MedPath

Study of Monovalent and Bivalent Recombinant Protein Vaccines Against COVID-19 in Adults 18 Years of Age and Older

Phase 3
Completed
Conditions
COVID-19
Interventions
Biological: Placebo
Biological: SARS-CoV-2 adjuvanted recombinant protein vaccine (bivalent D614 + B.1.351) (primary series)
Biological: SARS-CoV-2 adjuvanted recombinant protein vaccine (monovalent D614) (primary series)
Biological: SARS-CoV-2 adjuvanted recombinant protein vaccine (monovalent B.1.351) (booster dose) >= 4 months after last vaccination
Biological: SARS-CoV-2 adjuvanted recombinant protein vaccine(monovalent D614)(primary series)& SARS-CoV-2 adjuvanted recombinant protein vaccine(monovalent B.1.351)(booster dose)>=4 months after last vaccination
Registration Number
NCT04904549
Lead Sponsor
Sanofi Pasteur, a Sanofi Company
Brief Summary

The purpose of this Phase III study is to assess the efficacy, safety, and immunogenicity of two CoV2 preS dTM-AS03 vaccines (monovalent and bivalent) as part of primary series vaccinations in a multi-stage approach, as well as a booster injection of a CoV2 preS dTM-AS03 vaccine, in adults 18 years of age and older.

A total of approximately 21 046 participants are planned to be enrolled (5080 per study intervention group in Stage 1 and 5443 per study intervention group in Stage 2).

Initial, double-blind, primary series study design is planned for 365 days post-last Initial injection (ie, approximately 386 days total) for each participant.

Based on decisions of the Study Oversight Group, Stage 1 and Stage 2 participants will be invited to participate in an unblinded Crossover / Booster study design with duration as follows:

* For participants who initially received vaccine: 12 months post-booster (ie, approximately 18 to 24 months)

* For participants who initially received placebo: ≥ 4 months post-last dose of the primary series + 12 months post-booster (ie, approximately 28 to 34 months)

* For participants who do not consent to continue in the unblinded Crossover / Booster part of the study, all study procedures will be stopped and participants will be discontinued from the study.

Detailed Description

The duration of participation in the initial, double-blind, primary series design of the study will be approximately 365 days post-last injection (ie, approximately 386 days total) for each participant.

Based on decisions of the Study OG, Stage 1 and Stage 2 participants will be invited to participate in an unblinded Crossover / Booster study design with duration as follows:

* For participants who initially received vaccine: 12 months post-booster (ie, approximately 18 to 24 months)

* For participants who initially received placebo: ≥ 4 months post-last dose of the primary series + 12 months post-booster (ie, approximately 28 to 34 months)

* For participants who do not consent to continue in the unblinded Crossover / Booster part of the study, all study procedures will be stopped and participants will be discontinued from the study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
23726
Inclusion Criteria
  • Aged 18 years or older on the day of inclusion.

  • For persons living with human immunodeficiency virus (HIV), stable HIV infection determined by participant currently on antiretrovirals with CD4 count > 200/mm3.

  • SARS-CoV-2 rapid serodiagnostic test performed at the time of enrollment to detect presence of SARS-CoV-2 antibodies.

  • Does not intend to receive an authorized/approved COVID-19 vaccine despite encouragement by the Investigator to receive the authorized vaccine available to them at the time of enrollment.

  • Informed consent form has been signed and dated

  • Able to attend all visits and to comply with all study procedures

  • Covered by health insurance, only if required by local, regional or national regulations

  • A female participant is eligible to participate if she is not pregnant or breastfeeding and one of the following conditions applies:

    • is of non-childbearing potential. To be considered of non-childbearing potential, a female must be post-menopausal for at least 1 year or surgically sterile, or
    • is of childbearing potential and agrees to use an effective contraceptive method or abstinence from at least 4 weeks prior to the first study intervention administration until at least 12 weeks after the second study intervention administration.

A participant of childbearing potential must have a negative highly sensitive pregnancy test (urine or serum as required by local regulation) within 25 hours before any dose of study intervention.

Exclusion Criteria
  • Known systemic hypersensitivity to any of the vaccine components, or history of a life-threatening reaction to a vaccine containing any of the same substances.
  • Dementia or any other cognitive condition at a stage that could interfere with following the study procedures based on Investigator?s judgment.
  • Self-reported thrombocytopenia, contraindicating intramuscular (IM) vaccination based on Investigator?s judgment
  • Bleeding disorder, or receipt of anticoagulants in the past 21 days preceding inclusion, contraindicating IM vaccination based on Investigator?s judgment.
  • Unstable acute or chronic illness that in the opinion of the Investigator or designee poses additional risk as a result of participation or that could interfere with the study procedures.
  • Moderate or severe acute illness/infection (according to investigator judgment) on the day of vaccination or febrile illness (temperature ? 38.0 C [? 100.4 F]). A prospective participant should not be included in the study until the condition has resolved or the febrile event has subsided.
  • Receipt of any vaccine in the 30 days preceding or on the day of the first study vaccination or planned receipt of any vaccine between the first study vaccination and in the 30 days following the second study vaccination except for influenza vaccination, which may be received at any time in relation to study intervention.
  • Prior administration of a coronavirus vaccine (SARS-CoV-2, SARS-CoV, Middle East Respiratory Syndrome).
  • Receipt of solid-organ or bone marrow transplants in the past 180 days.
  • Receipt of anti-cancer chemotherapy in the last 90 days.
  • Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily.
  • Identified as an Investigator or employee of the Investigator or study center with direct involvement in the proposed study, or identified as an immediate family member (ie, parent, spouse, natural or adopted child) of the Investigator or employee with direct involvement in the proposed study.
  • Participation at the time of study enrollment (or in the 30 days preceding the first study vaccination) or planned participation during the present study period in another clinical study investigating a vaccine, drug, medical device, or medical procedure.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Stage 1: PlaceboPlacebo2 injections of placebo at Day 1 and Day 22
Stage 1: SARS-CoV-2 vaccineSARS-CoV-2 adjuvanted recombinant protein vaccine (monovalent B.1.351) (booster dose) >= 4 months after last vaccination2 injections of monovalent SARS-CoV-2 vaccine at Day 1 and Day 22
Stage 2: SARS-CoV-2 vaccineSARS-CoV-2 adjuvanted recombinant protein vaccine (bivalent D614 + B.1.351) (primary series)2 injections of bivalent SARS-CoV-2 vaccine at Day 1 and Day 22
Stage 1: PlaceboSARS-CoV-2 adjuvanted recombinant protein vaccine(monovalent D614)(primary series)& SARS-CoV-2 adjuvanted recombinant protein vaccine(monovalent B.1.351)(booster dose)>=4 months after last vaccination2 injections of placebo at Day 1 and Day 22
Stage 2: SARS-CoV-2 vaccineSARS-CoV-2 adjuvanted recombinant protein vaccine (monovalent B.1.351) (booster dose) >= 4 months after last vaccination2 injections of bivalent SARS-CoV-2 vaccine at Day 1 and Day 22
Stage 2: PlaceboPlacebo2 injections of placebo at Day 1 and Day 22
Stage 1: SARS-CoV-2 vaccineSARS-CoV-2 adjuvanted recombinant protein vaccine (monovalent D614) (primary series)2 injections of monovalent SARS-CoV-2 vaccine at Day 1 and Day 22
Stage 2: PlaceboSARS-CoV-2 adjuvanted recombinant protein vaccine(monovalent D614)(primary series)& SARS-CoV-2 adjuvanted recombinant protein vaccine(monovalent B.1.351)(booster dose)>=4 months after last vaccination2 injections of placebo at Day 1 and Day 22
Primary Outcome Measures
NameTimeMethod
Presence of medically attended adverse eventsFrom Day 1 to Day 387

Medically attended adverse events will be assessed throughout the study.

Presence of non-serious unsolicited adverse events (collected in the reactogenicity subset)Within 21 days after vaccination

Adverse events other than solicited reactions.

Presence of adverse events of special interestFrom Day 1 to Day 387

Adverse events of special interest will be assessed throughout the study.

Occurrences of symptomatic COVID-19From ≥ 14 days after the second injection to Day 387

Symptomatic COVID-19 is defined as virologically-confirmed SARS-CoV-2 infection accompanied by protocol-defined COVID-19-like illness.

Presence of immediate adverse eventsWithin 30 minutes after vaccination

Immediate adverse events include unsolicited injection site and systemic adverse events occurring within 30 minutes after injection.

Presence of serious adverse eventsFrom Day 1 to Day 387

Serious adverse events will be assessed throughout the study.

Presence of virologically-confirmed SARS-CoV-2 infections and/or symptomatic COVID-19From Day 1 to Day 387

Percentage of participants with positive result for SARSCoV-2 infection by Nucleic Acid Amplification Test (NAAT) on at least one respiratory sample accompanied or not by protocol-defined clinical COVID-19 symptoms.

Presence of solicited injection site or systemic reactions (collected in the reactogenicity subset)Within 7 days after vaccination

Injection site reactions: injection site pain, erythema and swelling. Systemic reactions: fever, headache, malaise, myalgia, arthralgia and chills.

Secondary Outcome Measures
NameTimeMethod
Occurrences of SARS-CoV-2 infectionFrom ≥ 14 days after the second injection to Day 387

SARS-CoV-2 infection is defined as a serologically-confirmed SARS-CoV-2 infection or virologically-confirmed SARS-CoV-2 infection.

Severity of symptoms associated with symptomatic COVID-19 episodeFrom Day 1 to Day 387
Occurrences of asymptomatic SARS-CoV-2 infectionFrom Day 1 to Day 387

Asymptomatic SARS-CoV-2 infection is defined as SARS-CoV-2 infection, with no reported COVID-19-like illness episodes between enrollment and 14 days after the timepoint at which SARS-CoV-2 infection is ascertained.

Viral copies/mL in respiratory samplesFrom Day 1 to Day 387
Occurrences of positive NAAT in respiratory samples at each follow-up timepoint during symptomatic COVID-19From Day 1 to Day 387
Occurrences of symptomatic COVID-19 with severity of moderate COVID-19 or worse.From Day 1 to Day 387

Composite endpoint of at least one of moderate or severe COVID-19.

Neutralizing antibody titerDay 1, Day 22, Day 43, Day 78, Day 134, Day 202, Day 292, and Day 387
Responders, as determined by neutralizing antibody titersDay 1, Day 22, Day 43, Day 78, Day 134, Day 202, Day 292, and Day 387

Responders are defined as participants who had baseline values below lower limit of quantification (LLOQ) with quantifiable neutralization titer above assay LLOQ at each pre-defined post-vaccination time point and participants with baseline values above LLOQ with a 4-fold increase in neutralizing antibody

Neutralizing antibody titer fold-rise post-vaccination at all pre-defined time pointsDay 1, Day 22, Day 43, Day 78, Day 134, Day 202, Day 292, and Day 387

Fold-rise in antibody neutralization titer post-vaccination relative to Day 1.

Occurrence of severe COVID-19From ≥ 14 days after the second injection to Day 387
Occurrences of CDC-defined COVID-19From Day 1 to Day 387

Virologically-confirmed SARS-CoV-2 infection with at least one of CDC-defined clinical symptoms.

Occurrences of hospitalized COVID-19From Day 1 to Day 387

Hospitalized COVID-19 is defined as an episode of symptomatic COVID-19 that requires inpatient hospitalization.

Number of days with positive NAATFrom Day 1 to Day 387
2-fold rise and 4-fold-rise in neutralization antibody titer at all pre-defined time pointsDay 1, Day 22, Day 43, Day 78, Day 134, Day 202, Day 292, and Day 387

Fold-rise in antibody neutralization titer post-vaccination relative to Day 1.

Occurrences of COVID-19 in each severity ratingFrom Day 1 to Day 387

COVID-19 severity score based on the ordinal scale of clinical assessment (7-point ordinal scale)

Death associated with COVID-19From Day 1 to day 387

Trial Locations

Locations (86)

AES - DRS - Simon Williamson Clinic, PC - Birmingham Site Number : 8400004

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Birmingham, Alabama, United States

Optimal Research Alabama Site Number : 8400019

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Huntsville, Alabama, United States

Peninsula Research Associates, Inc. Site Number : 8400021

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Rolling Hills Estates, California, United States

Synexus Clinical Research US, Inc. Site Number : 8400013

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Centennial, Colorado, United States

Optimal Research, LLC Site Number : 8400002

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Melbourne, Florida, United States

Synexus Clinical Research US, Inc. - Orlando Site Number : 8400020

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Orlando, Florida, United States

AES St. Petersburg Site Number : 8400017

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Pinellas Park, Florida, United States

Synexus Clinical Research US, Inc. - Atlanta Site Number : 8400005

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Atlanta, Georgia, United States

Synexus Clinical Research Evansville Site Number : 8400008

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Evansville, Indiana, United States

Synexus Clinical Research Anderson Site Number : 8400007

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Anderson, South Carolina, United States

Synexus Clinical Research Chicago Site Number : 8400012

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Chicago, Illinois, United States

Synexus St. Louis Site Number : 8400006

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Saint Louis, Missouri, United States

Synexus Clinical Research US, Inc. - Henderson Site Number : 8400018

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Henderson, Nevada, United States

Rochester Clinical Research, Inc. Site Number : 8400023

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Rochester, New York, United States

Synexus Akron Site Number : 8400009

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Akron, Ohio, United States

Synexus Clinical Research US, Inc. - Cincinnati Site Number : 8400010

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Cincinnati, Ohio, United States

Synexus US Columbus Site Number : 8400011

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Columbus, Ohio, United States

Coastal Carolina Research Center - N Charleston Site Number : 8400022

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North Charleston, South Carolina, United States

American Indian Clinical Trials Research Network Site Number : 8400025

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Rapid City, South Dakota, United States

AES Austin Site Number : 8400003

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Austin, Texas, United States

Synexus Dallas Site Number : 8400014

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Dallas, Texas, United States

Synexus Clinical Research US, Inc. - San Antonio Site Number : 8400015

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San Antonio, Texas, United States

AES Salt Lake City Site Number : 8400016

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Murray, Utah, United States

Investigational Site Number : 1700010

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Aguazul, Colombia

Investigational Site Number : 1700002

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Barranquilla, Colombia

Investigational Site Number : 1700008

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Barranquilla, Colombia

Investigational Site Number : 1700001

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Bogota, Colombia

Investigational Site Number : 1700005

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Cali, Colombia

Investigational Site Number : 1700006

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Chia, Colombia

Investigational Site Number : 1700004

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Floridablanca, Colombia

Investigational Site Number : 1700007

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Girardot, Colombia

Investigational Site Number : 1700009

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Meta, Colombia

Investigational Site Number : 1700015

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Quindio, Colombia

Investigational Site Number : 1700003

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Soledad, Colombia

Investigational Site Number : 2880002

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Kintampo, Ghana

Investigational Site Number : 2880003

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Kumasi, Ghana

Investigational Site Number : 2880001

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Navrongo, Ghana

Investigational Site Number : 3400001

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Municipio Del Distrito Central, Honduras

Investigational Site Number : 3400002

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San Pedro Sula, Honduras

Investigational Site Number : 3560010

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Ajmer, India

Investigational Site Number : 3560002

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Ambawadi, India

Investigational Site Number : 3560007

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Belgaum, India

Investigational Site Number : 3560001

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Jaipur, India

Investigational Site Number : 3560005

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Kanpur, India

Investigational Site Number : 3560009

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Nagpur, India

Investigational Site Number : 3560011

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Odisha, India

Investigational Site Number : 3560004

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Patna, India

Investigational Site Number : 3560003

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Punjagutta, India

Investigational Site Number : 3560006

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Tamilnadu, India

Investigational Site Number : 3920005

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Chiyoda-ku,, Tokyo, Japan

Investigational Site Number : 3920004

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Haramachi,Shinjuku-ku, Tokyo, Japan

Investigational Site Number : 3920003

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Kouenji minami,Suginami-ku, Tokyo, Japan

Investigational Site Number : 3920001

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Kyobashi Chuo-ku, Tokyo, Japan

Investigational Site Number : 3920002

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Ohta-ku, Tokyo, Japan

Investigational Site Number : 4040011

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Butere, Kenya

Investigational Site Number : 4040006

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Eldoret, Kenya

Investigational Site Number : 4040004

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Kericho, Kenya

Investigational Site Number : 4040002

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Kisumu, Kenya

Investigational Site Number : 4040003

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Kisumu, Kenya

Investigational Site Number : 4040012

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Kisumu, Kenya

Investigational Site Number : 4040008

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Mombasa, Kenya

Investigational Site Number : 4040001

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Nairobi, Kenya

Investigational Site Number : 4040007

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Nairobi, Kenya

Investigational Site Number : 4040009

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Thika, Kenya

Investigational Site Number : 4840009

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Mexico City, Ciudad De Mexico, Mexico

Investigational Site Number : 4840005

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Leon, Guanajuato, Mexico

Investigational Site Number : 4840004

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Acapulco, Guerrero, Mexico

Investigational Site Number : 4840003

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Guadalajara, Jalisco, Mexico

Investigational Site Number : 4840008

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Cuernavaca, Morelos, Mexico

Investigational Site Number : 4840006

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Temixco, Mexico

Investigational Site Number : 5240002

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Dhulikhel, Nepal

Investigational Site Number : 4840002

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Veracruz, Mexico

Investigational Site Number : 5240003

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Kathmandu, Nepal

Investigational Site Number : 5240001

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Nepalgunj, Nepal

Investigational Site Number : 8000002

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Entebbe, Uganda

Investigational Site Number : 8000005

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Entebbe, Uganda

Investigational Site Number : 8000001

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Kampala, Uganda

Investigational Site Number : 8000013

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Kampala, Uganda

Investigational Site Number : 8000007

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Kampala, Uganda

Investigational Site Number : 8000003

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Kampala, Uganda

Investigational Site Number : 8000004

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Kampala, Uganda

Investigational Site Number : 8000014

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Lira, Uganda

Investigational Site Number : 8040002

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Kiev, Ukraine

Investigational Site Number : 8040004

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Kyiv, Ukraine

Investigational Site Number : 8040003

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Kyiv, Ukraine

Investigational Site Number : 8040001

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Kyiv, Ukraine

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