Pneumonia Clinical Trial
Official title:
An Open-labeled, Randomized Controlled Trial Evaluating for Non-inferiority of 1+1 Compared to 2+1 Dosing Schedules of 10-valent and 13-valent Pneumococcal Conjugate Vaccine (PCV) in South African Children
This study will evaluate the immunogenicity of a reduced dosing schedule of Pneumococcal Conjugate vaccine (PCV) PCV10 and PCV13, in which children will receive a primary dose at either 6 or 14 weeks of age, followed by a booster dose at 9 months of age (1+1 schedule), and compare this immune response to those who receive a two dose primary series (at 6 and 14 weeks of age) and booster dose at 9-months (2+1 schedule).
Pneumonia is the leading global cause of childhood death outside of the neonatal period, and
contributes to 19% of the 10 million childhood deaths occurring annually, the majority of
which occurs in industrialising countries. Despite the successes in improving primary
healthcare in South Africa since 1994, pneumonia nevertheless remains a leading cause of
childhood death in South Africa, aggravated by the HIV/AIDS epidemic. Streptococcus
pneumoniae is recognised as the leading bacterial cause of pneumonia in children as well as
having been identified as a common cause of super-imposed bacterial infection in individuals
with respiratory virus-associated pneumonia.
In South Africa, the cost of procurement of PCV ($20 per dose) totals almost 50% of the total
cost of all vaccines purchased for the national immunisation program. Similarly, PCV is the
most expensive vaccine purchased by the Global Alliance for Vaccines and Immunisation (GAVI),
which heavily funds vaccine procurement for low income countries. The sustainability of
continued procurement of this vaccine at the current pricing in low-middle income countries
remains uncertain.
This will be a randomized, open-label study (laboratory personnel will however be blinded) in
which subjects are randomized to one of two (primary dose at either 6 or 14 weeks of age) 1+1
dosing schedules of PCV10 or PCV13, or to a 2+1 schedule of these vaccines. A total of 600
subjects will be randomized in a 1:1:1:1:1:1 ratio to one of the six groups. The study will
be undertaken at an experienced research site in Johannesburg, South Africa, where the 600
children born to HIV-uninfected women are expected to be enrolled over a 12- month period.
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