Healthy Infants Clinical Trial
Official title:
A Clinical Trial in Healthy Infants to Assess Lot-to-lot Consistency of Japanese Encephalitis Live Attenuated SA 14-14-2 Vaccine Manufactured in a New Good Manufacturing Practices Facility and Non-inferiority With Respect to an Earlier Product.
The proposed Japanese Encephalitis (JE)Vaccine study is a four-arm double-blind randomized controlled single center trial to evaluate, by examining post-vaccination seroprotection titers, the lot-to-lot consistency of three lots of JE live attenuated SA 14-14-2 vaccine manufactured in a new GMP facility, and to establish non-inferiority of the new vaccine in comparison to a single lot of the same vaccine manufactured in the existing facility. The study will enroll a total of 1,000 Bangladeshi infants aged 10 to 12 months. In addition to providing immunogenicity data, JEV05 will provide local safety data of JE live attenuated SA 14-14-2 vaccine among Bangladeshi children. This will be the first step to secure licensure for this life-saving vaccine in Bangladesh as well as provide data to support WHO prequalification of JE live attenuated SA 14-14-2 vaccine.
Vaccination is the most effective intervention to prevent JE and its associated morbidity
and mortality (http://www.who.int.nuvi/Je/en). JE live attenuated SA 14-14-2 vaccine has
been used in Asia for more than two decades in over 400 million children. Chengdu Institute
of Biological Products (CDIBP), a Chinese manufacturer, has been producing JE live
attenuated SA 14-14-2 vaccine since 1988. It has been demonstrated to be both safe and
immunogenic in several observational and case-control studies providing protection for at
least 5 years following a single dose. JE live attenuated SA 14-14-2 vaccine is licensed for
use in China, India, Nepal, South Korea, Sri Lanka, and Thailand. Countries that have
introduced JE vaccine into their national immunization programs have experienced dramatic
reductions in JE incidence, leading WHO to declare vaccination the preferred JE control
strategy.4
In order for JE live attenuated SA 14-14-2 vaccine to be available for purchase through
UNICEF and GAVI for broader international use, including in Bangladesh, JE live attenuated
SA 14-14-2 vaccine needs to undergo WHO prequalification. With technical support from PATH,
CDIBP has established a new GMP facility, Building 208 JE production unit, maintaining WHO
standards. A GMP Certificate for the new facility was issued on 11/16/2011. This certificate
provides market authorization to distribute the new vaccine in China. To achieve WHO
prequalification, JE live attenuated SA 14-14-2 vaccine produced in this new GMP facility
needs to be shown to be similarly safe and immunogenic to JE live attenuated SA 14-14-2
vaccine produced in the existing facility, the JE viral vaccine production plant, and needs
to demonstrate lot-to-lot consistency.
The proposed JEV05 study is a four-arm double-blind randomized controlled single center
trial testing the immunogenicity of four lots of JE live attenuated SA 14-14-2 vaccine -
three lots manufactured in the new GMP facility and one lot from the existing facility - in
a total of 1000 Bangladeshi infants aged 10 to 12 months. The study will be conducted in the
Matlab Health and Demographic Surveillance System (HDSS) intervention area, a rural site
where many vaccine trials have been conducted.
A 5 ml blood sample will be collected from each child before vaccination and at 28 days
post-vaccination. The sera will be tested using a plaque reduction neutralization test
(PRNT) with JE neutralizing antibody titers > 1:10 considered seroprotective. The JEV05
trial will provide immunogenicity data on the three vaccine lots produced in the new GMP
facility compared to a vaccine lot produced in the prior existing plant. It will also
provide local immunogenicity and safety data of JE live attenuated SA 14-14-2 vaccine among
Bangladeshi children. This will be the first step to secure licensure for this life-saving
vaccine in Bangladesh as well as provide data to support WHO prequalification of JE live
attenuated SA 14-14-2 vaccine.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Basic Science
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