H7N9 Vaccination With and Without AS03 and Unadjuvanted H3N2v Vaccination: Standard and Systems Biology Analyses
Condition: Avian Influenza; H1N1 Influenza; Influenza
MeSH terms: Influenza, Human; Influenza in Birds
Intervention: AS03; Influenza Virus Vaccine, Monovalent A/H3N2v A/Minnesota/11/2010 NYMC X-203; Monovalent influenza A/H7N9 virus vaccine
Intervention description: AS03 oil-in-water emulsion adjuvant.; Inactivated monovalent subvirion H3N2v vaccine containing hemagglutinin (HA) of A/Minnesota/11/2010 NYMC X-203 virus.; Monovalent influenza A/H7N9 virus vaccine.
Intervention MeSH terms: Vaccines
Phase: Phase 2
Study type: Interventional
Primary purpose: Prevention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Enrollment: 30.0
Sex: All
Minimum age: 18 Years
Maximum age: 49 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: A/H5N1; A/H7N9; ASO3 Adjuvant; influenza; monovalent; pH1N1; vaccines

Summary:

      This is a single center, randomized, partially-blinded, Phase II, small, targeted,
      prospective study in approximately 30 healthy male and non-pregnant female subjects aged 18
      to 49 years old, inclusive, designed to evaluate and compare the immunogenicity between an
      intramuscular monovalent inactivated influenza A/H7N9 virus vaccine given with and without
      AS03 adjuvant, and an intramuscular unadjuvanted monovalent inactivated influenza A/H3N2v
      virus vaccine. The primary objectives are (1) assessing the serum anti-HA
      hemagglutination-inhibition (HAI) response to influenza A/H7N9 antigen (with and without
      adjuvant) at Day 57 (approximately one month after the second study vaccination with A/H7N9
      vaccine with or without AS03) and influenza A/H3N2v antigen at Day 29 (approximately one
      month after the study vaccination with A/H3N2v), and (2) identifying differentially expressed
      genes in human immune cells on Days 2, 4, and 29 (following the first study vaccination with
      A/H7N9 vaccine with or without AS03) and on Days 30, 32, and 36 (following the second study
      vaccination with A/H7N9 vaccine with or without AS03), compared to baseline assessments
      performed prior to each study vaccination (Days -7, 1, and 29).
    

Eligibility criteria:

        Inclusion Criteria:

          1. Provide written informed consent prior to initiation of any study procedures.

          2. Are able to understand and comply with planned study procedures and be available for
             all study visits.

          3. Are males or non-pregnant females, 18 to 49 years old, inclusive.

          4. Are in good health*.

             *As determined by medical history and targeted physical examination, if indicated
             based on medical history, to evaluate acute or currently ongoing chronic medical
             diagnoses or conditions, defined as those that have been present for at least 90 days,
             that would affect the assessment of the safety of subjects or the immunogenicity of
             study vaccinations. Chronic medical diagnoses or conditions should be stable for the
             last 60 days. This includes no change in chronic prescription medication, dose, or
             frequency as a result of deterioration of the chronic medical diagnosis or condition
             in the 60 days prior to enrollment. Any prescription change that is due to change of
             health care provider, insurance company, etc., or that is done for financial reasons,
             as long as in the same class of medication, will not be considered a deviation of this
             inclusion criterion. Any change in prescription medication due to improvement of a
             disease outcome, as determined by the site principal investigator or appropriate
             sub-investigator, will not be considered a deviation of this inclusion criterion.
             Subjects may be on chronic or as needed (prn) medications if, in the opinion of the
             site principal investigator or appropriate sub-investigator, they pose no additional
             risk to subject safety or assessment of reactogenicity and immunogenicity and do not
             indicate a worsening of medical diagnosis or condition. Similarly, medication changes
             subsequent to enrollment and study vaccination are acceptable provided there was no
             deterioration in the subject's chronic medical condition that necessitated a
             medication change, and there is no additional risk to the subject or interference with
             the evaluation of responses to study vaccination. Note: Topical, nasal, and inhaled
             medications (with the exception of inhaled corticosteroids as outlined in the Subject
             Exclusion Criteria), herbals, vitamins, and supplements are permitted.

          5. Oral temperature is less than 100.4 degrees F.

          6. Pulse is 50 to 115 bpm, inclusive.

          7. Systolic blood pressure is 85 to 150 mm Hg, inclusive.

          8. Diastolic blood pressure is 55 to 95 mm Hg, inclusive.

          9. Erythrocyte sedimentation rate (ESR) is less than 30 mm per hour.

         10. Women of childbearing potential* must use an acceptable contraception method** from 30
             days before first study vaccination until 60 days after last study vaccination.

             *Not sterilized via tubal ligation, bilateral oophorectomy, hysterectomy or successful
             Essure (R) placement (permanent, non-surgical, non-hormonal sterilization) with
             documented radiological confirmation test at least 90 days after the procedure, and
             still menstruating or <1 year of the last menses if menopausal.

             **Includes, but is not limited to, non-male sexual relationships abstinence from
             sexual intercourse with a male partner, monogamous relationship with vasectomized
             partner who has been vasectomized for 180 days or more prior to the subject receiving
             the first study vaccination, barrier methods such as condoms or diaphragms with
             spermicide or foam, effective intrauterine devices, NuvaRing (R), and licensed
             hormonal methods such as implants, injectables or oral contraceptives ("the pill").

         11. Women of childbearing potential must have a negative urine or serum pregnancy test
             within 24 hours prior to study vaccination.

        Exclusion Criteria:

          1. Have an acute illness*, as determined by the site principal investigator or
             appropriate sub-investigator, within 72 hours prior to study vaccination.

             *An acute illness which is nearly resolved with only minor residual symptoms remaining
             is allowable if, in the opinion of the site principal investigator or appropriate
             sub-investigator, the residual symptoms will not interfere with the ability to assess
             safety parameters as required by the protocol.

          2. Have any medical disease or condition that, in the opinion of the site principal
             investigator or appropriate sub-investigator, is a contraindication to study
             participation*.

             *Including acute or chronic medical disease or condition, defined as persisting for at
             least 90 days that would place the subject at an unacceptable risk of injury, render
             the subject unable to meet the requirements of the protocol, or may interfere with the
             evaluation of responses or the subject's successful completion of this study.

          3. Have immunosuppression as a result of an underlying illness or treatment, or use of
             anticancer chemotherapy or radiation therapy (cytotoxic) within 3 years prior to study
             vaccination.

          4. Have known active neoplastic disease (excluding non-melanoma skin cancer) or a history
             of any hematologic malignancy.

          5. Have known human immunodeficiency virus (HIV), hepatitis B, or hepatitis C infection.

          6. Have known hypersensitivity or allergy to eggs, egg or chicken protein, squalene-based
             adjuvants, or other components of the study vaccines.

          7. Have a history of severe reactions following previous immunization with licensed or
             unlicensed influenza virus vaccines.

          8. Have a personal or family history of narcolepsy.

          9. Have a history of Guillain-Barré syndrome.

         10. Have a history of convulsions or encephalomyelitis within 90 days prior to study
             vaccination.

         11. Have a history of a potentially immune-mediated medical condition.

         12. Have a history of alcohol or drug abuse within 5 years prior to study vaccination.

         13. Have any diagnosis, current or past, of schizophrenia, bipolar disease, or other
             psychiatric diagnosis that may interfere with subject compliance or safety
             evaluations.

         14. Have been hospitalized for psychiatric illness, history of suicide attempt, or
             confinement for danger to self or others within 10 years prior to study vaccination.

         15. Have taken oral or parenteral (including intra-articular) corticosteroids of any dose
             within 30 days prior to study vaccination.

         16. Have taken high-dose inhaled corticosteroids within 30 days prior to study
             vaccination. High-dose defined as >840 mcg/day of beclomethasone dipropionate CFC or
             equivalent.

         17. Received licensed live vaccine within 30 days prior to the first study vaccination, or
             plans to receive licensed live vaccine within 30 days before or after each study
             vaccination.

         18. Received licensed inactivated vaccine within 14 days prior to the first study
             vaccination, or plans to receive licensed inactivated vaccine within 14 days before or
             after each study vaccination.

         19. Received immunoglobulin or other blood products (with exception of Rho D
             immunoglobulin) within 90 days prior to study vaccination.

         20. Received an experimental agent* within 30 days prior to the first study vaccination,
             or expects to receive an experimental agent** during the 13-month study-reporting
             period.

             *Including vaccine, drug, biologic, device, blood product, or medication.

             **Other than from participation in this study.

         21. Are participating or plan to participate in another clinical trial with an
             interventional agent* that will be received during the 13-month study-reporting
             period.

             *Including licensed or unlicensed vaccine, drug, biologic, device, blood product, or
             medication.

         22. Prior participation in a clinical trial of influenza A/H7 vaccine* or have a history
             of influenza A/H7 virus actual or potential exposure or infection prior to the first
             study vaccination.

             *And assigned to a group receiving influenza A/H7 vaccine, does not apply to
             documented placebo recipients.

         23. Prior participation in a clinical trial of influenza A/H3N2v vaccine* or have a
             history of influenza A/H3N2v virus actual or potential exposure or infection prior to
             the first study vaccination.

             *And assigned to a group receiving influenza A/H3N2v vaccine, does not apply to
             documented placebo recipients.

         24. Occupational exposure to or substantial direct physical contact* with birds in the
             past year or during the 28 days after each study vaccination.

             *Casual contact with birds at petting zoos or county or state fairs or having pet
             birds does not exclude subjects from study participation.

         25. Occupational exposure to or substantial direct physical contact* with pigs in the past
             year or during the 28 days after each study vaccination.

             *Casual contact with pigs at petting zoos or county or state fairs does not exclude
             subjects from study participation.

         26. Female subjects who are breastfeeding or plan to breastfeed at any given time from the
             first study vaccination until 30 days after the last study vaccination.

         27. Plan to travel outside the US (continental US, Hawaii, and Alaska) within 28 days
             after each study vaccination.

         28. Blood donation or planned blood donation within 30 days before enrollment until 30
             days after the last blood draw for this study.