RSV InfectionsPhase 3NCT06955728
A Clinical Trial on Safety in Pregnant Women and How Well the Infant is Protected Against RSV-associated Lower Respiratory Tract Infection When the Pregnant Woman Receives the Approved RSV Vaccine Compared to a Placebo.
A Phase 3 study testing Vaccine in people with RSV Infections and RSV Immunisation, run by University of Witwatersrand, South Africa at 11 sites in 4 countries.
Trial summary
Respiratory syncytial virus (RSV) is a virus that often affects children during childhood. Even though most cases of RSV are mild, it can cause serious disease and even death - especially in very young babies, babies born too early and those born with heart and lung problems. Read more about this study
- Who is it for?
- Ages 14 to 55 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- RSV Infections, RSV Immunisation, Preterm Labour
- What is being tested?
- Vaccine
- Type of treatment
- Vaccines
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 13,000 participants
- Where
- 11 sitesin 4 countries
- Study dates
- 3 Sep 2025to 29 Feb 2028
- Phase
- Phase 3
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 14 to 55 years
- Women only
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Pregnant women considered to be legally competent, as per country legislation, to consent for trial participation for herself and her newborn
- At a gestational age in keeping with in-country approval of the vaccine administration, and not in active labour. Gestational age will be based on GAIA LOC 1 to 2B criteria
- Mother is able to understand and comply with planned trial procedures
- Mother is attending ante-natal clinic
- Mother has documented test for HIV and syphilis during the current pregnancy,
- Provides written informed consent prior to initiation of trial. If the maternal participant is illiterate, a witnessed thumb-printed informed consent is acceptable
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- Intention to deliver at a hospital or birthing facility where trial procedures can be obtained (for immunogenicity cohort)
- Expected to be available for the duration of the trial and can be contacted by telephone or by physical visit during trial participation
- Participant is willing to give informed consent for her infant to participate in the trial
Who cannot join
- Body mass index of >40 kg/m2 at the time of the first obstetric visit during the current pregnancy
- Bleeding diathesis or condition (past or present) associated with prolonged bleeding that would, in the opinion of the investigator, contra-indicate intramuscular injection
- History of severe adverse reaction associated with a vaccine
- Current pregnancy complications or abnormalities at the time of consent that will increase the risk associated with the participation in and completion of the trial, including but not limited to the following:
- More than two fetuses (i.e. twins will be allowed)
- Preeclampsia, eclampsia, or uncontrolled gestational hypertension
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- Known placental abnormality.
- Known polyhydramnios or oligohydramnios
- Known endocrine disorders, including untreated hyperthyroidism or untreated hypothyroidism, or uncontrolled diabetes mellitus at the time of consent.
- Any signs of premature labour with the current pregnancy or having ongoing intervention (medical/ surgical) in the current pregnancy to prevent preterm birth.
- At least THREE prior pregnancy complications or abnormalities at the time of consent, based on the investigator's judgment, that will increase the risk associated with the participation in and completion of the trial, including but not limited to the following:
- Prior preterm delivery between 18 to ≤34 weeks gestation, or birth weight <2200 grams; (may be based on maternal history of prior preterm delivery where these details are not otherwise documented)
- Prior stillbirth or neonatal death within 7 days of birth.
- Previous infant with a known genetic disorder or major congenital anomaly
- Mother who is positive for syphilis and untreated at time of enrolment
- Mother living with HIV/AIDS considered to have WHO Clinical Stage 3 or 4 AIDS, or considered to be clinically unstable
- Major illness of the maternal participant or conditions of the foetus that, in the investigator's judgment, will substantially increase the risk associated with the maternal participant's participation in, and completion of, the trial
- Known or history of congenital or acquired immunodeficiency disorder, or rheumatologic disorder or other illness requiring chronic treatment with known immunosuppressant medications, including monoclonal antibodies, within the year prior to enrolment
- Other acute or chronic medical or psychiatric condition including recent (within the past year) or active suicidal ideation or behaviour or laboratory abnormality that may increase the risk associated with trial participation and, in the judgment of the investigator, would make the participant inappropriate for entry into this trial
- Participation in other studies involving investigational drug(s) within 28 days prior to consent and/or during trial participation.
- Use of systemic corticosteroids for >14 days within 28 days prior to trial enrolment. Prednisone use of <20 mg/day for ≤14 days is permitted. Inhaled/nebulized, intra-articular, intra-bursal, or topical (skin or eyes) corticosteroids are permitted
- Current alcohol abuse or illicit drug use
- Receipt of blood or plasma products or immunoglobulin (Ig) in past 60 days or planned receipt through delivery, with exception of Rho(D) immune globulin (eg, RhoGAM), which can be given at any time
- Previous vaccination with any licensed or investigational RSV vaccine or planned receipt during trial participation
Trial locations and contacts
11 sites in 4 countries. Contact the study team or a site near you to ask about taking part.
11 sites in 4 countries
South Africa6 sites, 6 recruiting
- Recruiting
Enhancing Care Foundation
Durban, KwaZulu-Natal, 4052
Rosie Mngqibisa, +27312611093, mngqibisa@ecarefoundation.com
Rosie Mngqibisa
- Recruiting
Wits RHI Shandukani CRS
Hillbrow, Gauteng, 2001
Lee Fairlie, lfairlie@wrhi.ac.za
Lee Fairlie
- Recruiting
VIDA Nkanyezi Research Unit
Johannesburg, Gauteng, 2093
Renate Strehlau, +27114709214, renate.strehlau@wits.ac.za
Renate Strehlau
- Recruiting
MRC Unit on Child and Adolescent Health
Rondebosch, Western Cape, 7700
Heather Zar, +27216585324, heather.zar@uct.ac.za
Heather Zar
- Recruiting
Setshaba Research Centre
Soshanguve, Gauteng, 0152
Patience Kwedza, +27127992422, pkwedza@setshaba.org.za
Patience Kwedza
- Recruiting
Wits Vaccines & Infectious Diseases Analytics (VIDA) Research unit
Soweto, Gauteng, 1864
Johann Greffrath, +27119834283, johann.greffrath@wits-vida.org
Johann Greffrath
Ghana2 sites, 2 recruiting
- Not yet recruiting
Dodowa Health Research Centre
Dodowa, Greater Accra Region
George Armah, +233244167999, GArmah@noguchi.ug.edu.gh
George Armah
- Not yet recruiting
Kintampo Health Research Centre
Kintampo, Bono East
Kwaku Poku Asante, +233 20 931 9145, kwakupoku.asante@kintampo-hrc.org
Kwaku Poku Asante
Kenya2 sites, 2 recruiting
- Not yet recruiting
Kenya Medical Research Institute Wellcome Trust
Kilifi, Kilifi County, 230-80108
Joyce Nyiro, +254724895735, jnyiro@kemri-wellcome.org
Joyce Nyiro
- Recruiting
Kenya Medical Research Institute Centre for Global Health Research
Kisumu, Nyanza, 40100
Nancy Otieno, (057) 2022983, notieno@kemri.go.ke
Nancy Otieno
The Gambia1 site, 1 recruiting
- Recruiting
MRC Unit The Gambia at London School of Hygiene & Tropical Medicine
Basse Santa Su, Upper River Division
Grant Mackenzie, (+220) (0) 4495835, gmackenzie@mrc.gm
Grant Mackenzie
About this study
Official title: A Phase-IIIb Individually Randomized, Placebo-controlled Trial on Safety of RSVA/B-preF Vaccine in Pregnant Women and Efficacy Against Severe RSV-associated Lower Respiratory Tract Infection in Infants
Respiratory syncytial virus (RSV) is a virus that often affects children during childhood. Even though most cases of RSV are mild, it can cause serious disease and even death - especially in very young babies, babies born too early and those born with heart and lung problems. It is the most common cause for children under 5 years old to be hospitalised. In 2019, there were about 33 million RSV-infections in the lower respiratory tract (in the lungs and below the voice box) of which 3,6 million people were hospitalised and 26,300 passed away in hospital due to RSV. Almost half (50%) of deaths that are caused by RSV, happen in children younger than 6 months old and the majority (more than 95%) of these deaths happen to infants and children in low- and middle-income countries.
A way that can help protect babies from becoming infected is through giving vaccines against the germ (RSV) that is targeted for prevention. There are currently no registered vaccines that can be given directly to babies however there is a lot of information available that shows that a vaccine can be safely giving to a mother while she is still pregnant. The mother then produces antibodies (protection cells) that is transferred to the baby before the baby is born, and the baby is protected from getting sick during the first few months of life.
Read more
One of the vaccines that has been developed (ABRYSVO) has been used in many clinical trials in pregnant moms (and older people) to test if it is safe and will protect young babies and much older people who are all at the highest risk for a severe RSV disease. The vaccine was given to more than 4,000 pregnant women. The results from the study and previous studies showed that the vaccine was safe and the babies had a lower chance of getting severe RSV disease and going to hospital. It showed that the vaccine prevented severe RSV infection in around 80% of babies younger than 90 days, and 70% of babies younger than 6 months. Therefore, the vaccine has been licensed in a few countries around the world (including the United States of America and other high-income countries) which means that pregnant women can receive this vaccine during their pregnancy if they wish to (without being on a clinical trial). It has also been licensed in South Africa but is not yet available in the country for pregnant women to receive. The licensure is also underway in other African countries.
However, the results of the previous studies of this vaccine also showed that a slightly higher number of premature babies were born to women who received the vaccine compared to women who did not receive the vaccine. The information received from these studies was however not enough to decide if the earlier births were related to the vaccine or not, and more information is needed - which is one of the main reasons for this study. Importantly, all of the babies who were born earlier were only born a few weeks earlier than expected (around 35 weeks of pregnancy), and all the babies were well and survived. The previous studies on this vaccine happened during the COVID-19 pandemic at which time people were wearing masks and contacting other people less therefore not spreading RSV around as we would normally expect. By doing this study, it will assist the investigators to determine if the vaccine is really as good as it is perceived to be for preventing serious RSV illness in the babies.
This RSV vaccine is a very important medical intervention, and it is as important that the effect that this vaccine will have on pregnant women and on the infants born to mothers who receive the vaccine can be measured. It is especially important in African and lower-middle income countries as the vaccine was not tested as much in people living in Africa compared to others. Therefore, the main reason for doing this trial is to see how much value the vaccine can bring to these countries in terms of protecting young babies and infants where many may get a severe infection and be hospitalised. It will also measure if the vaccine does increase the chances of a baby being born earlier than expected. It will only be carried out in the countries after the vaccine has been approved for use by pregnant women (at the right time) as part of their pregnancy care.
- Conditions
- RSV Infections, RSV Immunisation, Preterm Labour
- Being tested
- Vaccine, Placebo
- Medical subject headings
- Respiratory Syncytial Virus Infections, Obstetric Labor, Premature
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
VaccineDrug
The active ingredients in RSVpreF are 2 stabilized RSV prefusion F antigens, in equal amounts from virus subgroups A and B, in a lyophilized dosage form for reconstitution.
PlaceboOther
Placebo matched to vaccine but not containing any active ingredients
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Control group will receive the placebo which will match the vaccine to maintain the blind but will not contain any active product. Participants will be randomised 1:1 Receives: Other: Placebo |
| ABRYSVO (RSV A/B-pre-F vaccine) | Active comparator | ABRYSVO vaccine developed by Pfizer. The active ingredients in RSVpre-F are 2 stabilized RSV prefusion F antigens, in equal amounts from virus subgroups A and B, in a lyophilized dosage form for reconstitution Receives: Drug: Vaccine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Evaluate the efficacy of RSVA/B-preF against RSV-A or RSV-B subtype confirmed severe LRTI through to 180 days of age by measuring the first occurrence of RT-PCR confirmed RSV severe LRTI
The presence of LRTI will be confirmed according to case definition. The severity of LRTI will be based on the WHO grading criteria
Measured: From infant birth to 180 days of age
Evaluate the safety of RSVA/B-preF in relation to preterm births in women with gestational age (GA) staging Level of Certainty [LOC] 1 to 2B at time of enrolment by measuring the occurrence of preterm births (<37 weeks GA)
The GA staging will be based on Global Alignment on Immunization safety Assessment (GAIA) criteria
Measured: At delivery of the infant
Secondary outcomes (8)
Evaluate the efficacy of RSVA/B-preF against RSV-confirmed severe LRTI through to 90, 120 and 150 days of age by measuring the first occurrence of RT-PCR confirmed RSVA or RSVB severe LRTI
Measured: 90, 120 and 150 days of age
Evaluate the efficacy of RSVA/B-preF against RSV-confirmed LRTI resulting in hospitalization with use of supplemental oxygen OR O2 saturation of <92% (at 180 days, 90, 120 & 150 days) by measuring the first occurrence of RT-PCR confirmed RSVA or RSVB
Measured: At 90, 120, 150 and 180 days of age
Evaluate the efficacy of RSVA/B-preF against RSV-confirmed MA-LRTI and very-severe LRTI (at 180 days, and 90, 120 and 150 days) by measuring the first occurrence of RT-PCR confirmed RSVA or RSVB MALRTI or very-severe LRTI
Measured: 90, 120, 150 and 180 days of age
Evaluate the efficacy of RSVA/B-preF against RSV-confirmed: a. MA-LRTI; b. severe-LRTI; c. very-severe LRTI; d. LRTI hospitalization from 0 to 90 days and 91-180 days by measuring the first occurrence of RT-PCR confirmed RSVA or RSVB MA-LRTI
Measured: 0-90 and 91-180 days of age
Evaluate the efficacy of RSVA/B-preF against all-cause: a. MA-LRTI; b. severe LRTI; c. very-severe LRTI; d. LRTI hospitalization, by measuring the first occurrence of all-cause MALRTI
Measured: at 180 days, and 90, 120, and 150 days; and at 0-90 days and 91-180 days of age
Evaluate the safety of RSVA/B-preF against prematurity in women vaccinated at 28 to <32 weeks, 32 to 36 weeks by measuring the occurrence of pre-term delivery (<37 weeks)
Limited to women with GA staging using GAIA LOC 1 to 2B at time of enrolment
Measured: At delivery of the infant
Evaluate the safety of RSVA/B-preF against prematurity occurring at 28 to <32 weeks, 32 to 36 weeks by measuring the occurrence of pre-term delivery in the mentioned intervals
Limited to women with GA staging using GAIA LOC 1 to 2B at time of enrolment
Measured: At delivery of the infant
Evaluate the safety of RSVA/B-preF against low birth weight (<2500 grams) and very low birth weight (<1500 grams) by measuring the occurrence of low and very low birth weights
Measured: At delivery of the infant
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 May 2025
- Study start3 Sep 2025
- Primary completion29 Feb 2028 (estimated)
- Study completion29 Feb 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for RSV InfectionsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Although the active study intervention is an approved product, the trial has been re-classified at a Phase IIIb trial per the Regulator's request.
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 13,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Witwatersrand, South Africa
- Sponsor type
- University, hospital or other
- Collaborators
- World Health Organization, Bill and Melinda Gates Foundation
- Responsible party
- Sponsor
- Investigators
- Shabir Madhi, Study chair, Wits Vaccines & Infectious Diseases Analytics Research UnitZiyaad Dangor, Study director, Wits Vaccines & Infectious Diseases Analytics Research Unit
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06955728
- Sponsor's protocol ID
- RSV_IMPACT
- Status last verified
- May 2026
- First submitted
- 14 Apr 2025
- Last updated
- 18 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Progress reports for this trial will be made available to the trial funder, ethics committees, regulatory authorities and other stakeholders. Final trial results will be shared with the same stakeholders within 3 months of final lock of the trial database. Study data will be shared with Pfizer in the event of safety concerns or a request from a regulatory agency. Manuscript(s) will be prepared and submitted for peer-review in open access journals. All proposed publications will first be reviewed by Pfizer prior to publication for review of potential confidential information. A publication plan and proposal for criteria of authorship will be established with the sites. The trial database will be made publicly available upon request. Any transfer of data, will be governed, by the terms of the local Ethics Committee (HREC).