Andes Virus DNA Vaccine for the Prevention of Hantavirus Pulmonary Syndrome Using the PharmaJet Stratis(R) Needle-Free Injection Delivery Device
Condition: Hantavirus Pulmonary Infection; Immunisation
MeSH terms: Hantavirus Pulmonary Syndrome; Hantavirus Infections
Intervention: Andes virus DNA vaccine; Placebo
Intervention description: A vaccine targeting the hantavirus pulmonary syndrome (HPS) causative agent Andes Virus (ANDV), with potential pan-hantavirus effect. The plasmid backbone, pWRG7077, is modified to produce the active ingredient of the vaccine, plasmid pWRG/AND-M (opt2), and includes the ANDV M gene responsible for encoding viral GnGc envelope glycoproteins. ANDV DNA vaccine will be administered intramuscularly at 2 mg or 4 mg doses using the PharmaJet Stratis Needle-Free Injection System.; Normal saline injections will be administered intramuscularly as matching placebo using the PharmaJet Stratis Needle-Free Injection System
Phase: Phase 1
Study type: Interventional
Primary purpose: Prevention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Enrollment: 48.0
Sex: All
Minimum age: 18 Years
Maximum age: 49 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: Andes Virus DNA; ANDV DNA; Hantavirus; Immunogenicity; PharmaJet Stratis; Pulmonary Syndrome; Safety; Vaccine

Summary:

      This is a Phase 1, randomized, placebo controlled, double-blind, dose escalation trial of 48
      males and non-pregnant females, 18-49 years old, inclusive, who are in good health and meet
      all eligibility criteria. This trial is designed to assess the safety, reactogenicity and
      immunogenicity of an Andes Virus (ANDV) DNA vaccine for the prevention of Hantavirus
      Pulmonary Syndrome (HPS). ANDV DNA vaccine or placebo will be administered using the
      PharmaJet Stratis(R) Needle-Free Injection System. The study duration is 23 months while the
      subject participation duration is 12 months. Subjects assigned to the 3 dose regimen will
      receive ANDV DNA vaccine on Days 1, 29 and 169, and placebo on Day 57. Subjects assigned to
      the 4 dose regimen will receive ANDV DNA on Days 1, 29, 57 and 169. Two doses (2 or 4 mg) of
      ANDV DNA vaccine will be evaluated. The primary objective of this study is to assess the
      safety and reactogenicity of the ANDV DNA vaccine by dosage cohort and treatment arm when
      administered using the PharmaJet Stratis(R) Needle-Free Injection system in normal, healthy
      adults.
    

Eligibility criteria:

        Inclusion Criteria:

          1. Provide written informed consent before initiation of any study procedures.

          2. Are able to understand and comply with planned study procedures and be available for
             all study visits/phone calls.

          3. Males or non-pregnant females ages 18-49, inclusive.

          4. Are in good health*. *As determined by medical history and physical examination to
             evaluate acute or currently ongoing chronic medical diagnoses or conditions, defined
             as those that have been present for at least 90 days which 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 (no hospitalizations, ER
             or urgent care for condition and no adverse symptoms that need medical intervention
             such as medication change/supplemental oxygen). 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 (apart from
             steroids as outlined in the Subject Exclusion Criteria), herbals, vitamins, and
             supplements are permitted.

          5. Oral temperature is less than 100.0 degrees Fahrenheit (37.8 degrees Celsius).

          6. Pulse is 47 to 105 beats per minute (bpm), inclusive.

          7. Systolic blood pressure (BP) is 85 to 150 mm Hg, inclusive.

          8. Diastolic blood pressure (BP) is 55 to 95 mm Hg, inclusive.

          9. Have acceptable screening laboratories* within 28 days prior to enrollment. *Screening
             laboratory values that are outside acceptable range but are thought to be due to an
             acute condition or due to laboratory error may be repeated once.

         10. Urine protein screen is negative or trace.

         11. Drug screen for opiates is negative.

         12. HgbA1C < 6.3% at screening.

         13. HIV - 1/2 antibody negative.

         14. HCV antibody negative.

         15. HBsAg negative.

         16. Women of childbearing potential*, must be using an effective method of contraception**
             from 30 days prior to the first study vaccination until 90 days after the last study
             vaccination.

             *Women of childbearing potential are defined as those who have not been sterilized via
             tubal ligation, bilateral oophorectomy, hysterectomy, or successful Essure(R)
             placement (permanent, non-surgical, non-hormonal sterilization) with history of
             documented radiological confirmation test at least 90 days after the procedure (or
             with use of another birth control method if history of confirmation test not
             confirmed), AND are still menstruating or < 1 year since the last menses if
             perimenoapausal.

             **For this study, we define an effective contraceptive method as one that results in a
             failure rate of less than 1% per year when it is used consistently and correctly. This
             includes, but is not limited to, non-male sexual relationships, abstinence from sexual
             intercourse with a male partner, monogamous relationship with a vasectomized partner,
             male condoms with the use of applied spermicide, intrauterine devices, NuvaRing(R),
             and licensed hormonal methods such as implants, injectables or oral contraceptives
             ("the pill").

         17. Women of childbearing potential* must have a negative serum pregnancy test at
             screening and a negative urine pregnancy test within 24 hours prior to each study
             vaccination.

             *See definition of women of childbearing potential above.

         18. Sexually active male participants whose partner is a woman of childbearing potential*
             and has not had a vasectomy** must agree not to father a child until 90 days after the
             last vaccination***.

               -  See definition of women of childbearing potential above. **Performed > 1 year
                  prior to screening

                    -  Must agree to use a barrier method of birth control e.g., either condom with
                       spermicidal foam/gel/film/cream or partner reports usage of occlusive cap
                       (diaphragm or cervical/vault caps) with spermicidal
                       foam/gel/film/cream/suppository.

         19. Women agree to not donate eggs (ova, oocytes) and male subject agrees not to donate
             sperm from the start of screening onwards until at least 90 days after the last
             vaccination.

         20. Agree not to participate in another clinical trial during the study period.

         21. Agree not to donate blood to a blood bank for 3 months after receiving the last study
             vaccine.

        Exclusion Criteria:

          1. Women who are pregnant, planning to become pregnant or lactating*. *Includes
             breastfeeding or planning to breastfeed at any given time from the receipt of study
             vaccination through the 12-month trial period.

          2. Known allergy or history of anaphylaxis, severe local or other serious adverse
             reactions to vaccines or vaccine products*, or history of severe allergic reactions.

             *This includes a known allergy to an aminoglycoside (e.g., gentamicin, tobramycin,
             neomycin, streptomycin).

          3. Received an experimental agent* within 3 months prior to study vaccination, or expects
             to receive an experimental agent** during the 12-month trial-reporting period.

             *Including vaccine, drug, biologic, device, blood product, or medication.

             **Other than from participation in this study.

          4. Received any licensed live vaccine within 28 days prior to or after each study
             vaccination.

          5. Received a licensed inactivated vaccine within 14 days prior to or after each study
             vaccination*.

             *Allowable exception for inactivated seasonal influenza vaccine received more than 7
             days prior to or after a study vaccination.

          6. Individuals in whom the ability to observe possible local reactions at the eligible
             injection sites (deltoid region) is, unacceptably obscured due to a physical condition
             or permanent body art.

          7. Have an acute illness*, as determined by the site PI 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 PI or appropriate sub-investigator, the
             residual symptoms will not interfere with the ability to assess safety parameters as
             required by the protocol. Subjects may re-screen after an acute illness is resolved

          8. Any confirmed or suspected immunosuppressive or immunodeficient condition* or use of
             anticancer chemotherapy or radiation therapy (cytotoxic) within 3 years prior to study
             vaccination.

             *Including HIV infection

          9. Administration of chronic (defined as more than 14 days) immunosuppressants or other
             immune modifying drugs within 6 months of receipt of study vaccine*.

             *For corticosteroids, this means prednisone, or equivalent, greater than or equal to
             0.5 mg/kg/day. Intranasal and topical steroids ARE allowed; daily inhaled steroids for
             treatment of asthma NOT allowed.

         10. History of receipt of a Hantavirus vaccine, including vaccines for Hantaan virus,
             Puumala virus, or combination of both.

         11. Exposed to ANDV* or plans to travel to an endemic area** from enrollment through 6
             months post last vaccination.

             *Residence in an ANDV endemic area in the last 3 years or > 2 consecutive weeks of
             travel to an ANDV endemic area** in the last 3 years.

             **ANDV endemic areas include Chile, Brazil and Argentina.

         12. Any chronic or active neurologic disorder, including seizures and epilepsy, excluding
             febrile seizures as a child.

         13. History of receiving immunoglobulin or other blood product within the 3 months before
             enrollment in this study.

         14. Current or past history of alcohol or drug abuse in the last 5 years.

         15. Subjects with autoimmune disorders, chronic inflammatory disorders or neurological
             disorders with a potential autoimmune correlation.

         16. Have any diagnosis, current or past, of schizophrenia, bipolar disease, or other
             psychiatric diagnosis that may interfere with subject compliance or safety
             evaluations.

         17. 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.

         18. Have received any antiviral within 3 days of study vaccination.

         19. A diagnosis of Type I or II diabetes.

         20. Current employee or staff paid entirely or partially by the contract for this trial,
             or staff who are supervised by the PI or Sub-Investigators.

         21. Any condition that would, in the opinion of the Site Investigator or appropriate
             sub-investigator, is a contraindication to study participation*.

               -  Including acute or chronic (persisting for at least 90 days) clinically
                  significant medical disease or condition, 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 the study.