Immune Response to Rotavirus Vaccine After a Supplemental Dose Given at 9 Months of Age With Local EPI Vaccines in Mali
Condition: Diarrhea Rotavirus
MeSH terms: Diarrhea
Study type: Interventional
Phase: Phase 4

Summary: 
      This study is an evaluation of the immune response to pentavalent rotavirus vaccine (PRV)
      after an additional fourth dose is given at 9 months of age with local World Health
      Organization (WHO) Expanded Programme on Immunization (EPI) vaccines in Mali.
    

Detailed description: 
      Vaccination is the best way to prevent severe rotavirus disease and the deadly, dehydrating
      diarrhea that it causes. However, given only moderate efficacy in the first year of life and
      a possible further decline in immunity, it is considered a top priority by public health
      experts to evaluate the possible value of a "booster" dose of rotavirus vaccine in low income
      countries to confer longer duration of protection into the second year of life when disease
      burden continues to be high.

      This study is an open-label, individual-randomized, parallel-group, comparative
      immunogenicity trial. Participating infants randomized to Group A will receive one dose each
      of measles vaccine (MV), yellow fever vaccine (YFV), and meningitis conjugate vaccine
      (PsA-TT-5μg) at 9 months of age, and infants randomized to Group B will receive one dose each
      of MV, YFV, PsA-TT-5μg, and PRV at 9 months of age.

      The study will simultaneously evaluate two primary objectives, one for noninferiority of the
      response to MV given with PRV (co-primary objective 1) and one for noninferiority of the
      response to YFV given with PRV (co-primary objective 2).

      Secondary objectives of the study were the following:

        1. To evaluate the non-inferiority of the immune response 3 months post-vaccination (as
           sero-conversion) to MV given with PRV (Group B) to that given without PRV (Group A).

        2. To compare the immune response (as geometric mean titers [GMTs]) to YFV given with PRV
           (Group B) to that given without PRV (Group A).

        3. To evaluate the non-inferiority of the immune response (as sero-response) to PsA-TT-5μg
           given with PRV (Group B) compared to that given without PRV (Group A).

        4. To compare the immune response (as GMTs) to PsA-TT-5μg given with PRV (Group B) to that
           given without PRV (Group A).

        5. To evaluate the superiority of the immune response (as sero-response and geometric mean
           concentrations [GMCs]) to a supplemental dose of PRV given at 9 months of age with local
           EPI vaccines (Group B) compared no supplemental dose (Group A).

        6. To describe the safety profile of study vaccination with PRV.
    

Intervention name(s): pentavalent rotavirus vaccine (PRV); measles vaccine (MV); yellow fever vaccine (YFV); meningitis conjugate vaccine (PsA-TT-5μg)
Intervention type(s): Biological; Biological; Biological; Biological
Intervention description(s): Each two-ml dose contains 5 live human-bovine reassortant rotaviruses with a minimum of 2.0 - 2.8 x 106 infectious units (IU) per reassortant, depending on the serotype, and not greater than 116 x 106 IU per aggregate dose. Each vaccine dose contains sucrose, sodium citrate, sodium phosphate monobasic monohydrate, sodium hydroxide, polysorbate 80, cell culture media, and trace amounts of fetal bovine serum. RotaTeq contains no preservatives. RotaTeq is a pale yellow clear liquid that may have a pink tint. This vaccine was administered orally.; A lyophilized vaccine in a pack containing one vial plus one ampoule of sterile water for injection. After reconstitution, each 0.5 ml/dose of MV contains active substances not less than 1000 units of 50% cell culture infectious doses (CCID50) of MV. Measles Vaccine Live Attenuated virus is propagated on Human Diploid Cells. This MV is currently part of the local EPI program in Mali. This vaccine was administered subcutaneously to the right deltoid.; A freeze-dried live attenuated yellow fever virus of the 17D strain for injection. After reconstitution, one dose (0.5 ml) contains active substances not less than 1000 units of 50% lethal doses (LD50) of yellow fever virus. This YFV is currently part of the local EPI program in Mali. This vaccine was administered intramuscularly to the left deltoid.; A meningococcal A vaccine, with meningococcal A polysaccharide (PsA) conjugated to the carrier protein, tetanus toxoid (TT). After reconstitution, one dose (0.5 ml) contains 5μg meningococcal A polysaccharide and 5-16 μg tetanus toxoid as a carrier protein. PsA-TT-5μg was considered experimental at the initiation of this study, but received approval from the WHO for infants on 30 December 2014. For all participants enrolled January 1st, 2015 or later, PsA-TT-5μg was not included in Group A or Group B, due to its December 2014 expiration date. This vaccine was administered intramuscularly to the right thigh.
Other intervention name(s): RotaTeq; PsA-TT
Intervention MeSH terms: Vaccines
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: rotavirus; rotavirus vaccine; Mali; EPI vaccines