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COVID-19Phase 4NCT05343871

Immunogenicity and Safety of Fractional Booster Dose of COVID-19 Vaccines Available for Use in Pakistan/Brazil: A Phase 4 Dose-optimizing Trial

A Phase 4 study testing Sinovac, AZD1222 and BNT162b2 in people with COVID-19, run by Albert B. Sabin Vaccine Institute at 2 sites in 2 countries.

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

Since the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogen in late 2019, millions of people around the world have fallen ill and died from coronavirus disease 2019 (COVID-19), with variant-fueled case spikes causing repeated cycles of morbidity and mortality. Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
COVID-19
What is being tested?
Sinovac, AZD1222 and BNT162b2
Type of treatment
Vaccines
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,354 participants
Where
2 sitesin 2 countries
Study dates
5 Jul 2022to 11 Jan 2024
Phase
Phase 4
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 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Healthy male or female individuals aged 18 years to 60 years
  • Participant is willing and able to give written informed consent for participation in the trial
  • Individuals who can comply with trial procedures and are available for the duration of follow-up.
  • Brazil:
  • ● Previous vaccination with a complete primary series of Sinovac (Priming Group 1), AZD1222 (Priming Group 2), or BNT162b2 (Priming Group 3-B) at least 6 months prior to screening
  • Pakistan:
  • ● Previous vaccination with a complete primary series of Sinovac (Priming Group 1) or AZD1222 (Priming Group 2) at least 6 months prior to screening, or PCR-confirmed natural infection (Priming Group 3-P) between February 2021 - 6 months prior to screening

Who cannot join

  • Has a contraindication to BNT162b2, AZD1222 or Sinovac
  • Has received an incomplete primary COVID-19 vaccination series
  • Has received 3 doses of COVID-19 vaccine
  • Has received heterologous primary COVID-19 vaccination series
  • History of a solid organ or bone marrow transplant
  • History of malignancy (other than non-melanoma skin cancer) within the past five years
Show all 21Show fewer
  • Currently on hemodialysis
  • Any confirmed or suspected immunosuppressive or immunodeficiency condition or diagnosis
  • On chronic (>30 days) use of immunosuppressive medications at the time of enrollment (except topical steroids or short-term oral steroids, i.e., ≤14 days)
  • Known diagnosis of HIV with CD4 count <200 cells/mm3 (in the past 6 months)
  • Active or history of previous auto-immune neurological disorders (e.g., multiple sclerosis, Guillain-Barre syndrome, transverse myelitis) (excluding Bell's palsy)
  • Has received anti-CD20 monoclonal antibodies for any reason in the past 12 months
  • Has received monoclonal antibodies to treat a previous COVID-19 event
  • Pregnant at screening
  • Positive SARS-CoV-2 Antigen test in respiratory specimen at screening
  • Planning to migrate out of the study area within 6 months of the enrollment
  • Participants currently enrolled in any other COVID-19 vaccine research trial in which they are getting a COVID-19 vaccine during the study period
  • Illiterate individuals (Brazil only)
  • Has a severe and/or uncontrolled comorbidity
  • Pakistan (natural infection Priming Group (Priming Group 3-P)):
  • ● Prior vaccination with ANY vaccine against COVID-19

Trial locations and contacts

2 sites in 2 countries.

2 sites in 2 countries

Brazil1 site
  • FIOCRUZ

    Campo Grande, MS Do Sul

Other trials in Brazil

Pakistan1 site
  • Aga Khan University Clinical Trials Unit

    Karachi, Sindh

Other trials in Pakistan

About this study

Official title: Randomized Controlled Trial to Assess the Immunogenicity and Safety of Full Versus Fractional Dose of Pfizer/BioNTech, AstraZeneca, and Sinovac COVID-19 Vaccines Given as a Booster Dose at Least 6 Months After Primary Vaccination Series or PCR-confirmed Infection With SARS-CoV-2 in Healthy Adults

Since the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogen in late 2019, millions of people around the world have fallen ill and died from coronavirus disease 2019 (COVID-19), with variant-fueled case spikes causing repeated cycles of morbidity and mortality. The rapid development and emergency use authorization of vaccines against SARS-CoV-2 presents an enormous opportunity to protect populations, but bottlenecks in production have led to demand for vaccines that far outpaces supply. This project will investigate the immunogenicity of fractional doses of SARS-CoV-2 vaccines given a minimum of six months following an initial two-dose schedule or following natural immunity via documented infection. The consortium of research partners from the Sabin Vaccine Institute, Aga Khan University, Fundação Oswaldo Cruz (Fiocruz), and Stanford University will recruit volunteers to receive a full or fractional booster dose of BNT162b2, AZD1222 or Sinovac following receipt of their primary vaccination series or PCR-confirmed natural infection in Pakistan. The research team will follow participants for six months from boosting, with blood draws at baseline, 28 days, 3 months and 6 months, and measure sero-response rate (SRR) by anti-Spike immunoglobulin G (IgG) binding enzyme-linked immunosorbent assay (ELISA) with the ultimate aim of identifying whether fractional doses provide a similar immune response compared to full doses of vaccine.

Conditions
COVID-19
Being tested
Sinovac, AZD1222, BNT162b2
Keywords
Fractional dose, COVID-19
Medical subject headings
COVID-19

What participants receive

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

  • SinovacBiological

    Sinovac inactivated COVID-19 vaccine:

    ● Full dose (0.5 ml)

  • AZD1222Biological

    AstraZeneca ChAdOx1-S recombinant AZD1222 vaccine:

    • Full dose (0.5 ml)
    • Half dose (0.25 ml)
  • BNT162b2Biological

    Pfizer/BioNTech BNT162b2 mRNA vaccine:

    • Full dose (30 micrograms)
    • Half dose (15 micrograms)
    • One-third dose (10 micrograms)
Study groups in NCT05343871
Study groupRoleWhat they receive
Priming Group 1: Sinovac Prime, AZD1222 ½ dose (Brazil only)ExperimentalNot described
Receives: Biological: AZD1222
Priming Group 1: Sinovac Prime, AZD1222 full dose (Brazil only)Active comparatorNot described
Receives: Biological: AZD1222
Priming Group 1: Sinovac Prime, BNT162b2 1/3 doseExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 1: Sinovac Prime, BNT162b2 1/2 doseExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 1: Sinovac Prime, BNT162b2 full doseActive comparatorNot described
Receives: Biological: BNT162b2
Priming Group 1: Sinovac Prime, Sinovac full doseActive comparatorNot described
Receives: Biological: Sinovac
Priming Group 2: AZD1222 Prime, AZD1222 ½ dose (Brazil only)ExperimentalNot described
Receives: Biological: AZD1222
Priming Group 2: AZD1222 Prime, AZD1222 full dose (Brazil only)Active comparatorNot described
Receives: Biological: AZD1222
Priming Group 2: AZD1222 Prime, BNT162b2 1/3 doseExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 2: AZD1222 Prime, BNT162b2 1/2 doseExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 2: AZD1222 Prime, BNT162b2 full doseActive comparatorNot described
Receives: Biological: BNT162b2
Priming Group 3-B: BNT162b2 Prime, AZD1222 ½ dose (Brazil only)ExperimentalNot described
Receives: Biological: AZD1222
Priming Group 3-B: BNT162b2 Prime, AZD1222 full dose (Brazil only)Active comparatorNot described
Receives: Biological: AZD1222
Priming Group 3-B: BNT162b2 Prime, BNT162b2 1/3 dose (Brazil only)ExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 3-B: BNT162b2 Prime, BNT162b2 1/2 dose (Brazil only)ExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 3-B: BNT162b2 Prime, BNT162b2 full dose (Brazil only)Active comparatorNot described
Receives: Biological: BNT162b2
Priming Group 3-P: Natural Infection Prime, BNT162b2 1/3 dose (Pakistan only)ExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 3-P: Natural Infection Prime, BNT162b2 1/2 dose (Pakistan only)ExperimentalNot described
Receives: Biological: BNT162b2
Priming Group 3-P: Natural Infection Prime, BNT162b2 full dose (Pakistan only)Active comparatorNot described
Receives: Biological: BNT162b2

What is being measured

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

  1. Sero-response rate by Spike IgG binding ELISA at 28 days post booster

    Assess and compare humoral immune response from a fractional vs. full booster dose of BNT162b2 or AZD1222 in immunocompetent adults fully primed with BNT162b2, AZD1222, or Sinovac vaccines or natural infection, measured by anti-Spike IgG binding ELISA at 28 days post booster

    Measured: Day 28

  2. Safety and reactogenicity profile of fractional and full dose of study vaccines at 28 days post-booster vaccination

    Describe the safety and reactogenicity profile of fractional and full dose of study vaccines at 28 days post-booster vaccination through estimated incidence of solicited local and systemic adverse events, and incidence of unsolicited reported adverse events

    1. Occurrence of solicited local and systemic reactions within 7 days of booster
    2. Occurrence of unsolicited AEs within 28 days of booster

    Measured: Day 28

Secondary outcomes (2)
  1. Sero-response rate by anti-Spike IgG binding ELISA at 3m and 6m post booster

    Assess the persistence of humoral immunity after a fractional vs. full booster dose of BNT162b2 or AZD1222 in immunocompetent adults fully primed with BNT162b2, AZD1222, or Sinovac vaccines or natural infection, measured by anti-Spike IgG binding ELISA at 3m and 6m post booster

    Measured: Month 3 and Month 6

  2. Safety and reactogenicity profile of fractional and full dose of study vaccines throughout the trial

    Describe the safety and reactogenicity profile of fractional and full dose of study vaccines throughout the trial

    1. Occurrence of Medically attended adverse reactions within 3 months of booster
    2. Occurrence of adverse events (AE), Serious adverse events (SAE), and adverse events of special interest (AESI) within 28 days, 3 months, and 6 months of booster

    Measured: Throughout study, 6 months per participant

Timeline

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

  1. First posted25 Apr 2022
  2. Study start5 Jul 2022
  3. Primary completion28 Jul 2023
  4. Study completion11 Jan 2024

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 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
2,354 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05343871
Sponsor's protocol ID
Sabin CoV 22
Status last verified
Jan 2024
First submitted
20 Apr 2022
Last updated
30 Jan 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Barros Verruck J, Moreira Puga MA, de Oliveira RD, Vieira da Silva P, Charu V, Hedlin H, Lu D, Zhang A, Ritter V, Shaw B, Rosser JI, Seidman JC, Carter AS, Qamar F, Luby S, Garret D, Croda J. Antispike IgG antibody decay after immunisation with fractional versus full booster doses of COVID-19 vaccines: a 6-month longitudinal analysis of the FRACT-COV trial in Brazil. BMJ Public Health. 2025 Jul 5;3(2):e002331. doi: 10.1136/bmjph-2024-002331. eCollection 2025.

    PubMed 40620571

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Sinovac, AZD1222 and BNT162b2 in people with COVID-19, run by Albert B. Sabin Vaccine Institute at 2 sites in 2 countries.

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 7 inclusion and 21 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 30 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Brazil, Pakistan. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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?

Sero-response rate by Spike IgG binding ELISA at 28 days post booster (time frame: Day 28). The study lists 2 primary outcomes in all. 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 NCT05343871, which also lists 1 linked publication.

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 30 Jan 2024.

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