESIs were embolic and thrombotic events, hematopoietic thrombocytopenia, and cerebral hemorrhage.
Number of Participants With Solicited Systemic AEs up to 7 Days After Vaccination	Up to Day 7 post vaccination on Day 1 (up to Day 8)	Number of participants with solicited systemic AEs 7 days post vaccination were reported. An AE was any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. Solicited systemic AEs included fatigue, headache, myalgia, nausea, pyrexia, for which participants were specifically questioned and which were noted by participants in their participant diary for 7 days post vaccination (day of vaccination and the subsequent 7 days).
Geometric Mean Titers (GMTs) of Prefusion F-protein (Pre-F) Antibodies Immunoglobulin G (IgG) as Assessed by Enzyme-linked Immunosorbent Assay (ELISA) at 14 Days Post Vaccination	At 14 days post vaccination on Day 1 (Day 15)	GMTs of preF antibodies IgG at 14 days after the administration of Ad26.RSV.preF-based vaccine as assessed by ELISA were reported.
Area Under the Curve (AUC) of the Change From Baseline in Respiratory Infection Intensity and Impact Questionnaire (RiiQ) Total Symptom Scale Score	Baseline (Day 1) up to 24 months	RiiQ symptom scale was a 13-items questionnaire rated on a 4-point scale. The respiratory symptoms included 2 upper respiratory tract infection (URTI) symptoms (nasal congestion and sore throat), 4 lower respiratory tract infection (LRTI) symptoms (cough, wheezing, short of breath, and coughing up phlegm/sputum) and 7 systemic symptoms (headache, feeling feverish, neck pain, body aches and pain, fatigue/tiredness, interrupted sleep, and loss of appetite). Each symptom was rated on a scale of 0 to 3 where 0=None, 1=Mild, 2=Moderate, and 3=Severe. Higher scores indicated greater severity. RiiQ total Symptom score was the mean of all scores (based on 13 symptoms). The AUC of the change from baseline for the RiiQ total symptom score and the RiiQ lower respiratory symptom score during the ARI was calculated.

Trial Locations

Locations (218): New Horizon Research Center
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Miami, Florida, United States
Suncoast Research Associates, LLC
🇺🇸
Miami, Florida, United States
Clinical Site Partners, LLC
🇺🇸
Miami, Florida, United States
Harmony Clinical Research Inc
🇺🇸
North Miami Beach, Florida, United States
Healthcare Clinical Data Inc.
🇺🇸
North Miami, Florida, United States
Headlands Research Orlando
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Orlando, Florida, United States
Progressive Medical Research
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Port Orange, Florida, United States
Sandhill Research
🇺🇸
Saint Petersburg, Florida, United States
DBC Research
🇺🇸
Tamarac, Florida, United States
Palm Beach Research Center
🇺🇸
West Palm Beach, Florida, United States
Atlanta Center for Medical Research
🇺🇸
Atlanta, Georgia, United States
Meridian Clinical Research, LLC
🇺🇸
Endwell, New York, United States
Okanagan Clinical Trials
🇨🇦
Kelowna, British Columbia, Canada
LMC Clinical Research dba Manna Research Inc. Burlington
🇨🇦
Burlington, Ontario, Canada
LMC Clinical Research Inc. (Bayview)
🇨🇦
Toronto, Ontario, Canada
P3 Research Limited Kapiti
🇳🇿
Paraparaumu, New Zealand
P3 Reaearch Wellington
🇳🇿
Wellington, New Zealand
Synexus Polska Sp. z o.o. Oddzial w Czestochowie
🇵🇱
Czestochowa, Poland
Synexus Polska Sp. z o.o. Oddzial w Gdansku
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Gdansk, Poland
Synexus Polska Sp. z.o.o. Oddzial w Poznaniu
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Poznan, Poland
Centrum Medyczne Pratia Poznan
🇵🇱
Skorzewo, Poland
KO-MED Centra Kliniczne Staszow
🇵🇱
Staszow, Poland
Iatros International
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Bloemfontein, South Africa
Josha Research
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Bloemfontein, South Africa
Madibeng Centre for Research
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Brits, South Africa
Synexus Helderberg Clinical Research Centre
🇿🇦
Cape Town, South Africa
TREAD Research Tygerberg Hospital
🇿🇦
Cape Town, South Africa
TASK Central
🇿🇦
George, South Africa
Tiervlei Trial Centre
🇿🇦
Cape Town, South Africa
Allergy Immunology Unit
🇿🇦
Cape Town, South Africa
Synergy Biomed Research Institute (SBRI)
🇿🇦
East London, South Africa
CRISMO Bertha Gxowa Research Centre
🇿🇦
Johannesburg, South Africa
Worthwhile Clinical trials
🇿🇦
Johannesburg, South Africa
Clinresco Centres Pty Ltd
🇿🇦
Johannesburg, South Africa
DJW Research
🇿🇦
Krugersdorp, South Africa
Stanza Clinical Research Centre : Mamelodi
🇿🇦
Mamelodi East, South Africa
Newtown Clinical Research
🇿🇦
Newtown, South Africa
Paarl Research Centre
🇿🇦
Paarl, South Africa
Global Clin Trials Pretoria
🇿🇦
Pretoria, South Africa
Synexus Watermeyer
🇿🇦
Pretoria, South Africa
The Aurum Institute Rustenburg Clinical Research Site
🇿🇦
Rustenburg, South Africa
REIMED Vosloorus
🇿🇦
Vosloorus, South Africa
Welkom Clinical Trial Centre
🇿🇦
Welkom, South Africa
Be Part Yoluntu Centre
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Western Cape, South Africa
Hospital das Clinicas de Porto Alegre
🇧🇷
Porto Alegre, Brazil
CPQuali Pesquisa Clinica LTDA ME
🇧🇷
São Paulo, Brazil
Southern Clinical Trials Tasman
🇳🇿
Main Road Stoke, New Zealand
Central Phoenix Medical Clinic
🇺🇸
Phoenix, Arizona, United States
Medpharmics, LLC
🇺🇸
Albuquerque, New Mexico, United States
Synexus Clinical Research US Inc
🇺🇸
Murray, Utah, United States
Baptist Health Center For Clinical Research
🇺🇸
Little Rock, Arkansas, United States
JEM Research LLC
🇺🇸
Atlantis, Florida, United States
Clinical NeuroScience Solutions Inc
🇺🇸
Orlando, Florida, United States
Medication Management LLC
🇺🇸
Greensboro, North Carolina, United States
Clinical Trials of Texas Inc
🇺🇸
San Antonio, Texas, United States
Fundacao Faculdade Regional de Medicina de Sao Jose do Rio Preto Hospital de Base
🇧🇷
Sao Jose do Rio Preto, Brazil
DIEX Recherche Sherbrooke Inc
🇨🇦
Sherbrooke, Quebec, Canada
Synexus Scm Sp Z o o Oddzial Gdynia
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Gdynia, Poland
Synexus Polska Sp z o o Oddzial w Katowicach
🇵🇱
Katowice, Poland
Synexus Polska Sp z o o
🇵🇱
Lodz, Poland
KO MED Centra Kliniczne LUBLIN
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Lublin, Poland
KO MED Centra Kliniczne Pulawy
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Pulawy, Poland
Synexus Polska Sp z o o Oddzial w Warszawie
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Warszawa, Poland
Synexus Polska Sp z o o Oddzial we Wroclawiu
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Wroclaw, Poland
KO MED Centra Kliniczne Zamosc
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Zamosc, Poland
Kaohsiung Medical University Chung Ho Memorial Hospital
🇨🇳
Kaohsiung, Taiwan
Maharaj Nakorn Chiang Mai hospital Faculty of Medicine
🇹🇭
Muang, Thailand
Central Research Associates, Inc.
🇺🇸
Birmingham, Alabama, United States
Achieve Clinical Research, LLC
🇺🇸
Birmingham, Alabama, United States
Optimal Research
🇺🇸
Austin, Texas, United States
Coastal Clinical Research, Inc
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Mobile, Alabama, United States
Hope Research Institute
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Peoria, Arizona, United States
Clinical Research Consortium Arizona
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Tempe, Arizona, United States
Rancho Paseo Medical Group
🇺🇸
Banning, California, United States
Hope clinical Research LLC
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Canoga Park, California, United States
eStudySite
🇺🇸
Chula Vista, California, United States
Velocity Clinical Research, San Diego
🇺🇸
La Mesa, California, United States
Paradigm Clinical Research Centers, Inc.
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Wheat Ridge, Colorado, United States
Encompass Clinical Research
🇺🇸
Spring Valley, California, United States
Tekton Research Inc.
🇺🇸
San Antonio, Texas, United States
Clinical Research of South Florida, an AMR Company
🇺🇸
Coral Gables, Florida, United States
Prestige Clinical Research Center, Inc.
🇺🇸
Coral Gables, Florida, United States
Avail Clinical Research, LLC
🇺🇸
DeLand, Florida, United States
Velocity Clinical Research, Inc.
🇺🇸
Gaffney, South Carolina, United States
AMR Fort Myers Clinical Physiology Associates, an AMR company
🇺🇸
Fort Myers, Florida, United States
Velocity Clinical Research, Hallandale Beach
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Hallandale Beach, Florida, United States
Westside Center for Clinical Research
🇺🇸
Jacksonville, Florida, United States
Jacksonville Center For Clinical Research
🇺🇸
Jacksonville, Florida, United States
Altus Research, Inc
🇺🇸
Lake Worth, Florida, United States
Accel Research Sites
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Eatonton, Georgia, United States
Compass Research LLC
🇺🇸
Leesburg, Florida, United States
Suncoast Research Group
🇺🇸
Miami, Florida, United States
Clinical Research Atlanta
🇺🇸
Stockbridge, Georgia, United States
Advanced Clinical Research
🇺🇸
West Jordan, Utah, United States
Christie Clinic
🇺🇸
Champaign, Illinois, United States
Medisphere Medical Research Center, Llc
🇺🇸
Evansville, Indiana, United States
The South Bend Clinic Center for Research
🇺🇸
South Bend, Indiana, United States
Buynak Clinical Research
🇺🇸
Valparaiso, Indiana, United States
The Iowa Clinic, P.C.
🇺🇸
West Des Moines, Iowa, United States
Heartland Research Associates, LLC
🇺🇸
Newton, Kansas, United States
Johnson County Clin-Trials
🇺🇸
Lenexa, Kansas, United States
Heartland Clinical Research
🇺🇸
Wichita, Kansas, United States
Central Kentucky Research Associates, Inc.
🇺🇸
Lexington, Kentucky, United States
University of Louisville
🇺🇸
Louisville, Kentucky, United States
Centex Studies, Inc.
🇺🇸
Lake Charles, Louisiana, United States
Clinical Trials of America
🇺🇸
Monroe, Louisiana, United States
Tulane University School of Medicine
🇺🇸
New Orleans, Louisiana, United States
AMR New Orleans, Formerly New Orleans Center for Clinical Research - New Orleans, an AMR company
🇺🇸
New Orleans, Louisiana, United States
Central Maine Medical Center
🇺🇸
Lewiston, Maine, United States
Centennial Medical Group
🇺🇸
Elkridge, Maryland, United States
MedPharmics - Biloxi
🇺🇸
Biloxi, Mississippi, United States
Jefferson City Medical Group Family
🇺🇸
Jefferson City, Missouri, United States
The Center for Pharmaceutical Research (CPR)
🇺🇸
Kansas City, Missouri, United States
Sundance Clinical Research
🇺🇸
Saint Louis, Missouri, United States
Mercury Street Medical Group, PLLC
🇺🇸
Butte, Montana, United States
Meridian Clinical Research - Omaha
🇺🇸
Omaha, Nebraska, United States
Clinical Research Consortium, an AMR company
🇺🇸
Las Vegas, Nevada, United States
CHEAR Center, LLC
🇺🇸
Bronx, New York, United States
Regional Clinical Research, Inc.
🇺🇸
Endwell, New York, United States
Harlem Hospital Center
🇺🇸
New York, New York, United States
Finger Lakes Clinical Research
🇺🇸
Rochester, New York, United States
Richmond Behavioral Associates
🇺🇸
Staten Island, New York, United States
Accellacare Research of Cary
🇺🇸
Winston-Salem, North Carolina, United States
American Health Network, LLC
🇺🇸
Charlotte, North Carolina, United States
M3-Emerging Medical Research
🇺🇸
Durham, North Carolina, United States
Monroe Biomedical Research
🇺🇸
Monroe, North Carolina, United States
Wake Research Associates
🇺🇸
Raleigh, North Carolina, United States
PMG Research of Wilmington, LLC
🇺🇸
Wilmington, North Carolina, United States
Trial Management Associates, LLC
🇺🇸
Wilmington, North Carolina, United States
Velocity Clinical Research
🇺🇸
Cincinnati, Ohio, United States
Rapid Medical Research
🇺🇸
Cleveland, Ohio, United States
Lynn Institute of Norman
🇺🇸
Norman, Oklahoma, United States
Lynn Health Science Institute
🇺🇸
Oklahoma City, Oklahoma, United States
Clinical Research Institute of Southern Oregon, P.C.
🇺🇸
Medford, Oregon, United States
Preferred Primary Care Physicians Research
🇺🇸
Uniontown, Pennsylvania, United States
Omega Medical Research
🇺🇸
Warwick, Rhode Island, United States
Coastal Carolina Research Center
🇺🇸
Mount Pleasant, South Carolina, United States
PMG Research of Charleston, LLC
🇺🇸
Mount Pleasant, South Carolina, United States
Spartanburg Medical Research
🇺🇸
Spartanburg, South Carolina, United States
VitaLink Research Spartanburg
🇺🇸
Spartanburg, South Carolina, United States
Meridian Clinical Research - Dakota Dunes
🇺🇸
Dakota Dunes, South Dakota, United States
PMG Research of Bristol
🇺🇸
Bristol, Tennessee, United States
VGR & NOCCR - Knoxville
🇺🇸
Knoxville, Tennessee, United States
Clinical Research Associates Inc
🇺🇸
Nashville, Tennessee, United States
Central Texas Clinical Research
🇺🇸
Austin, Texas, United States
North Texas Infectious Diseases Consultants
🇺🇸
Dallas, Texas, United States
Vilo Research Group Inc
🇺🇸
Houston, Texas, United States
Texas Center for Drug Development Inc
🇺🇸
Houston, Texas, United States
Research Your Health
🇺🇸
Plano, Texas, United States
DM Clinical Research
🇺🇸
Tomball, Texas, United States
Martine Diagnostic Clinic
🇺🇸
Tomball, Texas, United States
Charlottesville Medical Research Center, LLC
🇺🇸
Charlottesville, Virginia, United States
Spectrum Medical, Inc
🇺🇸
Danville, Virginia, United States
Health Research of Hampton Roads, Inc
🇺🇸
Newport News, Virginia, United States
Clinical Research Associates of Tidewater
🇺🇸
Norfolk, Virginia, United States
Amherst Family Practice, PC
🇺🇸
Winchester, Virginia, United States
Paratus Clinical Canberra Clinic
🇦🇺
Bruce, Australia
Northside Health
🇦🇺
Coffs Harbour, Australia
Paratus Clinical Kanwal Clinic
🇦🇺
Kanwal, Australia
Mater Hospital Brisbane
🇦🇺
South Brisbane, Australia
UFRR - Universidade Federal de Roraima
🇧🇷
Boa Vista, Brazil
CMIP - Centro Mineiro de Pesquisa Ltda
🇧🇷
Juiz de Fora, Brazil
LMC Clinical Research dba Manna Research Inc. Toronto
🇨🇦
Toronto, Ontario, Canada
LMC Clinical Research dba Manna Research Inc. Quebec City
🇨🇦
Levis, Quebec, Canada
LMC Clinical Research dba Manna Research Inc. Montreal
🇨🇦
Pointe Claire, Quebec, Canada
DIEX Recherche Joliette Inc.
🇨🇦
Saint-Charles-Borromee, Quebec, Canada
DIEX Recherche Victoriaville Inc.
🇨🇦
Victoriaville, Quebec, Canada
DIEX Recherche Quebec Inc.
🇨🇦
Quebec, Canada
CENRESIN
🇨🇱
Quilota, Chile
Centro de Estudios Clínicos e Investigación Médica (CeCim)
🇨🇱
Santiago, Chile
Centro de Investigacion del Maule
🇨🇱
Talca, Chile
Donghai County Center for Disease prevention and Control
🇨🇳
Lianyungang, China
Funing County Center for Disease Control and Prevention
🇨🇳
Yancheng, China
Binhai County Center for Disease Control and Prevention
🇨🇳
Yancheng, China
OU Innomedica
🇪🇪
Tallinn, Estonia
Center for Clinical and Basic Research
🇪🇪
Tallinn, Estonia
Clinical Research Centre
🇪🇪
Tartu, Estonia
Espoon rokotetutkimusklinikka
🇫🇮
Espoo, Finland
Etelä-Helsingin rokotetutkimusklinikka
🇫🇮
Helsinki, Finland
Itä-Helsingin rokotetutkimusklinikka
🇫🇮
Helsinki, Finland
Järvenpään rokotetutkimusklinikka
🇫🇮
Järvenpää, Finland
Kokkolan rokotetutkimusklinikka
🇫🇮
Kokkola, Finland
Oulun rokotetutkimusklinikka
🇫🇮
Oulu, Finland
Porin rokotetutkimusklinikka
🇫🇮
Pori, Finland
Seinäjoen rokotetutkimusklinikka
🇫🇮
Seinäjoki, Finland
Tampereen rokotetutkimusklinikka
🇫🇮
Tampere, Finland
Turun rokotetutkimusklinikka
🇫🇮
Turku, Finland
Southern Clinical Trials Totara Clinical Research
🇳🇿
Auckland, New Zealand
Southern Clinical Trials, Waitemata
🇳🇿
Auckland, New Zealand
Optimal Clinical Trials
🇳🇿
Auckland, New Zealand
Southern Clinical Trials, Christchurch
🇳🇿
Christchurch, New Zealand
Lakeland Clinical Trials
🇳🇿
Upper Hutt, New Zealand
P3 Research Ltd
🇳🇿
Tauranga, New Zealand
China Medical University Hospital
🇨🇳
Taichung, Taiwan
Taipei Medical University
🇨🇳
Taipei City, Taiwan
National Taiwan University Hospital
🇨🇳
Taipei, Taiwan
Taipei Veterans General Hospital
🇨🇳
Taipei, Taiwan
Tri-Service General Hospital
🇨🇳
Taipei, Taiwan
Taipei Municipal Wanfang Hospital
🇨🇳
Taipei, Taiwan
Chang Gung Memorial Hospital- Linkou
🇨🇳
Taoyuan County, Taiwan
Royal Thai Army, Afrims
🇹🇭
Bangkok, Thailand
The Vaccine Trial Center(VTC), Faculty of Tropical Medicine
🇹🇭
Bangkok, Thailand
Siriraj Hospital
🇹🇭
Bangkok, Thailand
Srinagarind Hospital
🇹🇭
Khon Kaen, Thailand
King Chulalongkorn Memorial Hospital
🇹🇭
Pathumwan, Thailand
Synexus Midlands Clinical Research Centre
🇬🇧
Birmingham, United Kingdom
FutureMeds Soho Health Centre
🇬🇧
Birmingham, United Kingdom
Bradford Royal Infirmary
🇬🇧
Bradford, United Kingdom
FutureMeds Bridle Clinic
🇬🇧
Bromborough, United Kingdom
Synexus Wales Clinical Research Center
🇬🇧
Cardiff, United Kingdom
Synexus Lancashire Clinical Research Centre
🇬🇧
Chorley, United Kingdom
Panthera Biopartners
🇬🇧
Reading, United Kingdom
Synexus Scotland Clinical Research Centre
🇬🇧
Glasgow, United Kingdom
Synexus Hexham General Hospital
🇬🇧
Hexham, United Kingdom
Synexus Merseyside Clinical Research Centre
🇬🇧
Liverpool, United Kingdom
Synexus Manchester Clinical Research Center
🇬🇧
Manchester, United Kingdom
North Manchester General Hospital
🇬🇧
Manchester, United Kingdom
University Hospital of North Tees
🇬🇧
Stockton on Tees, United Kingdom