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    Clinical Trial Results:
    A phase 3, Observed-Blind, Randomized, Multi-center Study to Evaluate Safety and Immunogenicity of an Adjuvanted Trivalent Influenza Vaccine in Children 6 to <72 Months of Age in Mexico.

    Summary
    EudraCT number
    2014-004248-36
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    16 Jul 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    21 Feb 2016
    First version publication date
    21 Feb 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    V70_50
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02255279
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma Services AG
    Sponsor organisation address
    Lichtstrasse 35, Basel, Switzerland, 4056
    Public contact
    Clinical Trial Information Desk, Novartis Pharma Services AG, RegistryContactVaccinesUS@novartis.com
    Scientific contact
    Clinical Trial Information Desk, Novartis Pharma Services AG, RegistryContactVaccinesUS@novartis.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?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    14 Jan 2016
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    16 Jul 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    1. To assess the safety of aTIV and TIV vaccines administered to healthy subjects 6 to <72 months of age, from day 1 to day 50 (naïve subjects) and from day 1 to day 22 (non-naïve subjects). 2. To demonstrate non-inferiority of aTIV to TIV as measured by geometric mean titers (GMTs) in all three homologous virus strains, 21 days after last immunization, in subjects 6 to <72 months of age.
    Protection of trial subjects
    This clinical study was designed and shall be implemented and reported in accordance with the ICH Harmonized Tripartite Guidelines for Good Clinical Practice, with applicable local regulations including Norma Oficial Mexicana NOM-012-SSA3-2012, Novartis codes on protection of human rights, and with the ethical principles laid down in the Declaration of Helsinki (European Council 2001, US Code of Federal Regulations, ICH 1997). Child’s personal information will not be revealed and is protected under the “Federal Law of Protection of Personal Information in Possession of Individuals” published in “El Diario Oficial de la Federacion (Official Journal of the Federation)” the 5th July of 2010, in Mexico.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    23 Oct 2014
    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
    Mexico: 287
    Worldwide total number of subjects
    287
    EEA total number of subjects
    0
    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)
    125
    Children (2-11 years)
    162
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects were enrolled from 3 study centers in Mexico.

    Pre-assignment
    Screening details
    All enrolled subjects were included in study.

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Assessor
    Blinding implementation details
    The trial is designed as an observer-blind study. Unblinded designated qualified health care personnel were responsible for administering the study vaccines to subjects. They were instructed not to reveal the identity of vaccines either to the subject and/or parent(s)/legal guardian(s) or the investigative site personnel involved in the trial monitoring, processing samples and performing immunogenicity assays etc, except in an emergency up until completion of the trial and final data review.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    aTIV (6 Months to < 72 Months)
    Arm description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.
    Arm type
    Experimental

    Investigational medicinal product name
    Fluad
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    6 to <36 months: 0.25 mL ≥36 to <72 months: 0.5mL

    Arm title
    TIV (6 Months to < 72 Months)
    Arm description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of TIV to be administered.
    Arm type
    Active comparator

    Investigational medicinal product name
    Fluzone
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    6 to <36 months: 0.25 mL ≥36 to <72 months: 0.5mL

    Number of subjects in period 1
    aTIV (6 Months to < 72 Months) TIV (6 Months to < 72 Months)
    Started
    144
    143
    Completed
    139
    134
    Not completed
    5
    9
         Consent withdrawn by subject
    3
    6
         Lost to follow-up
    2
    2
         Protocol deviation
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    aTIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.

    Reporting group title
    TIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of TIV to be administered.

    Reporting group values
    aTIV (6 Months to < 72 Months) TIV (6 Months to < 72 Months) Total
    Number of subjects
    144 143 287
    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)
    63 62 125
        Children (2-11 years)
    81 81 162
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    0 0 0
        From 65-84 years
    0 0 0
        85 years and over
    0 0 0
    Age continuous
    Units: months
        arithmetic mean (standard deviation)
    29.5 ( 18.2 ) 30.1 ( 19.1 ) -
    Gender categorical
    Units: Subjects
        Female
    68 72 140
        Male
    76 71 147

    End points

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    End points reporting groups
    Reporting group title
    aTIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.

    Reporting group title
    TIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of TIV to be administered.

    Subject analysis set title
    All Enrolled Set
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    All screened subjects who provide informed consent and provide demographic and/or baseline screening assessments, regardless of the subject’s randomization and treatment status in the study and received a Subject ID.

    Subject analysis set title
    Solicited Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All subjects in the Exposed Set with any solicited adverse event data and/or indicators of solicited adverse events.

    Subject analysis set title
    Unsolicited Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All subjects in the Exposed Set with any unsolicited adverse event data.

    Subject analysis set title
    Per Protocol Set (PPS)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    All subjects in the Enrolled Set who: - receive a study vaccination and provide immunogenicity data on day 1 and day 22 (non-naïve subjects)/50 (naïve subjects); - are not excluded due to reasons defined prior to unblinding or analysis, such as protocol deviations, early termination, withdrawal of informed consent, etc.

    Subject analysis set title
    Naïve_aTIV (6 Months to <36 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 to <36 months old) dose of aTIV to be administered.

    Subject analysis set title
    Naïve_aTIV (≥ 36 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.

    Subject analysis set title
    Naïve_TIV (6 Months to < 36 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 to <36 months old) dose of TIV to be administered.

    Subject analysis set title
    Naïve_TIV (≥ 36 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.5 mL (for children ≥ 36 months to < 72 months old) dose of TIV to be administered.

    Subject analysis set title
    Non-naïve_aTIV (6 Months to <36 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 months to < 36 months old) dose of aTIV to be administered.

    Subject analysis set title
    Non-naïve_aTIV (≥ 36 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.5 mL (for children ≥ 36 months to < 72 months old) dose of aTIV to be administered.

    Subject analysis set title
    Non-naïve_TIV (6 Months to <36 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 to < 36 months old) dose of TIV to be administered.

    Subject analysis set title
    Non-naïve_TIV (≥ 36 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.5 mL (for children ≥ 36 months to < 72 months old) dose of TIV to be administered.

    Subject analysis set title
    Naïve_aTIV (6 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.

    Subject analysis set title
    Naïve_TIV (6 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of TIV to be administered.

    Subject analysis set title
    Non-naïve_aTIV (6 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.

    Subject analysis set title
    Non-naïve_TIV (6 Months to < 72 Months)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of TIV to be administered.

    Primary: 1. Number of Naïve Subjects 6 to < 36 Months Old Reporting Solicited Local and Systemic Adverse Events (AEs) From Day 1 to Day 7 Following Each Vaccination.

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    End point title
    1. Number of Naïve Subjects 6 to < 36 Months Old Reporting Solicited Local and Systemic Adverse Events (AEs) From Day 1 to Day 7 Following Each Vaccination. [1]
    End point description
    Number of naïve subjects 6 to < 36 months old reporting solicited local and systemic AEs from Day 1 to Day 7 after first vaccination and from Day 29 to Day 35 after second vaccination. Analysis performed on the Solicited Safety Set.
    End point type
    Primary
    End point timeframe
    From Day 1 to Day 7 by 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: No statistical analyses for this end point.
    End point values
    Naïve_aTIV (6 Months to <36 Months) Naïve_TIV (6 Months to < 36 Months)
    Number of subjects analysed
    68
    69
    Units: Partcipants
        Any Local (Vac-1)
    35
    20
        Any Local (Vac-2, N= 67,67)
    21
    15
        Injection site ecchymosis (Vac-1, N= 65,69)
    2
    2
        Injection site ecchymosis (Vac-2, N= 66,67)
    1
    1
        Injection site induration (Vac-1, N= 66,69)
    5
    6
        Injection site induration (Vac-2, N= 66,67)
    3
    4
        Injection site swelling (Vac-1, N= 65,69)
    8
    2
        Injection site swelling (Vac-2, N= 66,67)
    2
    2
        Injection site erythema (Vac-1, N= 64,69)
    9
    8
        Injection site erythema (Vac-2, N= 66,67)
    7
    4
        Injection site tenderness (Vac-1, N= 66,69)
    26
    16
        Injection site tenderness (Vac-1, N= 66,66)
    17
    13
        Any Systemic (Vac-1)
    34
    27
        Any Systemic (Vac-2, N= 67,67)
    27
    22
        Body Temperature (>=40° C) (Vac-1, N= 67,68)
    0
    0
        Body Temperature (>=40° C) (Vac-2, N= 67,67)
    0
    0
        Fever (Vac-1)
    7
    5
        Fever (Vac-2, N= 67,67)
    7
    2
        Change in eating habits (Vac-1, N= 67,69)
    14
    4
        Change in eating habits (Vac-2, N= 66,67)
    11
    7
        Diarrhea (Vac-1, N= 67,69)
    15
    15
        Diarrhea (Vac-2, N= 66,67)
    11
    11
        Irritability (Vac-1, N= 67,69)
    18
    13
        Irritability (Vac-2, N= 66,67)
    17
    9
        Persistent Crying (Vac-1, N= 67,69)
    15
    11
        Persistent Crying (Vac-2, N= 66,67)
    11
    9
        Sleepiness (Vac-1, N= 67,68)
    10
    11
        Sleepiness (Vac-2, N= 65,67)
    8
    9
        Vomiting (Vac-1, N= 67,68)
    5
    4
        Vomiting (Vac-2, N= 65,67)
    2
    2
        Prevention of Pain and/or Fever (Vac-1, N= 67,67)
    2
    2
        Prevention of Pain and/or Fever (Vac-2, N= 64,67)
    3
    2
        Treatment of Pain and/or Fever (Vac-1, N= 67,67)
    9
    7
        Treatment of Pain and/or Fever (Vac-2, N= 66,67)
    10
    2
    No statistical analyses for this end point

    Primary: 2. Number of Non-naïve Subjects 6 to < 36 Months Old Reporting Solicited Local and Systemic AEs From Day 1 to Day 7 After Vaccination.

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    End point title
    2. Number of Non-naïve Subjects 6 to < 36 Months Old Reporting Solicited Local and Systemic AEs From Day 1 to Day 7 After Vaccination. [2]
    End point description
    Number of non-naïve subjects 6 to <36 months old reporting solicited local and systemic adverse events (AEs) from Day 1 to Day 7 after vaccination. Analysis performed on the Solicited Safety Set.
    End point type
    Primary
    End point timeframe
    From Day 1 to Day 7.
    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: No statistical analyses for this end point.
    End point values
    Non-naïve_aTIV (6 Months to <36 Months) Non-naïve_TIV (6 Months to <36 Months)
    Number of subjects analysed
    22
    22
    Units: Participants
        Any Local
    10
    7
        Injection site ecchymosis
    0
    1
        Injection site induration
    2
    0
        Injection site swelling
    1
    1
        Injection site erythema
    2
    4
        Injection site tenderness (N= 22,21)
    9
    4
        Any Systemic
    9
    7
        Body Temperature (>= 40.0°C)
    0
    0
        Fever
    6
    1
        Change in eating habits
    4
    3
        Diarrhea
    3
    6
        Irritability
    4
    3
        Persistent Crying
    1
    1
        Sleepiness
    2
    0
        Vomiting (N= 21,21)
    1
    1
        Prevention of Pain and/or Fever (N= 21,22)
    0
    0
        Treatment of Pain and/or Fever (N= 21,22)
    2
    1
    No statistical analyses for this end point

    Primary: 3. Number of Naïve Subjects ≥ 36 Months to < 72 Months Old Reporting Solicited Local and Systemic AEs From Day 1 to Day 7 Following Each Vaccination.

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    End point title
    3. Number of Naïve Subjects ≥ 36 Months to < 72 Months Old Reporting Solicited Local and Systemic AEs From Day 1 to Day 7 Following Each Vaccination. [3]
    End point description
    Number of naïve subjects ≥36 months to < 72 months old reporting solicited local and systemic AEs from Day 1 to Day 7 after first vaccination and from Day 29 to Day 35 after second vaccination. Analysis performed on the Solicited Safety Set.
    End point type
    Primary
    End point timeframe
    From Day 1 to Day 7 by 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: No statistical analyses for this end point.
    End point values
    Naïve_aTIV (≥ 36 Months to < 72 Months) Naïve_TIV (≥ 36 Months to < 72 Months)
    Number of subjects analysed
    6
    4
    Units: Participants
        Any Local (Vac-1)
    5
    2
        Any Local (Vac-2, N= 6,3)
    4
    2
        Injection site ecchymosis (Vac-1)
    0
    0
        Injection site ecchymosis (Vac-2, N= 6,3)
    0
    0
        Injection site induration (Vac-1)
    2
    1
        Injection site induration (Vac-2, N= 6,3)
    2
    0
        Injection site swelling (Vac-1)
    2
    0
        Injection site swelling (Vac-2, N= 6,3)
    0
    0
        Injection site erythema (Vac-1)
    1
    0
        Injection site erythema (Vac-2, N= 6,3)
    0
    0
        Injection site pain (Vac-1)
    3
    2
        Injection site pain (Vac-2, N= 6,3)
    3
    2
        Any Systemic (Vac-1)
    3
    1
        Any Systemic (Vac-2, N= 6,3)
    2
    0
        Fatigue (Vac-1)
    1
    1
        Fatigue (Vac-2, N= 6,3)
    2
    0
        Myalgia (Vac-1)
    2
    0
        Myalgia (Vac-2, N= 6,3)
    1
    0
        Arthralgia (Vac-1)
    0
    0
        Arthralgia (Vac-2, N= 6,2)
    0
    0
        Headache (Vac-1)
    1
    1
        Headache (Vac-2, N= 6,2)
    1
    0
        Body Temperature (>= 40.0°C) (Vac-1)
    0
    0
        Body Temperature (>= 40.0°C) (Vac-2, N= 6,3)
    0
    0
        Fever (Vac-1)
    2
    0
        Fever (Vac-2, N= 6,3)
    1
    0
        Chills (Vac-1)
    0
    0
        Chills (Vac-2, N= 6,3)
    0
    0
        Change in Eating Habits (Vac-1, N= 5,4)
    2
    0
        Change in Eating Habits (Vac-2, N= 6,3)
    0
    0
        Diarrhea (Vac-1)
    0
    0
        Diarrhea (Vac-2, N= 6,3)
    0
    0
        Vomiting (Vac-1)
    0
    0
        Vomiting (Vac-2, N= 6,3)
    0
    0
        Prevention of Pain and/or Fever (Vac-1, N= 6,2)
    1
    0
        Prevention of Pain and/or Fever (Vac-2, N= 4,2)
    0
    0
        Treatment of Pain and/or Fever (Vac-1, N= 6,2)
    0
    0
        Treatment of Pain and/or Fever (Vac-2, N= 5,2)
    0
    0
    No statistical analyses for this end point

    Primary: 4. Number of Non-naïve Subjects ≥ 36 Months to < 72 Months Old Reporting Solicited Local and Systemic AEs From Day 1 to Day 7 Following Each Vaccination.

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    End point title
    4. Number of Non-naïve Subjects ≥ 36 Months to < 72 Months Old Reporting Solicited Local and Systemic AEs From Day 1 to Day 7 Following Each Vaccination. [4]
    End point description
    Number of non-naïve subjects ≥ 36 months to < 72 months old reporting solicited local and systemic AEs from Day 1 to Day 7 after vaccination. Analysis performed on the Solicited Safety Set.
    End point type
    Primary
    End point timeframe
    From Day 1 to Day 7.
    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: No statistical analyses for this end point.
    End point values
    Non-naïve_aTIV (≥ 36 Months to < 72 Months) Non-naïve_TIV (≥ 36 Months to < 72 Months)
    Number of subjects analysed
    44
    41
    Units: Numbers
        Any Local
    17
    20
        Injection site ecchymosis
    2
    1
        Injection site induration
    6
    3
        Injection site swelling
    4
    3
        Injection site erythema (N= 43,40)
    6
    7
        Injection site pain (N= 44,40)
    14
    16
        Injection site tenderness
    0
    0
        Any Systemic
    15
    7
        Fatigue (N= 44,40)
    6
    2
        Myalgia (N= 44, 40)
    7
    0
        Arthralgia (N= 44, 40)
    4
    0
        Headache (N= 44, 40)
    3
    2
        Body Temperature (≥ 40.0°C) (N= 44, 40)
    0
    0
        Fever
    2
    1
        Chills (N= 44, 40)
    2
    0
        Change in eating habits (N= 44, 39)
    8
    3
        Diarrhea (N= 44, 39)
    4
    3
        Vomiting (N= 44, 40)
    2
    1
        Prevention of Pain and/or Fever (N= 42, 40)
    0
    0
        Treatment of Pain and/or Fever (N=42, 40)
    5
    0
    No statistical analyses for this end point

    Primary: 5. Number of Naïve Subjects Aged 6 to < 72 Months Reporting All Unsolicited AEs From Day 1 to Day 50.

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    End point title
    5. Number of Naïve Subjects Aged 6 to < 72 Months Reporting All Unsolicited AEs From Day 1 to Day 50. [5]
    End point description
    Number of naïve subjects aged 6 to < 72 months reporting all unsolicited AEs, medically attended AEs, AE leading to study withdrawal and serious AEs (SAEs) from Day 1 to Day 50. Analysis performed on the Unsolicited Safety Set.
    End point type
    Primary
    End point timeframe
    From Day 1 to Day 50.
    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: No statistical analyses for this end point.
    End point values
    Naïve_aTIV (6 Months to < 72 Months) Naïve_TIV (6 Months to < 72 Months)
    Number of subjects analysed
    74
    73
    Units: Numbers
        Any AE
    33
    28
        At least Possibly related AE
    4
    4
        SAE
    0
    0
        At least possibly related SAE
    0
    0
        AE leading to study withdrawal
    0
    0
        Medically attended AE
    26
    25
        Death
    0
    0
    No statistical analyses for this end point

    Primary: 6. Number of Non-naïve Subjects Aged 6 to < 72 Months Reporting All Unsolicited AEs From Day 1 to Day 22.

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    End point title
    6. Number of Non-naïve Subjects Aged 6 to < 72 Months Reporting All Unsolicited AEs From Day 1 to Day 22. [6]
    End point description
    Number of non-naïve subjects aged 6 to < 72 months reporting all unsolicited AEs, medically attended AEs, AE leading to study withdrawal and serious AEs (SAEs) from Day 1 to Day 22. Analysis performed on the Unsolicited Safety Set.
    End point type
    Primary
    End point timeframe
    From Day 1 to Day 22.
    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: No statistical analyses for this end point.
    End point values
    Non-naïve_aTIV (6 Months to < 72 Months) Non-naïve_TIV (6 Months to < 72 Months)
    Number of subjects analysed
    66
    64
    Units: Numbers
        Any AE
    9
    6
        At least Possibly related AE
    2
    0
        SAE
    0
    0
        At least possibly related SAE
    0
    0
        AE leading to study withdrawal
    0
    0
        Medically attended AE
    3
    4
        Death
    0
    0
    No statistical analyses for this end point

    Secondary: 7. Geometric Mean Titers (GMTs), in All Three Homologous Virus Strains in Subjects 6 to < 72 Months of Age.

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    End point title
    7. Geometric Mean Titers (GMTs), in All Three Homologous Virus Strains in Subjects 6 to < 72 Months of Age.
    End point description
    Antibody response was assessed in terms of geometric mean titers (GMTs) in all three homologous virus strains, 21 days after last immunization, in subjects 6 to <72 months of age. The study is considered a success if the 21 days after last immunization GMT ratios of aTIV relative to TIV demonstrate as non-inferior with the lower limit of the two sided 95% CI above 0.67 (-0.176 on log10 scale) for each vaccine strain (Center for Biologics Evaluation and Research, CBER Guideline on Seasonal Vaccines May 2007). Analysis performed on the Per Protocol Set.
    End point type
    Secondary
    End point timeframe
    Day 1 and Day 22 (vaccine non-naïve subjects) or Day 50 (vaccine naïve subjects) post vaccination
    End point values
    aTIV (6 Months to < 72 Months) TIV (6 Months to < 72 Months)
    Number of subjects analysed
    114
    112
    Units: Titers
    geometric mean (confidence interval 95%)
        A/H1N1 (Day 1) (N= 113,112)
    14 (11 to 19)
    15 (11 to 20)
        A/H1N1 (Day 22 or Day 50)
    675 (536 to 849)
    166 (132 to 208)
        A/H3N2 (Day 1)
    59 (40 to 86)
    55 (38 to 81)
        A/H3N2 (Day 22 or Day 50)
    1280 (1077 to 1521)
    495 (417 to 588)
        B (Day 1)
    7.47 (6.41 to 8.71)
    6.92 (5.95 to 8.06)
        B (Day 22 or Day 50)
    76 (61 to 93)
    16 (13 to 20)
    Statistical analysis title
    aTIV (6 to < 72 Months), TIV (6 to < 72 Months)
    Statistical analysis description
    Geometric mean titers (GMTs), in H1N1 strain of all the three strains in Subjects 6 to < 72 months of Age.
    Comparison groups
    aTIV (6 Months to < 72 Months) v TIV (6 Months to < 72 Months)
    Number of subjects included in analysis
    226
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [7]
    Method
    ANCOVA
    Parameter type
    Ratio of GMTs
    Point estimate
    4.06
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    3
         upper limit
    5.51
    Notes
    [7] - Hypothesis: Demonstrate non-inferiority (NI) of aTIV to TIV: H0 : μAi - μBi ≤ -0.176 (Null) H1 : μAi - μBi ≥ -0.176 (alternative) (i= H1N1, H3N2, B) μA and μB are means of log10-transformed titers 21 days after last vaccination of the aTIV & TIV vaccine groups respectively. NI is claimed if LL of 95% CI for GMT ratios is >0.67. Significance level is α = 2.5% (1-sided), which needs no further adjustment for multiplicity as to reach NI, above hypothesis needs to be rejected for all 3 strains.
    Statistical analysis title
    aTIV (6 to < 72 Months), TIV (6 to < 72 Months)
    Statistical analysis description
    Geometric mean titers (GMTs), in H3N2 strain of all the three strains in Subjects 6 to < 72 months of Age.
    Comparison groups
    aTIV (6 Months to < 72 Months) v TIV (6 Months to < 72 Months)
    Number of subjects included in analysis
    226
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [8]
    Method
    ANCOVA
    Parameter type
    Ratio of GMTs
    Point estimate
    2.58
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    2.05
         upper limit
    3.25
    Notes
    [8] - Hypothesis: Demonstrate non-inferiority (NI) of aTIV to TIV: H0 : μAi - μBi ≤ -0.176 (Null) H1 : μAi - μBi ≥ -0.176 (alternative) (i= H1N1, H3N2, B) μA and μB are means of log10-transformed titers 21 days after last vaccination of the aTIV & TIV vaccine groups respectively. NI is claimed if LL of 95% CI for GMT ratios is >0.67. Significance level is α = 2.5% (1-sided), which needs no further adjustment for multiplicity as to reach NI, above hypothesis needs to be rejected for all 3 strains.
    Statistical analysis title
    aTIV (6 to < 72 Months), TIV (6 to < 72 Months)
    Statistical analysis description
    Geometric mean titers (GMTs), in B strain of all the three strains in Subjects 6 to < 72 months of Age.
    Comparison groups
    aTIV (6 Months to < 72 Months) v TIV (6 Months to < 72 Months)
    Number of subjects included in analysis
    226
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [9]
    Method
    ANCOVA
    Parameter type
    Ratio of GMTs
    Point estimate
    4.67
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    3.52
         upper limit
    6.2
    Notes
    [9] - Hypothesis: Demonstrate non-inferiority (NI) of aTIV to TIV: H0 : μAi - μBi ≤ -0.176 (Null) H1 : μAi - μBi ≥ -0.176 (alternative) (i= H1N1, H3N2, B) μA and μB are means of log10-transformed titers 21 days after last vaccination of the aTIV & TIV vaccine groups respectively. NI is claimed if LL of 95% CI for GMT ratios is >0.67. Significance level is α = 2.5% (1-sided), which needs no further adjustment for multiplicity as to reach NI, above hypothesis needs to be rejected for all 3 strains.

    Secondary: 8. Percentages of Subjects Achieving Seroconversion in HI Titers and Vaccine Group Differences at Day 1 and 21 Days After Last Vaccination with aTIV or TIV in Naïve and Non-naïve Subjects.

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    End point title
    8. Percentages of Subjects Achieving Seroconversion in HI Titers and Vaccine Group Differences at Day 1 and 21 Days After Last Vaccination with aTIV or TIV in Naïve and Non-naïve Subjects.
    End point description
    Percentages of subjects with seroconversion in all three homologous virus strains, 21 days after last immunization, in subjects 6 to <72 months of age, defined as: HI ≥ 40 subject with a pre-vaccination HI titer <10; a minimum 4-fold increase HI titer for subjects with a prevaccination HI titer ≥ 10, on Day 22 (non-naïve subjects) or Day 50 (naïve subjects), as applicable. Analysis performed on the Per Protocol Set.
    End point type
    Secondary
    End point timeframe
    Day 1 and Day 22 (vaccine non-naïve subjects) or Day 50 (vaccine naïve subjects) post vaccination.
    End point values
    aTIV (6 Months to < 72 Months) TIV (6 Months to < 72 Months)
    Number of subjects analysed
    114
    112
    Units: Percentages of subjects
    number (confidence interval 95%)
        H1N1 strain (N= 113,112)
    90 (83.2 to 95)
    75 (65.9 to 82.7)
        H3N2 strain
    77 (68.4 to 84.5)
    67 (57.4 to 75.6)
        B strain
    78 (69.4 to 85.3)
    22 (15 to 31.2)
    Statistical analysis title
    aTIV (6 to < 72 Months), TIV (6 to < 72 Months)
    Statistical analysis description
    Percentage of subjects achieving seroconversion in H1N1 strain after last vaccination with aTIV or TIV in naïve and non-naïve subjects.
    Comparison groups
    aTIV (6 Months to < 72 Months) v TIV (6 Months to < 72 Months)
    Number of subjects included in analysis
    226
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [10]
    Method
    Loglinear model
    Parameter type
    Vaccine Group Differences
    Point estimate
    17
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    8.1
         upper limit
    26.3
    Notes
    [10] - The following hypotheses should be tested to demonstrate non-inferiority of aTIV to TIV: H0i: πi1 > πi2-0.1 vs. H1i: πi1 > πi2- 0.1 where H0i and H1i represent the null and the alternative hypothesis (respectively) of the non- inferiority objective and πi1 and πi2 represent the seroresponse rates 21 days after last immunization of the aTIV and TIV vaccine groups respectively in the i-th strain (H1N1, H3N2, B). The non-inferiority criterion is -0.1 (i.e., -10%).
    Statistical analysis title
    aTIV (6 to < 72 Months), TIV (6 to < 72 Months)
    Statistical analysis description
    Percentage of subjects achieving seroconversion in H3N2 strain after last vaccination with aTIV or TIV in naïve and non-naïve subjects.
    Comparison groups
    aTIV (6 Months to < 72 Months) v TIV (6 Months to < 72 Months)
    Number of subjects included in analysis
    226
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [11]
    Method
    Loglinear model
    Parameter type
    Vaccine Group Differences
    Point estimate
    10
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.8
         upper limit
    21
    Notes
    [11] - The following hypotheses should be tested to demonstrate non-inferiority of aTIV to TIV: H0i: πi1 > πi2-0.1 vs. H1i: πi1 > πi2- 0.1 where H0i and H1i represent the null and the alternative hypothesis (respectively) of the non- inferiority objective and πi1 and πi2 represent the seroresponse rates 21 days after last immunization of the aTIV and TIV vaccine groups respectively in the i-th strain (H1N1, H3N2, B). The non-inferiority criterion is -0.1 (i.e., -10%).
    Statistical analysis title
    aTIV (6 to < 72 Months), TIV (6 to < 72 Months)
    Statistical analysis description
    Percentage of subjects achieving seroconversion in B strains after last vaccination with aTIV or TIV in naïve and non naïve subjects.
    Comparison groups
    aTIV (6 Months to < 72 Months) v TIV (6 Months to < 72 Months)
    Number of subjects included in analysis
    226
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [12]
    Method
    Loglinear model
    Parameter type
    Vaccine Group Differences
    Point estimate
    58
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    47.5
         upper limit
    68.5
    Notes
    [12] - The following hypotheses should be tested to demonstrate non-inferiority of aTIV to TIV: H0i: πi1 > πi2-0.1 vs. H1i: πi1 > πi2- 0.1 where H0i and H1i represent the null and the alternative hypothesis (respectively) of the non- inferiority objective and πi1 and πi2 represent the seroresponse rates 21 days after last immunization of the aTIV and TIV vaccine groups respectively in the i-th strain (H1N1, H3N2, B). The non-inferiority criterion is -0.1 (i.e., -10%).

    Secondary: 9. Geometric Mean Ratios (GMRs) of HI and Vaccine Group Differences at Day 1 and 21 Days After Last Vaccination With aTIV or TIV in Naïve and Non-naïve Subjects.

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    End point title
    9. Geometric Mean Ratios (GMRs) of HI and Vaccine Group Differences at Day 1 and 21 Days After Last Vaccination With aTIV or TIV in Naïve and Non-naïve Subjects.
    End point description
    GMRs of HI, day 22/day 1 (non-naïve subjects) or day 50/day 1 (naïve subjects) in all three homologous virus strains, 21 days after last immunization, in subjects 6 to <72 months of age. Being non-inferiority of aTIV to TIV established, GMT ratio of aTIV relative to TIV in all three homologous virus strains, 21 days after last immunization in subjects 6 to <72 months of age was evaluated using margins greater than the non-inferiority cut-off of 0.67. Analysis performed on the Per Protocol Set.
    End point type
    Secondary
    End point timeframe
    Day 1 and Day 22 (vaccine non-naïve subjects) or Day 50 (vaccine naïve subjects) post vaccination.
    End point values
    aTIV (6 Months to < 72 Months) TIV (6 Months to < 72 Months)
    Number of subjects analysed
    114
    112
    Units: Ratios
    number (confidence interval 95%)
        H1N1 strain (N= 113, 112)
    46 (34 to 62)
    11 (8.12 to 15)
        H3N2 strain
    21 (16 to 28)
    8.39 (6.26 to 11)
        B strain
    10 (8.25 to 13)
    2.3 (1.84 to 2.87)
    No statistical analyses for this end point

    Secondary: 10. Percentages of Subjects With a HI Titer ≥ 40, ≥110 and ≥ 330 and Vaccine Group Differences at Day 1 and 21 Days After Last Vaccination With aTIV or TIV in Naïve and Non-naïve Subjects.

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    End point title
    10. Percentages of Subjects With a HI Titer ≥ 40, ≥110 and ≥ 330 and Vaccine Group Differences at Day 1 and 21 Days After Last Vaccination With aTIV or TIV in Naïve and Non-naïve Subjects.
    End point description
    Percentage of subjects with a HI titer ≥ 40, ≥ 110 and ≥ 330 on Day 1, Day 22 (non naïve subjects) or Day 50 (naïve subjects), in all three homologous virus strains, 21 days after last immunization, in subjects 6 to <72 months of age.
    End point type
    Secondary
    End point timeframe
    Day 1 and Day 22 (vaccine non-naïve subjects) or Day 50 (vaccine naïve subjects) post vaccination.
    End point values
    aTIV (6 Months to < 72 Months) TIV (6 Months to < 72 Months)
    Number of subjects analysed
    114
    112
    Units: Percentages of subjects
    number (confidence interval 95%)
        H1N1 strain (HI titer ≥ 40, Day 1) (N= 113, 112)
    32 (23.4 to 41.3)
    33 (24.4 to 42.6)
        H1N1 strain (HI titer ≥ 40, Day 22 or Day 50)
    99 (95.2 to 99.98)
    88 (81 to 93.7)
        H1N1 strain (HI titer ≥110, Day 1) (N= 113, 112)
    19 (11.9 to 27)
    20 (12.7 to 28.2)
        H1N1 strain (HI titer ≥ 110, Day 22 or Day 50)
    96 (90.1 to 98.6)
    68 (58.4 to 76.4)
        H1N1 strain (HI titer ≥ 330, Day 1)
    4 (1.5 to 10)
    7 (3.1 to 13.6)
        H1N1 strain (HI titer ≥ 330, Day 22 or Day 50)
    78 (69.4 to 85.3)
    37 (27.7 to 46.2)
        H3N2 strain (HI titer ≥ 40, Day 1)
    56 (46.5 to 65.4)
    58 (48.3 to 67.3)
        H3N2 strain (HI titer ≥ 40, Day 22 or Day 50)
    100 (96.8 to 100)
    97 (92.4 to 99.4)
        H3N2 strain (HI titer ≥ 110, Day 1)
    44 (34.6 to 53.5)
    44 (34.4 to 53.4)
        H3N2 strain (HI titer ≥ 110, Day 22 or Day 50)
    99 (95.2 to 99.98)
    84 (75.8 to 90.2)
        H3N2 strain (HI titer ≥ 330, Day 1)
    33 (24.8 to 42.8)
    30 (22 to 39.8)
        H3N2 strain (HI titer ≥ 330, Day 22 or Day 50)
    86 (78.2 to 91.8)
    61 (51 to 69.8)
        B strain (HI titer ≥ 40, Day 1)
    9 (4.3 to 15.5)
    9 (4.4 to 15.8)
        B strain (HI titer ≥ 40, Day 22 or Day 50)
    84 (76.2 to 90.4)
    32 (23.6 to 41.6)
        B strain (HI titer ≥ 110, Day 1)
    2 (0.21 to 6.2)
    1 (0.02 to 4.9)
        B strain (HI titer ≥ 110, Day 22 or Day 50)
    43 (33.7 to 52.6)
    6 (2.5 to 12.5)
        B strain (HI titer ≥ 330, Day 1)
    0 (0 to 3.2)
    0 (0 to 3.2)
        B strain (HI titer ≥ 330, Day 22 or Day 50)
    8 (3.7 to 14.5)
    0 (0 to 3.2)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Throughout the study; Day 1 - Day 50 (naïve subjects) and Day 1 - Day 22 (non-naïve subjects).
    Adverse event reporting additional description
    Solicited adverse events were collected daily by the subject parent(s)/legal guardian(s) for 7 consecutive days starting from the day of vaccination/s (day 1 and day 29 for naïve subjects; day 1 for non-naïve subjects). Unsolicited adverse events were collected from day 1 to day 50 for naïve subjects, from day 1 to day 22 for non-naïve subjects.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19
    Reporting groups
    Reporting group title
    Naïve_aTIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.

    Reporting group title
    Naïve_TIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of TIV to be administered.

    Reporting group title
    Non-naïve_aTIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of aTIV to be administered.

    Reporting group title
    Non-naïve_TIV (6 Months to < 72 Months)
    Reporting group description
    A 0.25 mL (for children 6 to <36 months old) and 0.5 mL (for children ≥36 months to < 72 months old) dose of TIV to be administered.

    Serious adverse events
    Naïve_aTIV (6 Months to < 72 Months) Naïve_TIV (6 Months to < 72 Months) Non-naïve_aTIV (6 Months to < 72 Months) Non-naïve_TIV (6 Months to < 72 Months)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 77 (0.00%)
    0 / 78 (0.00%)
    0 / 67 (0.00%)
    0 / 64 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Naïve_aTIV (6 Months to < 72 Months) Naïve_TIV (6 Months to < 72 Months) Non-naïve_aTIV (6 Months to < 72 Months) Non-naïve_TIV (6 Months to < 72 Months)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    58 / 77 (75.32%)
    52 / 78 (66.67%)
    35 / 67 (52.24%)
    31 / 64 (48.44%)
    Nervous system disorders
    Somnolence
         subjects affected / exposed
    16 / 77 (20.78%)
    14 / 78 (17.95%)
    2 / 67 (2.99%)
    0 / 64 (0.00%)
         occurrences all number
    24
    21
    0
    2
    General disorders and administration site conditions
    Crying
         subjects affected / exposed
    20 / 77 (25.97%)
    15 / 78 (19.23%)
    1 / 67 (1.49%)
    1 / 64 (1.56%)
         occurrences all number
    0
    0
    1
    1
    Fatigue
         subjects affected / exposed
    3 / 77 (3.90%)
    1 / 78 (1.28%)
    6 / 67 (8.96%)
    2 / 64 (3.13%)
         occurrences all number
    1
    3
    3
    6
    Injection site erythema
    alternative assessment type: Systematic
         subjects affected / exposed
    13 / 77 (16.88%)
    11 / 78 (14.10%)
    8 / 67 (11.94%)
    11 / 64 (17.19%)
         occurrences all number
    14
    18
    11
    8
    Injection site induration
    alternative assessment type: Systematic
         subjects affected / exposed
    10 / 77 (12.99%)
    10 / 78 (12.82%)
    8 / 67 (11.94%)
    3 / 64 (4.69%)
         occurrences all number
    12
    12
    3
    8
    Injection site pain
         subjects affected / exposed
    33 / 77 (42.86%)
    25 / 78 (32.05%)
    23 / 67 (34.33%)
    20 / 64 (31.25%)
         occurrences all number
    34
    50
    20
    23
    Injection site swelling
    alternative assessment type: Systematic
         subjects affected / exposed
    12 / 77 (15.58%)
    2 / 78 (2.56%)
    5 / 67 (7.46%)
    4 / 64 (6.25%)
         occurrences all number
    6
    12
    4
    5
    Pyrexia
         subjects affected / exposed
    16 / 77 (20.78%)
    11 / 78 (14.10%)
    9 / 67 (13.43%)
    2 / 64 (3.13%)
         occurrences all number
    12
    22
    2
    11
    Gastrointestinal disorders
    Diarrhoea
    alternative assessment type: Systematic
         subjects affected / exposed
    22 / 77 (28.57%)
    21 / 78 (26.92%)
    7 / 67 (10.45%)
    9 / 64 (14.06%)
         occurrences all number
    35
    36
    10
    7
    Vomiting
    alternative assessment type: Systematic
         subjects affected / exposed
    7 / 77 (9.09%)
    6 / 78 (7.69%)
    4 / 67 (5.97%)
    2 / 64 (3.13%)
         occurrences all number
    6
    11
    2
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    6 / 77 (7.79%)
    8 / 78 (10.26%)
    2 / 67 (2.99%)
    0 / 64 (0.00%)
         occurrences all number
    9
    6
    0
    2
    Rhinorrhoea
         subjects affected / exposed
    2 / 77 (2.60%)
    4 / 78 (5.13%)
    0 / 67 (0.00%)
    1 / 64 (1.56%)
         occurrences all number
    4
    2
    1
    0
    Psychiatric disorders
    Eating disorder
         subjects affected / exposed
    20 / 77 (25.97%)
    9 / 78 (11.54%)
    12 / 67 (17.91%)
    6 / 64 (9.38%)
         occurrences all number
    12
    33
    6
    13
    Irritability
    alternative assessment type: Systematic
         subjects affected / exposed
    25 / 77 (32.47%)
    17 / 78 (21.79%)
    4 / 67 (5.97%)
    3 / 64 (4.69%)
         occurrences all number
    25
    42
    3
    4
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 77 (0.00%)
    0 / 78 (0.00%)
    4 / 67 (5.97%)
    0 / 64 (0.00%)
         occurrences all number
    0
    0
    0
    4
    Myalgia
         subjects affected / exposed
    2 / 77 (2.60%)
    0 / 78 (0.00%)
    7 / 67 (10.45%)
    0 / 64 (0.00%)
         occurrences all number
    0
    3
    0
    7
    Infections and infestations
    Conjunctivitis
         subjects affected / exposed
    0 / 77 (0.00%)
    4 / 78 (5.13%)
    0 / 67 (0.00%)
    0 / 64 (0.00%)
         occurrences all number
    4
    0
    0
    0
    Gastroenteritis
         subjects affected / exposed
    4 / 77 (5.19%)
    3 / 78 (3.85%)
    0 / 67 (0.00%)
    0 / 64 (0.00%)
         occurrences all number
    3
    4
    0
    0
    Nasopharyngitis
         subjects affected / exposed
    16 / 77 (20.78%)
    8 / 78 (10.26%)
    2 / 67 (2.99%)
    2 / 64 (3.13%)
         occurrences all number
    9
    18
    2
    2
    Pharyngitis
         subjects affected / exposed
    6 / 77 (7.79%)
    10 / 78 (12.82%)
    0 / 67 (0.00%)
    0 / 64 (0.00%)
         occurrences all number
    10
    7
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    18 Feb 2014
    In V70_50 protocol version 1 the sponsor is defined as “Novartis Vaccines and Diagnostics AG”, the protocol is amended to introduce the correct sponsor name: “Novartis Vaccines and Diagnostics”.
    03 Apr 2014
    Adult and pediatric presentations of Fluzone (0.5 and 0.25 prefilled syringes, respectively) were planned to be used for the study. However, for the required season Sanofi did not produce the Fluzone TIV pediatric presentation (0.25 prefilled syringe) which should have been used for vaccinating subjects 6 to <36 months of age. The study was therefore conducted using Fluzone 5 mL multidose vials for all subjects. Graduated syringes were provided to the sites to aspirate the appropriate volume for vaccination (0.25 mL for subjects 6 to <36 months of age, 0.5 mL for subjects >36 to <72 months of age). The protocol was amended to reflect this change in the comparator vaccine presentation.

    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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