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Heterologous Effects of VaccinesNCT02765126

Heterologous Effect of Diptheria, Tetanus, Acellular Pertussis Vaccination on Influenza Challenge in the Elderly

A study testing Seasonal influenza vaccine and Diphtheria-tetanus-acellular pertussis vaccine in people with Heterologous Effects of Vaccines, run by Clifford Craig Medical Research Trust at 1 site in Australia.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Vaccines can have non-targeted or heterologous (also called non-specific) immunological effects on the immune system i.e. effects other than inducing an immune response against the disease targeted by the vaccine. Read more about this study

Who is it for?
Ages 30 to 100 yearsHealthy volunteers can take part
Conditions the study is for
Heterologous Effects of Vaccines
What is being tested?
Seasonal influenza vaccine and Diphtheria-tetanus-acellular pertussis vaccine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
450 participants
Where
1 siteAustralia
Study dates
May 2016to Dec 2019
Phase
Interventional
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 30 to 100 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Two study groups 30-50 years old >65 years old

Who cannot join

  • Unwell on day of vaccination
  • Temperature >38°C
  • Active cancer
  • Active autoimmune disease
  • Diabetes mellitus
  • Taking immunosuppressive drugs including steroids
Show all 10Show fewer
  • Any vaccination in last 3 months
  • DT or DTaP vaccination in the last year
  • Known allergy or contraindication to influenza or DTaP vaccination
  • Pregnant or breastfeeding

Trial locations and contacts

1 site in 1 country.

Kathryn Ogden, MPH FRACGP contact

+61 3 6777 8790

kathryn.ogden@utas.edu.au

Jane Niekamp contact

research@cliffordcraig.org.au

Australia1 site, 1 recruiting
  • Clifford Craig Foundation

    Launceston, Tasmania, 7250

    Kathryn Ogden, MBBS, MPH, 03 6777 6010, kathryn.ogden@utas.edu.au

    Jane Niekamp, 03 6777 6010

    Recruiting

Other trials in Australia

About this study

Official title: Clifford Craig Vaccine Trial Centre: Heterologous Effect of Diptheria, Tetanus, Acellular Pertussis Vaccination on Influenza Vaccine Challenge in the Elderly

Vaccines can have non-targeted or heterologous (also called non-specific) immunological effects on the immune system i.e. effects other than inducing an immune response against the disease targeted by the vaccine. This trial aims to evaluate the non-specific immunological effects of two vaccines - diphtheria-tetanus-acellular pertussis (DTP) vaccine and seasonal influenza vaccine - in a cohort of elderly humans (>65 years of age) and healthy adult control subjects (30-50 years).

Read the detailed description

This prospective randomised study aims to investigate the heterologous immunological effects of DTP and seasonal influenza (Flu) vaccination in an elderly Tasmanian population and healthy adults. The study will assess whether prior or concurrent administration of DTP with seasonal Flu vaccination affects generalised inflammation / immune homeostasis and gene expression, with a particular focus of inflammation reactive cells. It will also analyse for effects of DTP on the induction of vaccine-specific immunity to seasonal influenza vaccination (antibodies and cellular). Volunteers will be randomised to one of three vaccine groups and serial blood samples taken for immunological assays for up to 30 weeks.

The study is exploratory and will investigate vaccine effects on multiple immune parameters.

Being tested
Seasonal influenza vaccine, Diphtheria-tetanus-acellular pertussis vaccine

What participants receive

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

  • Seasonal influenza vaccineBiological

    Also called Quadrivalent Influenza Vaccine

    Intramuscular standard seasonal influenza vaccine

  • Diphtheria-tetanus-acellular pertussis vaccineBiological

    Also called Boostrix vaccine

    Intramuscular DTaP vaccine

Study groups in NCT02765126
Study groupRoleWhat they receive
Group 1Active comparatorDiphtheria-tetanus-acellular pertussis vaccine administered day 0, followed by seasonal influenza vaccination four weeks later. Blood testing to occur day 0 (prior to vaccine administration), 24 hours, 1 week, 4 weeks, 4 weeks + 24 hours, 5 weeks, 8 weeks and 30 weeks. Stool samples to be taken at day 0 and 1 week post-vaccination.
Receives: Biological: Seasonal influenza vaccine; Biological: Diphtheria-tetanus-acellular pertussis vaccine
Group 2Active comparatorSeasonal influenza vaccine administered on day 0, to be offered DTP vaccine at week 26. Blood testing to occur day 0 (prior to vaccine administration), 24 hours, 1 week 1, 4 weeks and 26 weeks. Stool samples to be taken at day 0 and 1 week post-vaccination.
Receives: Biological: Seasonal influenza vaccine; Biological: Diphtheria-tetanus-acellular pertussis vaccine
Group 3Active comparatorSeasonal influenza vaccine and DTP vaccine administered together on day 0. Blood testing to occur day 0 (prior to vaccine administration), 24 hours, 1 week 1, 4 weeks and 26 weeks. Stool samples to be taken at day 0 and 1 week post-vaccination.
Receives: Biological: Seasonal influenza vaccine; Biological: Diphtheria-tetanus-acellular pertussis vaccine

What is being measured

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

  1. Number of inflammation reactive TNFR2+ regulatory T cells per mL of blood

    Change over time in different vaccine groups of Tregs measured by flow cytometry.

    Measured: 24 hours, 1 week, 4 weeks and 26 weeks

Secondary outcomes (4)
  1. Whole human genome transcription profile by next generation sequencing in log2 expression levels

    Differential gene expression 24 hours after vaccination compared to baseline, and vaccine groups compared to see which genes / pathways are affected. Differential transcription determined for each gene, then analysed using modular analysis tools to determine vaccine effects.

    Measured: 24 hours

  2. Influenza-specific antibody titres to seasonal influenza vaccination

    Change over time in the different vaccine groups of titres measured by haemagglutination inhibition assay.

    Measured: 4 weeks and 26 weeks

  3. Pro-inflammatory (TNF) to anti-inflammatory (IL-10) cytokine ratio in stimulated blood in pg/mL

    Change in TNF:IL-10 ratio post-vaccination over time as measured by cytokine multiplex assay of anti-CD3 stimulated PBMC.

    Measured: 24 hours, 1 week, 4 weeks and 26 weeks

  4. Influenza-specific IFN-g CD4 T cell responses to seasonal influenza vaccination in pg/mL

    Change over time in the different vaccine groups of IFN-g levels in supernatants from CD4 T cells cultured with live influenza virus

    Measured: 4 weeks and 26 weeks

Timeline

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

  1. First posted6 May 2016 (estimated)
  2. Study startMay 2016
  3. Primary completionDec 2019 (estimated)
  4. Study completionDec 2019 (estimated)

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 N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
450 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02765126
Sponsor's protocol ID
H0015460
Status last verified
Jul 2017
First submitted
3 May 2016
Last updated
27 Jul 2017
Results posted
No
Data monitoring committee
No
Individual data sharing
Yes: The transcriptome data will be de-identified and deposited in a pubic database. The de-identified microbiome data may well also be made publically available.

Publications

  • Meeting of the Strategic Advisory Group of Experts on immunization, April 2014 -- conclusions and recommendations. Wkly Epidemiol Rec. 2014 May 23;89(21):221-36. No abstract available. English, French.

    PubMed 24864348
  • Aaby P, Martins CL, Garly ML, Bale C, Andersen A, Rodrigues A, Ravn H, Lisse IM, Benn CS, Whittle HC. Non-specific effects of standard measles vaccine at 4.5 and 9 months of age on childhood mortality: randomised controlled trial. BMJ. 2010 Nov 30;341:c6495. doi: 10.1136/bmj.c6495.

    PubMed 21118875
  • Sorup S, Benn CS, Poulsen A, Krause TG, Aaby P, Ravn H. Live vaccine against measles, mumps, and rubella and the risk of hospital admissions for nontargeted infections. JAMA. 2014 Feb 26;311(8):826-35. doi: 10.1001/jama.2014.470.

    PubMed 24570246
  • Aaby P, Benn C, Nielsen J, Lisse IM, Rodrigues A, Ravn H. Testing the hypothesis that diphtheria-tetanus-pertussis vaccine has negative non-specific and sex-differential effects on child survival in high-mortality countries. BMJ Open. 2012 May 22;2(3):e000707. doi: 10.1136/bmjopen-2011-000707. Print 2012.

    PubMed 22619263
  • Nichol KL, Nordin JD, Nelson DB, Mullooly JP, Hak E. Effectiveness of influenza vaccine in the community-dwelling elderly. N Engl J Med. 2007 Oct 4;357(14):1373-81. doi: 10.1056/NEJMoa070844.

    PubMed 17914038
  • Goodwin K, Viboud C, Simonsen L. Antibody response to influenza vaccination in the elderly: a quantitative review. Vaccine. 2006 Feb 20;24(8):1159-69. doi: 10.1016/j.vaccine.2005.08.105. Epub 2005 Sep 19.

    PubMed 16213065
  • Sasaki S, Sullivan M, Narvaez CF, Holmes TH, Furman D, Zheng NY, Nishtala M, Wrammert J, Smith K, James JA, Dekker CL, Davis MM, Wilson PC, Greenberg HB, He XS. Limited efficacy of inactivated influenza vaccine in elderly individuals is associated with decreased production of vaccine-specific antibodies. J Clin Invest. 2011 Aug;121(8):3109-19. doi: 10.1172/JCI57834. Epub 2011 Jul 25.

    PubMed 21785218
  • Grant EJ, Chen L, Quinones-Parra S, Pang K, Kedzierska K, Chen W. T-cell immunity to influenza A viruses. Crit Rev Immunol. 2014;34(1):15-39. doi: 10.1615/critrevimmunol.2013010019.

    PubMed 24579700
  • Saurwein-Teissl M, Lung TL, Marx F, Gschosser C, Asch E, Blasko I, Parson W, Bock G, Schonitzer D, Trannoy E, Grubeck-Loebenstein B. Lack of antibody production following immunization in old age: association with CD8(+)CD28(-) T cell clonal expansions and an imbalance in the production of Th1 and Th2 cytokines. J Immunol. 2002 Jun 1;168(11):5893-9. doi: 10.4049/jimmunol.168.11.5893.

    PubMed 12023394
  • Weston WM, Friedland LR, Wu X, Howe B. Vaccination of adults 65 years of age and older with tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Boostrix((R))): results of two randomized trials. Vaccine. 2012 Feb 21;30(9):1721-8. doi: 10.1016/j.vaccine.2011.12.055. Epub 2011 Dec 31.

    PubMed 22212127
  • Solana R, Tarazona R, Gayoso I, Lesur O, Dupuis G, Fulop T. Innate immunosenescence: effect of aging on cells and receptors of the innate immune system in humans. Semin Immunol. 2012 Oct;24(5):331-41. doi: 10.1016/j.smim.2012.04.008. Epub 2012 May 4.

    PubMed 22560929
  • Panda A, Qian F, Mohanty S, van Duin D, Newman FK, Zhang L, Chen S, Towle V, Belshe RB, Fikrig E, Allore HG, Montgomery RR, Shaw AC. Age-associated decrease in TLR function in primary human dendritic cells predicts influenza vaccine response. J Immunol. 2010 Mar 1;184(5):2518-27. doi: 10.4049/jimmunol.0901022. Epub 2010 Jan 25.

    PubMed 20100933
  • Baylis D, Bartlett DB, Syddall HE, Ntani G, Gale CR, Cooper C, Lord JM, Sayer AA. Immune-endocrine biomarkers as predictors of frailty and mortality: a 10-year longitudinal study in community-dwelling older people. Age (Dordr). 2013 Jun;35(3):963-71. doi: 10.1007/s11357-012-9396-8. Epub 2012 Mar 3.

    PubMed 22388931
  • Franceschi C, Capri M, Monti D, Giunta S, Olivieri F, Sevini F, Panourgia MP, Invidia L, Celani L, Scurti M, Cevenini E, Castellani GC, Salvioli S. Inflammaging and anti-inflammaging: a systemic perspective on aging and longevity emerged from studies in humans. Mech Ageing Dev. 2007 Jan;128(1):92-105. doi: 10.1016/j.mad.2006.11.016. Epub 2006 Nov 20.

    PubMed 17116321
  • Bruunsgaard H, Andersen-Ranberg K, Hjelmborg Jv, Pedersen BK, Jeune B. Elevated levels of tumor necrosis factor alpha and mortality in centenarians. Am J Med. 2003 Sep;115(4):278-83. doi: 10.1016/s0002-9343(03)00329-2.

    PubMed 12967692

Questions about this trial

What is this clinical trial studying?

A study testing Seasonal influenza vaccine and Diphtheria-tetanus-acellular pertussis vaccine in people with Heterologous Effects of Vaccines, run by Clifford Craig Medical Research Trust at 1 site in Australia.

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 1 inclusion and 10 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: status not confirmed, as of the sponsor's last update on 27 Jul 2017. 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 Australia. 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.

Are results available for this study?

Results are not available in the source record.

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

Contact Kathryn Ogden, MPH FRACGP (+61 3 6777 8790, kathryn.ogden@utas.edu.au), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of inflammation reactive TNFR2+ regulatory T cells per mL of blood (time frame: 24 hours, 1 week, 4 weeks and 26 weeks). 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 NCT02765126, which also lists 28 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 27 Jul 2017.

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