E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Prophylaxis for Shigellosis induced by Shigella sonnei, Shigella flexneri 1b, Shigella flexneri 2a and Shigella flexneri 3a. |
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E.1.1.1 | Medical condition in easily understood language |
Prevention of diarrhoeal disease due to Shigella infection |
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E.1.1.2 | Therapeutic area | Diseases [C] - Bacterial Infections and Mycoses [C01] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10040550 |
E.1.2 | Term | Shigella infections |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10054178 |
E.1.2 | Term | Shigella infection |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10040542 |
E.1.2 | Term | Shigella |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10040547 |
E.1.2 | Term | Shigella flexneri |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10040551 |
E.1.2 | Term | Shigella sonnei |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10004016 |
E.1.2 | Term | Bacterial diarrhoea |
E.1.2 | System Organ Class | 10021881 - Infections and infestations |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10012735 |
E.1.2 | Term | Diarrhoea |
E.1.2 | System Organ Class | 10017947 - Gastrointestinal disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• To identify the preferred dose of each component of the altSonflex1-2-3 vaccine (low, medium, or high) for infants 9 months of age in Africa (Stage 2). • To evaluate the safety and reactogenicity of the altSonflex1-2-3 vaccine in all participants in Europe and Africa (Stage 1 and Stage 2).
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E.2.2 | Secondary objectives of the trial |
• To evaluate the immunogenicity profile of the altSonflex1-2-3 vaccine in all participants in Europe (Stage 1). • To evaluate the immunogenicity profile of the altSonflex1-2-3 vaccine in all participants in Africa (Stage 2). • To further characterise the immunogenicity profile of the S. sonnei component of altSonflex1-2-3 vaccine in all participants in Europe and Africa (Stage 1 and Stage 2). • To evaluate seroresponse with the altSonflex1-2-3 vaccine after each vaccination in all participants in Europe and Africa (Stage 1 and Stage 2). • To evaluate the immunogenicity of co-administered MR-VAC in infants 9 months of age in Africa (Stage 2), in the dose-finding cohort. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
All participants: •Participants and/or participants’ parent(s)/legally acceptable representative(s) LAR(s), who, in the opinion of the investigator, can and will comply with the requirements of the protocol (e.g. completion of the diary cards, return for follow-up visits). •Written or witnessed/thumb printed informed consent obtained from the participant/parent(s)/LAR(s) of the participant prior to performance of any study specific procedure. •Healthy participants as established by medical history, clinical examination, and laboratory assessment. •Participants satisfying all screening requirements. •Participants seronegative for hepatitis B, and hepatitis C. •Participants negative for human leukocyte antigen B27 (HLA-B27). Adults 18 to 50 years of age: •A male or female between, and including, 18 and 50 years of age at the time of the first study intervention administration. •Female participants of non-childbearing potential may be enrolled in the study. Non-childbearing potential is defined as pre-menarche, current bilateral tubal ligation or occlusion, hysterectomy, bilateral ovariectomy or post-menopause. •Female participants of childbearing potential may be enrolled in the study, if the participant: -has practiced adequate contraception for 1 month prior to study intervention administration, and -has a negative pregnancy test on the day of study intervention administration, and -has agreed to continue adequate contraception during the entire treatment period and for 1 month after completion of the study intervention administration series. •Participants seronegative for human immunodeficiency virus (HIV) Children 24 to 59 months of age: •A male or female between, and including, 24 and 59 months of age at the time of first vaccination. •Normal nutritional Z score (-2 standard deviation or greater) •Previously completed routine childhood vaccinations to the best knowledge of the participant’s parent(s)/LAR(s). •Born after gestation period of ≥37 weeks •Participants seronegative for HIV Infants 9 months of age: •A male or female 9 months of age at the time of first vaccination. •Normal nutritional Z score (-2 standard deviations or greater). •Previously completed routine childhood vaccinations to the best knowledge of the participant’s parent(s)/LAR(s). •Born after a gestation period of ≥37 weeks •Participants negative for HIV as confirmed by deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) testing |
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E.4 | Principal exclusion criteria |
All participants: •Known exposure to Shigella during lifetime of the participant as confirmed during interview with the participant or documented by patient records (e.g., history of microbiologically-confirmed Shigella infection), recent travel* (within 2 years) to a s country where Shigella or other eneteric infections are endemic, or recent occupation* (within 3 years) involving Shigella species. •Progressive, unstable or uncontrolled clinical conditions. •History (known or suspected) of any reaction or hypersensitivity likely to be exacerbated by any component of the study vaccine. •Any confirmed or suspected immunosuppressive or immunodeficient condition, based on medical history and physical examination (no laboratory testing required). •Hypersensitivity, including allergy, to medicinal products or medical equipment whose use is foreseen in this study. •Clinical conditions representing a contraindication to IM vaccination and blood draws. •Any behavioural or cognitive impairment or psychiatric disease that, in the opinion of the investigator, may interfere with the participant’s ability to participate in the study. •Acute disease and/or fever (defined as temperature 38.0°C) at the time of enrolment*. *The participant can still be enrolled into the study at a time when the acute disease and/or fever has resolved. •Any clinically significant haematological and/or biochemical laboratory abnormality. •Confirmed positive COVID-19 test during the period starting 30 days before the first administration of study vaccines (Day -30 to Day 1) •Any other clinical condition that, in the opinion of the investigator, might pose additional risk to the participant due to participation in the study. •Administration of long-acting immune-modifying drugs at any time during the study period (e.g. infliximab). •Prior receipt of an experimental Shigella vaccine or live Shigella challenge. •Use of any investigational or non-registered product (drug, vaccine or medical device)* other than the study vaccine during the period starting 30 days before the first dose of study intervention (Day -30 to Day 1), or planned use during the study period. *Use of herbs and traditional treatments is not considered an exclusion criterion •A vaccine not foreseen* by the Study Protocol administered during the period starting at -21 days before the first dose (-28 days in the case of live vaccines) and ending after the last dose of study intervention administration**. •Concurrently participating in another clinical study, at any time during the study period, in which the participant has been or will be exposed to an investigational or a non-investigational intervention (drug or invasive medical device). •Any study personnel or immediate dependents, family, or household member. Adults 18 to 50 years of age: •Acute or chronic illness, clinically significant pulmonary, cardiovascular, hepatic or renal functional abnormality, as determined by physical examination or laboratory screening tests. •Administration of immunoglobulins and/or any blood products or plasma derivatives, or bone marrow transplantation, during the period starting 3 months before the first dose of study vaccine or planned administration during the study period. •Chronic administration (defined as more than 14 days in total) of immunosuppressants or other immune-modifying drugs during the period starting 3 months prior to the first vaccine study intervention. For corticosteroids, this will mean prednisone equivalent greater than or equal to 20 mg/day for adult participants. Inhaled and topical steroids are allowed. •Pregnant or lactating female. •Female planning to become pregnant or planning to discontinue contraceptive precautions. •History of or current chronic alcohol consumption and/or drug abuse. Children 24 to 59 months of age and infants 9 months of age: •Acute or chronic clinically significant pulmonary, cardiovascular, hepatic or renal functional abnormality, as determined by physical examination or laboratory screening tests. •Chronic administration (defined as more than 14 days in total) of immunosuppressants or other immune-modifying drugs during the period starting 3 months prior to the first vaccine dose. For corticosteroids, this will mean prednisone equal or greater than 0.5 mg/kg/day or 20 mg/day whichever is the maximum dose for paediatric participants. Inhaled and topical steroids are allowed. •Child in care. Children 24 to 59 months of age: •Administration of immunoglobulins and/or any blood products or plasma derivatives, or bone marrow transplantation, during the period starting 3 months before the first dose of study vaccine or planned administration during the study period. Infants 9 months of age: •Administration of immunoglobulins and/or any blood products or plasma derivatives, or bone marrow transplantation, from birth or planned administration during the study period. |
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E.5 End points |
E.5.1 | Primary end point(s) |
A. Anti-serotype specific Shigella lipopolysaccharide (LPS) serum immunoglobulin G (IgG) titers in infants 9 months of age in Africa B. Number of adults 18 to 50 years of age in Europe with solicited administration site events C. Number of adults 18 to 50 years of age in Europe with solicited systemic events D. Number of adults 18 to 50 years of age in Europe with unsolicited adverse events (AEs) E. Number of adults 18 to 50 years of age in Europe with serious adverse events (SAEs) F. Number of adults 18 to 50 years of age in Europe with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 G. Number of adults 18 to 50 years of age in Europe with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92/Day 176 H. Number of adults 18 to 50 years of age in Africa with solicited administration site events I. Number of adults 18 to 50 years of age in Africa with solicited systemic events J. Number of adults 18 to 50 years of age in Africa with unsolicited AEs K. Number of adults 18 to 50 years of age in Africa with SAEs L. Number of adults 18 to 50 years of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 (7 days after the first study intervention administration) M. Number of adults 18 to 50 years of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92 (7 days after the second study intervention administration) N. Number of children 24 to 59 months of age in Africa with solicited administration site events O. Number of children 24 to 59 months of age in Africa with solicited systemic events P. Number of children 24 to 59 months of age in Africa with unsolicited AEs Q. Number of children 24 to 59 months of age in Africa with SAEs R. Number of children 24 to 59 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 (7 days after the first study intervention administration) S. Number of children 24 to 59 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92 (7 days after the second study intervention administration) T. Number of infants 9 months of age in Africa with solicited administration site events U. Number of infants 9 months of age in Africa with solicited systemic events V. Number of infants 9 months of age in Africa with unsolicited AEs W. Number of infants 9 months of age in Africa with SAEs X. Number of infants 9 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 8 (7 days after the first study intervention administration) Y. Number of infants 9 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 92 (7 days after the second study intervention administration) Z. Number of infants 9 months of age in Africa with deviations from normal values of haematological, renal, and hepatic panel test results at Day 260 (7 days after the third study intervention administration)
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
At Day 281 (A) During 7 days after each study intervention administration (B, C, H, I, N, O, T, U) During 28 days after each study intervention administration (D, J, P, V) During the entire study participation period (E, K, Q, W) At Day 8 (F, L, R, X) At Day 92/Day 176 (G) At Day 92 (M, S, Y) At Day 260 (Z)
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E.5.2 | Secondary end point(s) |
A.Anti-serotype specific Shigella LPS/OAg serum IgG geometric mean concentrations (GMCs) in adults 18 to 50 years of age in Europe
B. Anti-serotype specific Shigella LPS serum IgG GMTs in adults 18 to 50 years of age in Africa
C. Anti-serotype specific Shigella LPS serum IgG GMTs in children 24 to 59 months of age in Africa
D. Anti-serotype specific Shigella LPS serum IgG GMTs in infants 9 months of age in Africa
E. Number of adults 18 to 50 years of age in Europe achieving an ELISA level equivalent to ≥1:800 titer against S. sonnei LPS
F. Number of adults 18 to 50 years of age in Africa achieving an ELISA level equivalent to ≥1:800 titer against S. sonnei LPS
G. Number of children 24 to 59 months of age in Africa achieving an ELISA level equivalent to ≥1:800 titer against S. sonnei LPS
H. Number of infants 9 months of age in Africa achieving an ELISA level equivalent to ≥1:800 titer against S. sonnei LPS
I.Number of adults 18 to 50 years of age in Europe achieving an ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS
J. Number of adults 18 to 50 years of age in Africa achieving an ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS
K. Number of children 24 to 59 months of age in Africa achieving an ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS
L. Number of infants 9 months of age in Africa achieving an ELISA level equivalent to ≥1:1600 titer against S. sonnei LPS
M. Number of adults 18 to 50 years of age in Europe showing at least a 4-fold increase in anti-serotype specific Shigella LPS/OAg serum IgG concentrations
N. Number of adults 18 to 50 years of age in Africa showing at least a 4-fold increase in anti-serotype specific Shigella LPS serum IgG titers
O. Number of children 24 to 59 months of age in Africa showing at least a 4-fold increase in anti-serotype specific Shigella LPS serum IgG titers
P. Number of infants 9 months of age in Africa showing at least a 4-fold increase in anti-serotype specific Shigella LPS serum IgG titers
Q. Anti-measles IgG concentrations in infants 9 months of age in the dose-finding groups in Africa
R. Anti-rubella IgG concentrations in infants 9 months of age in the dose-finding groups in Africa
S. Number of infants 9 months of age in the dose-finding groups in Africa achieving anti-measles IgG concentrations of ≥150 mIU/mL and ≥200 mIU/mL
T. Number of infants 9 months of age in the dose-finding groups in Africa achieving anti-rubella IgG concentrations of ≥4 IU/mL and ≥10 IU/mL
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
At Day 1 and Day 85/Day 169, at Day 15 and at Day 29 and Day 113/Day197 (A, E, I)
At Day 1 and Day 85 and at Day 29 and Day 113 (B, C, F, G, J, K)
At Day 1, Day 85 and Day 253 and at Day 29, Day 113 and Day 281 (D, H, L)
At Day 15 and at Day 29 and Day 113/197 compared to Day 1 and Day 85/Day 169 (M)
At Day 29 and Day 113 compared to Day 1 and Day 85 (N, O)
At Day 29, Day 113 and Day 281 compared to Day 1, Day 85 and Day 253 (P)
At Day 1 and Day 281 (Q, R)
At Day 281 (S, T)
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity and dose selection |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | Yes |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Observer-blind (a type of double blinding) |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
MENVEO, INFANRIX, BOOSTRIX, TYPHIM VI |
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E.8.2.4 | Number of treatment arms in the trial | 20 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Date of last testing/reading released of the Human Biological Samples or imaging data, related to primary and secondary endpoints. End of Study must be achieved no later than 8 months after Last Subject Last Visit (LSLV). |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | 7 |
E.8.9.2 | In all countries concerned by the trial years | 3 |