1
|
Colombo L, Hadigal S, Nauta J, Kondratenko A, Rogoll J, Van de Witte S. Influvac Tetra: clinical experience on safety, efficacy, and immunogenicity. Expert Rev Vaccines 2024; 23:88-101. [PMID: 38088157 DOI: 10.1080/14760584.2023.2293241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION This paper summarizes the safety and immunogenicity data of Influvac Tetra across all age groups starting from 6 months of age, obtained during its clinical development program. AREAS COVERED The article covers the clinical development program of Influvac Tetra based on five registration studies that included different age groups, different comparators, and participants from Europe and Asia. Safety and immunogenicity were assessed in all studies and in one study, the efficacy of Influvac Tetra was assessed. EXPERT OPINION Seasonal influenza is a vaccine-preventable disease that can cause serious complications. Several types of influenza vaccines are available, including egg-based (standard dose, high dose, and adjuvanted), cell-based, and recombinant. The COVID-19 pandemic has stimulated innovation in the development such as mRNA vaccines. However, these vaccines are still in development and the true value still has to be proven. Regardless of the type of vaccine, it is also important to increase overall vaccination coverage. ECDC recommends that EU Member States implement action plans and policies aimed at reaching 75% coverage in at-risk groups and healthcare workers. Even so, vaccine coverage is still far from recommended.
Collapse
Affiliation(s)
| | | | - Jos Nauta
- Innovation & Development, Abbott, Weesp, The Netherlands
| | | | - Jutta Rogoll
- Global Pharmacovigilance, Abbott, Hannover, Germany
| | | |
Collapse
|
2
|
Chen J, Jiang F, Zhao C, Chai J, Li L, Guan Q, Li X, Wang F, Li A, Gao H, Wang M, Fu L, Nie F, Ling W, Deng H, Zhou L. Immunogenicity and safety of the quadrivalent inactivated split-virion influenza vaccine in populations aged ≥ 3 years: A phase 3, randomized, double-blind, non-inferiority clinical trial. Hum Vaccin Immunother 2023; 19:2245721. [PMID: 37587615 PMCID: PMC10438852 DOI: 10.1080/21645515.2023.2245721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/19/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023] Open
Abstract
This study aimed to evaluate the immunogenicity non-inferiority and safety of the quadrivalent inactivated split-virion influenza vaccine in participants ≥ 3 years old. A total of 3,328 participants were enrolled. Participants 3-8 years old were administered one or two doses of the investigational vaccine or one dose of the control vaccine, whereas the other participants were administered only one dose of the investigational or control vaccine. The immunogenicity and occurrence of adverse events (AEs) after 30 days of full-course vaccination and serious adverse events (SAEs) within 6 months after full-course vaccination were assessed. The sero-conversion rates (SCRs) of anti-H1N1, H3N2, B(Y), and B(V) antibodies in the test group were 74.64%, 87.40%, 82.66%, and 78.89%, respectively, and their geometric mean titers were 1:250.13, 1:394.54, 1:200.84, and 1:94.91, respectively, which were non-inferior to those in the control group. The SCRs and sero-protection rates in the two-dose group of participants 3-8 years old were greater than those in the one-dose group. The incidences of total AEs and adverse reactions in the test group were 31.6% and 21.7%, respectively, which were close to those in the control group. In the two-dose group, the incidence of adverse reactions was considerably lower in the second dose (5.5%) than in the first dose (14.7%). Most AEs were grade 1 in severity, and no SAEs were recorded. The investigational vaccine had immunogenicity non-inferior to the control vaccine, and two doses were more effective than one dose in participants 3-8 years old, with a good overall safety.Trial registration: CTR20200715.
Collapse
Affiliation(s)
- Jianmin Chen
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Feng Jiang
- Institute of Immunization Program, Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Chenyan Zhao
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control (NIFDC), Beijing, China
| | - Jing Chai
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Lanshu Li
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control (NIFDC), Beijing, China
| | - Qinghu Guan
- Institute of Immunization Program, Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Xiaoyu Li
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control (NIFDC), Beijing, China
| | - Feiyu Wang
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Ansheng Li
- Influenza Vaccine Production Workshop, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Hongxia Gao
- Quality Control Department, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Minghui Wang
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Liandi Fu
- Influenza Vaccine Production Workshop, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Fei Nie
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Weijun Ling
- Scientific Affairs Department, Simoon Record Beijing Co Ltd, Beijing, China
| | - Haobin Deng
- Department of Bases Development, Simoon Record Beijing Co Ltd, Beijing, China
| | - Lei Zhou
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| |
Collapse
|
3
|
Fan R, Huang X, Nian X, Ou Z, Zhou J, Zhang J, Zeng P, Zhao W, Deng J, Chen W, Chen S, Duan K, Chen Y, Li X, Zhang J, Yang X. Safety and immunogenicity of a quadrivalent influenza vaccine in adults aged 60 years or above: a phase III randomized controlled clinical study. Hum Vaccin Immunother 2021; 18:1-9. [PMID: 34473607 PMCID: PMC8920214 DOI: 10.1080/21645515.2021.1967041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
To control seasonal influenza epidemics in elders, a quadrivalent, inactivated, split-virion influenza vaccine (IIV4) comprising A and B lineages is produced for young individuals and adults aged ≥60 years. In this phase III, randomized, double-blind, active-controlled trial, we compared safety and immunogenicity of IIV4 with a licensed quadrivalent inactivated vaccine (IIV4-HL) produced by Hualan Biological Engineering during the 2019 influenza season. Participants were randomly assigned to receive IIV4 (n = 959) or IIV4-HL (n = 959). Compared to IIV4-HL, geometric mean titers (GMT) of hemagglutination inhibition (HAI) titers and seroconversion rate (SCR) of IIV4 demonstrated better antibody responses in A lineages (H1N1 and H3N2) (P < .01) and equivalent antibody responses in B lineages (B/Yamagata and B/Victoria) (P > .01) in both age groups. After immunization, IIV4 provided a satisfactory SCR and seroprotection rate (SPR) in elders. No discernible variation in immunogenicity was observed between the two age cohorts. In both age groups, IIV4 and IIV4-HL recipients experienced similar levels of solicited and unsolicited adverse events (AEs), and the incidence of AEs was low in both vaccine groups. Most AEs were of mild-to-moderate severity and no grade 3 AEs in IIV4 group, but AEs in adults aged 60–65 were little higher than in adults over 65 years in IIV4 and IIV4-HL groups (IIV4: 14.66% vs. 10.36%; IIV4-HL:14.67% vs. 11.43%). Totally, IIV4 was generally well tolerated and induced high antibody titers against all four influenza strains in elderly, making it a compelling alternative for the elderly aged ≥60 years. Trial registration: Clinical Trials.gov: 2015L00649-2.
Collapse
Affiliation(s)
- Renfeng Fan
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Xiaoyuan Huang
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Xuanxuan Nian
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Zhiqiang Ou
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Jian Zhou
- Gaozhou Center for Disease Control and Prevention, Gaozhou, China
| | - Jiayou Zhang
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Peiyu Zeng
- Gaozhou Center for Disease Control and Prevention, Gaozhou, China
| | - Wei Zhao
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Jinglong Deng
- Gaozhou Center for Disease Control and Prevention, Gaozhou, China
| | - Wei Chen
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Shaomin Chen
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Kai Duan
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Yingshi Chen
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Xinguo Li
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Jikai Zhang
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Xiaoming Yang
- National Engineering Technology Research Center of Combined Vaccines, Wuhan, China.,China National Biotec Group Company Limited, Beijing, China
| |
Collapse
|
4
|
Wang Y, Zhang Y, Wu H, Huang L, Yu H, Xie Z, Zhang H, Zhang W, Chen X, Zhang H, Zhang H, Jia C, Xia S, Wang S. Safety and immunogenicity of a quadrivalent inactivated subunit non-adjuvanted influenza vaccine: A randomized, double-blind, active-controlled phase 1 clinical trial. Vaccine 2021; 39:3871-3878. [PMID: 34088505 DOI: 10.1016/j.vaccine.2021.05.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/24/2021] [Accepted: 05/23/2021] [Indexed: 12/25/2022]
Abstract
Quadrivalent influenza inactivated vaccine (IIV4) is more likely to provide wider protection against yearly circulating influenza viruses than trivalent inactivated influenza vaccine (IIV3). In this study, a total of 320 participants were allocated to four age cohorts (6-35 months, 3-8 years, 9-17 years, and ≥ 18 years; 80 participants/cohort) according to their actual date of birth. Participants in each cohort were randomly assigned to two groups to receive intramuscular injection of the trial vaccine or the comparative vaccine in a one-dose (3-8 years, 9-17 years,and ≥ 18 years) schedule on day 0 or two-dose (6-35 months cohort) schedule on day 0 and 28. The first objective is to evaluate the safety and immunogenicity of the full-dose subunit non-adjuvanted IIV4 (FD-subunit NAIIV4) we developed versus an active-control, China-licensed split-virion NAIIV4, in people ≥ 3 years. The second objective is to evaluate the safety and immunogenicity of FD-subunit NAIIV4 versus the half-dose (HD-subunit NAIIV4) in toddlers aged 6-35 months. Results showed that all adverse reactions noted were rare, mild, and self-limited. In ≥ 3 years cohorts, systemic adverse reactions in FD-subunit NAIIV4 groups were less than the active control split-virion NAIIV4 groups ([Systemic adverse reaction rates (95%CI)], 15.0 (8.6-21.4) versus 19.2(12.1-26.2), p = 0.391). The overall seroprotection efficacy after vaccination were comparable between FD-subunit NAIIV4 and the active control split-virion NAIIV4([Seroprotection rates (95%CI)], H1N1, 99.2(81.3-100.0) versus 94.9(90.9-98.9), p = 0.117; H3N2, 81.7(74.7-88.6) versus 82.1(75.1-89.0), p = 0.939; BV, 75.8(68.2-83.5) versus 74.4(66.4-82.3), p = 0.793; BY, 94.2(90.0-98.4) versus 92.3(87.5-97.1), p = 0.568). Additionally, FD-subunit NAIIV4 has comparable safety and better seroprotection versus that of the half-dose in 6-35 months toddlers groups ([Total adverse reaction rates (95%CI)], 37.5(18.5-56.5) versus 47.5(26.1-68.9), p = 0.366) ([Seroprotection rates (95%CI)], H1N1, 85(56.4-100.0) versus 75.7(47.6-100.0), p = 0.117; H3N2, 50(28.1-71.9) versus 29.7(12.2-47.3), p = 0.070; BV, 75(48.2-100.0) versus 29.7(12.2-47.3), p < 0.001; BY, 75(48.2-100.0) versus 56.8(32.5-81.0), p = 0.091). As a result, the FD-subunit NAIIV4 we developed is safe and effective to provide broader and adequate protection against the circulating influenza viruses during 2018-2019, which could be an essential component of the global preventive strategy for influenza pandemic.
Collapse
Affiliation(s)
- Yanxia Wang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, Henan, China
| | - Yuhui Zhang
- Department of Quality Control, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Haofei Wu
- Department of Research and Development, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Lili Huang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, Henan, China
| | - Hailong Yu
- Department of Quality Control, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Zhiqiang Xie
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, Henan, China
| | - Huiping Zhang
- Department of Quality Control, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Wei Zhang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, Henan, China
| | - Xiaofen Chen
- Department of Quality Control, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Huan Zhang
- Department of Research and Development, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Hongdong Zhang
- Department of Research and Development, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Chunyu Jia
- Department of Research and Development, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China
| | - Shengli Xia
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, Henan, China.
| | - Shuai Wang
- Department of Research and Development, Ab&B Biotech Co., Ltd, Taizhou, Jiangsu, China; Department of Research and Development, Yither Biotech Co., Ltd, Shanghai, China.
| |
Collapse
|
5
|
Sawlwin DC, Graves Jones A, Albano FR. Modification of the vaccine manufacturing process improves the pyrogenicity profile of inactivated influenza vaccines in young children. Vaccine 2019; 37:2447-2454. [PMID: 30935743 DOI: 10.1016/j.vaccine.2019.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/21/2019] [Accepted: 03/23/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND There were increased reports of fevers and febrile reactions in young children (particularly children aged <5 years) receiving the Seqirus/CSL Southern Hemisphere 2010 trivalent inactivated influenza vaccine (IIV3). Modifying the vaccine manufacturing process by increasing the minimum concentration of splitting agent (sodium taurodeoxycholate [TDOC]) from 0.5% w/v to 1.5% w/v for all strains resolved this issue. The current analysis compared fever rates in three pediatric studies of Seqirus IIV3 (S-IIV3) or quadrivalent inactivated influenza vaccine (S-IIV4), prepared using the modified manufacturing process, with fever rates in three pediatric studies of historical (pre-2010) IIV3 formulations. The historical IIV3 formulations, S-IIV3, and S-IIV4 had 0/3, 2/3, and 4/4 vaccine strains split at 1.5% TDOC, respectively. METHODS For each study, fever rates (any grade and severe) were determined for the following age subgroups (as applicable), using the fever intensity grading system used in the S-IIV3/S-IIV4 studies: 6 months to <3 years; 3 to <5 years; 5 to <9 years; and 9 to <18 years. RESULTS For each age subgroup, the any grade and severe fever rates were lower in the S-IIV3/S-IIV4 studies than in the historical IIV3 formulation studies, with the greatest differences in fever rates observed in the youngest age groups. In the 6 months to <3 years group, the any grade fever rate was 7.0% (severe fever: 2.5%) in one S-IIV4 study compared with 38.7% to 40.0% (severe fever: 9.6% to 17.8%) in the historical IIV3 formulation studies. In the 3 to <5 years subgroup, the any grade fever rate was 4.9% (severe fever: 1.2%) in one S-IIV4 study compared with 34.1% to 36.0% (severe fever: 6.3% to 16.5%) in the historical IIV3 formulation studies. CONCLUSION This analysis provides clinical evidence that the modified manufacturing process improved the fever profile across all pediatric age groups, in particular, in children aged <5 years.
Collapse
Affiliation(s)
- Daphne C Sawlwin
- Global Pharmacovigilance and Risk Management, Seqirus Pty Ltd, Parkville, Victoria, Australia.
| | - Alison Graves Jones
- Global Pharmacovigilance and Risk Management, Seqirus Pty Ltd, Parkville, Victoria, Australia.
| | - Frank R Albano
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia.
| |
Collapse
|
6
|
Abstract
Influenza vaccination is recommended for all children 6 months of age and older who do not have contraindications. This article provides an overview of information concerning burden of influenza among children in the United States; US-licensed influenza vaccines; vaccine immunogenicity, effectiveness, and safety; and recent updates relevant to use of these vaccines in pediatric populations. Influenza antiviral medications are discussed. Details concerning vaccine-related topics may be found in the current US Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices recommendations for use of influenza vaccines (https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html). Additional information on influenza antivirals is located at https://www.cdc.gov/flu/professionals/antivirals/index.htm.
Collapse
|
7
|
Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices-United States, 2018-19 Influenza Season. MMWR Recomm Rep 2018; 67:1-20. [PMID: 30141464 PMCID: PMC6107316 DOI: 10.15585/mmwr.rr6703a1] [Citation(s) in RCA: 305] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This report updates the 2017-18 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2017;66[No. RR-2]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2018-19 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent (IIV4) and trivalent (IIV3) formulations. Recombinant influenza vaccine (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations. High-dose inactivated influenza vaccine (HD-IIV3) and adjuvanted inactivated influenza vaccine (aIIV3) will be available in trivalent formulations.Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2017; February 21, 2018; and June 20, 2018. New and updated information in this report includes the following four items. First, vaccine viruses included in the 2018-19 U.S. trivalent influenza vaccines will be an A/Michigan/45/2015 (H1N1)pdm09-like virus, an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus, and a B/Colorado/06/2017-like virus (Victoria lineage). Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013-like virus (Yamagata lineage). Second, recommendations for the use of LAIV4 (FluMist Quadrivalent) have been updated. Following two seasons (2016-17 and 2017-18) during which ACIP recommended that LAIV4 not be used, for the 2018-19 season, vaccination providers may choose to administer any licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). LAIV4 is an option for those for whom it is appropriate. Third, persons with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). Additional recommendations concerning vaccination of egg-allergic persons are discussed. Finally, information on recent licensures and labeling changes is discussed, including expansion of the age indication for Afluria Quadrivalent (IIV4) from ≥18 years to ≥5 years and expansion of the age indication for Fluarix Quadrivalent (IIV4), previously licensed for ≥3 years, to ≥6 months.This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2018-19 season in the United States. A Background Document containing further information and a brief summary of these recommendations are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html.These recommendations apply to U.S.-licensed influenza vaccines used within Food and Drug Administration-licensed indications. Updates and other information are available at CDC's influenza website (https://www.cdc.gov/flu). Vaccination and health care providers should check CDC's influenza website periodically for additional information.
Collapse
Affiliation(s)
- Lisa A. Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Leslie Z. Sokolow
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
- Battelle Memorial Institute, Atlanta, Georgia
| | - Karen R. Broder
- Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | | | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel B. Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| |
Collapse
|
8
|
Statler VA, Albano FR, Airey J, Sawlwin DC, Graves Jones A, Matassa V, Heijnen E, Edelman J, Marshall GS. Immunogenicity and safety of a quadrivalent inactivated influenza vaccine in children 6-59 months of age: A phase 3, randomized, noninferiority study. Vaccine 2018; 37:343-351. [PMID: 30057283 DOI: 10.1016/j.vaccine.2018.07.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/11/2018] [Accepted: 07/15/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND In the Southern Hemisphere 2010 influenza season, Seqirus' split-virion, trivalent inactivated influenza vaccine was associated with increased reports of fevers and febrile reactions in young children. A staged clinical development program of a quadrivalent vaccine (Seqirus IIV4 [S-IIV4]; Afluria® Quadrivalent/Afluria Quad™/Afluria Tetra™), wherein each vaccine strain is split using a higher detergent concentration to reduce lipid content (considered the cause of the increased fevers and febrile reactions), is now complete. METHODS Children aged 6-59 months were randomized 3:1 and stratified by age (6-35 months/36-59 months) to receive S-IIV4 (n = 1684) or a United States (US)-licensed comparator IIV4 (C-IIV4; Fluzone® Quadrivalent; n = 563) during the Northern Hemisphere 2016-2017 influenza season. The primary objective was to demonstrate noninferior immunogenicity of S-IIV4 versus C-IIV4. Immunogenicity was assessed by hemagglutination inhibition (baseline, 28 days postvaccination). Solicited, unsolicited, and serious adverse events were assessed for 7, 28, and 180 days postvaccination, respectively. RESULTS S-IIV4 met the immunogenicity criteria for noninferiority. Adjusted geometric mean titer ratios (C-IIV4/S-IIV4) for the A/H1N1, A/H3N2, B/Yamagata, and B/Victoria strains were 0.79 (95% CI: 0.72, 0.88), 1.27 (1.15, 1.42), 1.12 (1.01, 1.24), and 0.97 (0.86, 1.09), respectively. Corresponding values for differences in seroconversion rates (C-IIV4 minus S-IIV4) were -10.3 (-15.4, -5.1), 2.6 (-2.5, 7.8), 3.1 (-2.1, 8.2), and 0.9 (-4.2, 6.1). Solicited, unsolicited, and serious adverse events were similar between vaccines in both age cohorts, apart from fever. Fever rates were lower with S-IIV4 (5.8%) than C-IIV4 (8.4%), with no febrile convulsions reported with either vaccine during the 7 days postvaccination. CONCLUSION S-IIV4, manufactured with a higher detergent concentration, demonstrated noninferior immunogenicity to the US-licensed C-IIV4, with similar postvaccination safety and tolerability, in children aged 6-59 months. This completes the program demonstrating the immunogenicity and safety of S-IIV4 in participants aged 6 months and older. FUNDING Seqirus Pty Ltd; ClinicalTrials.gov identifier:NCT02914275.
Collapse
Affiliation(s)
- Victoria A Statler
- Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, Louisville, KY, USA
| | - Frank R Albano
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia.
| | - Jolanta Airey
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Daphne C Sawlwin
- Global Pharmacovigilance and Risk Management, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Alison Graves Jones
- Global Pharmacovigilance and Risk Management, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Vince Matassa
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Esther Heijnen
- Clinical Development, Seqirus Netherlands B.V., Amsterdam, The Netherlands
| | | | - Gary S Marshall
- Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, Louisville, KY, USA
| |
Collapse
|