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    Clinical Trial Results:
    Immunogenicity and Safety of the Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation (Intramuscular Route)

    Summary
    EudraCT number
    		 2007-000752-14
    Trial protocol
    		 GB  
    Global end of trial date
    03 Jul 2007

    Results information
    Results version number
    		 v1(current)
    This version publication date
    05 Feb 2016
    First version publication date
    03 Dec 2014
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    GRT82
    Additional study identifiers
    ISRCTN number
    		 -
    US NCT number
    		 NCT00491257
    WHO universal trial number (UTN)
    		 -
    Sponsors
    Sponsor organisation name
    Sanofi Pasteur SA
    Sponsor organisation address
    1541, Avenue Marcel Mérieux, Marcy L’Etoile, France, 69280
    Public contact
    Director, Clinical Development, Sanofi Pasteur SA, 33 (0)4 37 37 58 43, emmanuel.feroldi@sanofipasteur.com
    Scientific contact
    Director, Clinical Development, Sanofi Pasteur SA, 33 (0)4 37 37 58 43, emmanuel.feroldi@sanofipasteur.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    25 Jul 2007
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    03 Jul 2007
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To check the compliance, in terms of immunogenicity, of the inactivated, split-virion influenza vaccine Northern Hemisphere 2007-2008 formulation with the requirements of the Committee for Human Medicinal Products (CHMP) Note for Guidance (NfG) CPMP/BWP/214/96.
    Protection of trial subjects
    Only subjects who met all the study inclusion and none of the exclusion criteria were vaccinated in the study. Vaccinations were performed by qualified and trained study personnel. Subjects with allergy to any of the vaccine components were not vaccinated. After vaccination, subjects were also kept under clinical observation for 30 minutes to ensure their safety. Appropriate medical equipment were also available on site in case of any immediate allergic reactions.
    Background therapy
    		 Not aplicable
    Evidence for comparator
    		 Not applicable
    Actual start date of recruitment
    11 Jun 2007
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 130
    Worldwide total number of subjects
    130
    EEA total number of subjects
    130
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    88
    From 65 to 84 years
    42
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    		 Study subjects were enrolled and vaccinated on 11 June 2007 at 2 clinical centers in the United Kingdom.

    Pre-assignment
    Screening details
    		 A total of 130 subjects who met all inclusion criteria and none of the exclusion criteria were enrolled and vaccinated.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    		 Yes
    Allocation method
    Not applicable
    Blinding used
    		 Not blinded
    Blinding implementation details
    Not applicable

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    		 18 to 60 years
    Arm description
    		 Subjects aged 18 to 60 years who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Influenza vaccine (split virion, inactivated)
    Investigational medicinal product code
    314
    Other name
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL, intramuscular into the deltoid muscle, one dose on Day 0

    Arm title
    		 61 years or older
    Arm description
    		 Subjects aged 61 years or older who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Influenza vaccine (split virion, inactivated)
    Investigational medicinal product code
    314
    Other name
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL, intramuscular into the deltoid muscle, one dose on Day 0

    Number of subjects in period 1
    		18 to 60 years 61 years or older
    Started
    65
    65
    Completed
    64
    65
    Not completed
    1
    0
         Lost to follow-up
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    18 to 60 years
    Reporting group description
    		 Subjects aged 18 to 60 years who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.

    Reporting group title
    61 years or older
    Reporting group description
    		 Subjects aged 61 years or older who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.

    Reporting group values
    		 18 to 60 years 61 years or older Total
    Number of subjects
    		 65 65 130
    Age categorical
    Units: Subjects
        In utero
    		 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    		 0 0 0
        Newborns (0-27 days)
    		 0 0 0
        Infants and toddlers (28 days-23 months)
    		 0 0 0
        Children (2-11 years)
    		 0 0 0
        Adolescents (12-17 years)
    		 0 0 0
        Adults (18-64 years)
    		 65 23 88
        From 65-84 years
    		 0 42 42
        85 years and over
    		 0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    		 40.2 ( 12.75 ) 68.1 ( 5.04 ) -
    Gender categorical
    Units: Subjects
        Female
    		 28 31 59
        Male
    		 37 34 71
    Previous influenza vaccination
    Units: Subjects
        Yes
    		 20 51 71
        No
    		 45 14 59
    Previous influenza infection last winter
    Units: Subjects
        Yes
    		 3 1 4
        No
    		 62 64 126

    End points

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    End points reporting groups
    Reporting group title
    18 to 60 years
    Reporting group description
    		 Subjects aged 18 to 60 years who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.

    Reporting group title
    61 years or older
    Reporting group description
    		 Subjects aged 61 years or older who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.

    Primary: Summary of Geometric Mean Titers (GMTs) of Influenza Vaccine Antibodies Before and After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route

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    End point title
    		 Summary of Geometric Mean Titers (GMTs) of Influenza Vaccine Antibodies Before and After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route [1]
    End point description
    Influenza vaccine antibodies were assessed using the hemagglutination inhibition technique.
    End point type
    Primary
    End point timeframe
    Day 0 (pre-vaccination) and Day 21 post vaccination
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analyses were performed based on the study groups and the study vaccine administered for this outcome.
    End point values
    		 18 to 60 years 61 years or older
    Number of subjects analysed
    63
    65
    Units: Titers
    geometric mean (confidence interval 95%)
        Flu A/SolomonIslands/3/2006 (H1N1; Day 0)
    10.9 (8.2 to 14.5)
    13.1 (9.86 to 17.3)
        Flu A/Wisconsin/67/2005 (H3N2; Day 0)
    24.8 (16.8 to 36.5)
    58.1 (38.5 to 87.7)
        Flu B/Malaysia/2506/2004 (B native; Day 0)
    7.07 (6.07 to 8.24)
    10.3 (8.4 to 12.7)
        Flu B/Malaysia/2506/2004 (B split; Day 0)
    11.8 (9.58 to 14.5)
    26.2 (20.6 to 33.4)
        Flu A/SolomonIslands/3/2006 (H1N1; Day 21)
    311 (221 to 439)
    134 (95.9 to 188)
        Flu A/Wisconsin/67/2005 (H3N2; Day 21)
    445 (326 to 608)
    225 (163 to 310)
        Flu B/Malaysia/2506/2004 (B native; Day 21)
    46.2 (34.3 to 62)
    24.5 (19.4 to 31)
        Flu B/Malaysia/2506/2004 (B split; Day 21)
    116 (96.4 to 139)
    74.2 (62.6 to 88)
    No statistical analyses for this end point

    Primary: Summary of Geometric Mean Titers Ratios (GMTR) of Influenza Vaccine Antibodies After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route

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    End point title
    		 Summary of Geometric Mean Titers Ratios (GMTR) of Influenza Vaccine Antibodies After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route [2]
    End point description
    Influenza vaccine antibodies were assessed using the hemagglutination inhibition technique. Geometric mean titer ratio is the geometric mean of the individual post-vaccination/pre-vaccination titer of antibodies to the influenza virus antigens.
    End point type
    Primary
    End point timeframe
    Day 0 (pre-vaccination) and Day 21 post vaccination
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analyses were performed based on the study groups and the study vaccine administered for this outcome.
    End point values
    		 18 to 60 years 61 years or older
    Number of subjects analysed
    63
    65
    Units: Titer ratios
    geometric mean (confidence interval 95%)
        Flu A/SolomonIslands/3/2006 (H1N1)
    28.5 (19.2 to 42.3)
    10.3 (7.02 to 15)
        Flu A/Wisconsin/67/2005 (H3N2)
    18 (11.5 to 28)
    3.87 (2.64 to 5.68)
        Flu B/Malaysia/2506/2004 (B native)
    6.53 (4.88 to 8.73)
    2.37 (1.93 to 2.91)
        Flu B/Malaysia/2506/2004 (B split)
    9.81 (7.32 to 13.1)
    2.83 (2.27 to 3.53)
    No statistical analyses for this end point

    Primary: Percentage of Subjects with Seroprotection Against the Influenza Vaccine Antigens Before and After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route

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    End point title
    		 Percentage of Subjects with Seroprotection Against the Influenza Vaccine Antigens Before and After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route [3]
    End point description
    Influenza vaccine antibodies were assessed using the hemagglutination inhibition technique. Seroprotection was defined as titers ≥40 (1/dil) on Day 0 and Day 21.
    End point type
    Primary
    End point timeframe
    Day 0 (pre-vaccination) and Day 21 post vaccination
    Notes
    [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analyses were performed based on the study groups and the study vaccine administered for this outcome.
    End point values
    		 18 to 60 years 61 years or older
    Number of subjects analysed
    63
    65
    Units: Percentage of subjects
    number (not applicable)
        Flu A/SolomonIslands/3/2006 (H1N1; Day 0)
    19
    20
        Flu A/Wisconsin/67/2005 (H3N2; Day 0)
    42.9
    56.9
        Flu B/Malaysia/2506/2004 (B native; Day 0)
    4.8
    10.8
        Flu B/Malaysia/2506/2004 (B split; Day 0)
    7.9
    44.6
        Flu A/SolomonIslands/3/2006 (H1N1; Day 21)
    98.4
    87.7
        Flu A/Wisconsin/67/2005 (H3N2; Day 21)
    98.4
    93.8
        Flu B/Malaysia/2506/2004 (B native; Day 21)
    60.3
    40
        Flu B/Malaysia/2506/2004 (B split; Day 21)
    93.7
    84.6
    No statistical analyses for this end point

    Primary: Percentage of Subjects Achieving Seroconversion or Significant Increase Against the Influenza Vaccine Antigens Before and After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by Intramuscular Route

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    End point title
    		 Percentage of Subjects Achieving Seroconversion or Significant Increase Against the Influenza Vaccine Antigens Before and After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by Intramuscular Route [4]
    End point description
    Influenza vaccine antibodies were assessed using the hemagglutination inhibition technique. Seroconversion was defined as subjects with a titer <10 (1/dil) on Day 0 and a post-injection titer ≥40 (1/dil) on Day 21 or significant increase was defined as subjects with a titer ≥10 (1/dil) on Day 0 and a ≥4-fold increase from pre- to post-injection titer on Day 21.
    End point type
    Primary
    End point timeframe
    Day 21 post vaccination
    Notes
    [4] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analyses were performed based on the study groups and the study vaccine administered for this outcome.
    End point values
    		 18 to 60 years 61 years or older
    Number of subjects analysed
    63
    65
    Units: Percentage of subjects
    number (not applicable)
        Flu A/SolomonIslands/3/2006 (H1N1)
    88.9
    66.2
        Flu A/Wisconsin/67/2005 (H3N2)
    81
    36.9
        Flu B/Malaysia/2506/2004 (B native)
    54
    20
        Flu B/Malaysia/2506/2004 (B split)
    81
    26.2
    No statistical analyses for this end point

    Primary: Percentage of Subjects with at Least One Reaction Corresponding to those Listed in the EMEA Recommendation Within 3 Days After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by Intramuscular Route

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    End point title
    		 Percentage of Subjects with at Least One Reaction Corresponding to those Listed in the EMEA Recommendation Within 3 Days After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by Intramuscular Route [5]
    End point description
    Solicited injection site: Induration and Ecchymosis. Solicited systemic reactions: Temperature, Malaise, and Shivering.
    End point type
    Primary
    End point timeframe
    Day 0 up to Day 3 post-vaccination
    Notes
    [5] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analyses were performed based on the study groups and the study vaccine administered for this outcome.
    End point values
    		 18 to 60 years 61 years or older
    Number of subjects analysed
    65
    65
    Units: Percentage of subjects
    number (not applicable)
        Injection site induration >5 cm for >3 days
    0
    0
        Injection site ecchymosis
    10.9
    4.6
        Temperature >38˚C for ≥24 hours
    0
    0
        Malaise
    17.2
    6.2
        Shivering
    6.3
    4.6
    No statistical analyses for this end point

    Primary: Percentage of Subjects Reporting Solicited Injection-site or Systemic Reactions Within 3 Days After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route

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    End point title
    		 Percentage of Subjects Reporting Solicited Injection-site or Systemic Reactions Within 3 Days After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route [6]
    End point description
    Solicited injection site: Pain, Erythema, Swelling, Induration and Ecchymosis. Solicited systemic reactions: Fever, Headache, Malaise, Myalgia, and Shivering. Grade 3 injection site: Pain – Incapacitating, unable to perform usual activities; Erythema, Swelling, Induration, and Ecchymosis – ≥5 cm. Grade 3 systemic reactions: Fever – >39.0°C; Headache, Malaise, Myalgia, and Shivering – Prevents daily activities.
    End point type
    Primary
    End point timeframe
    Day 0 up to Day 3 post-vaccination
    Notes
    [6] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analyses were performed based on the study groups and the study vaccine administered for this outcome.
    End point values
    		 18 to 60 years 61 years or older
    Number of subjects analysed
    65
    65
    Units: Percentage of subjects
    number (not applicable)
        Injection site Pain
    39.1
    24.6
        Grade 3 Injection site Pain
    0
    0
        Injection site Erythema
    9.4
    10.8
        Grade 3 Injection site Erythema
    1.6
    4.6
        Injection site Swelling
    12.5
    12.3
        Grade 3 Injection site Swelling
    1.6
    1.5
        Injection site Induration
    15.6
    9.2
        Grade 3 Injection site Induration
    1.6
    0
        Injection site Ecchymosis
    10.9
    4.6
        Grade 3 Injection site Ecchymosis
    0
    0
        Fever
    1.6
    0
        Grade 3 Fever
    0
    0
        Headache
    26.6
    16.9
        Grade 3 Headache
    4.7
    1.5
        Malaise
    17.2
    6.2
        Grade 3 Malaise
    1.6
    1.5
        Myalgia
    23.4
    10.8
        Grade 3 Myalgia
    1.6
    0
        Shivering
    6.3
    4.6
        Grade 3 Shivering
    0
    0
    No statistical analyses for this end point

    Primary: Percentage of Subjects Reporting Solicited Injection-site or Systemic Reactions More than 3 Days After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route

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    End point title
    		 Percentage of Subjects Reporting Solicited Injection-site or Systemic Reactions More than 3 Days After Vaccination with Inactivated, Split-Virion Influenza Vaccine, Northern Hemisphere 2007-2008 Formulation by the Intramuscular Route [7]
    End point description
    Solicited injection site: Pain, Erythema, Swelling, Induration and Ecchymosis. Solicited systemic reactions: Fever, Headache, Malaise, Myalgia, and Shivering. Grade 3 injection site: Pain – Incapacitating, unable to perform usual activities; Erythema, Swelling, Induration, and Ecchymosis – ≥5 cm. Grade 3 systemic reactions: Fever – >39.0°C; Headache, Malaise, Myalgia, and Shivering – Prevents daily activities.
    End point type
    Primary
    End point timeframe
    >Day 3 post vaccination
    Notes
    [7] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive analyses were performed based on the study groups and the study vaccine administered for this outcome.
    End point values
    		 18 to 60 years 61 years or older
    Number of subjects analysed
    65
    65
    Units: Percentage of subjects
    number (not applicable)
        Injection site Pain
    0
    0
        Grade 3 Injection site Pain
    0
    0
        Injection site Erythema
    0
    0
        Grade 3 Injection site Erythema
    0
    0
        Injection site Swelling
    0
    0
        Grade 3 Injection site Swelling
    0
    0
        Injection site Induration
    0
    0
        Grade 3 Injection site Induration
    0
    0
        Injection site Ecchymosis
    0
    0
        Grade 3 Injection site Ecchymosis
    0
    0
        Fever
    0
    0
        Grade 3 Fever
    0
    0
        Headache
    1.6
    0
        Grade 3 Headache
    0
    0
        Malaise
    0
    1.5
        Grade 3 Malaise
    0
    0
        Myalgia
    0
    3.1
        Grade 3 Myalgia
    0
    0
        Shivering
    0
    0
        Grade 3 Shivering
    0
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse event data were collected from Day 0 (post-vaccination) up to Day 21 post-vaccination.
    Assessment type
    		 Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    		 MedDRA
    Dictionary version
    9.0
    Reporting groups
    Reporting group title
    18 to 60 years
    Reporting group description
    		 Subjects aged 18 to 60 years who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.

    Reporting group title
    61 years or older
    Reporting group description
    		 Subjects aged 61 years or older who received one dose of inactivated, split-virion influenza vaccine, Northern Hemisphere 2007-2008 formulation on day 0.

    Serious adverse events
    		 18 to 60 years 61 years or older
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 65 (0.00%)
    0 / 65 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    		 18 to 60 years 61 years or older
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    25 / 65 (38.46%)
    16 / 65 (24.62%)
    Nervous system disorders
    Headache
    alternative assessment type: Systematic
         subjects affected / exposed [1]
    17 / 64 (26.56%)
    11 / 65 (16.92%)
         occurrences all number
    17
    11
    General disorders and administration site conditions
    Injection site ecchymosis
    alternative assessment type: Systematic
         subjects affected / exposed [2]
    7 / 64 (10.94%)
    3 / 65 (4.62%)
         occurrences all number
    7
    3
    Malaise
    alternative assessment type: Systematic
         subjects affected / exposed [3]
    11 / 64 (17.19%)
    4 / 65 (6.15%)
         occurrences all number
    11
    4
    Shivering
    alternative assessment type: Systematic
         subjects affected / exposed [4]
    4 / 64 (6.25%)
    3 / 65 (4.62%)
         occurrences all number
    4
    3
    Injection site pain
    alternative assessment type: Systematic
         subjects affected / exposed [5]
    25 / 64 (39.06%)
    16 / 65 (24.62%)
         occurrences all number
    25
    16
    Injection site erythema
    alternative assessment type: Systematic
         subjects affected / exposed [6]
    6 / 64 (9.38%)
    7 / 65 (10.77%)
         occurrences all number
    6
    7
    Injection site swelling
    alternative assessment type: Systematic
         subjects affected / exposed [7]
    8 / 64 (12.50%)
    8 / 65 (12.31%)
         occurrences all number
    8
    8
    Injection site induration
    alternative assessment type: Systematic
         subjects affected / exposed [8]
    10 / 64 (15.63%)
    6 / 65 (9.23%)
         occurrences all number
    10
    6
    Musculoskeletal and connective tissue disorders
    Myalgia
    alternative assessment type: Systematic
         subjects affected / exposed [9]
    15 / 64 (23.44%)
    7 / 65 (10.77%)
         occurrences all number
    15
    7
    Notes
    [1] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [2] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [3] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [4] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [5] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [6] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [7] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [8] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.
    [9] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This was a solicited adverse event recorded in a diary card within 3 days of vaccination; the total number (N) reflects those subjects for which the diary cards were returned and for which data were available for the event during the period.

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    Substantial protocol amendments (globally)
    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)
    Were there any global interruptions to the trial? No

    Limitations and caveats
    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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