Poliomyelitis Clinical Trial
Official title:
A Phase 4, Randomized Trial to Assess the Safety and Immunogenicity of Inactivated Poliovirus Vaccine When Given Concomitantly With Measles and Rubella Combined Vaccine and Yellow Fever Vaccine at Nine Months and When Administered Via Different Vaccination Routes
The overall goal of this study is to identify interference between intramuscular Inactivated
Polio Vaccine (IPV) and other vaccines (Measles Rubella and Yellow Fever) co-administered at
nine months of age and to confirm the safety of co-administration. In addition, the study
will compare the immunogenicity and safety of IPV when administered via different routes.
A total of 1504 healthy infants between the ages of nine to ten months, who have completed
their primary immunizations, including at least three doses of trivalent Oral Polio Vaccine
(tOPV) will be recruited for this study.
In studies conducted to date, Inactivated Polio Vaccine (IPV) appears to boost the systemic
immunity generated by Oral Polio Vaccine (OPV) priming significantly more effectively than
the use of additional doses of OPV. The use of IPV to both enhance the immunity generated by
OPV and also to provide protection against circulating Vaccine Derived Polio Virus type 2
outbreaks and Vaccine Associated Paralytic Poliomyelitis has the potential to address
concerns regarding a switch to bivalent OPV.
Concomitant administration with Expanded Program of Immunisations(EPI) vaccines given at
about nine months would be a feasible programmatic approach. Maternal antibodies will have
largely waned by this point negating any inhibitory effect which they may have within the
priming schedule. Significant interference between IPV, Measles and Rubella (MR) and Yellow
Fever (YF) vaccines must be excluded to ensure that IPV introduction does not negatively
impact on the immunogenicity or safety of the other vaccines in the program at the same
point.
Restricted manufacturing capacity in the context of a higher manufacturing cost than OPV
would currently limit the rate at which IPV could be rolled out within a modified EPI
schedule. The administration of a fractional dose of the vaccine by the Intradermal route
would facilitate vaccine role out through limiting the cost and the manufacturing scale-up
required. The proposed study is phase 4, eight-arm, open label, randomized controlled
clinical vaccine trial. A total of 1504 randomized healthy infants between nine and ten
months will receive IPV, MR and YF vaccines either alone, in combinations of two vaccines, or
all three vaccines will be given together. Different routes (IM and fractional dose ID) and
needle free jet injections devices for administration of IPV will be compared in the
different groups. The participants will be assigned to one of eight groups using blocked
randomization scheme in a 1:1:1:1:1:1:1:1:1 ratio.
Non- inferiority of serological responses and median antibody titers will be the primary
immunogenicity end points. The incidence of serious adverse events and other important
medical events at any point during the study will be the primary safety end point in all
groups. Following device of reference needle/syringe administration, any local adverse event
(reactogenicity), which will be collected on day 0(day of vaccination), day 1, day 2 and day
3 will be a second primary safety endpoint.
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