Opportunistic Pneumococcal Immunisation Trial in MALnutrition

NCT ID: NCT06817421

Last Updated: 2025-12-18

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

NOT_YET_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

214 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-31

Study Completion Date

2029-02-28

Brief Summary

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The goal of the OPTIMAL clinical trial is to learn if a dose of a pneumococcal conjugate vaccine (PCV) generates a good immune response in young children who are in hospital with severe acute malnutrition.

Researchers will compare an intervention group who get a dose of a PCV (Pneumosil) to a control group who get a dose of a Typhoid conjugate vaccine (Typbar TCV). To ensure all participants receive timely potential benefits, at 3 months participants in the intervention group with receive a dose of Typbar TCV, and those in the conrol group will receive a dose of Pneumosil.

Participants will be visited 4 times at their homes over six months after vaccination, with a phone review at 12 months after vaccination.

Detailed Description

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This is a prospective, single-centre, double-blind, randomised controlled trial in 264 children aged 6-59 months hospitalised with severe acute malnutrition.

Participants will be randomised (1:1) to receive either a dose of a pneumococcal conjugate vaccine (Pneumosil, the intervention group) or a dose of a Typhoid conjugate vaccine (Typbar TCV, the control group). Stratification for randomisation will be done on (a) prior immunisation with a PCV (confirmed or unknown/unvaccinated); and (b) severity of malnurition (weight-for-height/length z-score \<-4 or \>=-4). Participants will be enrolled as soon as practical after admission to hospital, while randomisation and vaccine administration will occur once the participant is medically stable in the 'transition phase' of SAM care.

The primary objective is to demonstrate that immune responses to the 10 pneumococcal serotypes in Pneumosil are better in participants who receive Pneumosil, compared to those who receive Typbar TCV, when measured 28 days after vaccination.

Conditions

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Severe Acute Malnutrition in Childhood Pneumococcal Disease Pneumococcal Vaccines Pneumococcal Infection Pneumonia in Children

Keywords

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Pneumococcal Severe Acute Malnutrition in childhood Pneumococcal vaccine Pneumosil Pneumococcal disease Pneumococcal infection Pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A prospective, single-centre, double-blind, phase 4, randomised, controlled trial in children aged 6-59 months hospitalised with severe acute malnutrition.
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Treatment Arm: Pneumosil

Group Type EXPERIMENTAL

Pneumococcal conjugate vaccine

Intervention Type BIOLOGICAL

10-valent pneumococcal polysaccharide conjugate vaccine at a dosage of 2μg for each serotype polysaccharide for 1, 5, 6A, 7F, 9V, 14, 19A, 19F, 23F, and 4μg for serotype 6B, conjugated to a carrier protein (CRM197), polysorbate 20 and aluminium phosphate as an adjuvant. Administered as an intramuscular injection of 0.5mL.

Control Arm: Typbar TCV

Group Type OTHER

Typhoid conjugate vaccine

Intervention Type BIOLOGICAL

Typhoid conjugate vaccine at a dosage of 25μg purified Vi capsular polysaccharide of Salmonella typhi Ty2 conjugated to Tetanus Toxoid with preservative (2-Phenoxyethanol). Administered as an intramuscular injection of 0.5mL.

Interventions

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Pneumococcal conjugate vaccine

10-valent pneumococcal polysaccharide conjugate vaccine at a dosage of 2μg for each serotype polysaccharide for 1, 5, 6A, 7F, 9V, 14, 19A, 19F, 23F, and 4μg for serotype 6B, conjugated to a carrier protein (CRM197), polysorbate 20 and aluminium phosphate as an adjuvant. Administered as an intramuscular injection of 0.5mL.

Intervention Type BIOLOGICAL

Typhoid conjugate vaccine

Typhoid conjugate vaccine at a dosage of 25μg purified Vi capsular polysaccharide of Salmonella typhi Ty2 conjugated to Tetanus Toxoid with preservative (2-Phenoxyethanol). Administered as an intramuscular injection of 0.5mL.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

1. Aged 6-59 months at the time of hospitalisation
2. Hospitalised with severe acute malnutrition (SAM, defined as any one of a, b, or c):

1. weight-for-length/height z-score \<-3; or
2. middle upper arm circumference \<11.5cm; or
3. bilateral pitting pedal oedema unexplained by other causes
3. Parent/carer is willing for their child to participate in the study and has provided written informed consent
4. Parent/carer is willing to comply with all study procedures outlined in the protocol, including specimen collection, for the duration of the study

Exclusion Criteria

1. Known history of allergy or hypersensitivity to any component of either study vaccine, including diphtheria toxoid, or a history of anaphylactic shock.
2. Treatment with another investigational drug or other intervention in the 30 days prior to randomisation, or ongoing participation in another clinical trial.
3. Suspected primary or secondary immunodeficiency or prolonged administration (\>14 days) of an immune modifying drug (including oral glucocorticoids) in the past 3 months.
4. Known terminal illness expected to result in death within 6 months.
5. Participants who, in the opinion of the site Principal Investigator, are unable to comply with the study protocol, including scheduled visits, assessments, and any other protocol-required procedures.
6. Previously enrolled in this trial.
Minimum Eligible Age

6 Months

Maximum Eligible Age

59 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Murdoch Childrens Research Institute

OTHER

Sponsor Role collaborator

The University of Western Australia

OTHER

Sponsor Role collaborator

University of Edinburgh

OTHER

Sponsor Role collaborator

Timor-Leste Ministry of Health

UNKNOWN

Sponsor Role collaborator

Nick Fancourt

OTHER

Sponsor Role lead

Responsible Party

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Nick Fancourt

Senior Research Fellow

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Guido Valadares National Hospital (HNGV)

Dili, Timor-Leste, Timor-Leste

Site Status

Countries

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Timor-Leste

Central Contacts

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Nicholas S. S. Fancourt, PhD

Role: CONTACT

Phone: +61889468600

Email: [email protected]

Jane N Nelson, Bachelor of Nursing

Role: CONTACT

Phone: +61889468600

Email: [email protected]

Related Links

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Other Identifiers

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U1111-1312-6848

Identifier Type: OTHER

Identifier Source: secondary_id

MENTL2024-4996

Identifier Type: -

Identifier Source: org_study_id