A Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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California
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San Diego, California, United States, 34800
- Naval Medical Center San Diego
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Maryland
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Annapolis, Maryland, United States, 21402
- United States Naval Academy
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Bethesda, Maryland, United States, 20814
- Walter Reed National Military Medical Center
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Bethesda, Maryland, United States, 20307
- USU
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North Carolina
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Fort Bragg, North Carolina, United States, 28310
- Womack Army Medical Center
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Texas
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Fort Sam Houston, Texas, United States, 78234
- Brooke Army Medical Center
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San Antonio, Texas, United States, 78243
- Lackland Airforce Base
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Virginia
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Portsmouth, Virginia, United States, 23704
- Naval Medical Center Portsmouth
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Washington
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Tacoma, Washington, United States, 98431
- Madigan Army Medical Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Eligible for care in Department of Defense medical facilities (Defense Enrollment Eligibility Reporting System eligible)
- ≥18 years of age.
- At a participating Military Treatment Facility site for the purpose of receiving a seasonal (2018-2019, 2019-2020,2020-2021, 2021-2022) influenza vaccination.
- Able to speak English and able to provide informed consent
- Able to receive and respond to texts and/or emails, or a military recruit
Exclusion Criteria:
- Adults intending to receive or who have received the current seasons FluMist Vaccine (LAIV)
- Adults who have already received a flu vaccine within the current season
- Individual who cannot receive a flu vaccine or standard dosing due to another medical condition
- Allergic to gentamicin, polymyxin and/or neomycin
- Individuals who fail to meet the inclusion criteria
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Egg based influenza vaccines
Quadrivalent egg-based vaccines, which contain an inactivated form of the virus.
Vaccines will be given to the participant in accordance with standard clinical practices for those in the US military.
All egg-based vaccines are FDA licensed for use in the United States.
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Participants will be randomly allocated to one of three vaccine types in accordance with standard clinical practices for those in the US military.
All vaccines are FDA licensed for use in the United States.
|
|
Active Comparator: Recombinant influenza vaccines
FluBlok, recombinant HA influenza vaccine.
Vaccines will be given to the participant in accordance with standard clinical practices for those in the US military.
Flublok Quadrivalent is a quadrivalent recombinant influenza vaccine that has been licensed by the FDA for use in the United States.
|
Participants will be randomly allocated to one of three vaccine types in accordance with standard clinical practices for those in the US military.
All vaccines are FDA licensed for use in the United States.
|
|
Active Comparator: Cell-culture based influenza vaccines
Flucelvax, Madin-Darby canine kidney (MDCK)-cell-culture based inactivated influenza vaccine.
Vaccines will be given to the participant in accordance with standard clinical practices for those in the US military.
Flucelvax quadrivalent, the only cell-based flu vaccine FDA licensed for use in the United States.
|
Participants will be randomly allocated to one of three vaccine types in accordance with standard clinical practices for those in the US military.
All vaccines are FDA licensed for use in the United States.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Laboratory Confirmed Influenza
Time Frame: Onset > 13 days after vaccination up to 1 year
|
Laboratory-confirmed influenza as ascertained by a sensitive and specific assay.
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Onset > 13 days after vaccination up to 1 year
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hemagglutination Inhibition (HI) Titer Responses to Influenza Vaccine Strains.
Time Frame: Baseline to 21-35 days post vaccine
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Strain-specific seroconversion rate determined by reference hemagglutination inhibition assay.
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Baseline to 21-35 days post vaccine
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Pseudovirion Neutralization (PVN) Responses to Influenza Vaccine.
Time Frame: Baseline to 21-35 days post vaccine
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Neutralizing antibody responses (4-fold rise) to HA-psuedoviruses corresponding to vaccine-matched viruses, recently circulating influenza virus, and emerging influenza strain.
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Baseline to 21-35 days post vaccine
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Anti-Neuraminidase (Anti-NA) Titer Responses to Influenza Vaccine.
Time Frame: Baseline to 21-35 days post vaccine
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Anti-Neuraminidase (Anti-NA) titer responses determined by enzyme linked immuno-assay.
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Baseline to 21-35 days post vaccine
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Number of Participants With Influenza-Like Illness
Time Frame: Onset > 13 days after vaccination up to 1 year
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Rate of protocol defined influenza-like illness ascertained by participant response to active surveillance.
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Onset > 13 days after vaccination up to 1 year
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Number of Participants With SARS-CoV-2 and Influenza Co-Infection
Time Frame: Onset > 13 days after influenza vaccination up until one year
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Laboratory-confirmed SARS CoV2, and SARS CoV2 plus influenza co-infection, as ascertained by nasal swab PCR.
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Onset > 13 days after influenza vaccination up until one year
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Symptom Severity of SARS CoV2
Time Frame: onset >13 days after Influenza vaccination up to 1 year
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Symptom severity scores were reported by participants using FLU-PRO Plus (Influenza Patient Reported Outcomes), a standardized instrument developed to measure the intensity and frequency of viral respiratory tract symptoms.
FluPRO Plus symptom scores range from 0 ("not at all") to 4 ("very much"), with higher scores indicating greater severity.
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onset >13 days after Influenza vaccination up to 1 year
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Timothy Burgess, MD, Uniformed Services University of the Health Sciences
- Study Director: Rhonda Colombo, MD, Infectious Diseases Clinical Research Program
Publications and helpful links
General Publications
- Sanchez JL, Cooper MJ, Myers CA, Cummings JF, Vest KG, Russell KL, Sanchez JL, Hiser MJ, Gaydos CA. Respiratory Infections in the U.S. Military: Recent Experience and Control. Clin Microbiol Rev. 2015 Jul;28(3):743-800. doi: 10.1128/CMR.00039-14.
- Flannery B, Chung JR, Belongia EA, McLean HQ, Gaglani M, Murthy K, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Foust A, Sessions W, Berman L, Barnes JR, Spencer S, Fry AM. Interim Estimates of 2017-18 Seasonal Influenza Vaccine Effectiveness - United States, February 2018. MMWR Morb Mortal Wkly Rep. 2018 Feb 16;67(6):180-185. doi: 10.15585/mmwr.mm6706a2.
- Zost SJ, Parkhouse K, Gumina ME, Kim K, Diaz Perez S, Wilson PC, Treanor JJ, Sant AJ, Cobey S, Hensley SE. Contemporary H3N2 influenza viruses have a glycosylation site that alters binding of antibodies elicited by egg-adapted vaccine strains. Proc Natl Acad Sci U S A. 2017 Nov 21;114(47):12578-12583. doi: 10.1073/pnas.1712377114. Epub 2017 Nov 6.
- Wu NC, Zost SJ, Thompson AJ, Oyen D, Nycholat CM, McBride R, Paulson JC, Hensley SE, Wilson IA. A structural explanation for the low effectiveness of the seasonal influenza H3N2 vaccine. PLoS Pathog. 2017 Oct 23;13(10):e1006682. doi: 10.1371/journal.ppat.1006682. eCollection 2017 Oct.
- Skowronski DM, Janjua NZ, De Serres G, Sabaiduc S, Eshaghi A, Dickinson JA, Fonseca K, Winter AL, Gubbay JB, Krajden M, Petric M, Charest H, Bastien N, Kwindt TL, Mahmud SM, Van Caeseele P, Li Y. Low 2012-13 influenza vaccine effectiveness associated with mutation in the egg-adapted H3N2 vaccine strain not antigenic drift in circulating viruses. PLoS One. 2014 Mar 25;9(3):e92153. doi: 10.1371/journal.pone.0092153. eCollection 2014.
- Cobey S, Gouma S, Parkhouse K, Chambers BS, Ertl HC, Schmader KE, Halpin RA, Lin X, Stockwell TB, Das SR, Landon E, Tesic V, Youngster I, Pinsky BA, Wentworth DE, Hensley SE, Grad YH. Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013. Clin Infect Dis. 2018 Jul 18;67(3):327-333. doi: 10.1093/cid/ciy097.
- Wang W, Butler EN, Veguilla V, Vassell R, Thomas JT, Moos M Jr, Ye Z, Hancock K, Weiss CD. Establishment of retroviral pseudotypes with influenza hemagglutinins from H1, H3, and H5 subtypes for sensitive and specific detection of neutralizing antibodies. J Virol Methods. 2008 Nov;153(2):111-9. doi: 10.1016/j.jviromet.2008.07.015. Epub 2008 Sep 4.
- Wang W, Xie H, Ye Z, Vassell R, Weiss CD. Characterization of lentiviral pseudotypes with influenza H5N1 hemagglutinin and their performance in neutralization assays. J Virol Methods. 2010 May;165(2):305-10. doi: 10.1016/j.jviromet.2010.02.009. Epub 2010 Feb 11.
- Colombo RE, Richard SA, Schmidt K, Schofield C, Ganesan A, Campbell W, Hrncir D, Lalani T, Mende K, Markelz AE, Berjohn CM, Housel L, Becher D, Zell ER, Ewing D, Sundaram AK, Modi JR, Saperstein A, Tilley DH Jr, Williams A, McClenathan B, Collins L, Spooner C, Seshadri S, Fries A, Maves RC, Powers Iii JH, O'Connell RJ, Pollett SD, Simons MP, Coles CL, Burgess TH; PAIVED Study Group. Randomized Pragmatic Trial of the Comparative Effectiveness of Chicken Egg-Based Inactivated, Mammalian Cell Culture-Based Inactivated, and Recombinant Protein Quadrivalent Seasonal Influenza Vaccines in United States Military Health System Beneficiaries. Clin Infect Dis. 2025 Dec 24;81(5):e454-e463. doi: 10.1093/cid/ciaf503.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- IDCRP-120
- AAI1201200007000 (Other Grant/Funding Number: NIAID)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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