Cellular and Humoral Immune Response to Primary and Secondary Immunization With Subvirion H5N1 Vaccines
Summary
The purpose of the study is to evaluate safety and compare how the body reacts to 2 different strengths of the Clade (specific type of H5N1 virus) 2 H5N1 flu vaccine when given as a single vaccination with a high dose (90 mcg) or low dose (15 mcg) to volunteers who have received at least 2 doses of the Clade 1 H5N1 vaccine, in a previous National Institute of Health study or who have never received a H5N1 vaccine (naïve). Previously vaccinated subjects (in studies 04-0063, 05-0090, 05-0127) will receive either 15 or 90 mcg of H5N1 vaccine. Multiply boosted volunteers who participated study 05-0043 and received Clade 1 and 3 vaccines, will receive the same dose (15mcg). Vaccine naïve subjects will receive 2 doses of vaccine (15 or 90 mcg) separated by 28 days. Blood samples will be collected. Sixty volunteers age 18-64 may participate in study related procedures for approximately 7 months.
Description
In response to the steadily increasing number of reports of human infection with avian influenza A (H5N1) viruses, there is now a world-wide effort to develop and test potential candidate vaccines for this and other avian viruses with pandemic potential. The study will be conducted as a laboratory blinded assessment of the cellular immune response to A/Indonesia/5/05 vaccine in three populations: healthy adults who have previously received a clade 1 H5 vaccine in a Division of Microbiology and Infectious Diseases (DMID)-sponsored study; healthy adult recipients of prime-boost regimens representing two clades; and healthy adults with no previous H5 vaccination and who are not at risk for H5 exposures. Primed subjects are randomized to receive a single dose of either 15 mcg or 90 mcg of A/Indonesia/5/05 vaccine. Multiply boosted subjects are those who participated in study 05-0043, and have previously received both A/HK/97 (Clade 3) and A/VN/04 (Clade 1) vaccines. Because only a small number of such subjects are available, they will not be randomized but will all receive the same dose of vaccine. Unprimed subjects are randomized to receive 2 doses of 15 mcg or 90 mcg of A/Indonesia/5/05 vaccine separated by 28 days. In all groups, sera and peripheral blood mononuclear cells (PBMC) are obtained prior to and on days 3, 7, 14, and 28 after each dose. Primed and multiply boosted subjects also have sera and PBMC obtained on day 56. All groups will make a final study visit at 6 months following the last dose of vaccine (day 180 for primed and boosted subjects and day 208 for unprimed subjects). Approximately 60 subjects between the ages of 18 and 64 will participate in this study. The primary objective is to determine the safety of administration of the A/Indonesia/05 subvirion vaccine when administered to healthy, primed or unprimed adults. The secondary objectives are to: determine the effects of priming on the repertoire and phenotypes of B and T cells generated in response to vaccination; and evaluate whether pre-existing immunity to seasonal influenza viruses impacts the specificity and magnitude of the cluster of differentiation marker (CD)4 T cell response to H5 vaccination. The primary endpoint is reactogenicity, adverse event (AE) and serious adverse event (SAE) information, solicited in-clinic and via memory aids. The secondary endpoints are: peptide-specific responses of CD4 T cells before and at time points after immunization vaccination; numbers of antigen-specific antibody secreting cells by B cell enzyme-linked immunosorbent spot assay (ELISPOT) before and at time points after immunization vaccination in primed and unprimed individuals; and quantity of antigen specific memory B cells before and after vaccination in primed and unprimed individuals. This study is linked to DMID protocols 04-063, 05-0090, 05-0043 and 05-0127.
Study Design
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Prevention
Conditions
Influenza
Intervention
Inactivated Influenza A/H5N1/Indonesia/05/05 (clade 2)
Location
University of Rochester Medical Center
Rochester
New York
United States
14642
Status
Not yet recruiting
Source
National Institute of Allergy and Infectious Diseases (NIAID)
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT01086566
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Influenza A Virus, H5n1 Subtype
A subtype of INFLUENZA A VIRUS comprised of the surface proteins hemagglutinin 5 and neuraminidase 1. The H5N1 subtype, frequently referred to as the bird flu virus, is endemic in wild birds and very contagious among both domestic (POULTRY) and wild birds. It does not usually infect humans, but some cases have been reported.
Influenza B Virus
Species of the genus INFLUENZAVIRUS B that cause HUMAN INFLUENZA and other diseases primarily in humans. Antigenic variation is less extensive than in type A viruses (INFLUENZA A VIRUS) and consequently there is no basis for distinct subtypes or variants. Epidemics are less likely than with INFLUENZA A VIRUS and there have been no pandemics. Previously only found in humans, Influenza B virus has been isolated from seals which may constitute the animal reservoir from which humans are exposed.
Hemagglutinin Glycoproteins, Influenza Virus
Membrane glycoproteins from influenza viruses which are involved in hemagglutination, virus attachment, and envelope fusion. Fourteen distinct subtypes of HA glycoproteins and nine of NA glycoproteins have been identified from INFLUENZA A VIRUS; no subtypes have been identified for Influenza B or Influenza C viruses.
Influenza In Birds
Infection of domestic and wild fowl and other BIRDS with INFLUENZA A VIRUS. Avian influenza usually does not sicken birds, but can be highly pathogenic and fatal in domestic POULTRY.
Influenzavirus C
A genus of the family ORTHOMYXOVIRIDAE comprising viruses similar to types A and B but less common, more stable, more homogeneous, and lacking the neuraminidase protein. They have not been associated with epidemics but may cause mild influenza. Influenza C virus is the type species.
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