- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05265065
Evaluation of Full Versus Fractional Dose of COVID-19 Vaccine Given as a Booster for the Prevention of COVID-19 in Adults in Mongolia.
A Randomised Controlled Trial to Assess the Immunogenicity, Safety and Reactogenicity of Standard Dose Versus Fractional Doses of COVID-19 Vaccine (Pfizer-BioNTech) Given as a Booster Dose After Priming With Sinopharm, AstraZeneca or Sputnik in Healthy Adults in Mongolia
This clinical trial is a single-blind, randomised study to determine the reactogenicity and immunogenicity of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) vaccine (Pfizer-BioNTech) as booster dose in adults, who have previously received either Sinopharm (BBIBP-CorV®), AstraZeneca (ChAdOx1-S, or Vaxzevria®) or Sputnik V (Gam-COVID-Vac®) as their primary doses 6 to 9 months earlier. Both standard and fractional doses will be tested.
Participants are healthy adults aged 18 years or older, with no upper age limit. Procedures will be implemented to ensure participants of all ages (aged 18 and above) are included and that there is an even age distribution (<50 and ≥50 years) in each group. There will be a total of 6 groups (Sinopharm-standard dose Pfizer, Sinopharm-fractional dose Pfizer, AstraZeneca-standard dose Pfizer, AstraZeneca-fractional dose Pfizer, Sputnik - standard dose Pfizer, Sputnik - fractional dose Pfizer), with 200 participants per group for Sinopharm and 100 for AstraZeneca and Sputnik.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Ulaanbaatar, Mongolia
- District Health Centre
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Have completed two doses of Sinopharm, AstraZeneca or Sputnik vaccines with the recommended schedule 6 months prior to the date of enrolment
- Willing and able to give written informed consent
- Aged 18 years or above
- Willing to complete the follow-up requirements of the study
Exclusion Criteria:
- Received 3 doses of COVID-19 vaccine
- Received 2 doses of COVID-19 less than 6 months prior to the start of the trial
- Currently on immunosuppressive medication or anti-cancer chemotherapy
- HIV infection
- Congenital immune deficiency syndrome
- Has received immunoglobulin or other blood products in the 3 months prior to vaccination
- Study staff and their relatives
- Have a history of a severe allergic reaction to any COVID-19 vaccines or have a medical exception to receiving further COVID-19 vaccines
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: AstraZeneca (ChAdOx1-S, or Vaxzevria®) - Standard Pfizer-BioNTech booster group
Previously received two doses of AstraZeneca as primary COVID-19 vaccine
|
Tozinameran is a single-stranded, 5'-capped messenger RNA (mRNA) produced using a cellfree in vitro transcription from the corresponding DNA templates, encoding the viral spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dose - 30 µg in 0.3 ml. Liquid for injection. Single dose.
Other Names:
|
Experimental: AstraZeneca (ChAdOx1-S, or Vaxzevria®) - Fractional Pfizer-BioNTech booster group
Previously received two doses of AstraZeneca as primary COVID-19 vaccine . |
Tozinameran is a single-stranded, 5'-capped messenger RNA (mRNA) produced using a cellfree in vitro transcription from the corresponding DNA templates, encoding the viral spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dose - 15 µg in 0.15 ml. Liquid for injection. Single dose.
Other Names:
|
Active Comparator: Sinopharm (BBIBP-CorV®)- Standard Pfizer-BioNTech booster group
Previously received two doses of Sinopharm as primary COVID-19 vaccine
|
Tozinameran is a single-stranded, 5'-capped messenger RNA (mRNA) produced using a cellfree in vitro transcription from the corresponding DNA templates, encoding the viral spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dose - 30 µg in 0.3 ml. Liquid for injection. Single dose.
Other Names:
|
Experimental: Sinopharm (BBIBP-CorV®)- Fractional Pfizer-BioNTech booster group
Previously received two doses of Sinopharm as primary COVID-19 vaccine
|
Tozinameran is a single-stranded, 5'-capped messenger RNA (mRNA) produced using a cellfree in vitro transcription from the corresponding DNA templates, encoding the viral spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dose - 15 µg in 0.15 ml. Liquid for injection. Single dose.
Other Names:
|
Active Comparator: Sputnik V (Gam-COVID-Vac®)- Standard Pfizer-BioNTech booster group
Previously received two doses of Sputnik as primary COVID-19 vaccine
|
Tozinameran is a single-stranded, 5'-capped messenger RNA (mRNA) produced using a cellfree in vitro transcription from the corresponding DNA templates, encoding the viral spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dose - 30 µg in 0.3 ml. Liquid for injection. Single dose.
Other Names:
|
Experimental: Sputnik V (Gam-COVID-Vac®)- Fractional Pfizer-BioNTech booster group
Previously received two doses of Sputnik as primary COVID-19 vaccine
|
Tozinameran is a single-stranded, 5'-capped messenger RNA (mRNA) produced using a cellfree in vitro transcription from the corresponding DNA templates, encoding the viral spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dose - 15 µg in 0.15 ml. Liquid for injection. Single dose.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
SARS-CoV-2 specific Immunoglobulin (Ig)G antibodies at 28-days post booster vaccination
Time Frame: 28-days post booster vaccination
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Serum samples collected at 28-days post booster vaccination from all groups will be evaluated for SARS-CoV-2 specific IgG antibodies using IgG CMIA.
The primary endpoint is the seroresponse rate at the Day-28 visit.
The seroresponse rate at the individual level is defined as either a ≥4-fold rise in binding antibodies at the Day-28 visit compared to baseline (pre-vaccination) with a titre of <200 BAU/ml, a ≥2-fold rise among participants with a baseline (pre-vaccination) titre of >200 BAU/ml, or a ≥4-times the lower limit of detection if baseline levels are lower than the limit of detection.
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28-days post booster vaccination
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Total incidence of solicited reactions (systemic and local)
Time Frame: 7 days post booster vaccination
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Questionnaire to document solicited reactions is developed specifically for this study.
Data will be reported as the proportion of participants who report grade 3 or 4 reactions by each intervention arm.
Solicited reactions such as pain, tenderness, erythema/redness, induration, swelling, fever, nausea, vomiting, headache, fatigue/malaise, myalgia, arthralgia, diarrhea, enlarged lymph nodes will be collected from the participants 7 days post-vaccination.
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7 days post booster vaccination
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of unsolicited adverse events (AE)
Time Frame: 28 days-post booster vaccination
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All unsolicited AE will be collected for 28 days post booster vaccination.
Data will be presented as proportion of participants who report unsolicited AE.
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28 days-post booster vaccination
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Incidence of serious adverse events (SAE)
Time Frame: 12 months post booster vaccination
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SAE will be collected throughout the follow-up period of 12 months post booster vaccination.
Data will be presented as a proportion of participants who report unsolicited SAE.
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12 months post booster vaccination
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SARS-CoV-2 specific IgG antibodies at baseline (pre booster), 28- days, 6- and 12-months post booster vaccination.
Time Frame: Baseline (pre booster), 28 days, 6- and 12-months post booster vaccination
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Serum samples collected at baseline (pre booster), 28 days, 6- and 12-months post booster vaccination from all groups will be evaluated for SARS-CoV-2 specific IgG antibodies using IgG CMIA.
Data will be reported as binding antibody units (BAU)/mL and presented as geometric mean concentration (GMC) and 95% confidence intervals (CI).
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Baseline (pre booster), 28 days, 6- and 12-months post booster vaccination
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SARS-CoV-2 specific neutralising antibodies at baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination measured by surrogate virus neutralization test (sVNT).
Time Frame: Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Serum samples collected at baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination from all groups will be evaluated for SARS-CoV-2 specific neutralising antibodies using the GenScript® cPass surrogate virus neutralization test (sVNT) for both wild-type and Omicron variant.
Neutralising antibody response will be reported as percentage (%) inhibition of receptor binding domain-angiotensin-converting enzyme 2 (RBD-ACE2) binding relative to a positive control.
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Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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SARS-CoV-2 specific neutralising antibodies at baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination measured by SARS-CoV-2 microneutralisation assay
Time Frame: Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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A subset of samples (20%) from all four timepoints will be assessed using a SARS-CoV-2 microneutralisation assay to both the wild type (vaccine) strain and for two SARS-CoV-2 Variants of concern.
Neutralizing antibody will be reported as endpoint titre.
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Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Interferon gamma (IFNγ) concentrations in International Units (IU)/mL
Time Frame: Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Applicable to the subset participants with additional blood collection.
Interferon gamma (IFNγ) concentrations as a measurement of cellular immunity will be assessed on a subset of the participants from each group.
QuantiFERON Human IFN-γ SARS-CoV-2 (Qiagen) will be used to stimulate IFN-γ production in peripheral blood mononuclear cells (PBMCs) and then IFN-γ production will be measured using ELISA (enzyme-linked immunosorbent assay).
Data will be presented as GMC and 95% CI.
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Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Number of IFNγ producing cells/million PBMCs
Time Frame: Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Applicable to the subset participants with additional blood collection.
IFNγ producing cells as a measurement of cellular immunity will be assessed on a subset of the participants (40%) from each group.
IFN-γ Enzyme-Linked ImmunoSpot (Elispot) assay will be performed on isolated peripheral blood mononuclear cells (PBMCs).
Data will be reported as number of IFNγ producing cells/million and presented using means and 95% CI.
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Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Frequency of cytokine-expressing T cells
Time Frame: Assessed at 4 time-points (baseline, 28 days, 6 months, and 12 months)
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Frequency of cytokine-expressing T cells will be assessed on a subset of participants (40%) using flow cytometry (intracellular staining) on PBMCs samples.
Data will be reported as frequency (%) of cytokine-expressing T cells presented as means and 95% CI.
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Assessed at 4 time-points (baseline, 28 days, 6 months, and 12 months)
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Cellular immunity: Multiplex cytokine assays - reported as cytokine concentrations in pg/ml and presented as GMC and 95% CI
Time Frame: Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Cytokine concentrations following PBMCs stimulation will be assessed on a subset of participants (40%) using multiplex cytokine assays.Data will be reported as cytokine concentrations in pg/ml and presented as GMC and 95% CI.IFN-γ Elispot, intracellular cytokine assays (flow cytometry) and multiplex cytokine assays will be performed on isolated PBMCs.
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Baseline (pre booster), 28 days-, 6- and 12-months post booster vaccination
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Incidence of medically attended adverse events
Time Frame: 3 months post booster vaccination
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All participants with medically attended AE will be collected for 3 months post booster vaccination.
Data will be presented as proportion of participants who report unsolicited AE.
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3 months post booster vaccination
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Incidence of PCR confirmed COVID-19 infection
Time Frame: Up to 12 months post booster vaccination
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Confirmed COVID-19 infections will be documented throughout the follow-up period, by clinical severity.
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Up to 12 months post booster vaccination
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Kim Mulholland, MD/Prof, Murdoch Childrens Research Institute
- Principal Investigator: Tsetsegsaikhan Batmunkh, MD, Ministry of Health, Mongolia
Publications and helpful links
Helpful Links
- US Food and Drug Administration (FDA). Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials 2007
- Coalition for Epidemic Preparedness Innovations (CEPI). Priority List of Adverse Events of Special Interest
- Indonesia reports record number of doctor deaths from COVID-19 in July
- Quarter-dose of Moderna COVID vaccine still rouses a big immune response
- US Food and Drug Administration (FDA). Moderna COVID-19 Vaccine
- Australian Technical Advisory Group on Immunisation (ATAGI). ATAGI recommendations on the use of a booster dose of COVID-19 vaccine 2021
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 81800
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- ICF
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.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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