• Vaccine · Nov 2011

    Randomized Controlled Trial Multicenter Study Comparative Study

    A phase I randomized, double-blind, controlled trial of 2009 influenza A (H1N1) inactivated monovalent vaccines with different adjuvant systems.

    • Alexander R Precioso, João L Miraglia, Lúcia Maria A Campos, Alessandra C Goulart, Maria do Carmo S T Timenetsky, Maria Regina A Cardoso, Expedito Luna, Gabriella Mondini, José da S Guedes, and Isaias Raw.
    • Butantan Institute/Butantan Foundation, Clinical Trials Unit, São Paulo, Brazil. alexrp@butantan.gov.br
    • Vaccine. 2011 Nov 8;29(48):8974-81.

    MethodsWe conducted a phase I, multicenter, randomized, double-blind, placebo-controlled, multi-arm (10) parallel study involving healthy adults to evaluate the safety and immunogenicity of influenza A (H1N1) 2009 non-adjuvanted and adjuvanted candidate vaccines. Subjects received two intramuscular injections of one of the candidate vaccines administered 21 days apart. Antibody responses were measured by means of hemagglutination-inhibition assay before and 21 days after each vaccination. The three co-primary immunogenicity end points were the proportion of seroprotection >70%, seroconversion >40%, and the factor increase in the geometric mean titer >2.5.ResultsA total of 266 participants were enrolled into the study. No deaths or serious adverse events were reported. The most commonly solicited local and systemic adverse events were injection-site pain and headache, respectively. Only three subjects (1.1%) reported severe injection-site pain. Four 2009 influenza A (H1N1) inactivated monovalent candidate vaccines that met the three requirements to evaluate influenza protection, after a single dose, were identified: 15 μg of hemagglutinin antigen without adjuvant; 7.5 μg of hemagglutinin antigen with aluminum hydroxide, MPL and squalene; 3.75 μg of hemagglutinin antigen with aluminum hydroxide and MPL; and 3.75 μg of hemagglutinin antigen with aluminum hydroxide and squalene.ConclusionsAdjuvant systems can be safely used in influenza vaccines, including the adjuvant monophosphoryl lipid A (MPL) derived from Bordetella pertussis with squalene and aluminum hydroxide, MPL with aluminum hydroxide, and squalene and aluminum hydroxide.Copyright © 2011 Elsevier Ltd. All rights reserved.

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