Study Evaluating 7-Valent Pneumococcal Conjugate Vaccine in Healthy Infants
Condition: Pneumococcal Infections
MeSH terms: Pneumococcal Infections
Study type: Interventional
Phase: Phase 1

Summary: 
      This study is a combination of a Phase I and Phase III study design. The Phase I portion is
      an open-label, controlled study to evaluate the safety of 7vPnC in healthy Chinese infants.
      The Phase III portion is an open-label, controlled, randomized study to evaluate the safety
      and immunogenicity of 7-Valent Pneumococcal Conjugate Vaccine (7vPnC)in healthy Chinese
      infants. Both phases include a Primary Series which includes the primary 3 doses of 7vPnC and
      /or Diptheria and tetanus toxoids and accelular pertussis vaccine (DTaP) at about 3, 4, and 5
      months of age; and a Booster Dose which includes the 4th dose of 7vPnC at 12-15 months of
      age.
    

Detailed description: 
      This study is a combination of a Phase I and Phase III study design. The Phase I portion is
      an open-label, controlled study to evaluate the safety of 7vPnC in healthy Chinese infants.
      The Phase III portion is an open-label, controlled, randomized study to evaluate the safety
      and immunogenicity of 7vPnC in healthy Chinese infants. Both phases include a Primary Series
      which includes the primary 3 doses of 7vPnC and/or DTaP at about 3, 4, and 5 months of age;
      and a Booster Dose which includes the 4th dose of 7vPnC at 12-15 months of age. A total of
      822 healthy Chinese infants will be enrolled. The study will be conducted in 2 phases: Phase
      I and Phase III.

      Phase I: 22 healthy infants will be enrolled first and receive a dose of 7vPnC at least 7
      days prior to receiving DTaP and followed up on safety for 30 days post the immunization. If
      there are no adverse events of specific concern considered, in the opinion of the principal
      investigator, related to the study vaccine (including, though not limited to, infectious and
      allergic reactions as described in the China Immunization Handbook) within 4 days after the
      first dose immunization and no serious adverse event possibly, probably or definitely related
      to the study vaccine within 30 days after the first dose of immunization, Phase III can be
      initiated and the infants in Phase I will proceed to the next dose of the Primary Series. If
      such events occur, a medical review will be conducted by both the investigator and the
      Sponsor to decide if the study can proceed.

      Phase III: 800 infants will be enrolled and randomized to one of 3 groups according to the
      administration regimen. Group 1: 300 infants will receive the primary 3 doses of 7vPnC
      separately at 3, 4 and 5 months of age. Group 2: 300 infants will receive the primary 3 doses
      of 7vPnC concurrently with DTaP at 3, 4 and 5 months of age. Group 3: 200 infants will
      receive DTaP only at 3, 4 and 5 months of age. The injection site is the left upper arm
      deltoid for 7vPnC and the right upper arm deltoid for DTaP.

      Safety Evaluation: Each infant will have an initial physical examination and history obtained
      at the enrollment visit and a brief physical evaluation at each subsequent visit. Following
      immunization, each subject will be observed in the clinic for 30 minutes and evaluated for
      signs or symptoms of anaphylaxis and reactions at the injection sites. The parent or legal
      guardian will be required to take the infant's axillary temperature on the evening of
      immunization and for 3 consecutive evenings following the immunization. In addition, if the
      parent suspects that the infant may have a fever at any time in the four days following
      immunization, the temperature is to be taken and recorded. Thermometers for axillary
      temperature use and diary cards will be supplied by Wyeth for distribution to the parents.

      The parent or legal guardian of each subject will be instructed to complete a diary card for
      4 days [day of immunization (day 0) and next 3 days] following each immunization. Information
      collected will include: the subject's axillary temperature, local reactions at the 7vPnC
      injection site (All subjects in Phase I of the study and Group 1 and Group 2 of Phase III)
      and DTaP injection site (Group 2 and Group 3 of Phase III) (tenderness, presence and size of
      erythema and induration/swelling) and any systemic reactions (disrupted sleep, drowsiness,
      decreased appetite, irritability, vomiting, diarrhea and rash not limited to the injection
      site) occurring days 0-3. The subject will return to clinic or be visited at home on the day
      after immunization (Day 1) for local and systemic reaction observation by study personnel.
      The parent or legal guardian will be contacted by telephone or home visit at 2 and 3 days
      post-immunization to collect information on local and systemic events and the information
      will be recorded on the source data sheet by study personnel. On, or after, the fourth day
      after each immunization, the study personnel will collect the diary card. The data in the
      diary card will be reconciled with the data in the source data sheet. If there is
      discrepancy, it should be clarified with the parents and recorded.

      At the visit of next immunization, the interim medical history since Day 4 post last
      immunization will be reviewed with the parent/legal guardian. If there is any adverse event,
      it should be collected and recorded in the case report form. The primary source of data on
      adverse events will be the parent or legal guardian of each subject, as well as any medical
      records from a health care provider sought as a result of an adverse event. The parent/legal
      guardian is instructed to contact the investigators immediately for any serious adverse
      events.

      Assessment of Immunogenicity: Up to 3ml venous blood will be collected from 55 infants in
      Group 1, 55 infants in Group 2 and 55 infants in Group 3 of Phase III, immediately prior to
      the first dose and 30-40 days after the 3rd dose to assess the immunogenicity.

      Booster Dose: All infants in Phase I and Group 1 and Group 2 of Phase III will receive the
      booster dose of 7vPnC at 12-15 months of age. Local/systemic reactions will be observed in
      the same way as after the primary dose.

      Assessment of Immunogenicity: Up to 3ml venous blood will be collected from the same 55
      infants in Group 1 and 55 infants in Group 2 as in the Primary Series of Phase III,
      immediately prior to the forth dose and 30-40 days after the 4th dose to assess the
      immunogenicity.

      The statistical analysis of the two phases will be conducted separately. The statistical
      analysis of the primary series is planned when all subjects have received the 1st, 2nd and
      3rd dose of 7vPnC and 3 doses of DTaP or 3 doses of DTaP alone and the 30-day safety
      follow-up period has terminated. The analysis of the booster dose is planned when all
      subjects have received the 4th dose of 7vPnC and the 30-day safety follow-up period has
      terminated.
    

Intervention name(s): 7-valent pneumococcal conjugate vaccine; Diptheria and tetanus toxoids and accelular pertussis vaccine (DTaP)
Intervention type(s): Biological; Biological
Intervention MeSH terms: Vaccines; Heptavalent Pneumococcal Conjugate Vaccine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Vaccines, Pneumococcal Conjugate Vaccine