Immunogenecity and Safety of VaccinemRNA-1273 in Elderly Volunteers (Over 65 y) Compared to Younger Ones (18-45y)

Study Overview
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Brief Summary
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This study aims to evaluate the immunogenicity of Moderna mRNA-1273 vaccine in volunteers aged 65 years or more compared to volunteers aged 18-45 years, over 24 months duration. It will provide necessary data on the early immunological response to the vaccine and its evolution in quantitative and qualitative terms. This study will allow establishing how aging influences the response to the vaccine and help to adapt the vaccinal plan. For instance it will suggest the necessity of a vaccination booster.

Detailed Description
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Phase II, comparative, non-randomized trial assessing the immunogenicity and safety of vaccine candidate Moderna-1273 against SARS-CoV-2. A total of 180 volunteers will be included and vaccinated (2 doses, at day 1 and day 29), divided in 3 groups (60 volunteers 18 - 45 years old, 60 volunteers 65 - 74 years old, 60 volunteers at least 75 years old). Vaccinated volunteers of the three arms will be immune-monitored during 24 months via a battery of in vitro and ex vivo tests to comprehensively assess the course of humoral, cellular and mucosal immunity over time.

Official Title
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A Phase II Trial Assessing Immunogenicity and Safety of SARS-CoV-2 Vaccine mRNA-1273 in Volunteers Aged of 65 Years or More Compared to Participants 18-45 Years Old

Conditions
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Prevention of COVID19

Intervention / Treatment
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* Biological: mRNA-1273


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least 65 years old, at least 75 years old or 18 to 45 years old, depending on the group of inclusion. Healthy adults, or stable medical condition for adults with pre-existing medical conditions. A stable medical condition is defined as disease not requiring significant change in therapy or hospitalization for worsening disease during 3 months before enrolment, nor expected to require any significant change in therapy or hospitalization for worsening disease in foreseeable future. Understands and agrees to comply with the study procedures (visits, phone calls) and provides written free informed consent. Able to comply with study procedures based on Investigator judgement. Affiliated to a social security system, (except state medical aid) Exclusion criteria: Subject is ill or febrile (body temperature ≥ 38.0°C) within 72 prior hours or and/or symptoms suggestive of COVID-19 within the past 14 days at enrolment visit. (Ill or febrile participants may be re-scheduled within the inclusion period when no longer presenting symptoms) History of documented COVID-19 (PCR+, antigenic test+ or chest TDM+ or serology SARS-CoV-2+) prior to first vaccine administration Subjects with positive serology to SARS-CoV-2 at the enrolment visit Subjects who already received another anti-SARS-CoV-2-vaccine Subjects who received BCG given within the last year. An immediate family member or household member of study staff. Use of immunosuppressive drugs like e.g. corticosteroids at a dosage > 10mg/day (excluding topical preparations and inhalers) within 3 months prior to enrolment or 6 months for chemotherapies Received immunoglobulin or other blood product within 3 months prior to enrolment or planned receipt of immunoglobulin or a blood product through study completion. Received any vaccination within 4 weeks prior to first injection or plan to receive a licensed vaccine 4 weeks after the last injection. History of severe adverse reactions to vaccine administration, including anaphylaxis and related symptoms, such as rush, respiratory difficulty, angioedema and abdominal pain to vaccines, or history of allergic reaction likely to be exacerbated by any component of the anti-SARS-CoV-2-vaccine. History of severe allergic event Participation in another investigational clinical study (Jardé 1 or Jardé 2) within 4 weeks before the enrolment visits or planned before the study completion. Known HIV, active HCV or HBV infection Any pathological condition, such as cancer, which may be susceptible of reducing immunity response Any bleeding disorder considered as contraindication to intramuscular injection or phlebotomy The use of investigational Ig, investigational monoclonal antibodies or convalescent serum are not allowed during the study Any condition which in the opinion of the investigator may interfere with the aim of the study Pregnant or breastfeeding or positive pregnancy urine test at enrolment visit. Woman in childbearing without efficacious contraception (in the opinion of the investigator) for 31 days after treatment (2nd vaccine injection) People under legal protection measure (tutorship, curatorship or safeguard measures)

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: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 18-45 years old<br>18 - 45 years old (60 volunteers), 2 injections of mRNA-1273, at day 1 and day 29 | Biological: mRNA-1273<br>* SARS-CoV-2 vaccine<br>|
| Experimental: 65-74 years old<br>65 - 74 years old (60 volunteers), 2 injections of mRNA-1273, at day 1 and day 29 | Biological: mRNA-1273<br>* SARS-CoV-2 vaccine<br>|
| Experimental: At least 75 years old<br>At least 75 years old (60 volunteers), 2 injections of mRNA-1273, at day 1 and day 29 | Biological: mRNA-1273<br>* SARS-CoV-2 vaccine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Titers of anti-SARS-CoV-2 Spike IgG Immunoglobulin in sera | Anti-SARS-CoV-2 Spike specific IgG Immunity acquisition | Day 57 (28 days after second injection of mRNA-1273) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anti SARS-CoV -2 IgG, IgA and IgM (total and subclasses IgG1-4) as measured by ELISA. | Assessment of humoral immunity-systemic response | From Day 1 to Month 24 | 
| Anti-SARS-CoV-2 neutralizing antibody (in vitro neutralisation assay. | Assessment of humoral immunity-systemic response | From Day 1 to Month 24 | 
| Anti-SARS-CoV-2 -specific neutralizing antibody (Pseudo neutralisation assay using lentiviral phenotypes carrying specific SARS-Cov-2 proteins. | Assessment of humoral immunity-systemic response | From Day 1 to Month 24 | 
| Fluorospot assays (TH1, TH2, TH17, Cytotoxicity). Phenotyping of antigen specific T-Cells via Mass cytometry, B cell repertoire and memory | Assessment of cellular immunity acquisition | From Day 1 to Month 24 | 
| Mucosal SARS-CoV-2 -specific antibody via measure of sIgA, sIgM and IgG in saliva by specific home-made and commercially available ELISA assays. | Assessment of mucosal immunity | From Day 1 to Month 24 | 
| Functionality of mucosal sIgA and sIgM by Antibody Dependent Cellular Cytotoxicity (ADCC) assay specific for SARS-CoV-2 mucosal IgA and IgM | Assessment of mucosal immunity | From Day 1 to Month 24 | 
| Local and systemic reactogenicity | Clinical safety evaluation | From Day 1 to Month 24 | 
| Determination of autoimmunity markers such as antibodies Anti-nuclear (unit measure: titers) | Biological safety evaluation | From Day 1 to Month 24 | 
| Determination of autoimmunity markers such as antibodies Anti-ACL, Anti-β2-GP1, Rheumatoid factor (unit measure: U/L) | Biological safety evaluation | From Day 1 to Month 24 | 
| Determination of autoimmunity markers such as antibodies Anti-GM1, Anti-MAG ( unit measure: pos/ne) | Biological safety evaluation | From Day 1 to Month 24 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Vaccinology, Infectiology, Vaccine, COVID-19, Immunity, Immune, Cells, Mucosal immunity, Autoimmunity