Safety and Immunogenicity of MF59-Adjuvanted Cell Culture-Derived A/H5N1 Subunit Influenza Virus Vaccine: Dose-Finding Clinical Trials in Adults and the Elderly

Sharon E Frey, Sepehr Shakib, Pornthep Chanthavanich, Peter Richmond, Timothy Smith, Terapong Tantawichien, Claudia Kittel, Peter Jaehnig, Zenaida Mojares, Bikash Verma, Niranjan Kanesa-Thasan, Matthew Hohenboken, Sharon E Frey, Sepehr Shakib, Pornthep Chanthavanich, Peter Richmond, Timothy Smith, Terapong Tantawichien, Claudia Kittel, Peter Jaehnig, Zenaida Mojares, Bikash Verma, Niranjan Kanesa-Thasan, Matthew Hohenboken

Abstract

Background: A/H5N1 influenza viruses have high pandemic potential; consequently, vaccines need to be produced rapidly. MF59® adjuvant reduces the antigen required per dose, allowing for dose sparing and more rapid vaccine availability.

Methods: Two multicenter, phase II trials were conducted to evaluate the safety and immunogenicity of an MF59-adjuvanted, cell culture-derived, A/H5N1 vaccine (aH5N1c) among 979 adult (18-64 years old) and 1393 elderly (≥65 years old) subjects. Participants were equally randomized to receive 2 full-dose (7.5 μg of hemagglutinin antigen per dose) or 2 half-dose aH5N1c vaccinations 3 weeks apart. Outcomes were based on Center for Biologics Evaluation Research and Review (CBER) and Committee for Medicinal Products for Human Use (CHMP) licensure criteria (titers ≥1:40 and seroconversions on day 43). Solicited reactions and adverse events were assessed (www.clinicaltrials.gov: NCT01776541 and NCT01766921).

Results: CBER and CHMP criteria were met by both age groups. CBER criteria for hemagglutination titers were met for the full-dose formulation. Solicited reaction frequencies tended to be higher in the full-dose group and were of mild to moderate intensity. No vaccine-related serious adverse events occurred.

Conclusions: In adult and elderly participants, the full-dose aH5N1c vaccine formulation was well tolerated and met US and European licensure criteria for pandemic vaccines.

Keywords: H5N1 subunit vaccine; MF59 adjuvant; pandemic influenza; cell culture–derived vaccine; influenza; phase II.

Figures

Figure 1.
Figure 1.
Study design and subject disposition for adult (A; NCT01776541) and elderly (B; NCT01766921) clinical trials.
Figure 2.
Figure 2.
Geometric mean hemagglutination inhibition antibody titers (95% confidence interval) on day 1 and day 43 in adult (A; age 18–64 years) and elderly (B; age ≥65 years) subjects.

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Source: PubMed

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