A Phase 2/3 Open-Label Study to Evaluate the Safety and Immunogenicity of an XBB.1.5 (Omicron Subvariant) SARS CoV-2 rS Vaccine Booster Dose in Previously mRNA COVID 19 Vaccinated and Baseline SARS CoV 2 Seropositive COVID-19 Vaccine Naïve Participants
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- COVID-19
- Sponsor
- Novavax
- Enrollment
- 660
- Locations
- 19
- Primary Endpoint
- Part 2: ID 50 (Geometric Mean Titers) GMTs to the XBB.1.5 Omicron subvariant
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
This is a Phase 2/3 open-label study to evaluate the safety and immunogenicity of a booster dose of the XBB.1.5 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recombinant (r) spike (S) protein nanoparticle vaccine (SARS-CoV-2 rS) adjuvanted with Matrix-M™ in previously mRNA COVID-19 vaccinated adult participants ≥18 years of age and baseline SARS CoV-2 seropositive COVID-19 vaccine naïve participants ≥18 years of age.
Detailed Description
Novavax, Inc. developed a recombinant prototype COVID-19 vaccine constructed from the full-length ancestral (Wuhan) SARS CoV-2 S glycoprotein (GP) adjuvanted with the saponin-based Matrix-M adjuvant (NVX-CoV2373). Subsequently, the SARS CoV 2 Omicron variant and subvariants emerged with enhanced transmissibility and the most significant number of mutations in any strain to date. Current evidence demonstrates that variant strain mutations such as those in the Omicron XBB.1.5 sublineage confer the ability to evade both natural and vaccine-induced neutralizing antibodies. Part 1 of the study aims to investigate the safety and immunogenicity of the Novavax XBB.1.5 SARS-CoV-2 rS vaccine (NVX-CoV2601) adjuvanted with Matrix-M in previously COVID-19 mRNA vaccinated participants to determine if it induces superior antibody responses compared to a historical control of the prototype vaccine (original Wuhan strain), NVX-CoV2373. Part 2 of the study aims to investigate the safety and immunogenicity of 1 dose of NVX CoV2601 in baseline SARS-CoV-2 seropositive COVID-19 vaccine naïve participants to determine if it induces non-inferior antibody responses compared to 1 booster dose of NVX-CoV2601 in previously COVID-19 mRNA vaccinated individuals participating in Part 1. Part 1: Approximately 330 previously mRNA COVID-19 vaccinated participants will receive a booster dose of XBB.1.5 Omicron subvariant vaccine (NVX-CoV2601) on Day 0. Immunogenicity and 28-day safety data will be used for an interim analysis, while participants remain on the study for immunogenicity and safety data collection up to Day 180 post-vaccination. Part 2: After completion of Part 1, approximately 330 unvaccinated participants with a clinical history of COVID-19-like disease during the previous year will receive a booster dose of NVX-CoV2601 on Day 0. Immunogenicity and 28-day safety data will be used for an interim analysis, while participants remain on the study for immunogenicity and safety data collection up to Day 180 post vaccination.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adults ≥ 18 years of age at time of study vaccination.
- •Part 1: Previously vaccinated with ≥ 3 doses of the Moderna and/or Pfizer /BioNTech prototype monovalent and/or BA.4/5 containing bivalent COVID-19 vaccines with the last dose administered ≥ 90 days prior to study vaccination.
- •Part 2: Clinical history of COVID-19-like disease during the previous year.
- •Willing and able to give informed consent prior to study enrollment and to comply with study procedures.
- •Female participants of childbearing potential (defined as any participant who has experienced menarche and who is NOT surgically sterile \[ie, hysterectomy, bilateral tubal ligation, or bilateral oophorectomy\] or postmenopausal \[defined as amenorrhea ≥ 12 consecutive months\]) must agree to be heterosexually in-active from at least 28 days prior to enrollment and through the end of the study OR agree to consistently use a medically acceptable method of contraception listed below from ≥ 28 days prior to enrollment and through the end of the study.
- •Condoms (male or female) with spermicide (if acceptable in country)
- •Diaphragm with spermicide
- •Cervical cap with spermicide
- •Intrauterine device
- •Oral or patch contraceptives
Exclusion Criteria
- •Received COVID-19 vaccines other than Moderna and/or Pfizer-BioNTech in the past, inclusive of clinical trial COVID-19 vaccines.
- •Participation in research involving receipt of investigational products (drug/biologic/device) within 90 days prior to study vaccination (Day 0).
- •Received influenza vaccination within 14 days prior to study vaccination, or any other vaccine within 30 days prior to study vaccination.
- •Any known allergies to products contained in the investigational product.
- •Any history of anaphylaxis to any prior vaccine.
- •Autoimmune or immunodeficiency disease/condition (iatrogenic or congenital) requiring ongoing immunomodulatory therapy.
- •NOTE: Stable endocrine disorders (eg, thyroiditis, pancreatitis), including stable diabetes mellitus with no history of diabetic ketoacidosis are NOT excluded.
- •Chronic administration (defined as \> 14 continuous days) of immunosuppressant, systemic glucocorti-coids, or other immune-modifying drugs within 90 days prior to study vaccination (Day 0).
- •NOTE: An immunosuppressant dose of glucocorticoid is defined as a systemic dose ≥ 10 mg of prednisone per day or equivalent. The use of topical or intranasal glucocorticoids is permitted. Topical tacrolimus and ocular cyclosporin are permitted. Use of inhaled glucocorticoids is prohibited.
- •Received any prohibited medication (see Section 7.4.1), immunoglobulin, blood-derived products, or immunosuppressant drugs within 90 days prior to study vaccination (Day 0).
Outcomes
Primary Outcomes
Part 2: ID 50 (Geometric Mean Titers) GMTs to the XBB.1.5 Omicron subvariant
Time Frame: Day 28
ID 50 GMTs to the XBB.1.5 Omicron subvariant assessed at Day 28 following study vaccination.
Part 1: Pseudovirus neutralization (inhibitory dilution at a concentration of 50%; ID 50 ) to the NVX-CoV2601 vaccine
Time Frame: Day 28
Pseudovirus neutralization (inhibitory dilution at a concentration of 50%; ID 50 ) to the NVX-CoV2601 vaccine assessed at Day 28 following study vaccination.
Part 1: Seroresponse Rates (SRRs) in ID 50 titers to the NVXCoV2601 vaccine
Time Frame: Day 28
SRRs (proportion of seroconverted participants) in ID 50 titers to the NVXCoV2601 vaccine assessed at Day 28 following the study vaccination.
Part 2: SRRs in ID 50 titers to the XBB.1.5 Omicron subvariant
Time Frame: Day 28
SRRs (proportion of seroconverted participants) in ID 50 titers to the XBB.1.5 Omicron subvariant assessed at Day 28 following study vaccination.
Secondary Outcomes
- Part 1: Pseudovirus neutralization (inhibitory dilution at a concentration of 50%; ID50) to the NVX-CoV2601 vaccine(Day 28)
- Part 1: ID 50 geometric mean fold rise (GMFR) to the XBB.1.5 Omicron subvariant at relevant time points (Days 28 and 180) from baseline (Day 0).(Day 0 to Day 180)
- Part 1: SRRs in ID 50 titer concentrations to the XBB.1.5 Omicron subvariant at relevant time points.(Day 28 to Day 180)
- Part 1: ID 50 GMTs to the XBB.1.5 Omicron subvariant(Day 0 to Day 180)
- Part 1: Anti-S immunoglobulin G (IgG) geometric mean concentrations (GMCs, EU/mL) to the NVX-CoV2601 vaccine at relevant time points(Day 0 to Day 180)
- Part 2: Pseudovirus neutralization (ID 50 ) to the XBB.1.5 Omicron subvariant(Day 0 to Day 28)
- Part 1: Incidence and severity of solicited local and systemic adverse events (AEs)(Day 0 to Day 7)
- Part 1: Incidence and severity of unsolicited AEs(Day 28)
- Part 1: Incidence and severity of MAAEs attributed to study vaccine, adverse events of special interest (AESIs), and serious adverse events (SAEs)(Day 0 to Day 180)
- Part 2: Incidence and severity of solicited local and systemic adverse events (AEs)(Day 0 to Day 7)
- Part 2: Incidence, and severity of unsolicited AEs(Day 28)
- Part 2: Incidence and severity of MAAEs, AESIs, and SAEs(Day 0 to Day 180)