Safety and Efficacy Study of CVD 1208S, a Live, Attenuated Oral Vaccine to Prevent Shigella Infection Using cGMP

Safety, Clinical Tolerance, and Immunogenicity of CVD 1208S, a Delta guaBA, Delta Sen, Delta Set, Live, Oral Shigella Flexneri 2a Vaccine Manufactured Using cGMP

The purpose of this study is to determine whether CVD 1208S (a live, attenuated, oral vaccine) is safe and effective in the prevention of Shigella infection.

Study Overview

• Status: Completed
• Conditions: Shigella
• Intervention / Treatment: Biological: CVD 1208S, a Shigella flexneri 2a live, oral vaccine; Other: Placebo

Detailed Description

There are two purposes for conducting this Vaccine Study to evaluate an experimental vaccine called CVD 1208S (Center for Vaccine Development 1208S): 1) to learn whether CVD 1208S causes side effects, and 2) to learn whether the CVD 1208S gives people immunity to Shigella.

• Study Type: Interventional
• Enrollment (Actual): 26
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21201
      • University of Maryland, Baltimore Center for Vaccine Development
    • Baltimore, Maryland, United States, 21201
      • Shin Nippon Biomedical Laboratories, LTD. (SNBL) Inpatient Facility

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 45 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Age 18 to 45 years, inclusive.
• Good general health
• Expressed interest and availability to fulfill study requirements
• Informed, written consent.
• Agrees to indefinite storage of unused clinical specimens at the CVD for use in future research
• Agrees not to participate in another investigational vaccine or drug trial during the study
• Has no childbearing potential or agrees to abstain from becoming pregnant from the day of screening (at least 14 days before vaccination) until 6 weeks after the final vaccination by using birth control
• Agrees not to donate blood to a blood bank for 12 months after receiving the vaccine.

Exclusion Criteria:

• An acute or chronic medical condition that, in the opinion of the investigator, would render vaccination unsafe or would interfere with the evaluation of responses.
• Any current illness requiring daily medication (vitamins, birth control pills, nasal or topical medications, allowed);
• Blood in stool on >2 occasions (other than small amounts from straining) in past 12 months;
• Recurrent diarrhea (>5 episodes in past 6 months, each lasting 3 days or more).
• Immunosuppression
• Long term (greater than 2 weeks) use of oral or injected steroids, or high-dose inhaled steroids (>800 micrograms/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (Nasal and topical steroids are allowed).
• History of abdominal surgery
• Medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
• Known allergy or intolerance to ciprofloxacin, trimethoprim/sulfamethoxazole (or other sulfa antibiotic), ampicillin (for women) or corn.
• History of shigellosis or Shigella vaccination or challenge or a laboratory worker with known exposure to Shigella.

• Anticipates any of the following during the first 84 days (12 weeks) of the study (28 days, or 4 weeks for Cohort 1):

  • Shares a household with a child <3 years of age, a pregnant woman or a woman who plans to become pregnant during this time;
  • Household or sexual contact with someone who has weakened immunity (such as someone with HIV infection, someone receiving treatment for cancer, or an elderly person > 70 yrs);
  • Occupation as a food-handler, childcare (for children <3 years), or health care worker with direct patient contact.
• A clinically significant abnormality on physical examination
• Results of blood tests as defined by protocol
• Positive pregnancy test during medical screening or within 24 hours of inoculation or current breast feeding (women).
• Failure to attain a score of at least 70% on the written examination (two attempts permitted)
• During the past 3 years, developed diarrhea during travel to a developing country, or within 1 week of returning home.

• Receipt of any of the following:

  • Any vaccine or investigational drug within 30 days of study vaccine
  • A live, attenuated vaccine within 30 days of the study vaccine
  • A subunit or killed vaccine within 14 days of the study vaccine
  • A blood product in the 90 days before the study vaccine
• Receipt of antibiotics within 7 days of inoculation (or within 21 days if the antibiotic was azithromycin).
• Loose stools or any other acute illness such as fever >100.0 degrees F during the 48 hours before vaccination.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: PREVENTION
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: QUADRUPLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
PLACEBO_COMPARATOR: Placebo	Other: Placebo; Corn starch and baking soda are mixed with salt water and given by mouth.
EXPERIMENTAL: Vaccine-recipients	Biological: CVD 1208S, a Shigella flexneri 2a live, oral vaccine; The vaccine is mixed with salt water and given by mouth.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants with reactions and adverse events	occurence of diarrhea, dysentery and fever.	Reactions are evaluated for 7 days after each dose. Adverse events are evaluated for the entire study participation (6 months for cohort 1 and 8 months for all other cohorts).
Number of participants who receive the vaccine who get immunity to shigella	It is hoped that the vaccine will trigger the body's immune system to make specific responses such as antibodies (special proteins) and antibody-producing cells that are believed to protect against illness if a person is exposed to certain illness-causing Shigella in the future.	Immunity in the blood will be assessed using serial samples collected during the 84 days after the first vaccination. Immunity at the intestinal level will be assessed by collecting seral stool samples for 14 days after each vaccination.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants who pass the vaccine in their stool	Volunteers' stool will be tested to see if the vaccine is present. This will tell whether the vaccine is able to stick to the intestine and grow there. We will see whether this information predicts the strength of the immune responses to the vaccine and whether the vaccine could potentially be passed to close contacts.	The first 84 days after vaccination
The number of participants who develop various types of immune responses	We will look at the ability of the vaccine to evoke different types of responses in blood and stool that might protect them against Shigella infections in the future.	The first 84 days of the study

Collaborators and Investigators

• Sponsor: University of Maryland, Baltimore
• Collaborators: PATH
• Investigators: Principal Investigator: Karen L. Kotloff, M.D., University of Maryland,Baltimore Center for Vaccine Development

Publications and helpful links

General Publications

• Toapanta FR, Bernal PJ, Kotloff KL, Levine MM, Sztein MB. T cell mediated immunity induced by the live-attenuated Shigella flexneri 2a vaccine candidate CVD 1208S in humans. J Transl Med. 2018 Mar 13;16(1):61. doi: 10.1186/s12967-018-1439-1.

Study record dates

Study Major Dates

• Study Start: July 1, 2011
• Primary Completion (ACTUAL): September 1, 2012
• Study Completion (ACTUAL): September 1, 2012

Study Registration Dates

• First Submitted: October 26, 2011
• First Submitted That Met QC Criteria: February 8, 2012
• First Posted (ESTIMATE): February 13, 2012

Study Record Updates

• Last Update Posted (ACTUAL): April 30, 2021
• Last Update Submitted That Met QC Criteria: April 27, 2021
• Last Verified: April 1, 2021

More Information

Terms related to this study

• Keywords: Vaccine; Mucosal immunity; Shigella
• Additional Relevant MeSH Terms: Digestive System Diseases; Infections; Gastrointestinal Diseases; Gastroenteritis; Intestinal Diseases; Gram-Negative Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Enterobacteriaceae Infections; Dysentery; Dysentery, Bacillary
• Other Study ID Numbers: HP-00049727; Shigella CVD 28000 (OTHER: Center for Vaccine Development (CVD), UMB)