COV-COMPARE Immunogenicity of Vaccine VLA2001 Compared to AZD1222

Study Overview
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Brief Summary
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This is a multicentre, randomized, observer-blind, active-controlled, superiority, study in adults to compare the immunogenicity of VLA2001 to AZD1222 in terms of GMT of SARS-CoV-2-specific neutralising antibodies. Furthermore, VLA2001 will be compared to placebo in an adolescent population.

Detailed Description
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Approximately 4000 Adult participants will be recruited in the study. About 3000 participants aged 30 years and above will be randomized in a 2:1 ratio to receive 2 intramuscular recommended doses of either VLA2001 (n=2000) or AZD1222 (n=1000). In addition, approximately 1000 subjects aged 18-29 years will participate in this study in a non-randomized, open-label fashion to receive VLA2001. The 2 doses of vaccination for both vaccines will be administered 28 days apart, on Days 1 and 29. All visits will be conducted at the clinical site on an outpatient basis. All participants - except those who already received a licensed COVID-19 vaccine outside of the study - will be offered a booster dose with VLA2001 between Jan and Mar 2022 and will have a follow-up visit 14 days (Visit B2) and 6months after the booster dose. Approximately 660 Adolescent participants were planned to be recruited and randomized in a 1:1 ratio to receive 2 intramuscular doses of either VLA2001 (n=330) or placebo (n=300). Participants in the placebo group will receive a 2-dose primary immunization with VLA2001 on Day 85 and the second vaccination 28 days later. For safety reasons, the first 16 adolescents will be enrolled in an open label, non-randomized manner (sentinel dosing). Recruitment of adolescent participants has been stopped after recruitment of 6 randomized participants (3 randomized to VLA2001 and 3 participants randomized to placebo) due to the low recruitment rate. The study design ensures a safety follow-up of at least 6 months after the last VLA2001 vaccination/booster for all enrolled study participants Participants will be provided with an electronic Diary (e-Diary) and will be trained to record specifically solicited systemic and local symptoms daily as well as any additional AEs during follow-up period after each of both vaccinations up to the next visit to the site until Day 43 visit has been completed.

Official Title
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A Randomized, Observer-Blind, Controlled, Superiority Study To Compare The Immunogenicity Against COVID-19, Of VLA2001 Vaccine To AZD1222 Vaccine, In Adults Including a Randomized, Observer-blind, Placebo Controlled Part in Adolescents (≥12 to <18 Years)

Conditions
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SARS-CoV-2 Virus Infection

Intervention / Treatment
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* Biological: VLA2001
* Biological: AZD1222
* Biological: VLA2001 - adolescent part
* Biological: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants must have read, understood, and signed the informed consent form (ICF). Participants of either gender aged 12 years and older at screening. Medically stable Must be able to attend all visits of the study and comply with all study procedures, Women of childbearing potential (WOCBP) must be able and willing to use at least 1 highly effective method of contraception for a minimum of 3 months after the last dose of study vaccine. WOCBPs must have a negative pregnancy test prior to each vaccination. Exclusion Criteria: Participant is pregnant or planning to become pregnant within 3 months after study vaccine administration. History of allergy to any component of the vaccine. Significant infection (e.g. positive SARS-CoV-2 RT-PCR) or other acute illness, including fever > 100 °F (> 37.8 °C) 48 hours before vaccination. Participant has a known or suspected defect of the immune system Participant has a history of cerebral venous sinus thrombosis, heparin-induced thrombocytopenia or antiphospholipid syndrome. Participant has a history of malignancy in the past 5 years other than squamous cell or basal cell skin cancer. If there has been surgical excision or treatment more than 5 years ago that is considered to have achieved a cure, the participant may be enrolled. A history of hematologic malignancy is a permanent exclusion. Participants with a history of skin cancer must not be vaccinated at the previous tumour site. History of drug dependency or current use of drug of abuse or alcohol abuse at screening. Significant blood loss (> 450 mL) or has donated 1 or more units of blood or plasma within 6 weeks prior to the expected day of randomization (Visit 1). History of clinically significant bleeding disorder, or prior history of significant bleeding or bruising following IM injections or venepuncture. Severe and uncontrolled ongoing autoimmune or inflammatory disease History of Guillain-Barre syndrome or any other demyelinating condition. Any other significant disease, disorder or finding which in the opinion of the investigator may significantly increase the risk to the volunteer Prior/concomitant therapy: Receipt of immunoglobulin or another blood product within the 3 months before expected day of randomization (visit 1) in this study or those who expect to receive immunoglobulin or another blood product during this study. Receipt of medications and or vaccinations intended to prevent COVID-19. Receipt of any vaccine (licensed or investigational), other than licensed influenza vaccine, within 28 days prior to the expected day of randomization (Visit 1). Any member of the study team or sponsor. An immediate family member or household member of the study's personnel. Booster Vaccination (Adults and Adolescents) In addition to the above-described eligibility criteria, the following criteria must be met: 1. Participant has not received another licensed COVID-19 vaccine during the study

Ages Eligible for Study
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Minimum Age: 12 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: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: VLA2001<br><30 years will receive VLA2001; participants aged ≥30 years will be randomised 2:1 to receive VLA2001 or AZD1222 | Biological: VLA2001<br>* whole virus inactivated SARS-CoV-2 vaccine adjuvanted with cytosine phospho-guanine (CpG) 1018 in combination with aluminium hydroxide 2 vaccinations 28 days apart<br>|
| Active Comparator: AZD1222<br><30 years will receive VLA2001; participants aged ≥30 years will be randomised 2:1 to receive VLA2001 or AZD1222 | Biological: AZD1222<br>* 2 vaccinations 28 days apart AZD1222 is a recombinant, replication-defective chimpanzee adenovirus expressing the SARS-CoV-2 S surface glycoprotein.<br>|
| Experimental: VLA2001 - adolescent part<br>≥12 to < 18 years will be randomized 1:1 to receive VLA2001 or Placebo | Biological: VLA2001 - adolescent part<br>* whole virus inactivated SARS-CoV-2 vaccine adjuvanted with cytosine phospho-guanine (CpG) 1018 in combination with aluminium hydroxid 2 vaccinations 28 days apart and with a booster vaccination on day 208. Placebo group will receive VLA2001 on day 208 and following second vaccination 28 days later.<br>|
| Placebo Comparator: Placebo<br>≥12 to < 18 years will be randomized 1:1 to receive VLA2001 or Placebo | Biological: Placebo<br>* 2 vaccinations 28 days apart with placebo (PBS buffer based on Dulbecco's PBS media formulation without Calcium and Magnesium )<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Immune response measured after completion of a 2-dose immunization schedule, as determined by the geometric mean titer (GMT) ratio in adults and GMT in adolescents of SARS-CoV-2-specific neutralizing antibodies |  | Day 43 | 
| Immune response measured after completion of a 2-dose immunization schedule, as determined by Seroconversion in adults and adolescents (definded as 4-fold increase from baseline) of SARS-CoV-2-specific neutralizing antibodies |  | Day 43 | 
| Frequency and severity of any Adverse Events (AE) |  | Up to Day 43 post-vaccination | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of adult participants with seroconversion | Seroconversion is defined as >= 4-fold increase in SARS-CoV-2 neutralizing antibody titer against the Wuhan strain and IgG antibodies directed against the S-protein of the Wuhan strain between Day 1 and the defined post-vaccination timepoints | on Day 8 (age 55+ only), Day 29, Day 71 and Day 208 | 
| Proportion of adolescent participants with Seroconversion |  | on Day 43, Day 71/Day 85 and Day 127 | 
| Immune response in adults as determined geometric mean titer (GMT) of SARS-CoV-2-specific neutralising antibodies |  | on Day 8 (age 55+ only), Day 29, Day 71 and Day 208 | 
| Immune response in adolescents as determined by the GMT of SARS-CoV-2-specific neutralising antibodies |  | on Day 43, Day 71/Day 85 and Day 127 | 
| GMT ratio of SARS-CoV-2-specific neutralizing antibodies in the adolescent and adult population |  | on Day 43 | 
| Immune response in adults determined by the GMT of IgG antibodies to SARS-CoV-2 S-protein |  | on Day 8 (age 55+ only), Day 29, Day 43, Day 71 and Day 208 | 
| Immune response in adolescents determined by the GMT of IgG antibodies to SARS-CoV-2 S-protein |  | on Day 43, Day 71/Day 85 and Day 127 | 
| GMT ratio of IgG antibodies to SARS-CoV-2 S-protein in the adolescent and adult population |  | on Day 43 | 
| Assessment of T-cell responses from PBMCs on selected time points in a subset of participants after in vitro stimulation with SARS-CoV-2 antigens using e.g., ELISpot or intracellular cytokine staining |  | Adult: Day 29, Day 43, Day 71 and Day 208, Adolescence: on Day 43, Day 71/Day 85 and Day 127 | 
| Frequency and severity of solicited injection site and systemic reactions |  | until 7 days after each and any vaccination | 
| Frequency and severity of any AE |  | through study completion, up to 13 or 16 months | 
| Frequency and severity of any unsolicited AE |  | through study completion, up to 13 or 16 months | 
| Frequency and severity of any unsolicited vaccine-related AE |  | through study completion, up to 13 or 16 months | 
| Frequency and severity of any serious adverse event (SAE) |  | through study completion, up to 13 or 16 months | 
| Frequency and severity of any adverse event of special interest (AESI) |  | through study completion, up to 13 or 16 months | 
| Geometric mean fold rise (GMFR) with regards to SARS-CoV-2-specific neutralizing antibodies | adult participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| GMT of SARS-CoV-2-specific neutralizing antibodies as measured by MNA50 including formal non-inferiority testing on the GMT ratio | adult participants with single booster | on day of booster vaccination, 14 days and 6 months post booster | 
| Proportion of participants with 4-fold increase with regards to SARS-CoV-2-specific neutralizing antibodies | adult participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| GMFR with regards to S-protein binding antibodies | adult participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| Proportion of participants with 4-fold increase with regards to S-protein binding antibodies | adult participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| Assessment of T-cell responses from PBMCs in a subset of participants after in vitro stimulation with SARS-CoV-2 antigens using ELISpot | adult participants with single booster | on day of booster vaccination, 14 days and 6 months post booster | 
| Frequency and severity of solicited injection site and systemic reactions | adult participants with single booster | 7 days after booster vaccination | 
| Frequency and severity of any unsolicited AE | adult participants with single booster | up to 6 months after booster dose | 
| Frequency and severity of any vaccine-related | adult participants with single booster | up to 6 months after booster dose | 
| Frequency and severity of any serious adverse event (SAE) | adult participants with single booster | up to 6 months after booster dose | 
| Frequency and severity of any adverse event of special interest (AESI) | adult participants with single booster | up to 6 months after booster dose | 
| Geometric mean fold rise (GMFR) with regards to SARS-CoV-2-specific neutralizing antibodies | adolescent participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| GMT of SARS-CoV-2-specific neutralizing antibodies as measured by MNA50 | adolescent participants with single booster | Day of booser vaccination and 14 days post booster | 
| Proportion of participants with 4-fold increase with regards to SARS-CoV-2-specific neutralizing antibodies | adolescent participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| GMFR with regards to S-protein binding antibodies | adolescent participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| Proportion of participants with 4-fold increase with regards to S-protein binding antibodies | adolescent participants with single booster | from day of booster vaccination to 14 days after booster vaccination | 
| GMT measured as IgG antibodies against SARS-CoV-2 as determined by ELISA | adolescent participants with single booster | Day of booser vaccination and 14 days post booster | 
| Assessment of T-cell responses from PBMCs in a subset of participants after in vitro stimulation with SARS-CoV-2 antigens using ELISpot | adolescent participants with single booster | Day of booser vaccination and 14 days post booster | 
| Frequency and severity of solicited injection site and systemic reactions | adolescent participants with single booster | up to 7 days after booster vaccination | 
| Frequency and severity of any unsolicited AE | adolescent participants with single booster | 180 days post booster vaccination | 
| Frequency and severity of any serious adverse event (SAE) | adolescent participants with single booster | 180 days post booster vaccination | 
| Frequency and severity of any adverse event of special interest (AESI) | adolescent participants with single booster | 180 days post booster vaccination | 
| GMT measured as IgG antibodies against SARS-CoV-2 as determined by ELISA | adult participants with single booster | on day of booster vaccination, 14 days and 6 months post booster | 
| Frequency and severity of any vaccine related AE | adolescent participants with single booster | 180 days post booster vaccination | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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VLA2001, SARS-CoV-2 Virus Infection, COVID-19, inactivated-adjuvanted SARS-CoV-2 virus vaccine