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Lopez P, Bravo L, Buntinx E, Borja-Tabora C, Velasquez H, Rodriquez EJ, Rodriguez CA, Carlos J, Montellano MEB, Alberto ER, Salvani-Bautista M, Huang Y, Hu B, Li P, Han HH, Baccarini C, Smolenov I. Safety and immunogenicity of SCB-2019, an adjuvanted, recombinant SARS-CoV-2 trimeric S-protein subunit COVID-19 vaccine in healthy 12-17 year-old adolescents. Hum Vaccin Immunother 2023:2206359. [PMID: 37226504 DOI: 10.1080/21645515.2023.2206359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
We previously demonstrated the efficacy of the COVID-19 vaccine candidate, SCB-2019, in adults in the SPECTRA phase 2/3 efficacy study. We extended the study to include 1278 healthy 12-17-year-old adolescents in Belgium, Colombia, and the Philippines who received either two doses of SCB-2019 or placebo 21 days apart, to assess immunogenicity as neutralizing antibodies against prototype SARS-CoV-2 and variants of concern, and safety and reactogenicity as solicited and unsolicited adverse events with a comparator group of young adults (18-25 years). In participants with no evidence of prior SARS-CoV-2 infection SCB-2019 immunogenicity in adolescents was non-inferior to that in young adults; respective geometric mean neutralizing titers (GMT) against prototype SARS-CoV-2 14 days after the second vaccination were 271 IU/mL (95% CI: 211-348) and 144 IU/mL (116-178). Most adolescents (1077, 84.3%) had serologic evidence of prior SAR-CoV-2 exposure at baseline; in these seropositive adolescents neutralizing GMTs increased from 173 IU/mL (135-122) to 982 IU/mL (881-1094) after the second dose. Neutralizing titers against Delta and Omicron BA SARS-CoV-2 variants were also increased, most notably in those with prior exposure. SCB-2019 vaccine was well tolerated with generally mild or moderate, transient solicited and unsolicited adverse events that were comparable in adolescent vaccine and placebo groups except for injection site pain - reported after 20% of SCB-2019 and 7.3% of placebo injections. SCB-2019 vaccine was highly immunogenic against SARS-CoV-2 prototype and variants in adolescents, especially in those with evidence of prior exposure, with comparable immunogenicity to young adults. Clinical trial registration: EudraCT 2020-004272-17; ClinicalTrials.gov NCT04672395.
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Affiliation(s)
- Pio Lopez
- Centro de Estudios en Infectología Pediátrica, Universidad Del Valle Clínica Imbanaco, Cali, Colombia
| | - Lulu Bravo
- College of Medicine, University of the Philippines Manila, Ermita, The Philippines
| | | | | | - Hector Velasquez
- Center of Attention in Medical Research (CAIMED), Bogotá, Colombia
| | | | | | - Josefina Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, The Philippines
| | | | | | | | - Yung Huang
- Clover Biopharmaceuticals, Boston, MA, USA
| | - Branda Hu
- Clover Biopharmaceuticals, Boston, MA, USA
| | - Ping Li
- Clover Biopharmaceuticals, Boston, MA, USA
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Buntinx E, Brochado L, Borja-Tabora C, Yu CY, Alberto ER, Montellano MEB, Carlos JC, Toloza LB, Hites M, Siber G, Clemens R, Ambrosino D, Qin H, Chen HL, Han HH, Hu B, Li P, Baccarini C, Smolenov I. Immunogenicity of an adjuvanted SARS-CoV-2 trimeric S-protein subunit vaccine (SCB-2019) in SARS-CoV-2-naïve and exposed individuals in a phase 2/3, double-blind, randomized study. Vaccine 2023; 41:1875-1884. [PMID: 36781334 PMCID: PMC9910015 DOI: 10.1016/j.vaccine.2023.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND We evaluated immunogenicity of SCB-2019, a subunit vaccine candidate containing a pre-fusion trimeric form of the SARS-CoV-2 spike (S)-protein adjuvanted with CpG-1018/alum. METHODS The phase 2/3, double-blind, randomized SPECTRA trial was conducted in five countries in participants aged ≥ 18 years, either SARS-CoV-2-naïve or previously exposed. Participants were randomly assigned to receive two doses of SCB-2019 or placebo administered intramuscularly 21 days apart. In the phase 2 part of the study, on days 1, 22, and 36, neutralizing antibodies were measured by pseudovirus and wild-type virus neutralization assays to SARS-CoV-2 prototype and variants, and ACE2-receptor-binding antibodies and SCB-2019-binding antibodies were measured by ELISA. Cell-mediated immunity was measured by intracellular cytokine staining via flow cytometry. RESULTS 1601 individuals were enrolled between 24 March and 13 September 2021 and received at least one vaccine dose. Immunogenicity analysis was conducted in a phase 2 subset of 691 participants, including 428 SARS-CoV-2-naïve (381 vaccine and 47 placebo recipients) and 263 SARS-CoV-2-exposed (235 vaccine and 28 placebo recipients). In SARS-CoV-2-naïve participants, GMTs of neutralizing antibodies against prototype virus increased 2 weeks post-second dose (day 36) compared to baseline (224 vs 12.7 IU/mL). Seroconversion rate was 82.5 %. In SARS-CoV-2-exposed participants, one SCB-2019 dose increased GMT of neutralizing antibodies by 48.3-fold (1276.1 IU/mL on day 22) compared to baseline. Seroconversion rate was 92.4 %. Increase was marginal post-second dose. SCB-2019 also showed cross-neutralization capability against nine variants, including Omicron, in SARS-CoV-2-exposed participants at day 36. SCB-2019 stimulated Th1-biased cell-mediated immunity to the S-protein in both naïve and exposed participants. The vaccine was well tolerated, no safety concerns were raised from the study. CONCLUSIONS A single dose of SCB-2019 was immunogenic in SARS-CoV-2-exposed individuals, whereas two doses were required to induce immune response in SARS-CoV-2-naïve individuals. SCB-2019 elicited a cross-neutralizing response against emergent SARS-CoV-2 variants at antibody levels associated with clinical protection, underlining its potential as a booster. CLINICALTRIALS gov: NCT04672395; EudraCT: 2020-004272-17.
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Affiliation(s)
| | | | | | - Charles Y. Yu
- De La Salle Medical and Health Sciences Institute, Cavite City, Philippines
| | | | | | - Josefina C. Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Maya Hites
- Clinic of Infectious Diseases, Cliniques universitaires de Bruxelles Hôpital Erasme, Bruxelles, Belgium
| | | | - Ralf Clemens
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | | | | | - Branda Hu
- Clover Biopharmaceuticals, Boston, MA, USA
| | - Ping Li
- Clover Biopharmaceuticals, Boston, MA, USA
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Hosain R, Aquino P, Baccarini C, Smolenov I, Li P, Qin H, Verhoeven C, Hu B, Huang Y, Rubio P. Six-month safety follow-up of an adjuvanted SARS-CoV-2 trimeric S-protein subunit vaccine (SCB-2019) in adults: A phase 2/3, double-blind, randomized study. Vaccine 2023; 41:2253-2260. [PMID: 36868877 PMCID: PMC9915113 DOI: 10.1016/j.vaccine.2023.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND We evaluated the safety of SCB-2019, a protein subunit vaccine candidate containing a recombinant SARS-CoV-2 spike (S) trimer fusion protein, combined with CpG-1018/alum adjuvants. METHODS This ongoing phase 2/3, double-blind, placebo-controlled, randomized trial is being conducted in Belgium, Brazil, Colombia, the Philippines, and South Africa in participants ≥ 12 years of age. Participants were randomly assigned to receive 2 doses of SCB-2019 or placebo administered intramuscularly 21 days apart. Here, we present the safety results of SCB-2019 over the 6-month period following 2-dose primary vaccination series in all adult participants (≥18 years of age). RESULTS A total of 30,137 adult participants received at least one dose of study vaccine (n = 15,070) or placebo (n = 15,067) between 24 March 2021 and 01 December 2021. Unsolicited adverse events, medically-attended adverse events, adverse events of special interest, and serious adverse events were reported in similar frequencies in both study arms over the 6-month follow-up period. Vaccine-related SAEs were reported by 4 of 15,070 SCB-2019 recipients (hypersensitivity reactions in two participants, Bell's palsy, and spontaneous abortion) and 2 of 15,067 placebo recipients (COVID-19, pneumonia, and acute respiratory distress syndrome in one participant and spontaneous abortion in the other one). No signs of vaccine-associated enhanced disease were observed. CONCLUSIONS SCB-2019 administered as a 2-dose series has an acceptable safety profile. No safety concerns were identified during the 6-month follow-up after the primary vaccination. CLINICAL TRIALS REGISTRATION NCT04672395; EudraCT: 2020-004272-17.
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Affiliation(s)
| | | | | | | | - Ping Li
- Clover Biopharmaceuticals, Boston, MA, USA
| | | | | | - Branda Hu
- Clover Biopharmaceuticals, Boston, MA, USA
| | - Yung Huang
- Clover Biopharmaceuticals, Boston, MA, USA
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- Clover Biopharmaceuticals, Boston, MA, USA
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Smolenov I, Han HH, Li P, Baccarini C, Verhoeven C, Rockhold F, Clemens SAC, Ambrosino D, Richmond P, Siber G, Liang J, Clemens R. Impact of previous exposure to SARS-CoV-2 and of S-Trimer (SCB-2019) COVID-19 vaccination on the risk of reinfection: a randomised, double-blinded, placebo-controlled, phase 2 and 3 trial. Lancet Infect Dis 2022; 22:990-1001. [PMID: 35447085 PMCID: PMC9015644 DOI: 10.1016/s1473-3099(22)00144-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/04/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022]
Abstract
Background We previously reported the efficacy of the adjuvanted-protein COVID-19 vaccine candidate S-Trimer (SCB-2019) in adults who showed no evidence of previous exposure to SARS-CoV-2. In this study, we aimed to investigate the extent of protection afforded by previous exposure to SARS-CoV-2 on subsequent COVID-19 infection, as well as the efficacy, safety, and reactogenicity of SCB-2019 in participants who were enrolled in the Study evaluating Protective-Efficacy and safety of Clover's Trimeric Recombinant protein-based and Adjuvanted COVID-19 vaccine (SPECTRA) trial who had already been exposed to SARS-CoV-2 before vaccination. Methods In a phase 2 and 3 multicentre, double-blind, randomised, placebo-controlled trial (SPECTRA) done at 31 sites in five countries, participants were randomly assigned 1:1 using the Cenduit Interactive Response Technology system (IQVIA, Durham, NC, USA), with a block size of six, to receive two doses of either SCB-2019 or placebo 21 days apart. The primary outcomes of the SPECTRA trial were vaccine efficacy, measured by real-time PCR (rtPCR)-confirmed COVID-19 of any severity, with onset from 14 days after the second vaccine dose, as well as the safety and solicited local and systemic adverse events in the phase 2 subset. Here, we present secondary analyses to calculate the protective efficacy due to previous exposure to SARS-CoV-2 against reinfection with COVID-19 according to severity in SPECTRA participants who had evidence of exposure to SARS-CoV-2 at baseline, including efficacy against identified viral variants, as well as efficacy of SCB-2019 vaccination in this population. Findings We enrolled 30 174 participants between March 24, 2021, and Aug 10, 2021. In the 14 670 participants who were randomly assigned to receive placebo, there were 418 (2·8%) confirmed cases of COVID-19; 65 (0·9%) of 7339 SARS-CoV-2-exposed participants, and 353 (4·8%) of 7331 SARS-CoV-2-naive participants (attack rates of 5·5 cases per 100 person-years for SARS-CoV-2-exposed participants and 32·4 cases per 100 person-years for SARS-CoV-2-naive participants). Protective efficacy due to previous exposure to SARS-CoV-2 was 83·2% (95% CI 78·0–87·3) against any COVID-19, 92·5% (82·9–97·3) against moderate-to-severe COVID-19, and 100% (59·3–100) against severe COVID-19; no SARS-CoV-2-exposed participants had hospitalisation associated with COVID-19. Protective efficacy against variants were 100% for alpha (B.1.1.7) and lambda (C.37) variants, 88·6% (14·9–99·7) for B.1.623, 93·6% (80·1–98·7) for gamma (P.1), and 92·4% (81·2–97·6) for mu (B.1.621) variants, and lowest against beta (B.1.351; 72·2% [33·1–89·9]) and delta (B.1.617.2; 77·2% [61·3–87·2]) variants. In addition, one dose of SCB-2019 had 49·9% (1·5–75·6) efficacy against any symptomatic COVID-19, and two doses had 64·2% (26·5–83·8) efficacy. SCB-2019 was well tolerated in SARS-CoV-2-exposed participants, but was associated with higher rates of injection site pain (89 [33·8%] of 263 participants) than placebo (16 [6·7%] of 239 participants). Rates of solicited systemic adverse events, severe adverse events, and serious adverse events were similar between vaccine and placebo groups, and with rates in SARS-CoV-2-naive vaccine recipients. Interpretation Previous exposure to SARS-CoV-2 decreased the risk and severity of subsequent COVID-19 infection, even against newly emerging variants. Protection is further enhanced by one or two doses of SCB-2019. Funding Clover Biopharmaceuticals, The Coalition for Epidemic Preparedness Innovations (CEPI).
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Affiliation(s)
| | | | - Ping Li
- Clover Biopharmaceuticals, Cambridge, MA, USA
| | | | | | - Frank Rockhold
- Duke University Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | | | | | - Peter Richmond
- Division of Paediatrics, University of Western Australia, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth Children's Hospital, Perth, WA, Australia
| | | | | | - Ralf Clemens
- International Vaccine Institute, Seoul, Republic of Korea.
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Bravo L, Smolenov I, Han HH, Li P, Hosain R, Rockhold F, Clemens SAC, Roa C, Borja-Tabora C, Quinsaat A, Lopez P, López-Medina E, Brochado L, Hernández EA, Reynales H, Medina T, Velasquez H, Toloza LB, Rodriguez EJ, de Salazar DIM, Rodríguez CA, Sprinz E, Cerbino-Neto J, Luz KG, Schwarzbold AV, Paiva MS, Carlos J, Montellano MEB, de Los Reyes MRA, Yu CY, Alberto ER, Panaligan MM, Salvani-Bautista M, Buntinx E, Hites M, Martinot JB, Bhorat QE, Badat A, Baccarini C, Hu B, Jurgens J, Engelbrecht J, Ambrosino D, Richmond P, Siber G, Liang J, Clemens R. Efficacy of the adjuvanted subunit protein COVID-19 vaccine, SCB-2019: a phase 2 and 3 multicentre, double-blind, randomised, placebo-controlled trial. Lancet 2022; 399:461-472. [PMID: 35065705 PMCID: PMC8776284 DOI: 10.1016/s0140-6736(22)00055-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/05/2021] [Accepted: 12/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND A range of safe and effective vaccines against SARS CoV 2 are needed to address the COVID 19 pandemic. We aimed to assess the safety and efficacy of the COVID-19 vaccine SCB-2019. METHODS This ongoing phase 2 and 3 double-blind, placebo-controlled trial was done in adults aged 18 years and older who were in good health or with a stable chronic health condition, at 31 sites in five countries (Belgium, Brazil, Colombia, Philippines, and South Africa). The participants were randomly assigned 1:1 using a centralised internet randomisation system to receive two 0·5 mL intramuscular doses of SCB-2019 (30 μg, adjuvanted with 1·50 mg CpG-1018 and 0·75 mg alum) or placebo (0·9% sodium chloride for injection supplied in 10 mL ampoules) 21 days apart. All study staff and participants were masked, but vaccine administrators were not. Primary endpoints were vaccine efficacy, measured by RT-PCR-confirmed COVID-19 of any severity with onset from 14 days after the second dose in baseline SARS-CoV-2 seronegative participants (the per-protocol population), and the safety and solicited local and systemic adverse events in the phase 2 subset. This study is registered on EudraCT (2020-004272-17) and ClinicalTrials.gov (NCT04672395). FINDINGS 30 174 participants were enrolled from March 24, 2021, until the cutoff date of Aug 10, 2021, of whom 30 128 received their first assigned vaccine (n=15 064) or a placebo injection (n=15 064). The per-protocol population consisted of 12 355 baseline SARS-CoV-2-naive participants (6251 vaccinees and 6104 placebo recipients). Most exclusions (13 389 [44·4%]) were because of seropositivity at baseline. There were 207 confirmed per-protocol cases of COVID-19 at 14 days after the second dose, 52 vaccinees versus 155 placebo recipients, and an overall vaccine efficacy against any severity COVID-19 of 67·2% (95·72% CI 54·3-76·8), 83·7% (97·86% CI 55·9-95·4) against moderate-to-severe COVID-19, and 100% (97·86% CI 25·3-100·0) against severe COVID-19. All COVID-19 cases were due to virus variants; vaccine efficacy against any severity COVID-19 due to the three predominant variants was 78·7% (95% CI 57·3-90·4) for delta, 91·8% (44·9-99·8) for gamma, and 58·6% (13·3-81·5) for mu. No safety issues emerged in the follow-up period for the efficacy analysis (median of 82 days [IQR 63-103]). The vaccine elicited higher rates of mainly mild-to-moderate injection site pain than the placebo after the first (35·7% [287 of 803] vs 10·3% [81 of 786]) and second (26·9% [189 of 702] vs 7·4% [52 of 699]) doses, but the rates of other solicited local and systemic adverse events were similar between the groups. INTERPRETATION Two doses of SCB-2019 vaccine plus CpG and alum provides notable protection against the entire severity spectrum of COVID-19 caused by circulating SAR-CoV-2 viruses, including the predominating delta variant. FUNDING Clover Biopharmaceuticals and the Coalition for Epidemic Preparedness Innovations.
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Affiliation(s)
- Lulu Bravo
- University of the Philippines Manila, Ermita, Manila, Philippines
| | | | | | - Ping Li
- Clover Biopharmaceuticals, Cambridge, MA, USA
| | | | - Frank Rockhold
- Duke University Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | | | - Camilo Roa
- Manila Doctors Hospital, Manila, Philippines
| | | | | | - Pio Lopez
- Centro de Estudios en Infectología Pediátrica, Universidad Del Valle Clínica Imbanaco, Cali, Colombia
| | - Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica, Universidad Del Valle Clínica Imbanaco, Cali, Colombia
| | | | | | | | - Tatiana Medina
- Center of Attention in Medical Research, Bogotá, Colombia
| | | | | | | | | | | | - Eduardo Sprinz
- Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Maria Sanali Paiva
- Atena Institute of Clinical Research, Rio Grande do Norte, Natal, Brazil
| | - Josefina Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | | | - Charles Y Yu
- De La Salle Medical and Health Sciences Institute, Cavite City, Philippines
| | | | - Mario M Panaligan
- Infection Control Service, St Luke's Medical Center, Taguig, Philippines
| | | | | | - Maya Hites
- Clinic of Infectious Diseases, CUB-Hôpital Erasme, Bruxelles, Belgium
| | - Jean-Benoit Martinot
- Pulmonology Department, CHU Universite Catholique de Louvain Namur Site Sainte-Elisabeth, Namur, Belgium
| | - Qasim E Bhorat
- Soweto Clinical Trials Centre, Johannesburg, South Africa
| | - Aysha Badat
- Wits Clinical Research, Soweto, Johannesburg, South Africa
| | | | - Branda Hu
- Clover Biopharmaceuticals, Cambridge, MA, USA
| | - Jaco Jurgens
- DJW Research, Noordheuwel, Krugersdorp, Gauteng, South Africa
| | - Jan Engelbrecht
- Dr JM Engelbrecht Trial Site, Vergelegen Mediclinic, Western Cape, South Africa
| | | | - Peter Richmond
- Division of Paediatrics, University of Western Australia, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute and Perth Children's Hospital, Perth, WA, Australia
| | | | | | - Ralf Clemens
- Global Research in Infectious Diseases, Rio de Janeiro, Brazil.
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Simon MW, Brandon D, Christensen S, Baccarini C, Jordanov E, Dhingra MS. 2724. Safety and Immunogenicity of a Quadrivalent Meningococcal Conjugate Vaccine (MenACYW-TT) Administered in Healthy Meningococcal Vaccine-Naïve Children (2–9 Years). Open Forum Infect Dis 2019. [PMCID: PMC6809978 DOI: 10.1093/ofid/ofz360.2401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background MenACYW-TT is an investigational quadrivalent meningococcal conjugate vaccine that contains tetanus toxoid as carrier protein. The vaccine is intended for global use in individuals 6 weeks of age and older. We evaluated the safety and immunogenicity of MenACYW-TT compared with a licensed quadrivalent conjugate meningococcal vaccine (MenACWY-CRM [Menveo®]) in US children 2–9 years of age. Methods In a modified double-blind Phase III study (NCT03077438), 1000 children were randomized to receive one dose of either MenACYW-TT vaccine or MenACWY-CRM vaccine. Serum bactericidal assays with human (hSBA) and baby rabbit (rSBA) complement were used to measure antibodies against representative meningococcal serogroup strains at baseline and 30 days after vaccination. Safety data were collected up to 6 months post-vaccination. Results Non-inferiority of immune responses for all four serogroups, based on percentages of participants achieving hSBA vaccine seroresponse, was demonstrated for MenACYW-TT compared with MenACWY-CRM at Day 30 compared with baseline. The proportions of individuals with hSBA titers ≥ 1:8 following MenACYW-TT administration were higher than those after MenACWY-CRM administration for all four serogroups (A: 86.4% vs 79.3%; C: 97.8% vs 67.1%; W: 94.8% vs 86.3%; Y: 98.5% vs 90.8%). Similar results were observed in two age substrata (2 to 5 years and 6 to 9 years). Percentages of participants with post-vaccination rSBA titers ≥ 1:128 were comparable between both groups. The safety profiles of MenACYW-TT and MenACWY-CRM were comparable. Reactogenicity at the MenACYW-TT injection site was lower than at the MenACWY-CRM injection site. There were no immediate adverse events (AEs), no AEs leading to study discontinuation, and no vaccine-related serious adverse events reported in the study. Conclusion MenACYW-TT vaccine was well tolerated and demonstrated a non-inferior immune response compared with that for the licensed MenACWY-CRM vaccine when administered as a single dose to meningococcal vaccine-naïve children. Disclosures All authors: No reported disclosures.
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Affiliation(s)
| | | | - Shane Christensen
- J. Lewis Research, Inc., Foothill Family Clinic South, Salt Lake City, Utah
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Klein NP, Abu-Elyazeed R, Povey M, Macias Parra M, Diez-Domingo J, Ahonen A, Korhonen T, Tinoco JC, Weiner L, Marshall GS, Silas PE, Sarpong KO, Ramsey KP, Fling JA, Speicher D, Campos M, Munjal I, Peltier C, Vesikari T, Baccarini C, Caplanusi A, Gillard P, Carryn S, Henry O. Immunogenicity and Safety of a Measles-Mumps-Rubella Vaccine Administered as a First Dose to Children Aged 12 to 15 Months: A Phase III, Randomized, Noninferiority, Lot-to-Lot Consistency Study. J Pediatric Infect Dis Soc 2019; 9:194-201. [PMID: 30849175 PMCID: PMC7192400 DOI: 10.1093/jpids/piz010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 01/18/2019] [Accepted: 02/28/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND MMR II (M-M-R II [Merck & Co, Inc.]) is currently the only measles, mumps, and rubella (MMR) vaccine licensed in the United States. A second MMR vaccine would mitigate the potential risk of vaccine supply shortage or delay. In this study, we assessed the immunogenicity and safety of another MMR vaccine (MMR-RIT [Priorix, GlaxoSmithKline]) compared with those of the MMR II in 12- to 15-month-old children who received it as a first dose. METHODS In this phase III, observer-blinded, noninferiority, lot-to-lot consistency clinical trial (ClinicalTrials.gov identifier NCT01702428), 5003 healthy children were randomly assigned to receive 1 dose of MMR-RIT (1 of 3 production lots) or MMR II along with other age-recommended routine vaccines. We evaluated the immunogenicity of all vaccines in terms of antibody concentrations (by using an enzyme-linked immunosorbent assay or electrochemiluminescence assay) and/or seroresponse rates 43 days after vaccination. We also assessed the reactogenicity and safety of the vaccines. RESULTS Immunoresponses after vaccination with MMR-RIT were robust and noninferior to those after vaccination with the MMR II. Immunogenicity of the 3 production lots of MMR-RIT was consistent; more than 97% of the children had a seroresponse to MMR components. The coadministered vaccines elicited similar immunoresponses in the MMR-RIT and MMR II groups. Both MMR vaccines resulted in comparable reactogenicity profiles, and no safety concerns were detected. CONCLUSIONS If licensed, the MMR-RIT could provide a valid option for the prevention of measles, mumps, and rubella in children in the United States and would reduce potential risks of a vaccine shortage.
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Affiliation(s)
- Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, California,Correspondence: N. P. Klein, Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16th Floor, Oakland, CA 94612 ()
| | | | | | - Mercedes Macias Parra
- Department of Infectious Diseases, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Javier Diez-Domingo
- Fundacion para el Fomento de la Investigacion Sanitaria y Biomedica (FISABIO-Public Health), Valencia, Spain
| | - Anitta Ahonen
- Vaccine Research Center, University of Tampere, Finland
| | | | | | - Leonard Weiner
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York
| | - Gary S Marshall
- Department of Pediatrics, University of Louisville School of Medicine, Kentucky
| | | | - Kwabena O Sarpong
- Sealy Center for Vaccine Development, University of Texas, Galveston
| | | | - John A Fling
- Department of Pediatrics, University of North Texas Health Science Centre, Fort Worth
| | - David Speicher
- Pediatric Pulmonary Division, Rainbow Babies and Children’s Hospital, Cleveland, Ohio
| | - Maribel Campos
- Puerto Rico Clinical and Translational Research Consortium, San Juan
| | - Iona Munjal
- Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, New York
| | - Christopher Peltier
- Department of Pediatrics, University of Cincinnati College of Medicine and Pediatric Associates of Mt. Carmel, Inc, Ohio
| | - Timo Vesikari
- Vaccine Research Center, University of Tampere, Finland
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Faust SN, Le Roy M, Pancharoen C, Weber MAR, Cathie K, Behre U, Bernatoniene J, Snape MD, Helm K, Medina Pech CE, Henry O, Baccarini C, Povey M, Gillard P. Safety and immunogenicity of a varicella vaccine without human serum albumin (HSA) versus a HSA-containing formulation administered in the second year of life: a phase III, double-blind, randomized study. BMC Pediatr 2019; 19:50. [PMID: 30732648 PMCID: PMC6366055 DOI: 10.1186/s12887-019-1425-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/31/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A new formulation of the live-attenuated varicella vaccine Varilrix (GSK) produced without human serum albumin (HSA) was developed to minimize a theoretical risk of transmission of infectious diseases. A previous study showed that the vaccine was immunologically non-inferior to the HSA-containing vaccine and well-tolerated in toddlers; low-grade fever was numerically higher in children receiving the vaccine without HSA, but the study lacked power to conclude on this difference. METHODS In this phase III, double-blind, multi-center study, healthy 12-23-month-olds were randomized (1:1) to receive two doses of the varicella vaccine without (Var-HSA group) or with HSA (Var + HSA group) at days 0 and 42. The primary objective compared safety of the vaccines in terms of incidence of fever > 39.0 °C in the 15-day period post-first vaccination. The objective was considered met if the upper limit of the 95% confidence interval for the between-group difference in the incidence of fever > 39.0 °C was ≤5% (Var-HSA group minus Var + HSA group). Safety, reactogenicity and immune responses were evaluated. RESULTS Six hundred fifteen children in the Var-HSA group and 616 in the Var + HSA group received ≥1 vaccination. Fever > 39.0 °C was reported in 3.9 and 5.2% of participants in the Var-HSA and Var + HSA groups, with a between-group difference of - 1.29 (95% confidence interval: - 3.72-1.08); therefore, the primary objective was achieved. Fever rates post-each dose and the incidence of solicited local and general adverse events (AEs) were comparable between groups. Unsolicited AEs were reported for 43.9 and 36.5% of children in the Var-HSA group and 45.8 and 36.0% of children in the Var + HSA group, during 43 days post-dose 1 and 2, respectively. Serious AEs occurred in 2.1% (group Var-HSA) and 2.4% (group Var + HSA) of children, throughout the study. In a sub-cohort of 364 children, all had anti-varicella-zoster virus antibody concentrations ≥50 mIU/mL post-dose 2; comparable geometric mean concentrations were observed between the groups. CONCLUSIONS The varicella vaccine formulated without HSA did not induce higher rates of fever during the 15 day-post-vaccination period, as compared with the original HSA-containing vaccine. The two vaccines displayed similar safety and immunogenicity profiles in toddlers. TRIAL REGISTRATION NCT02570126 , registered on 5 October 2015 (www.clinicaltrials.gov).
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Affiliation(s)
- Saul N Faust
- NIHR Southampton Clinical Research Facility, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.
| | | | - Chitsanu Pancharoen
- Department of Pediatrics and Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand
| | - Miguel Angel Rodriguez Weber
- Instituto Nacional de Pediatria, Insurgentes Sur 3700C Col. Insurgentes Cuicuilco, Coyoacan, 04530, Mexico City, Mexico
| | - Katrina Cathie
- NIHR Southampton Clinical Research Facility, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Ulrich Behre
- Private Practice, Hauptstrasse 240, 77694, Kehl, Germany
| | - Jolanta Bernatoniene
- Pediatric Infectious Disease Department, Education Centre Level 6, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8AE, UK
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Headington, Oxford, OX3 9DU, UK
| | - Klaus Helm
- Private practice, Paulinenstrasse 71a, 32756, Detmold, Germany
| | - Carlos Eduardo Medina Pech
- Medical Care and Research SA de CV, Calle 32 No. 217 Col. Garcia Gineres, 97070, Mérida, Yucatán, Mexico
| | - Ouzama Henry
- GSK, 14200 Shady Grove Rd, Rockville, MD, 20850, USA
| | - Carmen Baccarini
- GSK at the time of study conduct, 160 North Gulph Road, King of Prussia, PA, 19406, USA
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Berry AA, Abu-Elyazeed R, Diaz-Perez C, Mufson MA, Harrison CJ, Leonardi M, Twiggs JD, Peltier C, Grogg S, Carbayo A, Shapiro S, Povey M, Baccarini C, Innis BL, Henry O. Two-year antibody persistence in children vaccinated at 12-15 months with a measles-mumps-rubella virus vaccine without human serum albumin. Hum Vaccin Immunother 2017; 13:1516-1522. [PMID: 28481690 PMCID: PMC5512763 DOI: 10.1080/21645515.2017.1309486] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
One combined measles-mumps-rubella (MMR) vaccine without Human Serum Albumin (HSA) is currently licensed in the USA (M-M-R II; Merck, USA) and another has been developed (Priorix™ [MMR-RIT, GSK, Belgium]). In this follow-up study, children from USA or Puerto Rico, who had received one dose of M-M-R II or MMR-RIT at 12-15 months of age in the primary study (NCT00861744), were followed-up for 2 y post-vaccination. Anti-measles and anti-rubella antibodies were measured using Enzyme-Linked Immunosorbent Assay (ELISA), and anti-mumps antibodies using ELISA and plaque reduction neutralization (PRN) assays. Serious adverse events (SAEs) were recorded during the entire follow-up. The according-to-protocol (ATP) persistence cohort included 752 children (M-M-R II = 186, MMR-RIT = 566), who received primary vaccination at a mean age of 12.3 ( ± 0.67) months. 104 children were revaccinated with MMR-containing vaccines; therefore, serology results for timepoints after revaccination were excluded from the analysis. Seropositivity for measles (Year 1≥ 98.3%; Year 2≥ 99.4%) and rubella (Year 1≥ 98.9%; Year 2 = 100%) remained as high at Year 2 as at Day 42. Similarly, seropositivity for mumps determined by ELISA (Year 1≥ 90.1%; Year 2≥ 94.1%) and PRN assays (Year 1≥ 87.5%; Year 2≥ 91.7%) persisted. Thirty-three SAEs were recorded in 23 children; 2 SAEs (inguinal adenitis and idiopathic thrombocytopenic purpura) and one SAE (febrile convulsion) were considered as potentially related to MMR-RIT and M-M-R II, respectively. This study showed that antibodies against measles, mumps and rubella persisted for up to 2 y post-vaccination with either MMR vaccine in children aged 12-15 months, and that both vaccines were well-tolerated during the follow-up period.
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Affiliation(s)
- Andrea A Berry
- a Center for Vaccine Development , Institute for Global Health, University of Maryland School of Medicine , Baltimore , MD , USA
| | | | - Clemente Diaz-Perez
- c School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan PR , Puerto Rico
| | - Maurice A Mufson
- d Joan C. Edwards School of Medicine, Marshall University , Huntington , WV , USA
| | - Christopher J Harrison
- e Children's Mercy Hospital and Clinics, and University of Missouri at Kansas City , Kansas City , MO , USA
| | | | | | | | - Stanley Grogg
- i Oklahoma State University, Center for Health Sciences , Tulsa , OK , USA
| | - Antonio Carbayo
- j Full Health University Medical Clinic , Santa Ana , CA , USA
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Henry O, Klein NP, Povey M, Parra MM, Diez-Domingo J, Ahonen A, Abu-Elyazeed R, Korhonen T, Tinoco JC, Weiner L, Marshall GS, Silas PE, Sarpong KO, Ramsey KP, Fling JA, Speicher D, Campos M, Munjal I, Peltier C, Vesikari T, Baccarini C, Innis BL, Carryn S. A Randomized, Consistency Study Comparing Immunogenicity and Safety of 2 Vaccines Against Measles, Mumps and Rubella (MMR) Administered to Children 12–15 Months of Age. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw194.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | - Javier Diez-Domingo
- Vaccine Research Unit, Fundación para el Fomento de la Investigación Sanitaria y Biomédica, Valencia, Spain
| | | | | | | | | | | | - Gary S. Marshall
- University of Louisville School of Medicine, Louisville, Kentucky
| | | | | | | | - John A. Fling
- University of North Texas Health Science Centre, Fort Worth, Texas
| | | | - Maribel Campos
- Puerto Rico Clinical and Translational Research Consortium, San Juan, Puerto Rico
| | - Iona Munjal
- Pediatric Infectious Disease, The Children's Hospital at Montefiore, Bronx, New York
| | | | - Timo Vesikari
- Vaccine Research Center, University of Tampere, Tampere, Finland
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Leonardi M, Latiolais T, Sarpong K, Simon M, Twiggs J, Lei P, Rinderknecht S, Blatter M, Bianco V, Baine Y, Friedland LR, Baccarini C, Miller JM. Immunogenicity and reactogenicity of Infanrix™ when co-administered with meningococcal MenACWY-TT conjugate vaccine in toddlers primed with MenHibrix™ and Pediarix™. Vaccine 2015; 33:924-32. [DOI: 10.1016/j.vaccine.2014.09.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/21/2014] [Accepted: 09/16/2014] [Indexed: 01/24/2023]
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Baxter R, Baine Y, Kolhe D, Baccarini C, Miller JM, Van Der Wielen M. 10865-year Antibody Persistence and Booster Response to a Meningococcal ACWY Tetanus Toxoid Conjugate Vaccine in Healthy Adolescents and Young Adults. Open Forum Infect Dis 2014. [DOI: 10.1093/ofid/ofu052.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Roger Baxter
- Kaiser Permanente Vaccine Study Center, Oakland, CA
| | - Yaela Baine
- GlaxoSmithKline Vaccines, King of Prussia, PA
| | - Devayani Kolhe
- GlaxoSmithKline Pharmaceuticals India Ltd., Bangalore, India
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Baccarini C, Ternouth A, Wieffer H, Vyse A. Reply Letter. Hum Vaccin Immunother 2013; 9:1325. [PMID: 23563056 PMCID: PMC3901825 DOI: 10.4161/hv.24087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Baccarini C, Ternouth A, Wieffer H, Vyse A. The changing epidemiology of meningococcal disease in North America 1945-2010. Hum Vaccin Immunother 2013; 9:162-71. [PMID: 23108355 PMCID: PMC3667932 DOI: 10.4161/hv.22302] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 09/05/2012] [Accepted: 09/20/2012] [Indexed: 01/23/2023] Open
Abstract
The epidemiology of Invasive Meningococcal Disease (IMD) is distinct in the United States and Canada compared with other countries. This review describes the incidence, mortality and vaccination strategies relevant to IMD in these countries over the past 65 y. The incidence of IMD has remained consistently low in both countries during this period. Serogroup B and serogroup C have been the most prominent disease-causing serogroups. Notably, serogroup Y has recently become an important cause of IMD in the USA, but has not been as prominent in Canada. Periodic rises in incidence have been characterized by local outbreaks that have raised public concern, especially those caused by serogroup C in Canada, and serogroup B in the USA. Case fatality rates have remained consistent at around 10-20%, but vary by age and serogroup. Recent outbreaks have led to the introduction of vaccination programs for both outbreak control and routine immunization.
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Hartanto VH, DiPiazza D, Ankem MK, Baccarini C, Lobby NJ. Comparison of recovery from postoperative pain utilizing two sling techniques. Can J Urol 2003; 10:1759-63. [PMID: 12625855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PURPOSE Bone anchors are used for suture fixation in a wide variety of reconstructive surgeries. They have been in use for pelvic floor reconstruction since 1992. Bone anchors provide a stable point of suture fixation in order to avoid tying over the mobile rectus fascia. The purpose of this study was to compare two sling techniques that utilize bone anchors with respect to recovery from postoperative pain, complete continence, operative time, and length of hospital stay. MATERIALS AND METHODS A total of 64 women (mean age = 57) were treated for stress urinary incontinence secondary to intrinsic sphincter deficiency or hypermobility between March 1998 to August 2000. Group I (SPWS) consisted of 30 patients who underwent insitu vaginal wall sling with suprapubic placement of bone anchors in the pubic tubercle utilizing the Vesica system. Group II (TVCS) consisted of 34 patients who underwent cadaveric fascia sling with transvaginal placement of bone anchors behind the symphysis pubis utilizing the Precision-TAC system. Phone interviews were conducted by a third party who was blinded to the details of the surgical technique, to assess pain at various postoperative times as well as current level of continence. The pain assessment was done using the Verbal Pain Assessment Scale (VAS). Complete continence was defined as dryness with no pad use. RESULTS Significant differences were discovered in both days to pain free state and operative time. No other differences were detected in continence or length of hospital stay. Based on the VAS, a pain free state was achieved for the TVCS group in 1.33 days and for the SPWS group in 9.7 days with p=0.00043. Mean operative time for the SPWS group was 96.9 minutes for the sling alone and 106.7 minutes when combined with cystocele repair. Mean operative time for the TVCS group was 75.36 minutes for the sling alone and 98.11 minutes when combined with cystocele repair. No patient in either group developed osteomyelitis, osteitis pubis, removal of the bone anchors for any reason, nor sling erosion. Seventy percent and 83.3% patients were completely dry (mean follow-up 12.5 months, range 3-30 months) in the SPWS and TVCS group, respectively. CONCLUSION A pain free state is achieved faster in patients undergoing transvaginal placement of bone anchors compared to bone anchors placed suprapubically. Bone anchors used in sling procedures are safe and achieve acceptable short term continence rates.
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Affiliation(s)
- Victor H Hartanto
- Department of Surgery, Division of Urology, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey, USA
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