Phase I Study of West Nile Virus Vaccine
Condition: West Nile Fever
MeSH terms: West Nile Fever
Study type: Interventional
Phase: Phase 1

Summary: 
      This study will test the safety of an experimental vaccine for preventing West Nile virus
      infection. The virus is spread mainly by mosquito bites. Symptoms can include high fever,
      headache, neck stiffness, stupor, muscle weakness, vision loss, numbness and paralysis.
      Rarely, infection leads to permanent nerve damage and possibly death. The vaccine used in the
      study is made from DNA that codes for West Nile virus proteins. Injected into a muscle, the
      DNA instructs the body to make a small amount of West Nile virus protein. This study will see
      if the body creates resistance or immunity to these proteins. Participants cannot get West
      Nile virus from the vaccine.

      Healthy normal volunteers between 18 and 65 years of age may be eligible for this study.
      Candidates are screened with a medical history, physical examination, and blood and urine
      tests for various infections and other medical problems. Women who are able to become
      pregnant are given a pregnancy test. Women who are pregnant or breastfeeding may not
      participate. Anyone who has received a vaccination for Yellow Fever or Japanese Encephalitis
      virus in the past may not participate in this research study.

      Participants will receive three injections of the experimental vaccine, the first on the
      first study day (Day 0), the second on Day 28, and the third on Day 56. The injections are
      given with a device called Biojector® (Registered Trademark) 2000 that delivers the vaccine
      through the skin into the muscle without the use of a needle. On the day of each injection,
      subjects are given a diary card to take home for recording their temperature and any symptoms
      or side effects for 5 days. They return to the clinic 2 weeks after each injection, bringing
      the completed card with them at that time. In addition to the injections, subjects have the
      following tests and procedures during clinic visits:

        -  Medical history and, if needed, physical examination: Day 0 and weeks 2, 4, 6, 8, 10,
           12, 24 and 32

        -  Vital signs and weight: Day 0 and weeks 2, 4, 6, 8, 10, 12, 24 and 32

        -  Lymph node exam: Day 0 and weeks 2, 4, 6, 8, 10, and 12

        -  Blood samples: Day 0 and weeks 2, 4, 6, 8, 10, 12, 24 and 32

        -  Pregnancy test (for women): Day 0 and weeks 4, 8 and 32

        -  Urine sample: Day 0 and weeks 2, 4, 6, 8, and 10

      The blood and urine tests are for health checks. Some blood samples are also used to study
      the immune response to the vaccine and for gene testing.
    

Detailed description: 
      Study Design: This is a Phase I open-label study to evaluate safety, tolerability, and
      immunogenicity of a recombinant DNA vaccine, VRC-WNVDNA020-00-VP. The hypothesis is that this
      regimen will be safe for human administration and elicit a higher titer of neutralizing
      antibody response than a prior WNV DNA vaccine. The primary objectives are to evaluate the
      safety and tolerability in humans of the investigational vaccine in healthy young adults and
      in healthy older adults. Secondary and exploratory objectives are related to the
      immunogenicity of the study vaccine.

      Product Description: VRC-WNVDNA020-00-VP is composed of a single closed-circular DNA plasmid
      that encodes the WNV viral protein precursor transmembrane (prM) and envelope (E) with a
      CMV/R promoter. Vaccine vials will be supplied at 4 mg/mL. Each DNA vaccination will be 1 mL
      of vaccine administered intramuscularly (IM) in the deltoid muscle using the Biojector 2000
      Needle-Free Injection Management System (Biojector).

      Subjects: A total of 30 healthy adults will be enrolled in two groups: Group 1 will be
      comprised of 15 healthy adults 18 to 50 years old and Group 2 will be comprised of 15 healthy
      adults 51 to 65 years old.

      Study Plan: All subjects will receive 3 injections on the schedule shown in the schema. The
      protocol requires nine clinic visits and three telephone follow-up contacts.

      Study Duration: 32 weeks of clinical follow up for each participant. A long-term follow-up
      contact at Week 52 may include interim medical history and research blood draw; or subject
      may opt for the long-term contact to occur by telephone, e-mail or mail for the interim
      medical history only.

      Study Endpoints: The primary endpoint is safety and tolerability of the regimen. The
      secondary immunogenicity endpoints are WNV neutralizing antibody, WNV specific antibody as
      measured by ELISA, WNV-specific T cell responses measured by intracellular cytokine staining
      (ICS) assay and ELISPOT. Other immunogenicity assays through Week 32 may also be completed as
      exploratory evaluations, as well as from the Week 52 blood samples if collected.
    

Intervention name(s): VRC-WNVDNA020-00-VP
Intervention type(s): Drug
Primary purpose: Treatment
Keywords: Flavivirus; Mosquito; Immunity; Preventive; West Nile Fever; West Nile Virus; Vaccine; Healthy Volunteer; HV