Effects of Iron Supplementation on Pediatric Vaccine Response

NCT ID: NCT04744818

Last Updated: 2024-01-24

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

NA

Total Enrollment

288 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-07

Study Completion Date

2023-10-16

Brief Summary

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ID/IDA affects many young children in Africa. Vaccines provide tremendous benefits in LMIC; however, they currently fail to reach their full potential. We need to better understand the causes of vaccine failure, in order to develop new strategies to improve vaccine immunogenicity.

This study will contribute to children's health by: (1) providing updated guidelines to better define the prevalence of ID/IDA in early infancy, and its safe and effective control using iron; and (2) providing a new approach to improve response to pediatric vaccines in LMIC, by ensuring adequate iron status at time of vaccination.

Detailed Description

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Two major pediatric public health goals in LMIC are increasing immunization effectiveness and reducing ID/IDA in children. ID/IDA affects many young children in Africa. Current guidelines do not recommend routine testing of hemoglobin in early infancy, as it is generally believed that most infants are born with adequate iron stores to last 6 months. However, many African infants are born with low iron stores and ID/IDA may develop earlier than generally appreciated, within 2-3 months after birth. Vaccines provide tremendous benefits in LMIC; however, they currently fail to reach their full potential. We need to better understand the causes of vaccine failure, in order to develop new strategies to improve vaccine immunogenicity. Despite lower efficacy in LMIC, these vaccines provide a major benefit because the disease burden is so high; however, if approaches can be found to improve immunogenicity, these vaccines would be even more powerful.

For this study, 6 weeks old infants will be randomly assigned to two study groups. Group 1 will receive iron at time of pediatric vaccinations from age 6-24 weeks. Group 2 will receive no iron at time of pediatric vaccinations. All infants will receive a multivitamin syrup from age 6-24 weeks. All infants remaining ID/IDA at age 24 weeks will receive iron. Infants will be followed-up until age 52 weeks.

Conditions

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Iron-deficiency Iron Deficiency Anemia Vaccination Pediatric ALL

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Immediate iron treatment

Iron and multivitamin syrup

Group Type ACTIVE_COMPARATOR

Iron syrup

Intervention Type DIETARY_SUPPLEMENT

Daily supplementation with iron

Multivitamin syrup

Intervention Type DIETARY_SUPPLEMENT

Daily supplementation with multivitamins

Delayed iron treatment

Multivitamin syrup

Group Type PLACEBO_COMPARATOR

Multivitamin syrup

Intervention Type DIETARY_SUPPLEMENT

Daily supplementation with multivitamins

Interventions

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Iron syrup

Daily supplementation with iron

Intervention Type DIETARY_SUPPLEMENT

Multivitamin syrup

Daily supplementation with multivitamins

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Mother at least ≥15 years of age.
* 6 weeks (+/- 3 days) of age
* Iron deficient (erythrocyte zinc protoporphyrin (ZnPP) \>61 μmol/mol heme)
* With or without anemia, but not severely anemic (Hb \>70 g/L)
* No malaria
* No medical condition that precludes study involvement
* Mother HIV negative
* Vaginal delivery
* No iron supplementation prior to study enrolment
* Not wasted (length for height z score of ≥-2)
* Not underweight (weight for age z score ≥-2)
* From the hospital record, term or late preterm delivery (≥34 weeks)
* Full-time breastfed at least until the screening
* No vaccines beyond the birth dose of OPV and BCG prior to enrolment
Minimum Eligible Age

39 Days

Maximum Eligible Age

45 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Jomo Kenyatta University of Agriculture and Technology Kenya

UNKNOWN

Sponsor Role collaborator

Karolinka Institute Sweden

UNKNOWN

Sponsor Role collaborator

University of Oxford

OTHER

Sponsor Role collaborator

National Institute for Public Health and Environment Netherlands

UNKNOWN

Sponsor Role collaborator

Jessica Rigutto

OTHER

Sponsor Role lead

Responsible Party

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Jessica Rigutto

Dr. Nicole Stoffel

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Msambweni County Referral Hospital

Msambweni, Kwale County, Kenya

Site Status

Human Nutrition Laboratory ETH Zurich

Zurich, , Switzerland

Site Status

Countries

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Kenya Switzerland

Other Identifiers

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VINO

Identifier Type: -

Identifier Source: org_study_id

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