E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with immune deficiency without proper response to previous SARS-CoV-2 vaccine doses. |
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E.1.1.1 | Medical condition in easily understood language |
Vaccination for protection against COVID-19 |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | HLGT |
E.1.2 | Classification code | 10003816 |
E.1.2 | Term | Autoimmune disorders |
E.1.2 | System Organ Class | 10021428 - Immune system disorders |
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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 | 10074555 |
E.1.2 | Term | Transplantation complication |
E.1.2 | System Organ Class | 10022117 - Injury, poisoning and procedural complications |
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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 | 10003921 |
E.1.2 | Term | B-cell unclassifiable lymphomas |
E.1.2 | System Organ Class | 100000004851 |
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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 investigate the immune response of a third SARS-CoV-2 mRNA vaccine dose in immunosuppressed patients with no or suboptimal vaccine response after the second dose. To investigate adverse events potentially linked to the third/fourth vaccine dose. |
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E.2.2 | Secondary objectives of the trial |
To investigate the immune response of a fourth SARS-CoV-2 mRNA vaccine dose in solid organ transplant recipients with no or suboptimal vaccine response after the third dose and to investigate the sustained immune response long-term. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Patients already included in one of the following ongoing vaccine observational subprotocols: • SARS-CoV-2 cellular and humoral immune response following vaccination of kidney transplant recipients and healthy controls • SARS-CoV-2 serological vaccine response in patients at Oslo University Hospital • Vaccine responses in MS: Nevrovax. • A Norwegian study of vaccine response to COVID-19 vaccines in patients using immunosuppressive medication within rheumatology and gastroenterology – The Nor-vaC study • Immunological response to Covid-19 vaccination in Lymphoma patients treated with Rituximab and in Bone marrow Transplanted patients. • Patients with an interval between the first and second vaccine dose according to drug label; 3 weeks for Comirnaty and 4 weeks for SpikeVax. • Patients with no or impaired humoral immune response more than 3 weeks after two doses of SARS-CoV-2 mRNA vaccine (SARS-CoV-2 SPIKE IgG ≤100 AU). • Available for vaccination at a few centralized centers (OUS, AHUS, Diakonhjemmet Hospital, HUS). • Not participating in therapeutical intervention studies. • Adult patients (≥18 years). • For fourth dose: Solid organ transplant recipients with no or impaired humoral immune response 4 weeks after three doses of SARS-CoV-2 mRNA vaccine (SARS-CoV-2 SPIKE IgG ≤100 AU).
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E.4 | Principal exclusion criteria |
• The second/third vaccine dose less than 4 weeks prior to vaccination with the third/fourth dose. • Pregnant patients or women of childbearing potential (WOCBP) not on highly effective contraception (not acceptable methods: progesterone-only oral hormonal contraception, male/female condom without spermicide or cap, diaphragm or sponge with spermicide). • Solid organ transplant recipients transplanted less than 6 months before the third dose vaccination. • Serious side effect of previous SARS-CoV-2 vaccination. • Allergic to any vaccine excipients. • Acute febrile illness or acute infection. • Received any vaccination against other infectious diseases within the last four weeks prior to the third dose. • Have experienced breakthrough SARS-CoV-2 infection during or following primary vaccination. • Participation in other vaccine studies.
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E.5 End points |
E.5.1 | Primary end point(s) |
Efficacy: SARS-CoV-2 SPIKE/RBD IgG antibody levels 4 weeks after administration of the third vaccine dose. Safety: Hospital admissions or deaths due to vaccine adverse events 6 weeks after the third/fourth dose.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
4 weeks after administration of the third vaccine dose for the efficacy end point. 6 weeks after administration of the third vaccine dose for the safety end point. |
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E.5.2 | Secondary end point(s) |
SARS-CoV-2 SPIKE/RBD IgG antibody levels 4 weeks after administration of the fourth vaccine dose. Humoral immune response at 3- and 6-months and sustained response up to 1 year after the third/fourth dose. Cellular immune responses at 4 weeks, 3- and 6 months and sustained response up to 1 year after the third/fourth dose in a subset of patients. Length of sustained humoral immune response following three versus two doses or four versus two doses.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Up to 1 years after the third/fourth vaccine doses. |
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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 | Yes |
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 | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Patients vaccinated with only two mRNA doses |
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E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
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 | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |