Maternal Flu Vaccine Trial in Bamako, Mali

NCT ID: NCT01430689

Last Updated: 2019-09-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

4193 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-12

Study Completion Date

2014-01-31

Brief Summary

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The Center for Vaccine Development - Mali is interested in learning if vaccinating a pregnant woman against influenza will protect her infant against this disease. The investigators know that influenza infection, the "flu", affects pregnant women and their infants in Mali. The illness known as flu is caused by a germ (virus) that is passed easily among people. The flu causes symptoms such as fever, cough, sore throat, runny nose, and body aches. Certain groups of people, such as pregnant women and infants, are at risk for having severe disease when they get the flu. Vaccination against influenza is not routinely available to pregnant women in Mali although it is recommended.

Women who wish to participate will have 5 visits to the clinic and weekly visits to the home to follow the health of the woman and her infant when it is born. The investigators will also ask permission to make weekly visits to all children under 5 years of age to follow their health as it relates to influenza infection.

Detailed Description

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This is a prospective, randomized, controlled observer-blind trial measuring the efficacy, safety and immunogenicity of TIV and the safety and immunogenicity of MCV in pregnant women and their infants up to 6 months of age. Women will be recruited in the 3rd trimester of pregnancy and vaccinated with either TIV or MCV. Safety assessments of the women will be completed 30 minutes and 1 week after vaccination, at delivery and 3 and 6 months after delivery. Safety assessments of the infants will be completed at birth and at 3 and 6 months of age. Immunogenicity assessments will include blood sampling of women immediately prior to vaccination, 4 weeks post-vaccination, at delivery and 3 and 6 months after delivery; infants will have cord blood collected at birth and peripheral blood collections at 3 and 6 months of age. Visits to ascertain the costs related to ILI and LCI will also be conducted. The majority of activities conducted in this trial are related to efficacy assessments which will continue until the newborn infant is 6 months of age. We will be conducting case detection for LCI via weekly household visits. In addition, hospital-based surveillance for meningococcal disease will be conducted to measure the efficacy of MCV.

Conditions

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Influenza

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Inactivated Influenza Vaccine Trivalent Types A and B

Women will be vaccinated with Influenza vaccine: Inactivated Influenza Vaccine Trivalent Types A and B

Group Type EXPERIMENTAL

Inactivated Influenza Vaccine Trivalent Types A and B

Intervention Type BIOLOGICAL

Pregnant Woman: Randomization to receive IM injection of Vaxigrip Influenza Vaccine once

Household and Woman/Infant surveillance

* Home visits weekly until the infant is born and reaches 6 months of age
* If the woman, her infant or other household contact has signs and symptoms consistent with Influenza Like Illness (ILI)a nasal and oropharyngeal swab will be obtained

Meningococcal Polysaccharide-Diphtheria Toxoid Conjugate

Women will be vaccinated with IM injection of Meningococcal Polysaccharide-Diphtheria Toxoid Conjugate Vaccine

Group Type ACTIVE_COMPARATOR

Meningococcal Polysaccharide-Diphtheria Toxoid Conjugate Vaccine

Intervention Type BIOLOGICAL

Pregnant Women - Randomized to receive IM injection of Menactra once

Household and Woman/Infant surveillance

* Home visits weekly until the infant is born and reaches 6 months of age
* If the woman, her infant or other household contact has signs and symptoms consistent with Influenza Like Illness (ILI)a nasal and oropharyngeal swab will be obtained

Interventions

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Inactivated Influenza Vaccine Trivalent Types A and B

Pregnant Woman: Randomization to receive IM injection of Vaxigrip Influenza Vaccine once

Household and Woman/Infant surveillance

* Home visits weekly until the infant is born and reaches 6 months of age
* If the woman, her infant or other household contact has signs and symptoms consistent with Influenza Like Illness (ILI)a nasal and oropharyngeal swab will be obtained

Intervention Type BIOLOGICAL

Meningococcal Polysaccharide-Diphtheria Toxoid Conjugate Vaccine

Pregnant Women - Randomized to receive IM injection of Menactra once

Household and Woman/Infant surveillance

* Home visits weekly until the infant is born and reaches 6 months of age
* If the woman, her infant or other household contact has signs and symptoms consistent with Influenza Like Illness (ILI)a nasal and oropharyngeal swab will be obtained

Intervention Type BIOLOGICAL

Other Intervention Names

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Vaxigrip Menactra - Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine; Product No. 49281-589-05

Eligibility Criteria

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Inclusion Criteria

1. Women in third trimester of pregnancy (≥ 28 weeks gestational age based upon last menstrual period, ultrasound or uterine height).
2. Subject is able to understand and comply with planned study procedures.
3. Subject has provided written informed consent prior to initiation of any study procedures.
4. Subject intends to reside in the study area until her newborn infant is 6 months of age.

Exclusion Criteria

1. Member of a household which already has a woman who is participating or has participated in this study
2. History of severe reactions following previous immunization with influenza or meningococcal vaccines
3. History of Guillain-Barré Syndrome
4. Known allergy or hypersensitivity to eggs, egg proteins, latex, diphtheria toxoid, or any other components of Vaxigrip and Menactra
5. Known chronic medical condition that in the judgment of the investigator could compromise the evaluation of the study vaccine or puts the subject at risk
6. Known active infection with human immunodeficiency virus (HIV), hepatitis B, or hepatitis C
7. Any of the following complications with the ongoing pregnancy: preterm labor (with cervical change), placental abruption, premature rupture of membranes, known major congenital anomaly, or preeclampsia.
8. Acute illness and/or an oral temperature greater than or equal to 37.8 degrees C, within 72 hours of vaccination (This may result in a temporary delay of vaccination)
9. Receipt of any other vaccine, excluding tetanus toxoid, within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines and meningococcal A conjugate vaccine (MenAfriVac)) prior to vaccination in this study
10. Woman who intends to travel out of the study area for the 40 days after delivery
11. Receipt of immunoglobulins and/or any blood products within 30 days prior to the administration of study vaccines
12. Chronic administration (defined as more than 14 days) of immunosuppressants or other immune-modifying agents within 90 days prior to administration of study vaccines (including systemic corticosteroids, e.g. prednisone or equivalent \> 0.5 mg/kg/day; topical and inhaled steroids are allowed)
13. Any condition which in the opinion of the investigator might compromise the well-being of the participant or compliance with study procedures or interfere with the evaluation of the study vaccines
Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Bill and Melinda Gates Foundation

OTHER

Sponsor Role collaborator

University of Maryland, Baltimore

OTHER

Sponsor Role lead

Responsible Party

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Milagritos Tapia

Faculty

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Milagritos D Tapia, MD

Role: PRINCIPAL_INVESTIGATOR

University of Maryland, College Park

Myron M Levine, MD, DTPH

Role: STUDY_DIRECTOR

University of Maryland, College Park

Samba O Sow, MD

Role: PRINCIPAL_INVESTIGATOR

Centre pour le Developpement des Vaccins - Mali

Locations

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Centre pour le Developpement des Vaccins - Mali

Bamako, , Mali

Site Status

Countries

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Mali

References

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Amin AB, Nunes MC, Tapia MD, Madhi SA, Cutland CL, Wairagkar N, Omer SB; for BMGF Supported Maternal Influenza Immunization Trials Investigators Group. Immunogenicity of influenza vaccines administered to pregnant women in randomized clinical trials in Mali and South Africa. Vaccine. 2020 Sep 22;38(41):6478-6483. doi: 10.1016/j.vaccine.2020.07.020. Epub 2020 Aug 29.

Reference Type DERIVED
PMID: 32868130 (View on PubMed)

Omer SB, Clark DR, Madhi SA, Tapia MD, Nunes MC, Cutland CL, Simoes EAF, Aqil AR, Katz J, Tielsch JM, Steinhoff MC, Wairagkar N; BMGF Supported Maternal Influenza Immunization Trials Investigators Group. Efficacy, duration of protection, birth outcomes, and infant growth associated with influenza vaccination in pregnancy: a pooled analysis of three randomised controlled trials. Lancet Respir Med. 2020 Jun;8(6):597-608. doi: 10.1016/S2213-2600(19)30479-5.

Reference Type DERIVED
PMID: 32526188 (View on PubMed)

Clark DR, Omer SB, Tapia MD, Nunes MC, Cutland CL, Tielsch JM, Wairagkar N, Madhi SA; for BMGF Supported Maternal Influenza Immunization Trials Investigators Group. Influenza or Meningococcal Immunization During Pregnancy and Mortality in Women and Infants: A Pooled Analysis of Randomized Controlled Trials. Pediatr Infect Dis J. 2020 Jul;39(7):641-644. doi: 10.1097/INF.0000000000002629.

Reference Type DERIVED
PMID: 32379201 (View on PubMed)

Omer SB, Clark DR, Aqil AR, Tapia MD, Nunes MC, Kozuki N, Steinhoff MC, Madhi SA, Wairagkar N; for BMGF Supported Maternal Influenza Immunization Trials Investigators Group. Maternal Influenza Immunization and Prevention of Severe Clinical Pneumonia in Young Infants: Analysis of Randomized Controlled Trials Conducted in Nepal, Mali and South Africa. Pediatr Infect Dis J. 2018 May;37(5):436-440. doi: 10.1097/INF.0000000000001914.

Reference Type DERIVED
PMID: 29443825 (View on PubMed)

Tapia MD, Sow SO, Tamboura B, Teguete I, Pasetti MF, Kodio M, Onwuchekwa U, Tennant SM, Blackwelder WC, Coulibaly F, Traore A, Keita AM, Haidara FC, Diallo F, Doumbia M, Sanogo D, DeMatt E, Schluterman NH, Buchwald A, Kotloff KL, Chen WH, Orenstein EW, Orenstein LAV, Villanueva J, Bresee J, Treanor J, Levine MM. Maternal immunisation with trivalent inactivated influenza vaccine for prevention of influenza in infants in Mali: a prospective, active-controlled, observer-blind, randomised phase 4 trial. Lancet Infect Dis. 2016 Sep;16(9):1026-1035. doi: 10.1016/S1473-3099(16)30054-8. Epub 2016 May 31.

Reference Type DERIVED
PMID: 27261067 (View on PubMed)

Other Identifiers

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HP-00049582

Identifier Type: -

Identifier Source: org_study_id

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