ID Administration of fIPV Using Intradermal Adapters vs. BCG Syringe

IPV Clinical Trial

— ID-ADAP  

Official title:

Intradermal Administration of Fractional Dose of Inactivated Poliovirus Vaccine Using Intradermal Adapters vs. BCG Syringe: Community Based Randomized Control Trial in Pakistan

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02769923
• Other study ID #: 3519-Ped-ERC-15
• Status: Completed
• Phase: N/A
• First received: May 2, 2016
• Last updated: September 12, 2017
• Start date: September 2015
• Est. completion date: November 2016

Study information

• Verified date: September 2017
• Source: Aga Khan University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The investigators will assess the usability and immune response following fractional dose inactivated polio virus vaccine (fIPV) administration with two novel intradermal adapters (ID adapter by West Pharmaceutical services Inc. and Star Intradermal syringe by Star Syringe Ltd.) and compare the response with the one achieved with fIPV administered with traditional BCG needle syringe.

Description:

The study will be conducted in following two phases.

1. Phase I: Ergonometric evaluation and serology: Phase I is based on community based randomized controlled trial with three arms. List of households with child aged 6-12 months will be retrieved from demographic surveillance system. Train CHWs will visit the household and provide relevant information regarding the study to the parents. The children of the parents who provide written informed consent will be screened for eligibility and enrolled into the study. The children accompanied with parents/guardians will be carried to the primary health center of the Dept. of pediatrics and child health, AKU. Baseline 3ml of blood will be collected by trained study phlebotomist in EDT tubes and will be transported to infectious disease research laboratory (IDRL) at AKU. A sample of 450 children will be randomized using sealed envelopes into one of the three study arms. Arm 1, will receive fIPV using WestPharma device, arm 2 will receive fIPV using Star ID syringe and arm 3 will receive fIPV using BCG syringe. The child will be observed for 30 minutes for any adverse event. The research Assistants will interview the parents to fill the socio-demographic questionnaire and vaccinators will fill ergonometric and injection quality questionnaires. The child will be followed after 28 days (4 weeks) of enrollment and another 3ml of blood will be collected by trained phlebotomist. Details of the visit will be recorded in follow-up questionnaire. Both baseline and endline blood samples will be tested for immune response against polio virus 1,2 and 3.

2. Phase II: Pilot campaign demonstration: In this phase, investigators will conduct a door to door campaign in the high risk community to provide fIPV using either WestPharma device or Star ID syringe or BCG needle syringe. In this campaign, any child less than 5 years of age, living in the study area and whose parents provide verbal consent will receive intradermal injection of fIPV using any of the three devices by the trained research assistants. This will be a one day campaign in coordination with provincial polio emergency operation center (EOC). About 300 children will receive fIPV using any of the three devices.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 450
• Est. completion date: November 2016
• Est. primary completion date: June 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 6 Months to 12 Months

Eligibility

Inclusion Criteria:

• Children aged 6-12 months living in four peri-urban slums of Bin Qasim Town, Karachi (Rehri Goth, Bhains Colony, Ali Akber Shah, Ibrahim Hydri).

Exclusion Criteria:

• Child found acutely ill at the time of enrolment and requiring emergent medical care/hospitalization.

• Refusal of blood testing.

• Any contraindication for ID injection.

• A diagnosis or suspicion of immunodeficiency disorder (either in the participant or in a member of the immediate family.

• e.g. several early infant deaths, household member on chemotherapy) will render the newborn ineligible for the study.

Related Conditions & MeSH terms

• IPV

Intervention

Device:
• Westpharma ID adapter
device used for administering intradermal injection
• Star ID syringe
device used for administering intradermal injection
• BCG NS
syringe used for administering intradermal injection

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
Aga Khan University	World Health Organization

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Difference in immune response against poliovirus type 1, 2 and 3 after 28 days of administration of fractional dose IPV	Seropositivity is defined as reciprocal titers of poliovirus neutralizing antibodies >8; seroconversion is defined as the change from seronegative to seropositive (from reciprocal titer of <8 to >8); and boosting is defined as >4-fold increase in titers. In this study, "immune response" combines both boosting and seroconversion.	up to day 28.
Secondary	Difference in bleb size after the intradermal injection among three arms	The bleb size will measured immediately after the administration of injection using the millimeter scale.	immediately after injection
Secondary	Difference in vaccine loss after the intradermal injection among three arms	The measurement is performed by blotting the skin with filter paper to collect liquid that was not delivered into the skin or leaked out after injection. The wet spot on the filter paper will be circled and the diameter of the circle compared to a reference template to quantify the amount of liquid present into the following categories: 0 µl, 0 to 5 µl, 5 to 10 µl, 10 to 20 µl, 20 to 40 µl, more than 40 µl.	immediately after injection
Secondary	Difference in local adverse events	local adverse events include redness, itching, etc.	within 30 minutes after injection