Study of the immunogenicity and safety of a single dose of a Live Attenuated Influenza Vaccine (LAIV) (FluenzTM) for each of three successive years in children naïve to, or in previous receipt of the AS03B adjuvanted H1N1 (2009)

ISRCTN ISRCTN11725083
DOI https://doi.org/10.1186/ISRCTN11725083
EudraCT/CTIS number 2013-003592-35
Secondary identifying numbers 16161
Submission date
17/04/2014
Registration date
17/04/2014
Last edited
21/06/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
The Department of Health has recently announced the implementation of annual vaccination for all those aged 18 years and under, with a type of flu vaccine called live attenuated influenza vaccine (LAIV). This is given as a nasal spray. The programme began in the influenza season, from September 2013, with children aged 2-4 years of age, and older children being included from the influenza season of 2014. This study aims to measure immune responses to the flu vaccination over three subsequent years.

Who can participate?
The study will include 500 children aged 5-10 years at enrolment.

What does the study involve?
All children in the study will be given flu vaccine annually and followed up over three continuous influenza seasons 2013/14, 2014/15 and 2015/16. Immune responses to the flu virus type (strain) present in the vaccine and to similar strains not contained in the vaccine, will be measured using blood samples and oral fluid samples collected before and 3 weeks after each annual vaccination. Participants will also be monitored throughout each influenza season for evidence of laboratory-confirmed influenza infection and other viral infections. Nasal swabs will be obtained by parents during any episode of influenza-like illness. Parents will be asked to complete a health diary for the week following each vaccination to record how their child has been. Serious side effects will be monitored and reported throughout the study period.

What are the possible benefits and risks of participating?
The benefit of taking part will be getting the vaccine early, since it is not known when children in this age group will be offered flu vaccine nationally. As with all vaccines there is always a risk of anaphylaxis, but this is very rare. Blood samples may cause pain and may leave a small bruise.

Where is the study run from?
Recruitment will be via GP surgeries in Hertfordshire (UK) and Gloucestershire (UK) and potentially in London (UK).

When is the study starting and how long is it expected to run for?
The study will run from September 2014 until March 2017.

Who is funding the study?
Department of Health (UK).

Who is the main contact?
Dr Jo Southern
jo.southern@phe.gov.uk

Contact information

Dr Jo Southern
Scientific

Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control (CIDSC) , 61 Colindale Avenue
London
NW9 5EQ
United Kingdom

Email jo.southern@phe.gov.uk

Study information

Study designNon-randomised; Interventional; Design type: Treatment
Primary study designInterventional
Secondary study designNon randomised controlled trial
Study setting(s)GP practice
Study typePrevention
Scientific titleA phase III/IV open-label study of the immunogenicity and safety of a single dose of a Live Attenuated Influenza Vaccine (LAIV) (FluenzTM) for each of three successive years in children naïve to, or in previous receipt of the AS03B adjuvanted H1N1 (2009)
Study acronymLAIV Immuno
Study objectivesThis study seeks primarily to measure antibody responses to the LAIV vaccination over three subsequent years.
We will also be assessing how well the vaccines are tolerated.

Primary objective:
To compare the immune system responses to various strains of flu after having the nasal influenza vaccine (LAIV) for each of three consecutive years in children aged 4-8 when they join the study and who have either previously had a dose of Pandemirix (a pandemic flu vaccine) or have never had any pandemic flu vaccine.

Secondary objectives:
To document the incidence of laboratory confirmed influenza and other respiratory viruses in the naïve and Pandemrix™ primed children over the three seasons.
To compare the safety and tolerability of annual doses of LAIV in naïve compared to Pandemrix™ vaccinated children
Ethics approval(s)West London MREC; 07/04/2014; ref. 13/LO/1854
Health condition(s) or problem(s) studiedTopic: Children, Primary Care; Subtopic: All Diagnoses, Not Assigned; Disease: All Diseases, All Diseases
InterventionEach participant will receive a single dose, 0.2 ml, of Fluenz each year for three years. Particulars about the vaccine can be found at http://www.medicines.org.uk/emc/medicine/25084

This will involve six blood samples, six dried blood spots (taken from the end of the blood sample needle) and six oral fluid samples – before and three weeks after each vaccination each year. These samples will allow us to assess how the immune system responds to the vaccinations in terms of the antibodies that are present. Each participant will be asked to complete a health diary for the week following vaccination. They will be asked to record any symptoms, which we will elicit in line with the information in the Summary of Product Characteristics (SPC) as well as any illnesses or visits to their GP or hospital.
Intervention typeBiological/Vaccine
Pharmaceutical study type(s)
PhasePhase IV
Drug / device / biological / vaccine name(s)
Primary outcome measureThe measures of immunogenicity, collected for all evaluable subjects include: Geometric mean titre.

All outcomes will be measured using blood samples, nasal swabs and diaries taken during the weeks immediately following vaccination and nasal swabs if and when a child has influenza symptoms.
Secondary outcome measuresAdverse (AE) and serious adverse events (SAEs) will be monitored
Overall study start date01/09/2014
Completion date31/03/2017

Eligibility

Participant type(s)Patient
Age groupChild
Lower age limit4 Years
Upper age limit8 Years
SexBoth
Target number of participantsPlanned Sample Size: 500; UK Sample Size: 500;
Total final enrolment254
Key inclusion criteria1. Parent/legal guardian gives written informed consent for participation of their child in the study.
2. Male or female aged 4 years (+364 days) to 8 years (+364 days) on the day of consent.
3. Documented prior receipt of Pandemrix, or no evidence in the medical notes of never having had pandemic influenza vaccine
Target Gender: Male & Female; Upper Age Limit 10 years ; Lower Age Limit 5 years
Key exclusion criteria*Absolute exclusion criteria: The participant may not enter the study if ANY of the following apply: From Fluenz Summary of Product Characterstics (SPC):
1. Hypersensitivity to the active substances, to any of the excipients (e.g. gelatin; see appendix 1), to gentamicin (a possible trace residue), to eggs or to egg proteins (e.g. ovalbumin).
2. Children and adolescents who are clinically immunodeficient due to conditions or immunosuppressive therapy such as: acute and chronic leukaemias; lymphoma; symptomatic HIV infection; cellular immune deficiencies; and high-dose corticosteroids. FLUENZ is not contraindicated for use in individuals with asymptomatic HIV infection; or individuals who are receiving topical/inhaled corticosteroids or low-dose systemic corticosteroids or those receiving corticosteroids as replacement therapy, e.g. for adrenal insufficiency.
3. Children and adolescents younger than 18 years of age receiving salicylate therapy because of the association of Reye's syndrome with salicylates and wildtype influenza infection.

Study-specific exclusions:
1. Any contraindication to vaccination as specified in the “Green Book” Immunisation against Infectious Disease, HMSO.
2. Known bleeding diathesis (or any condition that may be associated with a prolonged bleeding time).
3. Any other significant condition or circumstance which, in the opinion of the investigator, may either put the participant at risk because of participation in the study, or may influence the result of the study, or the participant’s ability to participate in the study.

*Temporary Exclusion Criteria:
From the SPC:
1. The concurrent use of FLUENZ with antiviral agents that are active against influenza A and/or B viruses has not been evaluated. However, based upon the potential for influenza antiviral agents to reduce the effectiveness of FLUENZ, it is recommended not to administer the vaccine until 48 hours after the cessation of influenza antiviral therapy. Administration of influenza antiviral agents within two weeks of vaccination may affect the response of the vaccine. Because of this information in the SPC, should any child be given these medications the administration of LAIV would be delayed as specified.

Study specific:
1. Fever (sublingual temperature = 38°C)
2. Received any blood or blood products within the past 12 weeks
Date of first enrolment01/09/2014
Date of final enrolment31/03/2017

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control (CIDSC) , 61 Colindale Avenue
London
NW9 5EQ
United Kingdom

Sponsor information

Health Protection Agency (HPA) (UK)
Government

Holborn Gate
London
WC1V 7PP
United Kingdom

ROR logo "ROR" https://ror.org/03sbpja79

Funders

Funder type

Government

Department of Health (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 21/06/2019 No No

Editorial Notes

21/06/2019: Added clinicaltrialsregister.eu link to basic results (scientific). Added total final enrollment.