The Effect of Fractional Doses of Pneumococcal Conjugate Vaccines on Immunogenicity and Carriage in Kenyan Infants (FPCV)
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ClinicalTrials.gov Identifier: NCT03489018 |
Recruitment Status :
Active, not recruiting
First Posted : November 21, 2018
Last Update Posted : November 7, 2023
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Before the introduction of pneumonia vaccines in 2000, between 700,000 - 1 million children died each year as a result of infection with the bacteria Streptococcus pneumoniae and the resulting diseases, namely, meningitis, sepsis and pneumonia. Most of the deaths were in Africa and Asia. Where the vaccines have been introduced, they have been highly effective and have already reduced disease. However, at 10 USD per child, they are not affordable to most low-income countries without financial support from Gavi, the Vaccine Alliance.
This project aims to assess whether lower doses of the two commercially available pneumonia vaccines can protect Kenyan infants as well as the full dose. The results could be used to increase the affordability of the pneumonia vaccine, and enable delivery of the vaccine to continue in the absence of Gavi support.
Condition or disease | Intervention/treatment | Phase |
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Pneumococcal Infection Streptococcus Pneumoniae Infection Invasive Pneumococcal Disease, Protection Against | Biological: PCV10 Biological: PCV13 | Phase 4 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 2100 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | Participants will be randomised to one of seven groups for the duration of the study: A. Full dose PCV13 vaccination in a 2p+1 schedule; B. 40% fractional dose PCV13 vaccination in a 2p+1 schedule; C. 20% fractional dose PCV13 vaccination in a 2p+1 schedule; D. Full dose PCV10 vaccination in a 2p+1 schedule; E. 40% fractional dose PCV10 vaccination in a 2p+1 schedule; F. 20% fractional dose PCV10 vaccination in a 2p+1 schedule; G. Full dose PCV10 vaccination in a 3p+0 schedule. |
Masking: | Triple (Participant, Investigator, Outcomes Assessor) |
Masking Description: | Participants, parents of participants and all of the study team apart from the vaccinator will be masked with respect to the infant's allocation to a trial arm between A-F. If randomly allocated to trial arm G, parents and study personnel will be unmasked due to the necessity for trial arm G to receive a different vaccine schedule compared to trial arms A-F. It is thought that this unmasking will have minimal impact on retention, follow up and outcome assessment across the trial arms for primary and secondary outcomes. |
Primary Purpose: | Prevention |
Official Title: | The Effect of Fractional Doses of Pneumococcal Conjugate Vaccines (PCV10 and PCV13) on Immunogenicity and Vaccine-serotype Carriage in Kenyan Infants |
Actual Study Start Date : | March 21, 2019 |
Actual Primary Completion Date : | September 30, 2022 |
Estimated Study Completion Date : | December 30, 2024 |
Arm | Intervention/treatment |
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Active Comparator: Full dose PCV13 (2p+1 schedule)
Full dose PCV13 administration in 2p+1 schedule
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Biological: PCV13
Experimental arms will receive a lower dose of the intervention than the marketed dose.
Other Names:
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Experimental: 40% dose PCV13 (2p+1 schedule)
Fractional (40%) dose PCV13 administration in 2p+1 schedule
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Biological: PCV13
Experimental arms will receive a lower dose of the intervention than the marketed dose.
Other Names:
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Experimental: 20% dose PCV13 (2p+1 schedule)
Fractional (20%) dose PCV13 administration in 2p+1 schedule
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Biological: PCV13
Experimental arms will receive a lower dose of the intervention than the marketed dose.
Other Names:
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Active Comparator: Full dose PCV10 (2p+1 schedule)
Full dose PCV10 administration in 2p+1 schedule
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Biological: PCV10
Experimental arms will receive a lower dose of the intervention than the marketed dose.
Other Names:
|
Experimental: 40% dose PCV10 (2p+1 schedule)
Fractional (40%) dose PCV10 administration in 2p+1 schedule
|
Biological: PCV10
Experimental arms will receive a lower dose of the intervention than the marketed dose.
Other Names:
|
Experimental: 20% dose PCV10 (2p+1 schedule)
Fractional (20%) dose PCV10 administration in 2p+1 schedule
|
Biological: PCV10
Experimental arms will receive a lower dose of the intervention than the marketed dose.
Other Names:
|
Active Comparator: Full dose PCV10 (3p+0 schedule)
The current vaccine (PCV10) and schedule (3p+0) in use in the Kenyan routine immunisation programme as an additional comparison arm.
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Biological: PCV10
Experimental arms will receive a lower dose of the intervention than the marketed dose.
Other Names:
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- Immunogenicity: The ratio of IgG GMCs at 1-month post boost [ Time Frame: 4-weeks post-boost (approximately 10 months of age) ]The ratio of the geometric mean concentrations of IgG after vaccination with 3 full or fractional doses of PCV
- Immunogenicity: the proportion of children who 'seroconvert' to vaccine-serotypes after vaccination [ Time Frame: 4-weeks post-primary series (approximately 18 weeks of age) ]The proportion of children with vaccine-serotype specific IgG antibody concentrations more than or equal to 0.35 mcg/ml after vaccination
- The proportion of children with evidence of vaccine-serotype carriage [ Time Frame: Approximately 18 months of age ]Vaccine-type carriage prevalence across arms
- The proportion of children with evidence of vaccine-serotype carriage [ Time Frame: Approximately 9 months of age ]Vaccine-type carriage prevalents across arms
- The direct vaccine effectiveness of full/fractional doses of PCV13 against carriage of serotypes 6A and 19A [ Time Frame: Approximately 18 months of age ]The direct effectiveness of full/fractional doses of PCV13 in preventing carriage of serotypes 6A and 19A compared to that of full dose PCV10
- Opsonophagocytic activity of vaccine-induced antibody to 4 serotypes [ Time Frame: Approximately 18 months of age ]Functionality of the antibody response
- Immunogenicity: the geometric mean concentration (GMC) of serotype-specific IgG [ Time Frame: 4-weeks post-primary series (approximately 18 weeks of age) ]IgG GMCs elicited post-primary series
- Safety: the prevalence of adverse events following immunisation by arm [ Time Frame: Infants 6weeks-18 months of age ]The proportion fo children with adverse events following immunisation by arm
- Immunogenicity: The geometric mean concentration (GMC) of serotype-specific IgG after the primary series of the 2p+1 schedule, prior to boost (9 months of age) and at the end of study follow-up at 18 months of age. [ Time Frame: Approximately 9 and 18 months of age ]IgG GMCs at 9 and 18 months of age
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Ages Eligible for Study: | 6 Weeks to 8 Weeks (Child) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Healthy infants aged 6-8 weeks of age (HIV positive or negative but with no symptoms of current clinical immunosuppression i.e. HIV infection at WHO clinical stage 1);
- Parents are willing to provide informed consent for their child to participate in the study
- Parents and infant are likely to remain in the study area until the infant is 18 months of age and comply with study requirements including the requirement to return to the same health facility to obtain all other childhood vaccines.
Exclusion Criteria:
- Infants >8 weeks of age at time of enrolment
- Signs or symptoms of immunosuppression or HIV infection clinical stage 2 or above.
- Acute illness (e.g. febrile disease) on the day of vaccination
- Contraindications precluding vaccination (e.g. hypersensitivity to any component of the vaccine, including diphtheria toxoid)
- Previous PCV vaccination
- Family are planning to migrate out of the study areas before the end of the study follow-up
- Family are planning to obtain the subsequent vaccine doses of the routine immunisation schedule elsewhere and therefore their child may receive a full dose under the routine vaccination programme.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03489018
Kenya | |
KEMRI Wellcome Trust Research Programme | |
Kilifi, Kenya |
Principal Investigator: | J. Anthony G Scott, DTMH FMedSci | London School of Hygiene & Tropical Medicine, Keppel Street, London |
Documents provided by London School of Hygiene and Tropical Medicine:
Responsible Party: | London School of Hygiene and Tropical Medicine |
ClinicalTrials.gov Identifier: | NCT03489018 |
Other Study ID Numbers: |
QA1075 |
First Posted: | November 21, 2018 Key Record Dates |
Last Update Posted: | November 7, 2023 |
Last Verified: | March 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | The data will be open access and held in the LSHTM data repository (http://datacompass.lshtm.ac.uk/cgi/request_doc?docid=1); Data access will be granted upon reasonable request after the primary analyses of the trial, as specified, are published. |
Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) Clinical Study Report (CSR) |
Time Frame: | After the primary analyses of the trial are published |
Access Criteria: | Upon reasonable request with pre-specified hypothesis |
URL: | http://datacompass.lshtm.ac.uk/cgi/request_doc?docid=1 |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | Yes |
Pneumococcal Vaccines; Immunogenicity, Vaccine 10-valent pneumococcal vaccine 13-valent pneumococcal vaccine Schedule Pneumococcal Infection Kenya Infant |
Vaccines, Conjugate Humans Immunization schedule Streptococcus pneumoniae vaccine Dose-Response Relationship, immunologic Equivalence Trial as Topic |
Infections Communicable Diseases Pneumonia Pneumonia, Pneumococcal Pneumococcal Infections Disease Attributes Pathologic Processes Respiratory Tract Infections Lung Diseases Respiratory Tract Diseases |
Streptococcal Infections Gram-Positive Bacterial Infections Bacterial Infections Bacterial Infections and Mycoses Pneumonia, Bacterial Vaccines Heptavalent Pneumococcal Conjugate Vaccine Immunologic Factors Physiological Effects of Drugs |