Comparison of Immunogenicity of Inactivated Poliovirus Vaccine (IPV) Administered Intramuscularly or Intradermally

NCT04027036 | Completed Phase 2

• 1 other identifier: fIPV-CISPOC
• Study Type: interventional
• Target: 382
• Locations: 1 country
• Sites: 2

Brief Summary

Polio is an acute transmissible disease caused by any of the three polio virus serotypes (types 1, 2 or 3). In Mozambique, polio vaccination is part of the immunization schedule of the expanded vaccination program. The oral vaccine (OPV) is administered at months 0,2,3, and 4 and a single dose of the inactivated poliovirus vaccine (IPV) is given intramuscularly at month 4. In 2016 shortage of IPV supply caused stock-outs and put strain on IPV use for routine immunizations as well as for poliovirus outbreak response. Therefore, assessment of new vaccine regimens using smaller doses of IPV are needed. Administration of fractionated IPV (fIPV), i.e., 1/5 (0.1mL) of the standard dose, intradermally has shown to be safe and to provide an immune response similar to the standard dose of IPV that is currently given intramuscularly. However, intradermal administration of fIPV is technically difficult and many countries are hesitant to adopt fIPV in their routine immunization schedules. Therefore, the investigators need data confirming that the use of the fIPV vaccine intramuscularly is safe and the immune response is not inferior to the use of fIPV intradermally. Study Objective: to compare the immunogenicity of fIPV administered intramuscularly or intradermally in infants at 2 and 4 months of age. Study Hypotheses: the seroconversion rate after administration of one or two doses of fIPV intramuscularly is not inferior to the fIPV intradermally. The priming effect after fIPV administered intramuscularly is not inferior to the fIPV intradermally. Study Methods: This will be a phase II non-inferiority clinical trial. 360 children will be enrolled in two study groups, with prior consent of the parents / guardians. In group I, 180 children will receive 0.1 ml of IPV intramuscularly and in group II 180 children will receive the same dose intradermally. There will not be a group control. The children will be selected at birth at pre-defined health units in Maputo city. The fractional IPV vaccine will be given to children at 2 and 4 months of age during routine vaccinations. In total there will be four study visits, of which the first two are vaccination visits. All visits will be performed at the health units. 1 ml of blood will be collected at each study visit to assess the immune response before and after vaccination. Data will be collected by trained and qualified personnel and in accordance with Good Clinical Practice standards. Adverse events following administration of the vaccine will be monitored and all serious adverse events will be reported to ethics and regulatory committees, and to World Health Organization (WHO). Evaluation of the immune response: Seroconversion rates and priming effect will be evaluated. Serum will be tested for the presence of neutralizing antibodies against poliovirus using standard neutralization assays and immunogenicity will be assessed by titration of anti-polio 2 immunoglobulin G.

Conditions

Polio

Keywords

Vaccine; Polio Virus

Outcome Measures

Primary Outcomes (1)

• Seroconversion

  Difference in seroconversion between arms as expressed by proportion of seropositive children on final blood collection.

  month 5

Secondary Outcomes (1)

• Priming

  month 4+1week

Study Arms (2)

fIPV Intramuscular

ACTIVE COMPARATOR

180 children will receive 0,1 ml of inactivated poliovirus vaccine intramuscularly

Biological: Inactivated poliovirus vaccine in reduced doses

fIPV Intradermal

ACTIVE COMPARATOR

180 children will receive 0,1ml of inactivated poliovirus vaccine intradermally

Biological: Inactivated poliovirus vaccine in reduced doses

Interventions

Inactivated poliovirus vaccine in reduced doses BIOLOGICAL

contains the following excipients: 2-phenoxyethanol (2.5 mg), water for injection and diluent solution and phosphate buffer having the following composition: sodium phosphate, sodium chloride, potassium chloride, magnesium sulfate, phenol red and calcium chloride. dosage:0,1ml duration: first dose: month 2 of age; second dose: month 4 of age

fIPV Intradermal; fIPV Intramuscular

Eligibility Criteria

• Age: 2 Months - 2 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Children whose parents/guardians consent to their participation;
• Children whose parents/guardians live in the study area and do not intend to depart during the study period.

You may not qualify if:

• Children whose parents are under the legal age with exception of 16-years-old parents who are already living in marital status;
• Children whose parents have mental illness;
• Children with immunosuppression.

Sponsors & Collaborators

• Instituto Nacional de Saúde, Mozambique: lead
• World Health Organization: collaborator

Study Sites (2)

Instituto Nacional de Saúde-Mozambique CISPOC

Maputo, 21-462867, Mozambique

Location

INSMozambique

Maputo, Mozambique

Location

Related Publications (9)

• Mohammed AJ, AlAwaidy S, Bawikar S, Kurup PJ, Elamir E, Shaban MM, Sharif SM, van der Avoort HG, Pallansch MA, Malankar P, Burton A, Sreevatsava M, Sutter RW. Fractional doses of inactivated poliovirus vaccine in Oman. N Engl J Med. 2010 Jun 24;362(25):2351-9. doi: 10.1056/NEJMoa0909383.

  PMID: 20573923 BACKGROUND

• Resik S, Tejeda A, Mach O, Fonseca M, Diaz M, Alemany N, Garcia G, Hung LH, Martinez Y, Sutter R. Immune responses after fractional doses of inactivated poliovirus vaccine using newly developed intradermal jet injectors: a randomized controlled trial in Cuba. Vaccine. 2015 Jan 3;33(2):307-13. doi: 10.1016/j.vaccine.2014.11.025. Epub 2014 Nov 22.

  PMID: 25448109 BACKGROUND

• Nelson KS, Janssen JM, Troy SB, Maldonado Y. Intradermal fractional dose inactivated polio vaccine: a review of the literature. Vaccine. 2012 Jan 5;30(2):121-5. doi: 10.1016/j.vaccine.2011.11.018. Epub 2011 Nov 17.

  PMID: 22100886 BACKGROUND

• Resik S, Tejeda A, Lago PM, Diaz M, Carmenates A, Sarmiento L, Alemani N, Galindo B, Burton A, Friede M, Landaverde M, Sutter RW. Randomized controlled clinical trial of fractional doses of inactivated poliovirus vaccine administered intradermally by needle-free device in Cuba. J Infect Dis. 2010 May 1;201(9):1344-52. doi: 10.1086/651611.

  PMID: 20350164 BACKGROUND

• Cadorna-Carlos J, Vidor E, Bonnet MC. Randomized controlled study of fractional doses of inactivated poliovirus vaccine administered intradermally with a needle in the Philippines. Int J Infect Dis. 2012 Feb;16(2):e110-6. doi: 10.1016/j.ijid.2011.10.002. Epub 2011 Dec 5.

  PMID: 22153001 BACKGROUND

• Troy SB, Kouiavskaia D, Siik J, Kochba E, Beydoun H, Mirochnitchenko O, Levin Y, Khardori N, Chumakov K, Maldonado Y. Comparison of the Immunogenicity of Various Booster Doses of Inactivated Polio Vaccine Delivered Intradermally Versus Intramuscularly to HIV-Infected Adults. J Infect Dis. 2015 Jun 15;211(12):1969-76. doi: 10.1093/infdis/jiu841. Epub 2015 Jan 7.

  PMID: 25567841 BACKGROUND

• Soonawala D, Verdijk P, Wijmenga-Monsuur AJ, Boog CJ, Koedam P, Visser LG, Rots NY. Intradermal fractional booster dose of inactivated poliomyelitis vaccine with a jet injector in healthy adults. Vaccine. 2013 Aug 12;31(36):3688-94. doi: 10.1016/j.vaccine.2013.05.104. Epub 2013 Jun 13.

  PMID: 23770332 BACKGROUND

• Resik S, Tejeda A, Sutter RW, Diaz M, Sarmiento L, Alemani N, Garcia G, Fonseca M, Hung LH, Kahn AL, Burton A, Landaverde JM, Aylward RB. Priming after a fractional dose of inactivated poliovirus vaccine. N Engl J Med. 2013 Jan 31;368(5):416-24. doi: 10.1056/NEJMoa1202541.

  PMID: 23363495 BACKGROUND

• Weldon WC, Oberste MS, Pallansch MA. Standardized Methods for Detection of Poliovirus Antibodies. Methods Mol Biol. 2016;1387:145-76. doi: 10.1007/978-1-4939-3292-4_8.

  PMID: 26983734 BACKGROUND

MeSH Terms

Conditions

Poliomyelitis

Interventions

Poliovirus Vaccine, Inactivated

Condition Hierarchy (Ancestors)

Myelitis; Central Nervous System Infections; Infections; Enterovirus Infections; Picornaviridae Infections; RNA Virus Infections; Virus Diseases; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Neuroinflammatory Diseases; Neuromuscular Diseases

Intervention Hierarchy (Ancestors)

Vaccines, Inactivated; Vaccines; Biological Products; Complex Mixtures; Poliovirus Vaccines; Viral Vaccines

Study Officials

• Edna Viegas, MD,PhD

  INS-CISPOC

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 17, 2019
• First Posted: July 19, 2019
• Study Start: August 6, 2020
• Primary Completion: May 31, 2022
• Study Completion: May 31, 2022
• Last Updated: January 31, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, CSR, ANALYTIC CODE

Locations

MO (2)