Improving Rotavirus Vaccine Immune Response
4 de abril de 2013 actualizado por: International Centre for Diarrhoeal Disease Research, Bangladesh
Improving the Immune Response to Rotavirus Vaccine
Rotavirus is the leading cause of severe gastroenteritis in infants and young children worldwide and is estimated to account for 600,000 deaths in children <5 years of age.
However, live oral enteric vaccines (e.g.
OPV, cholera vaccines, typhoid vaccine) have been less immunogenic in poor communities with high levels of malnutrition and poor sanitation.
Rotavirus vaccines also appear to be less immunogenic in the setting where they are most needed.
High maternal antibody (IgG) to rotavirus and breast feeding near the time of vaccination may inhibit rotavirus vaccine effectiveness.
We propose a quick study to look at practical ways to improve the immunogenicity of rotavirus vaccine in our own setting in Bangladesh.
The objectives are to assess if delaying Rotarix vaccination will improve the immune response to the vaccine and to assess if avoiding breastfeeding in the 45 minutes before and after vaccine administration will improve the immune response to administration of Rotarix vaccine.
The study will be conducted in the urban Dhaka Mirpur Community, a setting where previous rotavirus vaccine immunogenicity studies have been successfully conducted.
A total of 300 infant will be randomly assigned to one of the following groups: 1) Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus vaccine with no intervention in normal breastfeeding practices before and after receiving vaccine.
2) Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
3) Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus, with no intervention in normal breastfeeding practices before and after receiving vaccine.
4) Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
Blood and stool samples will be collected from infants and breast milk from mothers.
The primary outcome is to determine the sero-conversion rate of anti-rotavirus IgA in different groups of infants.
Descripción general del estudio
Estado
Terminado
Condiciones
Descripción detallada
The study will be conducted in a suburb of Dhaka in the area of Mirpur. Mirpur is one of the 14 Thanas of Dhaka cities with a population of about one million in an area of 59 square kilometers. Mirpur Thana of Dhaka city is divided into several sections. There are 14 sections in Mirpur Thana. The area is densely populated and located 20 minutes away from the lCDDR,B's Dhaka Hospital . The population is stable with low socioeconomic conditions. The average income in the slum areas of Mirpur is Tk.4200 (about US $ 62) per month per family. 25% of fathers and 15% of mothers have more than 5 years of formal education. The study will be conducted in section 11 and 12 of Mirpur which has a population of about 500,000. We recently conducted phase I and II of the rotavirus vaccine study in this site. Several other studies (phase II ETEC, killed cholera vaccine) are ongoing in this area. Children will be identified through active surveillance of new births in the community and the study subjects will be recruited through home visits by the locally recruited field workers.
2.2 .Design : Randomized intervention trial
Study groups:
- Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus vaccine with no intervention in normal breastfeeding practices before and after receiving vaccine.
- Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus. Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
- Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus, with no intervention in normal breastfeeding practices before and after receiving vaccine.
- Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus. Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
Samples collected:
- Blood draw at the time of first dose of Rotavirus vaccine and 4 weeks after the second dose
- Breast milk sample at 6 weeks for the mothers in study groups A and B, and at 14 weeks for mothers in study groups C and D (see below for groups).
- Stool sample prior to dose one and on day 3 and 7 after each dose to look for vaccine virus shedding
Tipo de estudio
Intervencionista
Inscripción (Actual)
300
Fase
- Fase 3
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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-
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Dhaka, Bangladesh, 1216
- Mirpur
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
1 mes a 45 años (Niño, Adulto)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- male or female,
- aged 6 weeks at the time of enrollment,
- written informed consent,
- free of chronic or serious medical condition as determined by history and physical exam and plan to stay in community for at least 6 months
Exclusion Criteria:
- fever (>38 C),
- acute or chronic illness,
- use of antimicrobial drug within previous 14 days,
- hypersensitivity to any of the vaccine components (see vaccine composition),
- use of any investigational drug during previous 30 days,
- any uncorrected congenital malformation of the gastrointestinal tract,
- use of any immunosuppressing drugs during the last 14 days (likelihood is remote),
- any evidence by physical exam of immunosuppresing condition,
- administration of gamma globulin or any other blood product,
- previous intussusception or abdominal surgery.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Experimental: 6 weeks RV & normal breast feeding
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus vaccine with no intervention in normal breastfeeding practices before and after receiving vaccine.
|
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus vaccine with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus, with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
|
|
Experimental: 6 weeks RV & delayed breastfeeding
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
|
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus vaccine with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus, with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
|
|
Experimental: 14 weeks RV & Normal breastfeeding
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus, with no intervention in normal breastfeeding practices before and after receiving vaccine.
|
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus vaccine with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus, with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
|
|
Experimental: 14 weeks RV & delayed breastfeedin
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
|
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus vaccine with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 6 and 10 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus, with no intervention in normal breastfeeding practices before and after receiving vaccine.
Administration of Rotarix at 14 and 18 weeks co-administered with oral polio virus.
Breastfeeding will not be permitted 45 minutes prior to vaccine administration and 45 minutes after each vaccine administration.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Immunogenicity of Rotavirus Vaccine
Periodo de tiempo: 24 months
|
Sero-conversion rate of anti-rotavirus IgA
|
24 months
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
anti-rotavirus IgA
Periodo de tiempo: 24 months
|
Geometric mean concentration of anti-rotavirus IgA Enterovirus excretion in children at the time of vaccination
|
24 months
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de julio de 2010
Finalización primaria (Actual)
1 de abril de 2011
Finalización del estudio (Actual)
1 de diciembre de 2011
Fechas de registro del estudio
Enviado por primera vez
2 de abril de 2013
Primero enviado que cumplió con los criterios de control de calidad
4 de abril de 2013
Publicado por primera vez (Estimar)
5 de abril de 2013
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
5 de abril de 2013
Última actualización enviada que cumplió con los criterios de control de calidad
4 de abril de 2013
Última verificación
1 de diciembre de 2009
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- PR-09070
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre Rotavirus Vaccine & Breastfeeding
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GlaxoSmithKlineTerminadoInfecciones, RotavirusRepública Dominicana, Honduras, Panamá, México, Brasil, Argentina, Colombia, Chile, Finlandia, Nicaragua, Perú, Venezuela
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GlaxoSmithKlineTerminadoInfecciones, RotavirusBangladesh
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GlaxoSmithKlineTerminado
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GlaxoSmithKlineTerminadoInfecciones, RotavirusFinlandia, Alemania, España, Italia, Francia, República Checa
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GlaxoSmithKlineTerminadoInfecciones por rotavirusSudáfrica
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Beijing Zhifei Lvzhu Biopharmaceutical Co., LtdActivo, no reclutandoVoluntarios SaludablesPorcelana
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Butantan InstituteTerminado
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Federico II UniversityMerck Sharp & Dohme LLCAún no reclutandoInfecciones meningocócicas | Infecciones por rotavirus | Vacunación
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Centre for Infectious Disease Research in ZambiaImperial College London; Christian Medical College, Vellore, IndiaTerminadoEnfermedad diarreicaZambia
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Merck Sharp & Dohme LLCTerminadoGastroenteritis pediátrica