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Response to Live Attenuated Influenza Vaccine in Tonsillar Tissues and Blood (FLU-Tonsil)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03884296
Recruitment Status : Recruiting
First Posted : March 21, 2019
Last Update Posted : May 4, 2022
Sponsor:
Collaborators:
National Institutes of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by (Responsible Party):
Philip Grant, Stanford University

Study Description
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Brief Summary:
This is one project of a larger ongoing study related to the immune system's response to the flu virus. This study is designed to investigate the immune response to a nasal flu immunization in tonsillar tissue compared to what can be measured in the blood.

Condition or disease Intervention/treatment Phase
Influenza Biological: FluMist Phase 4

Detailed Description:

This is a Phase IV study of licensed influenza vaccines with up to 50 male and female volunteers, 2-49 years of age. Volunteers were patients undergoing tonsillectomy for treatment of obstructive sleep apnea (OSA) or other non-infectious indication as part of their routine medical care.

The investigator intends to collect blood and lymphoid tissues routinely discarded during surgery from adults and children after routine seasonal live attenuated influenza vaccination (LAIV) to determine how immune memory develops at the actual site of infection, and how immunization may alter this process.

The first research study visit will take place approximately 3-14 days prior to the scheduled date of tonsillectomy surgery. During this visit, 20 mL blood sample will be obtained and participants will receive FluMist (intranasal, quadrivalent, live-attenuated influenza vaccine). This is one of the routinely available and recommended vaccines for the age groups included in this study.

The second study visit will take place on the same day of the scheduled surgery for the tonsillectomy. Another blood sample (maximum volume of 20 mL) will be collected along with the discarded tonsillar tissue. Blood and tissues will be sent to the lab.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Basic Science
Official Title: Response to Live Attenuated Influenza Vaccine in Tonsillar Tissues and Blood
Actual Study Start Date : April 15, 2019
Estimated Primary Completion Date : December 2024
Estimated Study Completion Date : December 2024

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Flu Flu Shot Vaccines

Arms and Interventions
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Arm Intervention/treatment
Study Phase
Participants will be given the current year's quadrivalent, live, attenuated seasonal influenza vaccine (LAIV4)/FluMist® intranasally 3-14 days prior to tonsillectomy.
 Biological: FluMist
Quadrivalent, live, attenuated influenza vaccine, intranasal spray


Outcome Measures
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Primary Outcome Measures :
  1. Plasma HAI titer [ Time Frame: Day 3-14 after receipt of LAIV ]
    HAI titer measures imune response to influenza vaccination

  2. Number of Participants With Related Adverse Events [ Time Frame: Day 0 to 14 post-immunization ]
    We will capture AEs to LAIV


Eligibility Criteria
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Ages Eligible for Study:   2 Years to 49 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. 2-49-year-old male and female patients undergoing tonsillectomy for obstructive sleep apnea or other non-infectious indication.
  2. Willing and able to complete the informed consent process
  3. Availability for follow-up for the planned duration of the study
  4. Acceptable medical history by review of inclusion/exclusion criteria

Exclusion Criteria:

  1. Prior off-study vaccination with seasonal influenza vaccine within three months of study vaccination
  2. Life-threatening reactions to previous influenza vaccinations
  3. Asthma (contraindication for receipt of LAIV4)
  4. Allergy to egg or egg products or to vaccine components including gentamicin, gelatin, arginine or MSG.
  5. Active systemic or serious concurrent illness, including febrile illness on the day of vaccination
  6. History of immunodeficiency (including HIV infection)
  7. Known or suspected impairment of immunologic function; may include significant liver disease, diabetes mellitus treated with insulin or moderate to severe renal disease
  8. Hospitalization in the past year for congestive heart failure or emphysema.
  9. Chronic Hepatitis B or C.
  10. Recent or current use of immunosuppressive medication, including systemic glucocorticoids (corticosteroid nasal sprays and topical steroids are permissible). Use of oral steroids (<20mg prednisone-equivalent/day) may be acceptable after review by the investigator.
  11. Participants in close contact with anyone who has a severely weakened immune system
  12. Malignancy, other than squamous cell or basal cell skin cancer (includes solid tumors such as breast cancer or prostate cancer with recurrence in the past year, and any hematologic cancer such as leukemia).
  13. Autoimmune disease (including rheumatoid arthritis treated with immunosuppressive medication such as Plaquenil, methotrexate, prednisone, Enbrel) which, in the opinion of the investigator might jeopardize volunteer safety or compliance with the protocol.
  14. History of blood dyscrasias, renal disease, or hemoglobinopathies requiring regular medical follow up or hospitalization during the preceding year
  15. Use of any anti-coagulation medication such as Coumadin or Lovenox, or anti-platelet agents such as aspirin (except up to 325 mg. per day), Plavix, or Aggrenox will be reviewed by investigators to determine if study participation would affect the volunteer's safety or compliance with the protocol.
  16. Receipt of blood or blood products within the past 6 months or planned used during the study.
  17. A medical or psychiatric condition or occupational responsibilities that preclude participant compliance with the protocol
  18. Receipt of an inactivated vaccine 14 days prior to study enrollment, or planned vaccinations prior to completion of last study visit (~ 14 days after study vaccination)
  19. Receipt of a live, attenuated vaccine within 60 days prior to enrollment of planned vaccination prior to completion of last study visit (~ 14 days after study enrollment)
  20. Need for allergy immunization (that cannot be postponed) until after the last study visit.
  21. History of Guillain-Barre# syndrome
  22. Pregnant or breastfeeding woman
  23. Use of investigational agents within 30 days prior to enrollment or planned use during the study.
  24. Donation of the equivalent of a unit of blood within 6 weeks prior to enrollment or donation of platelets within 2 weeks of enrollment or planned donation prior to completion of the last visit.
  25. Any condition which, in the opinion of the investigator, might interfere with volunteer safety, study objectives or the ability of the participant to understand or comply with the study protocol.
Contacts and Locations
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Information from the National Library of Medicine

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): NCT03884296


Contacts
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Contact: Philip Grant, MD 6507239443 pmgrant@stanford.edu

Locations
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United States, California
Stanford University Medical Center, Lane building L134 Recruiting
Stanford, California, United States, 94305
Contact: Philip M Grant, MD    650-723-9443    pmgrant@stanford.edu   
Sponsors and Collaborators
Stanford University
National Institutes of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
More Information
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Responsible Party: Philip Grant, Assistant Professor of Medicine (Infectious Diseases), Stanford University
ClinicalTrials.gov Identifier: NCT03884296    
Other Study ID Numbers: 50122
5U19AI057229-15 ( U.S. NIH Grant/Contract )
First Posted: March 21, 2019    Key Record Dates
Last Update Posted: May 4, 2022
Last Verified: May 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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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
Keywords provided by Philip Grant, Stanford University:
Obstructive sleep apnea
Quadrivalent live, attenuated influenza vaccine
Flumist
Additional relevant MeSH terms:
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Influenza, Human
Respiratory Tract Infections
Infections
Orthomyxoviridae Infections
 RNA Virus Infections
Virus Diseases
Respiratory Tract Diseases