Ebola Virus Disease Clinical Trial
Official title:
Evaluating the Long Term Immunogenicity of Ebola Virus Vaccines Ad26-ZEBOV, MVA-BN-Filo and rVSV-ZEBOV
The aim of this study is to investigate the persistence of the vaccine induced immune
response between 24 - 60 months following primary vaccination.
The study consists of three cohorts:
Cohort 1: volunteers from the Phase 1 study of the various prime/boost regimes with two viral
vectored Ebola vaccines: Ad26-ZEBOV and MVA-BN-Filo vaccines
Cohort 2: volunteers who have been vaccinated previously with Ebola vaccine r-VSV-ZEBOV
Cohort 3: volunteers from the Phase 2 study of 3 prime/boost regimes with Ad26.ZEBOV and
MVA-BN-Filo vaccines (VAC52150EBL2001: EVOLVE).
The Ebola Virus Disease (EVD), is caused by the viruses belonging to the genus Ebola virus.
The disease occurs in sporadic outbreaks in the endemic zones of Africa and results in high
mortality. During an outbreak, human to human to transmission occurs by contact with the body
fluids of an infected individual. In the inter-endemic period the disease is zoonotically
sustained in the environment. Prevention or control of future endemic outbreaks in the high
risk areas of Africa will require effective preventative strategies including immunisation.
Cohort 1:
The Phase 1 study with the multiple heterologous prime boost regimes of the Ad26-ZEBOV and
the MVA-BN-Filo vaccines demonstrated a substantive immunogenicity and safety of the
vaccines. A combined immune response of humoral and cellular immunity was observed in the
study participants. Furthermore, persistence of the immune response was evident at one year
following the primary vaccination. It is not known whether the immune response persists
beyond this time point. The duration of the immunological response is important as it will
inform the clinical utility of the vaccines and whether or not additional booster dosage will
be required and if so, at what interval.
In this study we will invite the 56 participants from the Phase 1 study at two time points:
24 - 30 months and 36 - 48 months after receiving the primary vaccination. Following
consenting and enrolment into the study, the participants will undergo a blood test. We will
assess the humoral immunity by estimating the level of binding antibody to the Ebola virus
envelope glycoprotein. Cellular immunity will be assessed by estimating the functional CD4+
and the CD8+ T cells secreting the pro-inflammatory cytokines. We will undertake this
assessment by intracellular staining of the peripheral blood mononuclear cells (PBMC) and
using flowcytometry technique to identify the positively stained cells. A second assessment
of the cellular immunity will be carried out by an in-house ELISpot technique subject to
availability of additional funding.
Cohort 2:
In October 2015, contacts of a laboratory-confirmed case of Ebola virus diseases (EVD) in the
U.K. were given the rVSV-EBOV vaccine as a part of clinical preventative care. Subsequently,
these recipients of the rVSV-EBOV vaccine were enrolled and followed up for safety and immune
response until one year post vaccination in the Glasgow Ebola Vaccine Follow-up Study (REC
reference 15/WS/0251). The duration of persistence of the immune response to rVSV-EBOV beyond
360 days is unknown and may impact on the use of the vaccine in any future Ebola outbreaks.
This study provides an opportunity to study the immune response beyond 1 year from the prime
vaccination and to compare those results with the response to MVA-BN-Filo and Ad26-ZEBOV
vaccines. This study will also allow for a further period of safety follow-up for this
cohort.
Twenty-six individuals were vaccinated with the r-VSV-EBOV Ebola vaccine in Glasgow following
possible exposure to a patient with confirmed Ebola virus disease as a part of preventative
clinical care. All 26 individuals will be invited to take part in this study.
Cohort 3:
This cohort consists of participants from the Phase 2 study of 3 prime/boost regimes with
Ad26.ZEBOV and MVA-BN-Filo vaccines (VAC52150EBL2001: EVOLVE). This was a randomized,
observer-blind, placebo-controlled, parallel-group, multicentre, Phase 2 study to evaluate
the safety, tolerability and immunogenicity of 3 heterologous prime-boost regimens which
differed in the timing of the boost vaccination. The dose of each study vaccine (Ad26.ZEBOV,
MVA-BN-Filo or placebo) and the sequence of vaccination were identical in each group. The
prime/boost regimens were commenced in July 2015 and completed in February 2016.
Recruitment of participants in Group 1 (unblinded) of EVOLVE into the PRISM study can
commence once all approvals are in place. However, for participants in Group 2 (blinded) of
the EVOLVE study, recruitment and enrolment will not commence until after EVOLVE has been
unblinded (anticipated to occur in Q4 2018 - Q1 2019).
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