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Evaluating the Infectivity, Safety, and Immunogenicity of a Respiratory Syncytial Virus Vaccine (RSV 6120/∆NS2/1030s) in RSV-Seropositive Children and RSV-Seronegative Infants and Children

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ClinicalTrials.gov Identifier: NCT03387137
Recruitment Status : Recruiting
First Posted : December 29, 2017
Last Update Posted : December 29, 2017
Sponsor:
Information provided by (Responsible Party):

Study Description
Brief Summary:
The purpose of this study is to evaluate the infectivity, safety, and immunogenicity of a single dose of a recombinant, live-attenuated respiratory syncytial virus (RSV) vaccine (RSV 6120/∆NS2/1030s) in RSV-seropositive children 12 to 59 months of age and RSV-seronegative infants and children 6 to 24 months of age.

Condition or disease Intervention/treatment Phase
RSV Infection Biological: RSV 6120/∆NS2/1030s Biological: Placebo Phase 1

Detailed Description:

This study will evaluate the infectivity, safety, and immunogenicity of a single dose of a recombinant, live-attenuated RSV vaccine (RSV 6120/∆NS2/1030s) in RSV-seropositive children 12 to 59 months of age and RSV-seronegative infants and children 6 to 24 months of age.

The vaccine will be evaluated in a stepwise fashion beginning in RSV-seropositive children (Group 1), and then in RSV-seronegative infants and children (Group 2). In each group, participants will be randomly assigned to receive a single dose of RSV 6120/∆NS2/1030s vaccine or placebo at study entry (Day 0).

Participants will be enrolled in the study between April 1 and October 31, outside of the RSV season. Group 1 (RSV-seropositive children) will be followed for 28 days. Group 2 (RSV-seronegative infants and children) will remain on study until they complete the post-RSV season visit between April 1 and April 30 in the calendar year following enrollment.

The expected initial study duration will be 28 days for Group 1 participants and between 6 and 13 months for Group 2 participants, depending on when they enroll in the study. Group 2 participants may participate in an optional second season of RSV surveillance during November to March of the second year following enrollment. The expected study duration for these Group 2 participants will be up to 25 months.

Study visits for all participants may include clinical assessments, blood collection, and nasal washes. Additionally, participants' parents or guardians will be contacted by study staff at various times during the study to monitor participants' health.


Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 45 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Phase I Placebo-Controlled Study of the Infectivity, Safety and Immunogenicity of a Single Dose of a Recombinant Live-Attenuated Respiratory Syncytial Virus Vaccine, RSV 6120/∆NS2/1030s, Lot RSV#012A, Delivered as Nose Drops to RSV-Seropositive Children 12 to 59 Months of Age and RSV-Seronegative Infants and Children 6 to 24 Months of Age
Actual Study Start Date : October 13, 2017
Estimated Primary Completion Date : December 26, 2019
Estimated Study Completion Date : April 30, 2021
Arms and Interventions

Arm Intervention/treatment
Experimental: Group 1: RSV 6120/∆NS2/1030s Vaccine
RSV-seropositive children will receive a single dose of 10^5.7 plaque-forming units (PFUs) of RSV 6120/∆NS2/1030s vaccine at study entry (Day 0).
Biological: RSV 6120/∆NS2/1030s
Delivered as nose drops
Placebo Comparator: Group 1: Placebo
RSV-seropositive children will receive a single dose of placebo at study entry (Day 0).
Biological: Placebo
Delivered as nose drops
Experimental: Group 2: RSV 6120/∆NS2/1030s Vaccine
RSV-seronegative infants and children will receive a single dose of 10^5.0 PFUs of RSV 6120/∆NS2/1030s vaccine at study entry (Day 0).
Biological: RSV 6120/∆NS2/1030s
Delivered as nose drops
Placebo Comparator: Group 2: Placebo
RSV-seronegative infants and children will receive a single dose of placebo at study entry (Day 0).
Biological: Placebo
Delivered as nose drops


Outcome Measures

Primary Outcome Measures :
  1. Grades of study product-related solicited adverse events (AEs) (RSV-seropositive participants) [ Time Frame: Measured through Day 10 ]
    Assessed by protocol-determined grading system

  2. Grades of study product-related solicited AEs (RSV-seronegative participants) [ Time Frame: Measured through Day 28 ]
    Assessed by protocol-determined grading system

  3. Grades of study product-related unsolicited AEs (RSV-seropositive participants) [ Time Frame: Measured through Day 10 ]
    Assessed by protocol-determined grading system

  4. Grades of study product-related unsolicited AEs (RSV-seronegative participants) [ Time Frame: Measured through Day 28 ]
    Assessed by protocol-determined grading system

  5. Grades of study product-related serious adverse events (SAEs) (RSV-seropositive participants) [ Time Frame: Measured through Day 28 ]
    Assessed by protocol-determined grading system

  6. Grades of study product-related SAEs (RSV-seronegative participants) [ Time Frame: Measured through Day 56 ]
    Assessed by protocol-determined grading system

  7. Frequency of infection with RSV (RSV-seropositive subjects) [ Time Frame: Measured through Day 28 ]
    As defined as 1) vaccine virus identified in a nasal wash (a binary outcome based on nasal washes done throughout the study period; Day 0 nasal wash will be counted as baseline) or 2) a greater than or equal to 4-fold rise in RSV neutralizing antibody titer

  8. Frequency of infection with RSV (RSV-seronegative subjects) [ Time Frame: Measured through Day 56 ]
    As defined as 1) vaccine virus identified in a nasal wash (a binary outcome based on nasal washes done throughout the study period; Day 0 nasal wash will be counted as baseline) or 2) a greater than or equal to 4-fold rise in RSV neutralizing antibody titer

  9. Peak titer of vaccine virus shed (RSV-seropositive subjects) [ Time Frame: Measured through Day 10 ]
    Based on laboratory evaluations

  10. Peak titer of vaccine virus shed (RSV-seronegative subjects) [ Time Frame: Measured through Day 28 ]
    Based on laboratory evaluations

  11. Duration of virus shedding in nasal washes (RSV-seropositive subjects) [ Time Frame: Measured through Day 10 ]
    As determined by a) culture and b) reverse transcription polymerase chain reaction (RT-PCR)

  12. Duration of virus shedding in nasal washes (RSV-seronegative subjects) [ Time Frame: Measured through Day 28 ]
    As determined by a) culture and b) RT-PCR

  13. RSV-neutralizing serum antibody titer (RSV-seropositive subjects) [ Time Frame: Measured through Day 28 ]
    Based on laboratory evaluations

  14. RSV-neutralizing serum antibody titer (RSV-seronegative subjects) [ Time Frame: Measured through Day 56 ]
    Based on laboratory evaluations

  15. Immunoglobulin G (IgG) serum antibody titers to RSV F glycoprotein enzyme-linked immunosorbent assay (ELISA) (RSV-seropositive subjects) [ Time Frame: Measured through Day 28 ]
    Based on laboratory evaluations

  16. IgG serum antibody titers to RSV F glycoprotein (ELISA) (RSV-seronegative subjects) [ Time Frame: Measured through Day 56 ]
    Based on laboratory evaluations


Secondary Outcome Measures :
  1. Frequency of symptomatic, medically attended respiratory and febrile illness in the RSV-seronegative (group 2) vaccine and placebo recipients who experience natural infection with wt RSV during the first RSV season [ Time Frame: Measured through participants' last study visit, up to a total of 6 to 13 months after study entry, depending on when participants enroll in the study ]
    Assessed by protocol-determined grading system

  2. Frequency of symptomatic, medically attended respiratory and febrile illness in the RSV-seronegative vaccine and placebo recipients with natural infection with wt RSV through the second RSV season in subjects participating in 2nd season surveillance [ Time Frame: Measured through participants' last study visit, up to a total of 25 months after study entry, depending on when participants enroll in the study ]
    Assessed by protocol-determined grading system

  3. Severity of symptomatic, medically attended respiratory and febrile illness in the RSV-seronegative (group 2) vaccine and placebo recipients who experience natural infection with wt RSV during the first RSV season [ Time Frame: Measured through participants' last study visit, up to a total of 6 to 13 months after study entry, depending on when participants enroll in the study ]
    Assessed by protocol-determined grading system

  4. Severity of symptomatic, medically attended respiratory and febrile illness in the RSV-seronegative vaccine and placebo recipients with natural infection with wt RSV through the second RSV season in subjects participating in 2nd season surveillance [ Time Frame: Measured through participants' last study visit, up to a total of 25 months after study entry, depending on when participants enroll in the study ]
    Assessed by protocol-determined grading system

  5. Frequency of antibody responses in the RSV-seronegative vaccine and placebo recipients who experience natural infection with wt RSV during the first RSV season [ Time Frame: Measured through participants' last study visit, up to a total of 6 to 13 months after study entry, depending on when participants enroll in the study ]
    Based on laboratory evaluations

  6. Frequency of antibody responses in the RSV-seronegative vaccine and placebo recipients who experience natural infection with wt RSV during a second RSV season for those who choose to participate [ Time Frame: Measured through participants' last study visit, up to a total of 25 months after study entry, depending on when participants enroll in the study ]
    Based on laboratory evaluations

  7. Quality of RSF F-specific antibody [ Time Frame: Measured through participants' last study visit, up to a total of 25 months after study entry, depending on when participants enroll in the study ]
    Based on laboratory evaluations

  8. Epitope specificity of RSF F-specific antibody [ Time Frame: Measured through participants' last study visit, up to a total of 25 months after study entry, depending on when participants enroll in the study ]
    Based on laboratory evaluations


Eligibility Criteria

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Ages Eligible for Study:   6 Months to 60 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria for RSV-Seropositive Children:

  • Greater than or equal to 12 months of age and less than 60 months of age at the time of inoculation
  • Screening serum specimen for RSV neutralizing antibody is obtained within the calendar year of inoculation
  • Seropositive for RSV antibody, defined as serum RSV neutralizing antibody titer greater than or equal to 1:40
  • Pre-inoculation serum sample for RSV neutralizing antibody testing is obtained no more than 56 days prior to inoculation
  • In good health based on review of the medical record, history, and physical examination at the time of inoculation
  • Received routine immunizations appropriate for age based on the Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger
  • Growing normally for age as demonstrated on a standard growth chart and has a current height and weight above the 3rd percentile for age
  • Expected to be available for the duration of the study
  • Parent/guardian is willing and able to provide written informed consent

Exclusion Criteria for RSV-Seropositive Children:

  • Born at less than 34 weeks gestation
  • Maternal history of positive HIV test
  • Evidence of chronic disease
  • Known or suspected impairment of immune function
  • Bone marrow/solid organ transplant recipient
  • Major congenital malformations, including congenital cleft palate or cytogenetic abnormalities
  • Suspected or documented developmental disorder, delay, or other developmental problem
  • Cardiac abnormality requiring treatment
  • Lung disease or reactive airway disease
  • More than one episode of wheezing in the first year of life
  • Wheezing episode or received bronchodilator therapy within the past 12 months
  • Wheezing episode or received bronchodilator therapy after the age of 12 months
  • Previous receipt of supplemental oxygen therapy in a home setting
  • Previous receipt of an investigational RSV vaccine
  • Previous receipt or planned administration of anti-RSV drug (ribavirin) or RSV antibody product including RSV immune globulin (RSV Ig) or RSV monoclonal antibody (RSV mAb)
  • Previous receipt of immunoglobulin or any antibody products within the past 6 months
  • Previous receipt of any other blood products within the past 6 months
  • Previous anaphylactic reaction
  • Previous vaccine-associated adverse reaction that was Grade 3 or above
  • Known hypersensitivity to any vaccine component
  • Member of a household that contains an infant who is less than 12 months of age at the date of inoculation through the 10th day after inoculation
  • Member of a household that, at the date of inoculation through the 10th day after inoculation, contains an immunocompromised individual including but not limited to:

    • a person who is HIV-infected
    • a person who has received chemotherapy within the 12 months prior to enrollment
    • a person receiving immunosuppressant agents
    • a person living with a solid organ or bone marrow transplant
  • Will attend a daycare facility that does not separate children by age and contains an infant who is less than 12 months of age at the date of inoculation through the 10th day after inoculation
  • Receipt of any of the following prior to enrollment:

    • any inactivated vaccine or live-attenuated rotavirus vaccine within the 14 days prior, or
    • any live vaccine, other than rotavirus vaccine, within the 28 days prior, or
    • another investigational vaccine or investigational drug within 28 days prior, or
    • salicylate (aspirin) or salicylate-containing products within the past 28 days
  • Scheduled administration of any of the following after planned inoculation:

    • inactivated vaccine or live-attenuated rotavirus vaccine within the 14 days after, or
    • any live vaccine other than rotavirus in the 28 days after, or
    • another investigational vaccine or investigational drug in the 28 days after
  • Receipt of any of the following medications within 3 days of study enrollment:

    • systemic antibacterial, antiviral, antifungal, anti-parasitic, or antituberculous agents, whether for treatment or prophylaxis, or
    • intranasal medications, or
    • other prescription medications except the permitted concomitant medications listed below:
    • Permitted concomitant medications (prescription or non-prescription) include nutritional supplements, medications for gastroesophageal reflux, eye drops, and topical medications, including (but not limited to) cutaneous (topical) steroids, topical antibiotics, and topical antifungal agents.
  • Any of the following events at the time of enrollment:

    • fever (temporal or rectal temperature of greater than or equal to 100.4°F), or
    • upper respiratory signs or symptoms (rhinorrhea, cough, or pharyngitis) or
    • nasal congestion significant enough to interfere with successful inoculation, or
    • otitis media

Inclusion Criteria for RSV-Seronegative Infants and Children:

  • Greater than or equal to 6 months of age and less than 25 months of age at the time of inoculation
  • Screening and pre-inoculation serum specimens for RSV-neutralizing antibody are obtained no more than 42 days prior to inoculation
  • Seronegative for RSV antibody, defined as serum RSV-neutralizing antibody titer less than 1:40
  • In good health based on review of the medical record, history, and physical examination at the time of inoculation
  • Received routine immunizations appropriate for age based on the ACIP Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger
  • Growing normally for age as demonstrated on a standard growth chart, AND

    • If less than 1 year of age: has a current height and weight above the 5th percentile for age
    • If greater than or equal to 1 year of age: has a current height and weight above the 3rd percentile for age
  • Expected to be available for the duration of the study
  • Parent/guardian is willing and able to provide written informed consent

Exclusion Criteria for RSV-Seronegative Infants and Children:

  • Born at less than 34 weeks gestation
  • Born at less than 37 weeks gestation, and at the date of inoculation less than 1 year of age
  • Maternal history of a positive HIV test
  • Evidence of chronic disease
  • Known or suspected infection or impairment of immunological functions
  • Bone marrow/solid organ transplant recipient
  • Major congenital malformations, including congenital cleft palate or cytogenetic abnormalities
  • Suspected or documented developmental disorder, delay, or other developmental problem
  • Cardiac abnormality requiring treatment
  • Lung disease or reactive airway disease
  • More than one episode of wheezing in the first year of life
  • Wheezing episode or received bronchodilator therapy within the past 12 months
  • Wheezing episode or received bronchodilator therapy after the age of 12 months
  • Previous receipt of supplemental oxygen therapy in a home setting
  • Previous receipt of an investigational RSV vaccine
  • Previous receipt or planned administration of anti-RSV antibody product including ribavirin, RSV Ig, or RSV mAb
  • Previous receipt of immunoglobulin or any antibody products within the past 6 months
  • Previous receipt of any blood products within the past 6 months
  • Previous anaphylactic reaction
  • Previous vaccine-associated adverse reaction that was Grade 3 or above
  • Known hypersensitivity to any study product component
  • Member of a household that contains an infant who is less than 6 months of age at the date of inoculation through the 28th day after inoculation
  • Member of a household that, at the date of inoculation through the 28th day after inoculation, contains an immunocompromised individual including but not limited to:

    • a person who is HIV-infected
    • a person who has received chemotherapy within the 12 months prior to enrollment
    • a person receiving immunosuppressant agents
    • a person living with a solid organ or bone marrow transplant
  • Attends a daycare facility that does not separate children by age and contains an infant less than 6 months of age at the date of inoculation through the 28th day after inoculation
  • Receipt of any of the following prior to enrollment:

    • any inactivated vaccine or live-attenuated rotavirus vaccine within the 14 days prior, or
    • any live vaccine, other than rotavirus vaccine, within the 28 days prior, or
    • another investigational vaccine or investigational drug within 28 days prior, or
    • salicylate (aspirin) or salicylate-containing products within the past 28 days
  • Scheduled administration of any of the following after planned inoculation

    • inactivated vaccine or live-attenuated rotavirus vaccine within the 14 days after, or
    • any live vaccine other than rotavirus in the 28 days after, or
    • another investigational vaccine or investigational drug in the 56 days after
  • Receipt of any of the following medications within 3 days of study enrollment:

    • systemic antibacterial, antiviral, antifungal, anti-parasitic, or antituberculous agents, whether for treatment or prophylaxis, or
    • intranasal medications, or
    • other prescription medications except the permitted concomitant medications listed below:
    • Permitted concomitant medications (prescription or non-prescription) include nutritional supplements, medications for gastroesophageal reflux, eye drops, and topical medications, including (but not limited to) cutaneous (topical) steroids, topical antibiotics, and topical antifungal agents.
  • Any of the following events at the time of enrollment:

    • fever (temporal or rectal temperature of greater than or equal to 100.4°F), or
    • upper respiratory signs or symptoms (rhinorrhea, cough, or pharyngitis) or
    • nasal congestion significant enough to interfere with successful inoculation, or
    • otitis media

Inclusion Criteria for RSV-Seronegative Children Participating in a Second Season of RSV Surveillance:

  • RSV-seronegative participants who have completed the initial RSV season surveillance portion of the study and whose parent/guardian is willing and able to provide written informed consent
  • Expected to be available during the second year of RSV surveillance

Exclusion Criteria for RSV-Seronegative Children Participating in a Second Season of RSV Surveillance:

  • Currently enrolled in another RSV study
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03387137


Locations
United States, Maryland
Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health Recruiting
Baltimore, Maryland, United States, 21205
Contact: Suzanne Woods, CRNP-P, CCRP    410-614-1880    swoods12@jhu.edu   
Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
Investigators
Principal Investigator: Ruth A. Karron, MD Johns Hopkins Bloomberg School of Public Health (JHSPH)
More Information

Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT03387137     History of Changes
Other Study ID Numbers: CIR 322
First Posted: December 29, 2017    Key Record Dates
Last Update Posted: December 29, 2017
Last Verified: December 2017

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
Respiratory Syncytial Virus Infections
Pneumovirus Infections
Paramyxoviridae Infections
Mononegavirales Infections
RNA Virus Infections
Virus Diseases
Vaccines
Immunologic Factors
Physiological Effects of Drugs