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    Clinical Trial Results:
    A Randomized, Double-blind, Phase 3 Study to Evaluate Safety, Reactogenicity, and Immunogenicity of Co-administration of Ad26.COV2.S and Influenza Vaccines in Healthy Adults 18 Years of Age and Older

    Summary
    EudraCT number
    2021-003953-43
    Trial protocol
    PL   BE  
    Global end of trial date
    15 Nov 2022

    Results information
    Results version number
    v2(current)
    This version publication date
    01 Feb 2024
    First version publication date
    01 Dec 2023
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    VAC31518COV3005
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05091307
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Janssen Vaccines & Prevention B.V.
    Sponsor organisation address
    Archimedesweg 4-6, CN Leiden, Netherlands, 2333
    Public contact
    Clinical Registry Group, Janssen Vaccines & Prevention B.V., ClinicalTrialsEU@its.jnj.com
    Scientific contact
    Clinical Registry Group, Janssen Vaccines & Prevention B.V., ClinicalTrialsEU@its.jnj.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
    15 Nov 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Nov 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of this trial was to demonstrate the non-inferiority (NI) of the humoral immune response of the 4 influenza vaccine strains after concomitant administration of the Ad26.COV2.S vaccine and a seasonal quadrivalent standard-dose influenza vaccine versus the administration of a seasonal quadrivalent standard-dose influenza vaccine administered alone; and to demonstrate the NI of the binding antibody response after concomitant administration of Ad26.COV2.S vaccine and a seasonal quadrivalent standard-dose influenza vaccine versus the administration of Ad26.COV2.S vaccine administered alone.
    Protection of trial subjects
    This study was conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki and that are consistent with Good Clinical Practice and applicable regulatory requirements.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    02 Nov 2021
    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
    Belgium: 99
    Country: Number of subjects enrolled
    Poland: 114
    Country: Number of subjects enrolled
    United States: 648
    Worldwide total number of subjects
    861
    EEA total number of subjects
    213
    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)
    674
    From 65 to 84 years
    186
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 861 subjects were enrolled, of which 715 subjects completed the 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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo
    Arm description
    Subjects aged greater than or equal to (>=) 18 years and older received a single intramuscular (IM) injection of Ad26.COV2.S at 5*10^10 viral particles (vp) dose level and a seasonal quadrivalent (Q) standard dose (SD) influenza vaccine with 60 micrograms (mcg) hemagglutinin (HA) on Day 1 followed by a single IM injection of placebo (matched to Ad26.COV2.S) on Day 29.
    Arm type
    Experimental

    Investigational medicinal product name
    Ad26.COV2.S
    Investigational medicinal product code
    Other name
    VAC31518; JNJ-78436735
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Subjects received a single dose of Ad26.COV2.S at 5*10^10 vp dose level on Day 1.

    Investigational medicinal product name
    Q SD influenza vaccine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Subjects received a Q SD influenza vaccine with 60 mcg HA on Day 1.

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Subjects received a single dose of placebo (matched to Ad26.COV2.S) on Day 29.

    Arm title
    Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Arm description
    Subjects aged >=18 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q SD influenza vaccine with 60 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a single dose of placebo (matched to Ad26.COV2.S) on Day 1.

    Investigational medicinal product name
    Q SD influenza vaccine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a seasonal Q SD influenza vaccine with 60 mcg of HA on Day 1

    Investigational medicinal product name
    Ad26.COV2.S
    Investigational medicinal product code
    Other name
    VAC31518; JNJ-78436735
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a single dose of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Arm title
    Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo
    Arm description
    Subjects aged >=65 years and older received a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level and a seasonal Q high dose (HD) influenza vaccine with 240 mcg HA on Day 1 followed by a single IM injection of placebo (matched to Ad26.COV2.S) on Day 29.
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Subjects received a single dose of placebo (matched to Ad26.COV2.S) on Day 29.

    Investigational medicinal product name
    Ad26.COV2.S
    Investigational medicinal product code
    Other name
    VAC31518; JNJ-78436735
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Subjects received a single dose of Ad26.COV2.S at 5*10^10 vp dose level on Day 1.

    Investigational medicinal product name
    Q HD influenza vaccine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a seasonal Q HD influenza vaccine with 240 mcg HA on Day 1.

    Arm title
    Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Arm description
    Subjects aged >=65 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q HD influenza vaccine with 240 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Subjects received a single dose of placebo (matched to Ad26.COV2.S) on Day 1.

    Investigational medicinal product name
    Q HD influenza vaccine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a seasonal Q HD influenza vaccine with 240 mcg of HA on Day 1.

    Investigational medicinal product name
    Ad26.COV2.S
    Investigational medicinal product code
    Other name
    VAC31518; JNJ-78436735
    Pharmaceutical forms
    Injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Subjects received a single dose of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Number of subjects in period 1
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Started
    382
    386
    47
    46
    Treated (Vaccinated subjects)
    382
    384
    47
    46
    Completed
    312
    316
    43
    44
    Not completed
    70
    70
    4
    2
         Adverse event, serious fatal
    -
    -
    1
    -
         Covid-19 Vaccine/Treatment
    14
    15
    1
    1
         Consent withdrawn by subject
    16
    16
    -
    1
         Physician decision
    1
    -
    -
    -
         Unspecified
    4
    4
    -
    -
         Initiated Prohibited Medication
    1
    -
    -
    -
         Randomised but not vaccinated
    -
    2
    -
    -
         Lost to follow-up
    33
    33
    2
    -
         Protocol deviation
    1
    -
    -
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo
    Reporting group description
    Subjects aged greater than or equal to (>=) 18 years and older received a single intramuscular (IM) injection of Ad26.COV2.S at 5*10^10 viral particles (vp) dose level and a seasonal quadrivalent (Q) standard dose (SD) influenza vaccine with 60 micrograms (mcg) hemagglutinin (HA) on Day 1 followed by a single IM injection of placebo (matched to Ad26.COV2.S) on Day 29.

    Reporting group title
    Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Reporting group description
    Subjects aged >=18 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q SD influenza vaccine with 60 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Reporting group title
    Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo
    Reporting group description
    Subjects aged >=65 years and older received a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level and a seasonal Q high dose (HD) influenza vaccine with 240 mcg HA on Day 1 followed by a single IM injection of placebo (matched to Ad26.COV2.S) on Day 29.

    Reporting group title
    Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Reporting group description
    Subjects aged >=65 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q HD influenza vaccine with 240 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Reporting group values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S Total
    Number of subjects
    382 386 47 46 861
    Age Categorical
    Units: subjects
        Children (2-11 years)
    0 0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0 0
        Adults (18-64 years)
    336 338 0 0 674
        From 65 to 84 years
    46 48 47 45 186
        85 years and over
    0 0 0 1 1
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    46.2 ± 14.92 45.5 ± 15.25 71.1 ± 4.58 71.3 ± 5.29 -
    Sex: Female, Male
    Units: subjects
        Female
    191 178 22 33 424
        Male
    191 208 25 13 437

    End points

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    End points reporting groups
    Reporting group title
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo
    Reporting group description
    Subjects aged greater than or equal to (>=) 18 years and older received a single intramuscular (IM) injection of Ad26.COV2.S at 5*10^10 viral particles (vp) dose level and a seasonal quadrivalent (Q) standard dose (SD) influenza vaccine with 60 micrograms (mcg) hemagglutinin (HA) on Day 1 followed by a single IM injection of placebo (matched to Ad26.COV2.S) on Day 29.

    Reporting group title
    Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Reporting group description
    Subjects aged >=18 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q SD influenza vaccine with 60 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Reporting group title
    Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo
    Reporting group description
    Subjects aged >=65 years and older received a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level and a seasonal Q high dose (HD) influenza vaccine with 240 mcg HA on Day 1 followed by a single IM injection of placebo (matched to Ad26.COV2.S) on Day 29.

    Reporting group title
    Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Reporting group description
    Subjects aged >=65 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q HD influenza vaccine with 240 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Primary: Groups 1 and 2: Geometric Mean Titers (GMTs) of Hemagglutination Inhibition (HI) Antibodies Against Each of the Four Influenza Vaccine Strains 28 Days after the Administration of a Seasonal Quadrivalent Standard-dose Influenza Vaccine

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    End point title
    Groups 1 and 2: Geometric Mean Titers (GMTs) of Hemagglutination Inhibition (HI) Antibodies Against Each of the Four Influenza Vaccine Strains 28 Days after the Administration of a Seasonal Quadrivalent Standard-dose Influenza Vaccine [1]
    End point description
    GMTs of HI antibodies were measured using hemagglutination inhibition (HAI) assay against each of four influenza vaccine strains (A/Victoria [H1N1], A/Cambodia [H3N2], B/Victoria [B/Victoria] and B/Phuket [B/Yamagata]). This endpoint was planned to be analysed for specified arms only. The per-protocol influenza immunogenicity (PPII) set included all randomised subjects who received Ad26.COV2.S vaccine in combination with seasonal influenza vaccine for co-administration group and those who received seasonal influenza vaccine alone for control group, for whom immunogenicity data were available for at least one of influenza strains in vaccine. Subjects with major protocol deviation were excluded from PPII analysis. 'N' (number of subjects analysed)=subjects who were evaluable for this endpoint.
    End point type
    Primary
    End point timeframe
    28 days after vaccination with seasonal quadrivalent standard-dose influenza vaccine (Day 29)
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This outcome measure was planned to be analysed for specified arm only.
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    320
    333
    Units: Titers
    geometric mean (confidence interval 95%)
        A/Victoria (H1N1)
    306 (271 to 346)
    393 (348 to 445)
        A/Cambodia (H3N2)
    134 (119 to 150)
    165 (147 to 186)
        B/Victoria (B/Victoria)
    38 (34 to 43)
    38 (33 to 43)
        B/Phuket (B/Yamagata)
    32 (29 to 36)
    33 (30 to 37)
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    A/Victoria (H1N1): Based on analysis of variance (ANOVA) models, CIs around the difference (Group 2 [control group] minus Group 1 [CoAd group]) was calculated and back-transformed (by exponentiation: 2^CI) to CIs around a geometric mean ratio (GMR: GMTControl/GMTCoAd).
    Comparison groups
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo v Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Number of subjects included in analysis
    653
    Analysis specification
    Pre-specified
    Analysis type
    [2]
    Method
    ANOVA
    Parameter type
    Geometric Mean Ratio
    Point estimate
    1.28
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.09
         upper limit
    1.53
    Notes
    [2] - The criterion for non-inferiority (NI) was the upper bound of the 2-sided 95% CI for the GMR was below 1.5.
    Statistical analysis title
    Statistical Analysis 2
    Statistical analysis description
    A/Cambodia (H3N2): Based on ANOVA models, CIs around the difference (Group 2 [control group] minus Group 1 [CoAd group]) was calculated and back-transformed (by exponentiation: 2^CI) to CIs around a geometric mean ratio (GMR: GMTControl/GMTCoAd).
    Comparison groups
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo v Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Number of subjects included in analysis
    653
    Analysis specification
    Pre-specified
    Analysis type
    [3]
    Method
    ANOVA
    Parameter type
    Geometric Mean Ratio
    Point estimate
    1.23
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.05
         upper limit
    1.45
    Notes
    [3] - The criterion for NI was the upper bound of the 2-sided 95% CI for the GMR was below 1.5.
    Statistical analysis title
    Statistical Analysis 3
    Statistical analysis description
    B/Victoria (B/Victoria): Based on ANOVA models, CIs around the difference (Group 2 [control group] minus Group 1 [CoAd group]) was calculated and back-transformed (by exponentiation: 2^CI) to CIs around a geometric mean ratio (GMR: GMTControl/GMTCoAd).
    Comparison groups
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo v Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Number of subjects included in analysis
    653
    Analysis specification
    Pre-specified
    Analysis type
    [4]
    Method
    ANOVA
    Parameter type
    Geometric Mean Ratio
    Point estimate
    0.99
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.84
         upper limit
    1.19
    Notes
    [4] - The criterion for NI was the upper bound of the 2-sided 95% CI for the GMR was below 1.5.
    Statistical analysis title
    Statistical analysis 4
    Statistical analysis description
    B/Phuket (B/Yamagata): Based on ANOVA models, CIs around the difference (Group 2 [control group] minus Group 1 [CoAd group]) was calculated and back-transformed (by exponentiation: 2^CI) to CIs around a geometric mean ratio (GMR: GMTControl/GMTCoAd).
    Comparison groups
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo v Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Number of subjects included in analysis
    653
    Analysis specification
    Pre-specified
    Analysis type
    [5]
    Method
    ANOVA
    Parameter type
    Geometric Mean Ratio
    Point estimate
    1.03
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.88
         upper limit
    1.21
    Notes
    [5] - The criterion for NI was the upper bound of the 2-sided 95% CI for the GMR was below 1.5.

    Primary: Groups 1 and 2: Geometric Mean Concentrations (GMCs) of Antibodies Measured by Spiked-Enzyme-linked Immunosorbent Assay (S-ELISA) 28 Days After Administration of Ad26.COV2.S Vaccine

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    End point title
    Groups 1 and 2: Geometric Mean Concentrations (GMCs) of Antibodies Measured by Spiked-Enzyme-linked Immunosorbent Assay (S-ELISA) 28 Days After Administration of Ad26.COV2.S Vaccine [6]
    End point description
    GMCs of antibody titers measured by S-ELISA at 28 days after administration of Ad26.COV2.S vaccine was reported. This endpoint was planned to be analysed for specified arms only. Seronegative subjects (at Day 1) who became serology positive during the study, subjects with positive molecular test for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) and major protocol deviation were excluded from PPSI analysis. The per protocol SARS-CoV-2 immunogenicity set (PPSI) included all randomised subjects who received Ad26.COV2.S vaccine in combination with seasonal influenza vaccine for co-administration group and Ad26.COV2.S vaccine alone for control group, and for whom immunogenicity data was available. Here, 'N' (number of subjects analysed) signifies subjects who were evaluable for this endpoint.
    End point type
    Primary
    End point timeframe
    28 days after vaccination with Ad26.COV2.S vaccine (Group 1: Day 29, Group 2: Day 57)
    Notes
    [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This outcome measure was planned to be analysed for specified arm only.
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    257
    209
    Units: ELISA Unit per millilitre (EU/mL)
        geometric mean (confidence interval 95%)
    22531 (20140 to 25205)
    25035 (22189 to 28246)
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Based on ANOVA models, CIs around the difference (Group 2 [control group] minus Group 1 [CoAd group]) was calculated and back-transformed (by exponentiation: 2^CI) to CIs around a geometric mean ratio (GMR: GMTControl/GMTCoAd).
    Comparison groups
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo v Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Number of subjects included in analysis
    466
    Analysis specification
    Pre-specified
    Analysis type
    [7]
    Method
    ANOVA
    Parameter type
    Geometric Mean Ratio
    Point estimate
    1.11
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.97
         upper limit
    1.26
    Notes
    [7] - The criterion for NI was the upper bound of the 2-sided 95% CI for the GMR was below 1.5.

    Secondary: Number of Subjects With Solicited Local Adverse Events (AEs) up to 7 Days After Each Vaccination

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    End point title
    Number of Subjects With Solicited Local Adverse Events (AEs) up to 7 Days After Each Vaccination
    End point description
    An AE was any untoward medical occurrence in a clinical study subject administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. Solicited local AEs were defined events that subjects were specifically asked about and which were noted by subjects in the diary. Solicited local AEs included erythema, swelling/induration, and pain/tenderness. The full analysis set (FAS) included all randomised subjects with at least 1 documented study vaccine administration. Here, 'n' (number analysed) signifies subjects who were evaluated at each specified category.
    End point type
    Secondary
    End point timeframe
    7 days after first vaccination on Day 1 (up to Day 8); 7 days after second vaccination on Day 29 (up to Day 36)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    382
    384
    47
    46
    Units: Subjects
        After first vaccination (n=382,384,47,46)
    261
    204
    23
    21
        After second vaccination (n=342,348,46,45)
    34
    210
    3
    24
    No statistical analyses for this end point

    Secondary: Number of Subjects With Solicited Systemic AEs up to 7 Days After Each Vaccination

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    End point title
    Number of Subjects With Solicited Systemic AEs up to 7 Days After Each Vaccination
    End point description
    An AE was any untoward medical occurrence in a clinical study subject administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. Solicited systemic AEs included fever (defined as body temperature of 38.0-degree celsius or higher), headache, fatigue, myalgia, nausea, vomiting were collected within 7 days after each vaccination. The FAS included all randomised subjects with at least 1 documented study vaccine administration. Here, 'n' (number analysed) signifies subjects who were evaluated at each specified category.
    End point type
    Secondary
    End point timeframe
    7 days after first vaccination on Day 1 (up to Day 8); 7 days after second vaccination on Day 29 (up to Day 36)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    382
    384
    47
    46
    Units: Subjects
        After first vaccination (n=382,384,47,46)
    256
    205
    30
    26
        After second vaccination (n=342,348,46.45)
    84
    208
    8
    22
    No statistical analyses for this end point

    Secondary: Number of Subjects With Unsolicited AEs up to 28 Days After Each Vaccination

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    End point title
    Number of Subjects With Unsolicited AEs up to 28 Days After Each Vaccination
    End point description
    An AE was any untoward medical occurrence in a clinical study subjects administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. Unsolicited AEs were all AEs for which the subject is not specifically questioned in the subject diary. The FAS included all randomised subjects with at least 1 documented study vaccine administration. Here, 'n' (number analysed) signifies subjects who were evaluated at each specified category.
    End point type
    Secondary
    End point timeframe
    28 days after first vaccination on Day 1 (up to Day 29); 28 days after second vaccination on Day 29 (up to Day 57) 
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    382
    384
    47
    46
    Units: Subjects
        After first vaccination (n=382,384,47,46)
    71
    71
    10
    9
        After second vaccination (n=342,348,46,45)
    36
    50
    11
    8
    No statistical analyses for this end point

    Secondary: Number of Subjects With Medically-attended Adverse Events (MAAEs)

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    End point title
    Number of Subjects With Medically-attended Adverse Events (MAAEs)
    End point description
    Number of subjects with MAAEs was reported. MAAEs were defined as AEs with medically-attended visits including hospital, emergency room, urgent care clinic, or other visits to or from medical personnel for any reason. New onset of chronic diseases was collected as part of the MAAEs. The FAS included all randomised subjects with at least 1 documented study vaccine administration.
    End point type
    Secondary
    End point timeframe
    From Day 1 (post-vaccination) to end of the study (up to 12.5 months)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    382
    384
    47
    46
    Units: Subjects
    51
    51
    11
    16
    No statistical analyses for this end point

    Secondary: Number of Subjects With Serious Adverse Events (SAEs)

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    End point title
    Number of Subjects With Serious Adverse Events (SAEs)
    End point description
    An AE was any untoward medical occurrence in a clinical study subject administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. SAE was any untoward medical occurrence that at any dose results in any of the following outcomes: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly/birth defect; suspected transmission of any infectious agent via a medicinal product or medically important. The FAS included all randomised subjects with at least 1 documented study vaccine administration.
    End point type
    Secondary
    End point timeframe
    From Day 1 (post-vaccination) to end of the study (up to 12.5 months)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    382
    384
    47
    46
    Units: Subjects
    9
    7
    1
    2
    No statistical analyses for this end point

    Secondary: Number of Subjects with AEs Leading to Withdrawal from the Study

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    End point title
    Number of Subjects with AEs Leading to Withdrawal from the Study
    End point description
    Number of subjects with AE leading to withdrawal from the study was reported. The FAS included all randomised subjects with at least 1 documented study vaccine administration.
    End point type
    Secondary
    End point timeframe
    From Day 1 (post-vaccination) to end of the study (up to 12.5 months)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    382
    384
    47
    46
    Units: Subjects
    0
    0
    0
    0
    No statistical analyses for this end point

    Secondary: Number of Subjects With Adverse Events of Special Interest (AESIs)

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    End point title
    Number of Subjects With Adverse Events of Special Interest (AESIs)
    End point description
    Number of subjects with AESIs was reported. AESIs were significant AEs that were judged to be of special interest because of clinical importance, known or suspected class effects, or based on nonclinical signals. Thrombosis with Thrombocytopenia Syndrome (TTS), a syndrome characterised by a combination of both a thrombotic event and thrombocytopenia, was considered to be an AESI in this study. A suspected TTS case was defined as: Thrombotic events: suspected deep vessel venous or arterial thrombotic events; Thrombocytopenia, defined as platelet count below 150,000/microliter. The FAS included all randomised subjects with at least 1 documented study vaccine administration.
    End point type
    Secondary
    End point timeframe
    From Day 1 (post-vaccination) to end of the study (up to 12.5 months)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    382
    384
    47
    46
    Units: Subjects
    9
    12
    0
    0
    No statistical analyses for this end point

    Secondary: Groups 3 and 4: GMTs of HI Antibodies Against Each of the Four Influenza Vaccine Strains 28 Days after the Administration of a Seasonal Quadrivalent High-dose Influenza Vaccine

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    End point title
    Groups 3 and 4: GMTs of HI Antibodies Against Each of the Four Influenza Vaccine Strains 28 Days after the Administration of a Seasonal Quadrivalent High-dose Influenza Vaccine [8]
    End point description
    GMTs of HI antibodies were measured using hemagglutination inhibition (HAI) assay against each of four influenza vaccine strains (A/Victoria [H1N1], A/Tasmania[H3N2], B/Washington [B/Victoria] and B/Phuket [B/Yamagata]). This endpoint was planned to be analysed for specified arms only. The PPII set included all randomised subjects who received Ad26.COV2.S vaccine in combination with a seasonal influenza vaccine for the coadministration group and those who received a seasonal influenza vaccine alone for the control group, for whom immunogenicity data were available for at least one of the influenza strains in the vaccine. Here, 'N' (number of subjects analysed) signifies subjects who were evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    28 days after vaccination with seasonal quadrivalent high-dose influenza vaccine (Day 29)
    Notes
    [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This outcome measure was planned to be analysed for specified arm only.
    End point values
    Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    43
    41
    Units: Titers
    geometric mean (confidence interval 95%)
        A/Victoria (H1N1)
    286 (204 to 400)
    484 (369 to 636)
        A/Tasmania (H3N2)
    284 (200 to 402)
    509 (365 to 711)
        B/Washington (B/Victoria)
    61 (46 to 81)
    75 (53 to 106)
        B/Phuket (B/Yamagata)
    38 (29 to 50)
    39 (30 to 52)
    No statistical analyses for this end point

    Secondary: Group 3 and 4: GMCs of Antibodies Measured by S-ELISA 28 Days After Administration of Ad26.COV2.S Vaccine

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    End point title
    Group 3 and 4: GMCs of Antibodies Measured by S-ELISA 28 Days After Administration of Ad26.COV2.S Vaccine [9]
    End point description
    GMCs of antibody titers measured by S-ELISA at 28 days after administration of Ad26.COV2.S vaccine was reported. This endpoint was planned to be analysed for specified arms only. Seronegative subjects (at Day 1) who became serology positive during the study, subjects with positive molecular test for SARSCoV-2 and major protocol deviation were excluded from PPSI analysis. The PPSI included all randomised subjects who received Ad26.COV2.S vaccine in combination with seasonal influenza vaccine for the co-administration group and Ad26.COV2.S vaccine alone for the control group, and for whom immunogenicity data was available. Here, 'N' (number of subjects analysed) signifies subjects who were evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    28 days after vaccination with Ad26.COV2.S vaccine (Group 3: Day 29, Group 4: Day 57)
    Notes
    [9] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This outcome measure was planned to be analysed for specified arm only.
    End point values
    Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    39
    33
    Units: EU/mL
        geometric mean (confidence interval 95%)
    17569 (13391 to 23051)
    20743 (12732 to 33794)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Seroconversion for each of the 4 Influenza Vaccine Strains at 28 Days After the Administration of a Seasonal Quadrivalent (High-dose and Standard-dose) Influenza Vaccine

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    End point title
    Percentage of Subjects with Seroconversion for each of the 4 Influenza Vaccine Strains at 28 Days After the Administration of a Seasonal Quadrivalent (High-dose and Standard-dose) Influenza Vaccine
    End point description
    Seroconversion of 4 influenza vaccine strains (group 1 & 2: A/Victoria [H1N1], A/Cambodia [H3N2], B/Victoria [B/Victoria], B/Phuket [B/Yamagata]; group 3 & 4: A/Victoria [H1N1], B/Phuket (B/Yamagata), A/Tasmania [H3N2], B/Washington [B/Victoria]) at 28 days after administration of seasonal quadrivalent (HD & SD) influenza vaccine: HI titer >=1:40 in subjects with pre-vaccination HI titer of less than(<)1:10 or >=4-fold HI titer increase in subjects with pre-vaccination HI titer of >=1:10.'n=0'&99999: none of subjects were evaluable at specified timepoint. PPII set: all randomised subjects who received Ad26.COV2.S vaccine in combination with seasonal influenza vaccine for co-administration group and those who received seasonal influenza vaccine alone for control group, for whom immunogenicity data were available for at least 1 of influenza strains in vaccine; excluded subjects with major protocol deviation. N (number of subjects analysed)=subjects who were evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    28 days after the administration of a seasonal quadrivalent influenza vaccine (Day 29)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    320
    333
    43
    41
    Units: Percentage of subjects
    number (confidence interval 95%)
        A/Victoria (H1N1) (n=320,333,43,41)
    64.1 (58.5 to 69.3)
    70.0 (64.7 to 74.8)
    65.1 (49.1 to 79.0)
    70.7 (54.5 to 83.9)
        A/Cambodia (H3N2) (n=320,333,0,0)
    39.1 (33.7 to 44.6)
    46.8 (41.4 to 52.4)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
        B/Victoria (B/Victoria) (n=320,333,0,0)
    42.8 (37.3 to 48.4)
    43.5 (38.1 to 49.1)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
        B/Phuket (B/Yamagata)(n=320,333,43,41)
    35.3 (30.1 to 40.8)
    36.9 (31.7 to 42.4)
    37.2 (23.0 to 53.3)
    34.1 (20.1 to 50.6)
        A/Tasmania (H3N2)(n=0,0,43,41)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    72.1 (56.3 to 84.7)
    70.7 (54.5 to 83.9)
        B/Washington (B/Victoria) (n=0,0,43,41)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    41.9 (27.0 to 57.9)
    53.7 (37.4 to 69.3)
    No statistical analyses for this end point

    Secondary: GMCs of Antibodies Measured by S-ELISA 28 Days After Administration of Ad26.COV2.S Vaccine in COVID-19 Vaccine Naive Subjects

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    End point title
    GMCs of Antibodies Measured by S-ELISA 28 Days After Administration of Ad26.COV2.S Vaccine in COVID-19 Vaccine Naive Subjects
    End point description
    GMCs of antibodies measured by S-ELISA 28 days after administration of Ad26.COV.S vaccine in Covid-19 vaccine naive subjects was reported. In the below data table, '0' in the number analysed field signifies that none of the subjects were evaluable at the specified timepoint. PPSI included all randomised subjects who received Ad26.COV2.S vaccine in combination with seasonal influenza vaccine for co-administration group and Ad26.COV2.S vaccine alone for control group and for whom immunogenicity data was available. Subjects with positive molecular test for SARSCoV-2 were also excluded. Here, 'N' (number of subjects analysed)=who were evaluable for this endpoint, 'n'(number analysed)=subject who were evaluated at specified timepoint. Here, -99999 and 99999 signifies that lower limit and upper limit of 95% confidence interval could not be estimated as only 1 subject was analysed on Day 57 in Group 4.
    End point type
    Secondary
    End point timeframe
    28 days after the administration of Ad26.COV2.S vaccine (that is, for Groups 1 and 3: Day 29; for Groups 2 and 4: Day 57)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    46
    40
    0 [10]
    1
    Units: EU/mL
        geometric mean (confidence interval 95%)
    10340 (6557 to 16306)
    14704 (9010 to 23998)
    ( to )
    38905 (-99999 to 99999)
    Notes
    [10] - No Subjects were available for analysis on Day 29 in Group 3.
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Seroprotection for each of the 4 Influenza Vaccine Strains as HI titer >= 1:40 at 28 Days After the Administration of a Seasonal Quadrivalent (High-dose and Standard-dose) Influenza Vaccine

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    End point title
    Percentage of Subjects with Seroprotection for each of the 4 Influenza Vaccine Strains as HI titer >= 1:40 at 28 Days After the Administration of a Seasonal Quadrivalent (High-dose and Standard-dose) Influenza Vaccine
    End point description
    Seroprotection was defined for each of the 4 influenza vaccine strains (For group 1 and 2: A/Victoria [H1N1], A/Cambodia [H3N2], B/Victoria [B/Victoria], B/Phuket [B/Yamagata]; For group 3 and 4: A/Victoria [H1N1], B/Phuket (B/Yamagata), A/Tasmania [H3N2], B/Washington [B/Victoria]) as HI titer >=1:40 at 28 days after the administration of a seasonal quadrivalent (HD and SD) influenza vaccine. 'n=0' & 99999: signifies that none of the subjects were evaluable at the specified timepoint. The PPII set included all randomised subjects who received Ad26.COV2.S vaccine in combination with seasonal influenza vaccine for coadministration group and those who received seasonal influenza vaccine alone for control group, for whom immunogenicity data were available for at least one of influenza strains in vaccine. Subjects with major protocol deviation were excluded from PPII analysis. 'N' (number of subjects analysed)= subjects who were evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    28 days after the administration of a seasonal quadrivalent influenza vaccine (Day 29)
    End point values
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Number of subjects analysed
    320
    333
    43
    41
    Units: Percentage of subjects
    number (confidence interval 95%)
        A/Victoria (H1N1) (n=320,333,43,41)
    97.8 (95.5 to 99.1)
    97.3 (94.9 to 98.8)
    100.0 (91.8 to 100.0)
    100.0 (91.4 to 100.0)
        A/Cambodia (H3N2) (n=320,333,0,0)
    92.8 (89.4 to 95.4)
    93.4 (90.2 to 95.8)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
        B/Victoria (B/Victoria) (n=320,333,0,0)
    56.9 (51.2 to 62.4)
    57.4 (51.8 to 62.7)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
        B/Phuket (B/Yamagata) (n=320,333,43,41)
    52.2 (46.6 to 57.8)
    55.0 (49.4 to 60.4)
    62.8 (46.7 to 77.0)
    63.4 (46.9 to 77.9)
        A/Tasmania (H3N2) (n=0,0,43,41)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    97.7 (87.7 to 99.9)
    100.0 (91.4 to 100.0)
        B/Washington (B/Victoria) (n=0,0,43,41)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    79.1 (64.0 to 90.0)
    82.9 (67.9 to 92.8)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From Day 1 (post-vaccination) to end of the study (up to 12.5 months)
    Adverse event reporting additional description
    The full analysis set (FAS) included all randomised subjects with at least 1 documented study vaccine administration.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo
    Reporting group description
    Subjects aged greater than or equal to (>=) 18 years and older received a single intramuscular (IM) injection of Ad26.COV2.S at 5*10^10 viral particles (vp) dose level and a seasonal quadrivalent (Q) standard dose (SD) influenza vaccine with 60 micrograms (mcg) hemagglutinin (HA) on Day 1 followed by a single IM injection of placebo (matched to Ad26.COV2.S) on Day 29.

    Reporting group title
    Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S
    Reporting group description
    Subjects aged >=18 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q SD influenza vaccine with 60 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Reporting group title
    Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo
    Reporting group description
    Subjects aged >=18 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q SD influenza vaccine with 60 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Reporting group title
    Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Reporting group description
    Subjects aged >=18 years and older received a single IM injection of placebo (matched to Ad26.COV2.S) and a seasonal Q SD influenza vaccine with 60 mcg of HA on Day 1 followed by a single IM injection of Ad26.COV2.S at 5*10^10 vp dose level on Day 29.

    Serious adverse events
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Total subjects affected by serious adverse events
         subjects affected / exposed
    9 / 382 (2.36%)
    2 / 46 (4.35%)
    1 / 47 (2.13%)
    7 / 384 (1.82%)
         number of deaths (all causes)
    0
    0
    1
    0
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Gastrointestinal Neoplasm
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Polycythaemia Vera
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Deep Vein Thrombosis
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Abnormal Uterine Bleeding
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleurisy
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary Oedema
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary Embolism
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Bipolar Disorder
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Joint Injury
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Fibula Fracture
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Chronic Left Ventricular Failure
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac Arrest
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    1 / 47 (2.13%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    Nervous system disorders
    Optic Neuritis
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Thrombocytopenia
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Biliary Obstruction
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin Ulcer
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Calculus Urinary
         subjects affected / exposed
    0 / 382 (0.00%)
    1 / 46 (2.17%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Osteoarthritis
         subjects affected / exposed
    0 / 382 (0.00%)
    1 / 46 (2.17%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Staphylococcal Infection
         subjects affected / exposed
    1 / 382 (0.26%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    0 / 384 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Covid-19
         subjects affected / exposed
    0 / 382 (0.00%)
    0 / 46 (0.00%)
    0 / 47 (0.00%)
    1 / 384 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Group 1: Ad26.COV2.S + Q SD Influenza Vaccine and Placebo Group 4: Placebo + Q HD Influenza Vaccine and Ad26.COV2.S Group 3: Ad26.COV2.S + Q HD Influenza Vaccine and Placebo Group 2: Placebo + Q SD Influenza Vaccine and Ad26.COV2.S
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    45 / 382 (11.78%)
    6 / 46 (13.04%)
    11 / 47 (23.40%)
    45 / 384 (11.72%)
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    3 / 382 (0.79%)
    3 / 46 (6.52%)
    2 / 47 (4.26%)
    5 / 384 (1.30%)
         occurrences all number
    3
    3
    2
    7
    Covid-19
         subjects affected / exposed
    42 / 382 (10.99%)
    5 / 46 (10.87%)
    10 / 47 (21.28%)
    42 / 384 (10.94%)
         occurrences all number
    42
    5
    10
    42

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    15 Feb 2022
    The purpose of this amendment was to perform a descriptive analysis for the high-dose regimen instead, because it was unlikely that enough subjects greater than or equal to (>=)65 years of age could be recruited in time before the end of the influenza season to power the non-inferiority hypothesis testing.

    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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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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