Trial Outcomes & Findings for FLUAD vs. FLUZONE HD Influenza Vaccine in Residents of Long Term Care (NCT NCT03694808)

NCT ID: NCT03694808

Last Updated: 2024-04-30

Results Overview

HAI is an in vitro bioassay testing subjects' sera for specific anti-influenza antibodies to each strain in the vaccine. Seroconversion is 4-fold rise in antibody titer. The FDA uses this as the standard immunogenicity assay for licensure. The investigators will follow the guidelines set out in the FDA guidance document on non-inferiority immunogenicity studies for the analysis plan.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

478 participants

Primary outcome timeframe

1 month post vaccine administration

Results posted on

2024-04-30

Participant Flow

19 people were excluded prior to assignment to a group. People were excluded from the study if investigators failed to obtain all proper documentation on time (HIPPA, consent), if they withdrew consent, already got vaccine elsewhere, on antibiotics, ivermectin, refused vaccination, were hospitalized, left the facility prior to study completion for any reason.

Participant milestones

Participant milestones
Measure
Fluad Vaccine
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Study
STARTED
240
219
Overall Study
COMPLETED
194
193
Overall Study
NOT COMPLETED
46
26

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Sex was not reported on 2 people in the Fluad vaccine group.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Fluad Vaccine
n=194 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=193 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Total
n=387 Participants
Total of all reporting groups
Age, Continuous
79.5 Years
STANDARD_DEVIATION 9.8 • n=194 Participants
80.6 Years
STANDARD_DEVIATION 9.3 • n=193 Participants
80 Years
STANDARD_DEVIATION 9.6 • n=387 Participants
Sex: Female, Male
Female
102 Participants
n=192 Participants • Sex was not reported on 2 people in the Fluad vaccine group.
93 Participants
n=193 Participants • Sex was not reported on 2 people in the Fluad vaccine group.
195 Participants
n=385 Participants • Sex was not reported on 2 people in the Fluad vaccine group.
Sex: Female, Male
Male
90 Participants
n=192 Participants • Sex was not reported on 2 people in the Fluad vaccine group.
100 Participants
n=193 Participants • Sex was not reported on 2 people in the Fluad vaccine group.
190 Participants
n=385 Participants • Sex was not reported on 2 people in the Fluad vaccine group.
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=194 Participants
5 Participants
n=193 Participants
8 Participants
n=387 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
183 Participants
n=194 Participants
181 Participants
n=193 Participants
364 Participants
n=387 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
8 Participants
n=194 Participants
7 Participants
n=193 Participants
15 Participants
n=387 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=194 Participants
0 Participants
n=193 Participants
0 Participants
n=387 Participants
Race (NIH/OMB)
Asian
0 Participants
n=194 Participants
0 Participants
n=193 Participants
0 Participants
n=387 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=194 Participants
0 Participants
n=193 Participants
0 Participants
n=387 Participants
Race (NIH/OMB)
Black or African American
27 Participants
n=194 Participants
21 Participants
n=193 Participants
48 Participants
n=387 Participants
Race (NIH/OMB)
White
156 Participants
n=194 Participants
161 Participants
n=193 Participants
317 Participants
n=387 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=194 Participants
0 Participants
n=193 Participants
0 Participants
n=387 Participants
Race (NIH/OMB)
Unknown or Not Reported
11 Participants
n=194 Participants
11 Participants
n=193 Participants
22 Participants
n=387 Participants

PRIMARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

HAI is an in vitro bioassay testing subjects' sera for specific anti-influenza antibodies to each strain in the vaccine. Seroconversion is 4-fold rise in antibody titer. The FDA uses this as the standard immunogenicity assay for licensure. The investigators will follow the guidelines set out in the FDA guidance document on non-inferiority immunogenicity studies for the analysis plan.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=192 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=190 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Hemagglutinin Inhibition (HAI) H1N1 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
213.4 Titer
Interval 156.9 to 290.4
261.9 Titer
Interval 192.3 to 356.6
Overall Hemagglutinin Inhibition (HAI) H1N1 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
70.5 Titer
Interval 53.5 to 92.9
67.2 Titer
Interval 52.3 to 86.3

PRIMARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

HAI is an in vitro bioassay testing subjects' sera for specific anti-influenza antibodies to each strain in the vaccine. Seroconversion is 4-fold rise in antibody titer. The FDA uses this as the standard immunogenicity assay for licensure. The investigators will follow the guidelines set out in the FDA guidance document on non-inferiority immunogenicity studies for the analysis plan.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=194 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=193 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Hemagglutinin Inhibition (HAI) H3N2 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
375.5 Titer
Interval 271.3 to 519.7
517.3 Titer
Interval 380.8 to 702.6
Overall Hemagglutinin Inhibition (HAI) H3N2 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
140.2 Titer
Interval 96.9 to 202.7
120.4 Titer
Interval 87.2 to 166.2

PRIMARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

HAI is an in vitro bioassay testing subjects' sera for specific anti-influenza antibodies to each strain in the vaccine. Seroconversion is 4-fold rise in antibody titer. The FDA uses this as the standard immunogenicity assay for licensure. The investigators will follow the guidelines set out in the FDA guidance document on non-inferiority immunogenicity studies for the analysis plan.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=194 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=193 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Hemagglutinin Inhibition (HAI) B Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
113.6 Titer
Interval 87.6 to 146.8
210.4 Titer
Interval 152.5 to 290.3
Overall Hemagglutinin Inhibition (HAI) B Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
75.5 Titer
Interval 58.1 to 98.1
66.1 Titer
Interval 51.1 to 85.5

PRIMARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

HAI is an in vitro bioassay testing subjects' sera for specific anti-influenza antibodies to each strain in the vaccine. Seroconversion is 4-fold rise in antibody titer. The FDA uses this as the standard immunogenicity assay for licensure. The investigators will follow the guidelines set out in the FDA guidance document on non-inferiority immunogenicity studies for the analysis plan.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=192 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=190 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall HAI H1N1 Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
29.2 percentage of participants
Interval 20.3 to 40.0
44.6 percentage of participants
Interval 33.8 to 55.9
Overall HAI H1N1 Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
48.5 percentage of participants
Interval 38.7 to 58.5
43 percentage of participants
Interval 33.6 to 52.9

PRIMARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

HAI is an in vitro bioassay testing subjects' sera for specific anti-influenza antibodies to each strain in the vaccine. Seroconversion is 4-fold rise in antibody titer. The FDA uses this as the standard immunogenicity assay for licensure. The investigators will follow the guidelines set out in the FDA guidance document on non-inferiority immunogenicity studies for the analysis plan.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=194 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=193 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall HAI H3N2 Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
35.2 percentage of participants
Interval 25.6 to 46.0
57 percentage of participants
Interval 45.9 to 67.5
Overall HAI H3N2 Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
70.9 percentage of participants
Interval 61.0 to 79.2
70.1 percentage of participants
Interval 60.4 to 78.4

PRIMARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

HAI is an in vitro bioassay testing subjects' sera for specific anti-influenza antibodies to each strain in the vaccine. Seroconversion is 4-fold rise in antibody titer. The FDA uses this as the standard immunogenicity assay for licensure. The investigators will follow the guidelines set out in the FDA guidance document on non-inferiority immunogenicity studies for the analysis plan.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=194 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=193 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall HAI B Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
34.1 percentage of participants
Interval 24.7 to 44.8
47.7 percentage of participants
Interval 36.9 to 58.7
Overall HAI B Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
36.9 percentage of participants
Interval 27.8 to 47.0
39.3 percentage of participants
Interval 30.1 to 49.2

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

Neuraminidase inhibition (NAI) assays will be performed to measure anti-neuraminidase titers. Seroconversion is 4-fold rise in antibody titer.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=192 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=189 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Neuraminidase Inhibition (NAI) H1N1 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
167.7 Titer
Interval 128.2 to 219.3
71.8 Titer
Interval 53.0 to 97.3
Overall Neuraminidase Inhibition (NAI) H1N1 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
666.4 Titer
Interval 497.7 to 892.3
297.8 Titer
Interval 214.3 to 413.8

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

Neuraminidase inhibition (NAI) assays will be performed to measure anti-neuraminidase titers. Seroconversion is 4-fold rise in antibody titer.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=194 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=192 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Neuraminidase Inhibition (NAI) H3N2 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
27.3 Titer
Interval 23.3 to 32.1
24.9 Titer
Interval 20.6 to 30.1
Overall Neuraminidase Inhibition (NAI) H3N2 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
46.7 Titer
Interval 37.1 to 58.8
44.7 Titer
Interval 35.4 to 56.4

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

Neuraminidase inhibition (NAI) assays will be performed to measure anti-neuraminidase titers. Seroconversion is 4-fold rise in antibody titer.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=192 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=189 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall H1N1 NAI Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
64 percentage of participants
Interval 53.1 to 73.7
9.6 percentage of participants
Interval 4.6 to 18.6
Overall H1N1 NAI Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
60.2 percentage of participants
Interval 50.1 to 69.6
43.4 percentage of participants
Interval 33.9 to 53.4

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: The total number analyzed represents the overall number of participants per group analyzed for both years combined. The total number analyzed per year is represented in the row value.

Neuraminidase inhibition (NAI) assays will be performed to measure anti-neuraminidase titers. Seroconversion is 4-fold rise in antibody titer.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=194 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=192 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall NAI H3N2 Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 1 (2018-2019)
20.9 percentage of participants
Interval 13.3 to 30.9
10.5 percentage of participants
Interval 5.2 to 19.4
Overall NAI H3N2 Seroconversion Rate Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
Year 2 (2019-2020)
32 percentage of participants
Interval 23.4 to 42.1
20.8 percentage of participants
Interval 13.7 to 29.9

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: SVN assay was only performed on samples for the 2018-2019 flu season. The 2019-2020 assays were not performed due to interruption by SARS-Cov-2 pandemic.

Serum virus neutralization (SVN) assays will be performed to measure the ability of serum to inhibit influenza infection.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=65 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=67 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Serum Virus Neutralization (SVN) H1N1 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
675.7 Titer
Interval 532.2 to 872.7
791.3 Titer
Interval 647.7 to 966.7

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: No data was collected

Hemagglutinin inhibition (HAI), neuraminidase inhibition (NAI) assays and serum virus neutralization (SVN) assays will be performed with heterologous A/H3N2 strains to determine if Fluad has an increased breadth of both B and T cell responses as would be predicted from an adjuvanted vaccine.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: SVN assay was only performed on samples for the 2018-2019 flu season. The 2019-2020 assays were not performed due to interruption by SARS-Cov-2 pandemic.

Serum virus neutralization (SVN) assays will be performed to measure the ability of serum to inhibit influenza infection.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=66 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=65 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Serum Virus Neutralization (SVN) H3N2 Titer Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
270.8 Titer
Interval 180.0 to 407.3
405.0 Titer
Interval 279.9 to 586.0

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: SVN assay was only performed on samples for the 2018-2019 flu season. The 2019-2020 assays were not performed due to interruption by SARS-Cov-2 pandemic.

Serum virus neutralization (SVN) assays will be performed to measure the ability of serum to inhibit influenza infection.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=65 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=67 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Serum Virus Neutralization (SVN) H1N1 Seroconversion Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
32.3 percentage of participants
Interval 21.5 to 45.2
31.3 percentage of participants
Interval 20.9 to 44.0

SECONDARY outcome

Timeframe: 1 month post vaccine administration

Population: SVN assay was only performed on samples for the 2018-2019 flu season. The 2019-2020 assays were not performed due to interruption by SARS-Cov-2 pandemic.

Serum virus neutralization (SVN) assays will be performed to measure the ability of serum to inhibit influenza infection.

Outcome measures

Outcome measures
Measure
Fluad Vaccine
n=66 Participants
A single adjuvanted dose (AD) intramuscular injection Fluad Vaccine: single adjuvanted dose (AD) intramuscular injection
Fluzone Vaccine
n=65 Participants
A single high dose (HD) intramuscular injection Fluzone HD Vaccine: single high dose (HD) intramuscular injection
Overall Serum Virus Neutralization (SVN) H3N2 Seroconversion Between FLUAD and FLUZONE HD at 1 Month Post-vaccination.
21.2 percentage of participants
Interval 12.5 to 33.3
43.1 percentage of participants
Interval 31.1 to 55.9

OTHER_PRE_SPECIFIED outcome

Timeframe: 6-8 months post vaccine administration

Population: No data collected

A record review and a blood 2 weeks after the influenza season is over will be done. From a record review the dates and diagnoses of hospitalizations and/or "influenza like illness" (ILI) will be recorded. Serologic evidence of influenza infection ( \>=4-fold titer rise beyond the post-vaccine titers) will be determined from the remote blood draw. An exploratory analysis will be performed comparing the efficacy of the two vaccines.

Outcome measures

Outcome data not reported

Adverse Events

Fluad Vaccine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 1 deaths

Fluzone Vaccine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 1 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. David Canaday

University Hospitals Cleveland Medical Center

Phone: 216-368-5537

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place