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InfluenzaPhase 2NCT05082688

Age Differences in Influenza and Herpes Zoster Vaccine Responses (INFLUENZA-SHINGRIX)

A Phase 2 study testing Herpes zoster vaccination (Shingrix, GSK) and Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK) in people with Influenza and Herpes Zoster, run by Radboud University Medical Center at 1 site in Netherlands.

Completed

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

Official record
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Trial summary

Vaccines are used to prevent infectious diseases worldwide. Unfortunately, many vaccines, like the flu vaccine, are less effective in older adults. This single-centre open label partially randomised, partially placebo-controlled trial evaluates the differences in immune response between young and older adults after… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Influenza, Herpes Zoster
What is being tested?
Herpes zoster vaccination (Shingrix, GSK) and Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
148 participants
Where
1 siteNetherlands
Study dates
20 Sep 2021to 17 May 2023
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 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age between 18-35 years old OR age ≥60 years old
  • Written informed consent

Who cannot join

  • Known allergy to (components of) the influenza or herpes zoster vaccine
  • Immunocompromised subjects and subjects with active malignancy within the last two years
  • Previous herpes zoster vaccination in the last year
  • Receipt of any vaccination 4 weeks prior to the start of the study or plans to receive any other vaccination in the first 2 months after inclusion
  • Use of systemic immunomodulatory drugs:steroids, anti-inflammatory biological treatments (e.g. anti-cytokine monoclonal antibodies)
  • Acute or active illness within two weeks prior to the start of the study
  • Pregnant, breastfeeding or planning to become pregnant during the study period

Trial locations and contacts

1 site in 1 country.

Netherlands1 site
  • Radboud University

    Nijmegen, Gelderland, 6525GA

Other trials in Netherlands

About this study

Official title: Exploratory Study Into Age-related Immunological Differences Related to Immunogenicity in Influenza Vaccination and Herpes Zoster Vaccination

Vaccines are used to prevent infectious diseases worldwide. Unfortunately, many vaccines, like the flu vaccine, are less effective in older adults.

This single-centre open label partially randomised, partially placebo-controlled trial evaluates the differences in immune response between young and older adults after vaccination with a quadrivalent inactivated influenza vaccine and an adjuvanted herpes zoster vaccination.

Exploring the underlying mechanisms between the differences in immunogenicity can provide important information for future vaccine development.

Read the detailed description

Rationale: Vaccination of the older adults is often advised as they are a high-risk population; however, vaccine efficacy generally decreases with age. This is mainly due to a decrease in adaptive immune responses known as immunosenescence, which is a factor influencing the response to influenza vaccination. On the other hand, there are vaccines that show high efficacy (more than 95%) in older adults, one of the most effective being the AS01 adjuvanted herpes zoster vaccine, Shingrix. The differential immune pathways associated with vaccine responsiveness as well as the immune mechanisms by which adjuvants overcome immunosenescence remain poorly understood. Targeting key immune pathways could be a way to improve vaccine efficacy in older adults.

Objective: To explore immunological features between young and older adults after administration of an adjuvanted herpes zoster (Shingrix) or influenza unadjuvanted (Fluarix) vaccine that could explain differences in vaccine immunogenicity.

Study design: A single centre open label, randomised, and partially placebo-controlled trial Study population: Approximately 140 healthy adults, 80 of which are between 18-35 years old, the other 60 are 60+ years old.

Intervention: Two groups of young and elderly volunteers receive recombinant zoster vaccine (Shingrix), while two other groups will receive a quadrivalent influenza vaccine (Fluarix). Two groups of young volunteers will receive a placebo.

Main study parameter: To identify immune senescence-related differences contributing to vaccine immunogenicity

Being tested
Herpes zoster vaccination (Shingrix, GSK), Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK), Placebo
Keywords
Vaccination, Trained immunity, Immunosenescence, Inflammaging
Medical subject headings
Influenza, Human, Herpes Zoster

What participants receive

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

  • Herpes zoster vaccination (Shingrix, GSK)Biological

    Shingrix is an ASO1-adjuvanted herpes zoster vaccination used to prevent shingles and its associated complications in at-risk populations

  • Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK)Biological

    Fluarix Tetra is a quadrivalent inactivated influenza vaccine

  • PlaceboBiological

    0.9% NaCl

Study groups in NCT05082688
Study groupRoleWhat they receive
1: Young adults herpes zoster vaccinationExperimentalYoung adults between 18 and 35 years old will receive the herpes zoster vaccine (Shingrix). 60 days later, they will receive a booster dose.
Receives: Biological: Herpes zoster vaccination (Shingrix, GSK)
2: Older adults herpes zoster vaccinationExperimentalAdults older than 60 years of age will receive the herpes zoster vaccine (Shingrix). 60 days later, they will receive a booster dose.
Receives: Biological: Herpes zoster vaccination (Shingrix, GSK)
3: Young adults influenza vaccinationExperimentalYoung adults between 18 and 35 years old will receive the influenza vaccine (Fluarix Tetra).
Receives: Biological: Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK)
4: Older adults influenza vaccinationExperimentalAdults older than 60 years of age will receive the influenza vaccine (Fluarix Tetra).
Receives: Biological: Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK)
5: Young adults herpes zoster vaccination related placeboPlacebo comparatorYoung adults between 18 and 35 years old will receive the placebo injection (0.9% NaCl). 60 days later, they will receive another placebo.
Receives: Biological: Placebo
6: Young adults influenza vaccination related placeboPlacebo comparatorYoung adults between 18 and 35 years old will receive the placebo injection (0.9% NaCl).
Receives: Biological: Placebo

What is being measured

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

  1. Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

    IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

    Measured: 2 months after influenza vaccination

  2. Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

    IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

    Measured: 6 months after influenza vaccination

  3. Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

    IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

    Measured: 2 months after the first dose of herpes zoster vaccination

  4. Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

    IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

    Measured: 2 months after the second dose of herpes zoster vaccination

  5. Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

    IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

    Measured: 6 months after the second dose of herpes zoster vaccination

  6. Change in transcriptional profile of individual cells from PBMC population

    Gene expression profile of PBMCs will be measured by single cell-RNA sequencing.

    Measured: 2 months after influenza vaccination

  7. Change in transcriptional profile of individual cells from PBMC population

    Gene expression profile of PBMCs will be measured by single cell-RNA sequencing.

    Measured: 6 months after influenza vaccination

  8. Transcriptional profile of individual cells from PBMC population

    Gene expression profile of PBMCs will be measured by single cell-RNA sequencing.

    Measured: 2 months after the first dose of herpes zoster vaccination

  9. Transcriptional profile of individual cells from PBMC population

    Gene expression profile of PBMCs will be measured by single cell-RNA sequencing.

    Measured: 2 months after the second dose of herpes zoster vaccination

  10. Transcriptional profile of individual cells from PBMC population

    Gene expression profile of PBMCs will be measured by single cell-RNA sequencing.

    Measured: 6 months after the second dose of herpes zoster vaccination

Secondary outcomes (23)
  1. Changes in the adaptive immune cell populations in blood

    Ratio of adaptive immune cells (T and B cells) and their subtypes will be measured by FACS.

    Measured: 2 months after influenza vaccination

  2. Changes in the adaptive immune cell populations in blood

    Ratio of adaptive immune cells (T and B cells) and their subtypes will be measured by FACS.

    Measured: 6 months after influenza vaccination

  3. Changes in the adaptive immune cell populations in blood

    Ratio of adaptive immune cells (T and B cells) and their subtypes will be measured by FACS.

    Measured: 2 months after the first dose of herpes zoster vaccination

  4. Changes in the adaptive immune cell populations in blood

    Ratio of adaptive immune cells (T and B cells) and their subtypes will be measured by FACS.

    Measured: 2 months after the second dose of herpes zoster vaccination

  5. Changes in the adaptive immune cell populations in blood

    Ratio of adaptive immune cells (T and B cells) and their subtypes will be measured by FACS.

    Measured: 6 months after the second dose of herpes zoster vaccination

  6. Baseline DNA methylation

    CpG methylation profile of PBMCs

    Measured: Baseline (before vaccination)

  7. Changes in B and T cell receptor repertoires

    B and T cell receptors will be sequenced.

    Measured: 2 months after influenza vaccination

  8. Changes in B and T cell receptor repertoires

    B and T cell receptors will be sequenced.

    Measured: 2 months after the first dose of herpes zoster vaccination

  9. Changes in B and T cell receptor repertoires

    B and T cell receptors will be sequenced.

    Measured: 2 months after the second dose of herpes zoster vaccination

  10. Changes in circulating protein concentrations

    Concentrations of circulating inflammatory proteins, including TNF, IL-6, IL-8, CCL3, CCL4, CXCL9, CXCL10, CXCL11, will be measured by Olink.

    Measured: 2 months after influenza vaccination

  11. Changes in circulating protein concentrations

    Concentrations of circulating inflammatory proteins, including TNF, IL-6, IL-8, CCL3, CCL4, CXCL9, CXCL10, CXCL11, will be measured by Olink.

    Measured: 2 months after the first dose of herpes zoster vaccination

  12. Changes in circulating protein concentrations

    Concentrations of circulating inflammatory proteins, including TNF, IL-6, IL-8, CCL3, CCL4, CXCL9, CXCL10, CXCL11, will be measured by Olink.

    Measured: 2 months after the second dose of herpes zoster vaccination

  13. Influenza vaccine-specific antibodies in the serum

    HAI titers will be measured.

    Measured: 2 months after influenza vaccination

  14. Shingles vaccine-specific antibody production in the serum

    Anti-gE titers will be measured.

    Measured: 2 months after the first herpes zoster vaccination

  15. Shingles vaccine-specific antibody production in serum

    Anti-gE titers will be measured.

    Measured: 2 months after the second herpes zoster vaccination

  16. Percentage of participants reporting local reactions

    Pain at the injection site, redness, and swelling

    Measured: 7 days after influenza and herpes zoster vaccination

  17. Percentage of participants reporting systemic events

    Fever, fatigue, headache, chills, vomiting, diarrhea

    Measured: 7 days after influenza and herpes zoster vaccination

  18. Changes in epigenetic markers in PBMCs

    ATAC-sequencing will be performed to measure post transcriptional modifications (methylation, acetylation, etc) on histones.

    Measured: 2 months after influenza vaccination

  19. Changes in epigenetic markers in PBMCs

    ATAC-sequencing will be performed to measure post transcriptional modifications (methylation, acetylation, etc) on histones.

    Measured: 6 months after influenza vaccination

  20. Changes in epigenetic markers in PBMCs

    ATAC-sequencing will be performed to measure post transcriptional modifications (methylation, acetylation, etc) on histones.

    Measured: 2 months after the first herpes zoster vaccination

  21. Changes in epigenetic markers in PBMCs

    ATAC-sequencing will be performed to measure post transcriptional modifications (methylation, acetylation, etc) on histones.

    Measured: 2 months after the second herpes zoster vaccination

  22. Changes in epigenetic markers in PBMCs

    ATAC-sequencing will be performed to measure post transcriptional modifications (methylation, acetylation, etc) on histones.

    Measured: 6 months after the second herpes zoster vaccination

  23. C-reactive protein in the serum

    Soluble C-reactive protein (CRP) concentrations will be measured.

    Measured: Baseline (before vaccination)

Timeline

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

  1. First posted19 Oct 2021
  2. Study start20 Sep 2021
  3. Primary completion17 May 2023
  4. Study completion17 May 2023

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
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
148 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05082688
Sponsor's protocol ID
NL76061.091.20
Other IDs
2020-005682-13
Status last verified
Jun 2023
First submitted
22 Jan 2021
Last updated
29 Jun 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Herpes zoster vaccination (Shingrix, GSK) and Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK) in people with Influenza and Herpes Zoster, run by Radboud University Medical Center at 1 site in Netherlands.

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 2 inclusion and 7 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 29 Jun 2023. 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 Netherlands. 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. Some participants in this study may receive a placebo. 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?

Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens (time frame: 2 months after influenza vaccination). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 29 Jun 2023.

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