Safety of a Influenza Vaccine Produced Either in Mammalian Cell Culture or in Embryonated Hen Eggs in Adults and Elderly With and Without Underlying Medical Conditions, and Immunogenicity in a Subset of Subjects With Underlying Medical Conditions

Study Overview
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Brief Summary
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Evaluation of the safety of Trivalent Subunit Influenza Vaccine Produced either in Mammalian Cell Culture or in embryonated Hen Eggs in subjects 18 years of age and above with and without underlying medical conditions and evaluation of the immunogenicity in a subset of subjects with underlying medical conditions, compared to an egg-based vaccine in a post marketing setting.

Official Title
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A Phase IV, Multi-Center, Active-Controlled, Observer-Blind Study to Evaluate the Safety of a Trivalent Subunit Influenza Vaccine Produced Either in Mammalian Cell Culture (Optaflu®) or in Embryonated Hen Eggs (Agrippal®) in Adults and Elderly With and Without Underlying Medical Conditions, and to Evaluate the Immunogenicity in a Subset of Subjects With Underlying Medical Conditions

Conditions
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Seasonal Influenza, Vaccine

Intervention / Treatment
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* Biological: Cell-derived influenza vaccine
* Biological: Egg-derived influenza vaccine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects 18 years of age and above, mentally competent, willing and able to give informed consent prior to study entry; Able to comply with all study procedures and requirements. Exclusion Criteria: History of any anaphylaxis, serious vaccine reactions, or hypersensitivity to any vaccine component; Fatal prognosis of an underlying medical condition (<12 months life expectancy); History of Guillain-Barre syndrome; Bleeding diathesis or receiving anticoagulants of the coumarin type; Hospitalization or residence in a nursing care facility; Planned to receive seasonal influenza vaccine outside of this study; Receipt of another vaccine within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to enrollment in this study; Fever (defined as axillary temperature ≥38.0°C) or any acute illness within 3 days prior to study vaccination; Receipt of another investigational agent within 30 days prior to enrollment in the study or before completion of the safety follow-up period in another study, whichever is longer, and unwilling to refuse participation in another clinical study through the end safety follow up period of the study; Any condition, which, in the opinion of the investigator, might prevent the subject from participation or interfere with the evaluation of the study objectives; Females who were pregnant or nursing (breastfeeding) mothers, or females of childbearing potential who were sexually active and had not used or did not plan to use acceptable birth control measures during the first 3 weeks after vaccination. Oral, injected or implanted hormonal contraceptive, diaphragm or condom with spermicidal agent or intrauterine device were considered acceptable forms of birth control.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: cTIV<br>Subjects received one vaccination of cell culture-derived influenza vaccine | Biological: Cell-derived influenza vaccine<br>* 1 dose of 0.5 mL in the deltoid region of the non-dominant arm<br>|
| Active Comparator: TIV<br>Subjects received one vaccination of egg-derived influenza vaccine | Biological: Egg-derived influenza vaccine<br>* 1 dose of 0.5 mL in the deltoid region of the non-dominant arm<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Subjects Who Reported At Least One Reactogenicity Sign After One Vaccination of TIV or cTIV | Safety was assessed as the number of all subjects who reported at least one sign of reactogenicity after one vaccination of egg-derived (TIV) or cell culture-derived (cTIV) influenza virus vaccine from Day 1 through Day 7 post-vaccination. | From Day 1 up to and including Day 7 post-vaccination | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Healthy Adults and Elderly Who Reported Solicited Local and Systemic Adverse Events (AEs) After One Vaccination of TIV or cTIV | Analysis was performed on a subset of safety population which included the healthy adults (≥18 to ≤60 years) and elderly (≥61 years). | From Day 1 through Day 7 post-vaccination | 
| Number of Adults and Elderly With Underlying Medical Conditions Who Reported Solicited Local and Systemic Adverse Events After One Vaccination of TIV or cTIV | Analysis was performed on a subset of safety population which included the adults (≥18 to ≤60 years) and elderly (≥61 years) with underlying medical conditions. | From Day 1 through Day 7 post-vaccination | 
| Percentages Of Subjects With Underlying Medical Conditions Who Achieved Hemagglutination Inhibition (HI) Titer ≥40 After One Vaccination of TIV or cTIV | Immunogenicity was measured as the percentage of adults (≥18 to ≤60 years) and elderly (≥61 years) achieving HI titers ≥40 at baseline (Day 1) and three weeks (Day 22) after one vaccination of TIV or cTIV for each of three vaccine strains, evaluated using hemagglutination inhibition (HI) egg-derived antigen assay. This criterion is met according to European (CHMP) guideline if the percentage of subjects achieving HI titers ≥40 is >70% (≥18 to ≤60 years), or >60% (≥61 years). | Before vaccination (Day 1) and three weeks after vaccination (Day 22) | 
| Percentages Of Subjects Who Achieved Seroconversion Or Significant Increase In HI Titers After One Vaccination of TIV or cTIV | Seroconversion or significant increase in HI titer as per CHMP criteria for each of the three strains is defined as the percentage of subjects with a prevaccination HI titer <10 to a postvaccination titer ≥40; or in subjects with prevaccination HI titer ≥10, a ≥4-fold increase in postvaccination HI antibody titer. According to the CHMP criteria, the percentage of subjects achieving seroconversion/significant increase should be >40% (≥18 to ≤60 years) or >30% (≥61 years). | Three weeks post-vaccination (Day 22) | 
| Geometric Mean Titers of Subjects With Underlying Medical Conditions After One Vaccination of TIV or cTIV | Immunogenicity was measured as HI geometric mean titers (GMTs) of subjects with underlying conditions, directed against each of three vaccine strains at baseline (Day 1) and three weeks after vaccination (Day 22) in adults (≥18 to ≤60 years) and elderly (≥61 years). | Before vaccination (Day 1) and three weeks after vaccination (Day 22) | 
| Geometric Mean Ratio of Subjects With Underlying Medical Conditions After One Vaccination of TIV or cTIV | Immunogenicity was measured as the geometric mean ratio (GMR), calculated as the ratio of postvaccination to prevaccination HI GMTs for each of the three strains, three weeks after one vaccination (Day 22) of TIV or cTIV. CHMP criteria is considered fulfilled for each of the three strains if the geometric mean increase GMR (Day 22/Day 1) in HI antibody titer is >2.5 (≥18 to ≤60 years) or >2.0 (≥61 Years). | Three weeks post-vaccination (Day 22) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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influenza, vaccine