AzTrials
AzTrials

Pneumococcal InfectionsPhase 2NCT00170612

Pneumococcal Vaccination of Fiji Infants

A Phase 2 study testing Pneumovax 23 and Prevnar in people with Pneumococcal Infections, run by University of Melbourne at 1 site in Fiji.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Pneumonia is the most common reason for admission of Fijian children to hospitals. The most common germ causing pneumonia is "streptococcus pneumoniae." It is a common cause of meningitis (infection around the brain and spinal cord), ear infections, and blood infections and it lives in the nose of humans. Read more about this study

Who is it for?
Ages 6 to 8 weeksHealthy volunteers can take part
Conditions the study is for
Pneumococcal Infections
What is being tested?
Pneumovax 23 and Prevnar
Could I receive a placebo?
No, everyone receives an active treatment
How many people
552 participants
Where
1 siteFiji
Study dates
Nov 2005to Aug 2008
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 to 8 weeks
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Healthy infant aged between 6 and 8 weeks
  • No significant maternal or perinatal history
  • Written and signed parental/caregiver consent
  • Lives within 30 minutes of the health clinic
  • Family anticipate living in the study area for the next 2 years

Who cannot join

  • Known allergy to any component of the vaccine
  • Allergic reaction or anaphylactoid reaction with previous vaccines
  • Known immunodeficiency disorder
  • HIV positive mother (many women are tested for HIV antenatally, however a test is not planned; therefore it would be based on clinic records or self report)
  • Known thrombocytopenia or coagulation disorder
  • On immunosuppressive medication
Show all 12Show fewer
  • Received any blood product since birth
  • Severe congenital anomaly
  • Chronic or progressive disease
  • Seizure disorder
  • History of invasive Pneumococcal, meningococcal, or Haemophilus influenzae diseases
  • Moderate or severe acute infection (temporary exclusion); Minor illnesses such as an uncomplicated upper respiratory tract infection, localized skin infections, or mild diarrhea will not be an exclusion criterion

Trial locations and contacts

1 site in 1 country.

Fiji1 site
  • Colonial War Memorial Hospital

    Suva

About this study

Official title: A Single-Blind Open-Label Randomized Phase II Study of the Safety, Immunogenicity and Impact on Pneumococcus (Pnc) Carriage of the Pnc Vaccination Regimens Combining 1, 2, or 3 Doses of 7-Valent Pneumococcal Conjugate Vaccine (PCV) in the First 4 Months of Life Followed by a Single Dose of 23-Valent Pneumococcal Polysaccharide Vaccine (PPS) at 12 Months of Age

Pneumonia is the most common reason for admission of Fijian children to hospitals. The most common germ causing pneumonia is "streptococcus pneumoniae." It is a common cause of meningitis (infection around the brain and spinal cord), ear infections, and blood infections and it lives in the nose of humans. A vaccine has been developed that will help prevent these common diseases but prevents only about one quarter of pneumonia cases and it is expensive. This study explores new ways of giving this vaccine that are affordable, safe, and effective in countries such as Fiji. About 550 Fijian infants presenting at 6 weeks of age, for their first diptheria, tetanus, toxoid, pertussis vaccine immunization, to one of the participating Health Centers or Colonial War Memorial Hospital in urban Suva, Fiji will be enrolled. Children will remain in the study for 2 years. Study procedures include full vaccination against 7 types of pneumococcus, blood tests, and nasal swabs.

Read the detailed description

This research project began as a study of alternative strategies for Pnc (Pneumococcus) immunization for children in developing countries. In the original study, infants presenting to a health center in urban Fiji were randomized to receive 1, 2, or 3 doses of PCV (Prevnar) followed by a dose of 23-valent PPS (Pneumococcal polysaccharide vaccine) at 6 or 9 months of age. The regimens were compared with each other and with 2 control groups with respect to immunogenicity, impact on carriage of vaccine type Pnc, and response to a small dose of PPS at 15 months of age. After the trial was underway and 228 infants had been recruited, concerns were raised about the safety of PPS in infancy. Specifically concerns were raised that it might result in later immunological hyporesponsiveness in some of the recipients, to some of the serotypes. After a thorough review it was decided to proceed with the study, but to modify it so that it addressed directly the issue of potential hyporesponsiveness, while not giving PPS to any children under 12 months of age. This protocol represents the completion of the study with the new design for the children already enrolled, and a new design for a further cohort of children who will be enrolled. The newly designed trial will be a single blind, open-label, randomized, controlled trial of 550 healthy infants. Infants will be randomized to 1 of 8 equal groups to receive 0, 1, 2, or 3 doses of PCV (Pneumococcal conjugate vaccine), with or without a booster of PPS at 12 months of age. Two control groups will be recruited, 1 will receive no PCV in infancy and the other will receive a dose of PPS at 12 months of age. At 18 months of age, all infants will receive a 20 percent dose of PPS to stimulate and allow the assessment of immunological memory. At 2 years of age, any child who has received no or one dose of PCV (Groups E, F, G and H) will receive a single dose of PCV. Blood samples will be taken at 18 weeks age, 12 months of age, before the 18 months dose and 4 weeks later. In addition half of the children will have a blood sample taken at 9 months and the other half will have a sample taken 2 weeks after their 12 month dose of PPS. The 9- and 12-month blood sample will assess the long-term persistence of circulating antibody and avidity maturation following a 1, 2, or 3 dose primary series of PCV. The primary objective is to demonstrate noninferiority at 19 months of age, of those groups receiving PPS at 12 months and those who do not with respect to the proportion of children in each group, with a satisfactory immune response at 19 months of age, measured by OPA to each of the 11 serotypes included in the PPS for which an OPA has been developed. The secondary objective is to assess the immunogenicity and impact on carriage of various Pnc vaccination regimens that combine 1 to 3 doses of PCV with a dose of PPS, concerns regarding the potential for the development of hyporesponsiveness. Endpoints to be evaluated will include serotype specific immunoglobulin G antibody measured by enzyme-linked immunosorbent assay to the 23 serotypes in the PPS, avidity assays to the same serotypes, opsonophagocytic assays to the 11 serotypes for which these assays are currently available, and Pnc carriage by serotype. With hyporesponsiveness as the primary endpoint of interest a scheme of analysis has been proposed which will require a minimum sample size of 500.

Being tested
Pneumovax 23, Prevnar
Keywords
Pneumococcal infections, Fiji, infants, vaccine
Medical subject headings
Pneumococcal Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pneumovax 23Biological

    23-valent PPS, 25 micrograms/serotype

  • PrevnarBiological

    7-valent PCV, 2 micrograms/serotype, except serotype 6B which is 4 micrograms/serotype

Study groups in NCT00170612
Study groupRoleWhat they receive
AExperimentalPCV at 6 weeks, 10 weeks, and 14 weeks; PPS at 18 months
Receives: Biological: Pneumovax 23; Biological: Prevnar
BExperimentalPCV at 6 weeks, 10 weeks, and 14 weeks; PPS at 12 months and 18 months
Receives: Biological: Pneumovax 23; Biological: Prevnar
CExperimentalPCV at 6 weeks and 14 weeks; PPS at 18 months
Receives: Biological: Pneumovax 23; Biological: Prevnar
DExperimentalPCV at 6 weeks and 14 weeks; PPS at 12 months and 18 months
Receives: Biological: Pneumovax 23; Biological: Prevnar
EExperimentalPCV at 14 weeks; PPS at 18 months
Receives: Biological: Pneumovax 23; Biological: Prevnar
FExperimentalPCV at 14 weeks; PPS at 12 months and 18 months
Receives: Biological: Pneumovax 23; Biological: Prevnar
GExperimentalNo PCV; PPS at 12 months and 18 months
Receives: Biological: Pneumovax 23
HActive comparatorNo PCV; PPS at 18 months
Receives: Biological: Pneumovax 23

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. For each serotype assayed (23 for ELISA and 11 for functional assays) the proportion of children responding to the micro-PPS dose at 18 months and the GMC of the response will be compared between children who receive PPS at 12 months and those who do not

    Measured: 19 months of age

Secondary outcomes (3)
  1. Proportion of children showing hyporesponse at 18 months to more than half of all 23 serotypes

    Measured: 18 weeks; 12.5 months of age

  2. Immunogenicity and carriage: Immune responses following the primary series of conjugate vaccination, measured by ELISA and OPA will be compared between the group receiving two doses of PCV and those receiving 3 doses of vaccine

    Measured: 18 months of age

  3. Rate of decline: assessment of antibody levels

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Sep 2005 (estimated)
  2. Study startNov 2005
  3. Primary completionJan 2008
  4. Study completionAug 2008

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
552 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00170612
Sponsor's protocol ID
03-042
Other IDs
FNRERC Reference # 2002-001
Status last verified
Oct 2008
First submitted
13 Sep 2005
Last updated
21 Oct 2008
Results posted
No
Data monitoring committee
Yes

Publications

  • Russell FM, Balloch A, Licciardi PV, Carapetis JR, Tikoduadua L, Waqatakirewa L, Cheung YB, Mulholland EK, Tang ML. Serotype-specific avidity is achieved following a single dose of the 7-valent pneumococcal conjugate vaccine, and is enhanced by 23-valent pneumococcal polysaccharide booster at 12 months. Vaccine. 2011 Jun 15;29(27):4499-506. doi: 10.1016/j.vaccine.2011.04.038. Epub 2011 May 1.

    PubMed 21539882
  • Russell FM, Carapetis JR, Burton RL, Lin J, Licciardi PV, Balloch A, Tikoduadua L, Waqatakirewa L, Cheung YB, Tang ML, Nahm MH, Mulholland EK. Opsonophagocytic activity following a reduced dose 7-valent pneumococcal conjugate vaccine infant primary series and 23-valent pneumococcal polysaccharide vaccine at 12 months of age. Vaccine. 2011 Jan 10;29(3):535-44. doi: 10.1016/j.vaccine.2010.10.046. Epub 2010 Oct 31.

    PubMed 21044669
  • Russell FM, Carapetis JR, Satzke C, Tikoduadua L, Waqatakirewa L, Chandra R, Seduadua A, Oftadeh S, Cheung YB, Gilbert GL, Mulholland EK. Pneumococcal nasopharyngeal carriage following reduced doses of a 7-valent pneumococcal conjugate vaccine and a 23-valent pneumococcal polysaccharide vaccine booster. Clin Vaccine Immunol. 2010 Dec;17(12):1970-6. doi: 10.1128/CVI.00117-10. Epub 2010 Oct 13.

    PubMed 20943882
  • Russell FM, Carapetis JR, Balloch A, Licciardi PV, Jenney AW, Tikoduadua L, Waqatakirewa L, Pryor J, Nelson J, Byrnes GB, Cheung YB, Tang ML, Mulholland EK. Hyporesponsiveness to re-challenge dose following pneumococcal polysaccharide vaccine at 12 months of age, a randomized controlled trial. Vaccine. 2010 Apr 26;28(19):3341-9. doi: 10.1016/j.vaccine.2010.02.087. Epub 2010 Mar 4.

    PubMed 20206670
  • Russell FM, Licciardi PV, Balloch A, Biaukula V, Tikoduadua L, Carapetis JR, Nelson J, Jenney AW, Waqatakirewa L, Colquhoun S, Cheung YB, Tang ML, Mulholland EK. Safety and immunogenicity of the 23-valent pneumococcal polysaccharide vaccine at 12 months of age, following one, two, or three doses of the 7-valent pneumococcal conjugate vaccine in infancy. Vaccine. 2010 Apr 19;28(18):3086-94. doi: 10.1016/j.vaccine.2010.02.065. Epub 2010 Mar 1.

    PubMed 20199764

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Pneumovax 23 and Prevnar in people with Pneumococcal Infections, run by University of Melbourne at 1 site in Fiji.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Oct 2008. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Fiji. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

For each serotype assayed (23 for ELISA and 11 for functional assays) the proportion of children responding to the micro-PPS dose at 18 months and the GMC of the response will be compared between children who receive PPS at 12 months and those who do not (time frame: 19 months of age). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00170612, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Oct 2008.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in