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    Clinical Trial Results:
    Immune Response to Pertussis After Vaccination With a Tdap-IPV Booster Vaccine in Children in the Republic of South Africa: Effect of Homologous and Heterologous Pertussis Vaccination Priming Background

    Summary
    EudraCT number
    2022-002452-40
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    11 Jan 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Oct 2023
    First version publication date
    15 Oct 2023
    Other versions

    Trial information

    Close Top of page
    Trial identification
    Sponsor protocol code
    TD500056
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04300192
    WHO universal trial number (UTN)
    U1111-1223-5186
    Sponsors
    Sponsor organisation name
    Sanofi Pasteur
    Sponsor organisation address
    14 Espace Henry Vallée, Lyon, France, 69007
    Public contact
    Trial Transparency Team, Sanofi Pasteur, Contact-US@sanofi.com
    Scientific contact
    Trial Transparency Team, Sanofi Pasteur, Contact-US@sanofi.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
    12 Jul 2023
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    11 Jan 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Humoral Immune Response: - To describe the long-term humoral immune responses to pertussis, diphtheria and tetanus after homologous and heterologous pertussis vaccine priming regimens. - To determine the effects of the priming regimen on humoral responses to booster vaccination with tetanus toxoid, reduced diphtheria toxoid and acellular pertussis- inactivated poliomyelitis vaccine (Tdap-IPV) vaccine. Cell-mediated Immunity: - To describe the long-term cell-mediated immune responses to pertussis after homologous and heterologous pertussis vaccine priming regimens. - To determine the effects of the priming regimen on cell-mediated immune response to booster vaccination with Tdap-IPV vaccine.
    Protection of trial subjects
    Vaccinations were performed by qualified and trained study personnel. Subjects with allergy to any of the vaccine components were not vaccinated. After vaccination, subjects were also kept under clinical observation for 30 minutes to ensure their safety. Appropriate medical equipment were also available on site in case of any immediate allergic reactions.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    27 Jan 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
    South Africa: 274
    Worldwide total number of subjects
    274
    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)
    0
    Children (2-11 years)
    113
    Adolescents (12-17 years)
    161
    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
    The study was conducted at 3 active sites in South Africa from 27 January 2021 to 11 January 2023. Subjects primed with whole-cell pertussis (wP) and/or acellular pertussis (aP) vaccines in various combination as per national recommendation during their first 2 years of life were enrolled in this study

    Pre-assignment
    Screening details
    A total of 274 subjects were enrolled in the study, of which 1 subject was not assigned to any of the study groups and was not vaccinated due to determination of protocol deviation post-enrollment.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Group 1: Adacel Quadra® vaccine
    Arm description
    Subjects primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as intramuscular (IM) injection on Day 0.
    Arm type
    Experimental

    Investigational medicinal product name
    Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
    Investigational medicinal product code
    Other name
    Adacel Quadra®, Repevax®, Triaxis® Polio, ADACEL®-POLIO
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 millilitres (mL) IM injection into the deltoid muscle on Day 0.

    Arm title
    Group 2: Adacel Quadra® vaccine
    Arm description
    Subjects primed with primary pertussis vaccination (3 doses of wP vaccine followed by 1 dose of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.
    Arm type
    Experimental

    Investigational medicinal product name
    Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
    Investigational medicinal product code
    Other name
    Adacel Quadra®, Repevax®, Triaxis® Polio, ADACEL®-POLIO
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL IM injection into the deltoid muscle on Day 0.

    Arm title
    Group 3: Adacel Quadra® vaccine
    Arm description
    Subjects primed with primary pertussis vaccination (2 doses of wP vaccine followed by 2 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.
    Arm type
    Experimental

    Investigational medicinal product name
    Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
    Investigational medicinal product code
    Other name
    Adacel Quadra®, Repevax®, Triaxis® Polio, ADACEL®-POLIO
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL IM injection into the deltoid muscle on Day 0.

    Arm title
    Group 4: Adacel Quadra® vaccine
    Arm description
    Subjects primed with primary pertussis vaccination (1 dose of wP vaccine followed by 3 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.
    Arm type
    Experimental

    Investigational medicinal product name
    Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
    Investigational medicinal product code
    Other name
    Adacel Quadra®, Repevax®, Triaxis® Polio, ADACEL®-POLIO
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL IM injection into the deltoid muscle on Day 0.

    Arm title
    Group 5: Adacel Quadra® vaccine
    Arm description
    Subjects primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.
    Arm type
    Experimental

    Investigational medicinal product name
    Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
    Investigational medicinal product code
    Other name
    Adacel Quadra®, Repevax®, Triaxis® Polio, ADACEL®-POLIO
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL IM injection into the deltoid muscle on Day 0.

    Arm title
    Group 6: Adacel Quadra® vaccine (HIV positive)
    Arm description
    Subjects with human immunodeficiency virus (HIV) infection and primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.
    Arm type
    Experimental

    Investigational medicinal product name
    Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
    Investigational medicinal product code
    Other name
    Adacel Quadra®, Repevax®, Triaxis® Polio, ADACEL®-POLIO
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL IM injection into the deltoid muscle on Day 0.

    Arm title
    Group 7: Adacel Quadra® vaccine (HIV positive)
    Arm description
    Subjects with HIV infection and primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.
    Arm type
    Experimental

    Investigational medicinal product name
    Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
    Investigational medicinal product code
    Other name
    Adacel Quadra®, Repevax®, Triaxis® Polio, ADACEL®-POLIO
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL IM injection into the deltoid muscle on Day 0.

    Number of subjects in period 1 [1]
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Started
    103
    29
    4
    1
    103
    10
    23
    Vaccinated
    103
    29
    4
    1
    102
    10
    22
    Completed
    103
    29
    4
    1
    102
    7
    18
    Not completed
    0
    0
    0
    0
    1
    3
    5
         Protocol deviation
    -
    -
    -
    -
    1
    3
    5
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: One subject was not assigned to any of the study groups and was not vaccinated due to determination of protocol deviation post-enrollment.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Group 1: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as intramuscular (IM) injection on Day 0.

    Reporting group title
    Group 2: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (3 doses of wP vaccine followed by 1 dose of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 3: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (2 doses of wP vaccine followed by 2 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 4: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (1 dose of wP vaccine followed by 3 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 5: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 6: Adacel Quadra® vaccine (HIV positive)
    Reporting group description
    Subjects with human immunodeficiency virus (HIV) infection and primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 7: Adacel Quadra® vaccine (HIV positive)
    Reporting group description
    Subjects with HIV infection and primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group values
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive) Total
    Number of subjects
    103 29 4 1 103 10 23 273
    Age categorical
    Units: Subjects
    Age continuous
    Here, '99999' was used as a space filler which denotes that standard deviation (SD) was not calculable because only one subject was involved in the analysis.
    Units: years
        arithmetic mean (standard deviation)
    14.0 ( 0.685 ) 12.5 ( 0.509 ) 12.0 ( 0 ) 12.0 ( 99999 ) 10.4 ( 0.803 ) 13.2 ( 1.32 ) 10.8 ( 0.984 ) -
    Gender categorical
    Units: Subjects
        Female
    60 10 2 0 50 2 10 134
        Male
    43 19 2 1 53 8 13 139

    End points

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    End points reporting groups
    Reporting group title
    Group 1: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as intramuscular (IM) injection on Day 0.

    Reporting group title
    Group 2: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (3 doses of wP vaccine followed by 1 dose of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 3: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (2 doses of wP vaccine followed by 2 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 4: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (1 dose of wP vaccine followed by 3 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 5: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 6: Adacel Quadra® vaccine (HIV positive)
    Reporting group description
    Subjects with human immunodeficiency virus (HIV) infection and primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 7: Adacel Quadra® vaccine (HIV positive)
    Reporting group description
    Subjects with HIV infection and primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Primary: Geometric Mean Concentrations (GMCs) of Total Immunoglobulin G (IgG) Anti-pertussis Antibodies Against Pertussis Antigens

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    End point title
    Geometric Mean Concentrations (GMCs) of Total Immunoglobulin G (IgG) Anti-pertussis Antibodies Against Pertussis Antigens [1]
    End point description
    GMCs of IgG anti-pertussis antibodies: anti-pertussis (anti-PT) toxin, anti-filamentous hemagglutinin (anti-FHA), anti-pertactin (anti-PRN) and anti-fimbriae (anti-FIM) types 2 and 3 were measured by multiplexed meso scale discovery electrochemiluminescence (MSD ECL) assay. Results were expressed in enzyme-linked immunosorbent assay (ELISA) units (EU)/mL. Analysis was performed on full analysis set (FAS) which included subjects who received a dose of the study vaccine and with pre-vaccination or post-vaccination blood sample results available. Here, '-99999 and 99999' were used as a space filler which denotes that 95 percent (%) confidence interval (CI) was not computable due to the low number of subjects.
    End point type
    Primary
    End point timeframe
    Day 0 (pre-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: As the endpoint was descriptive in nature, no statistical analysis was reported.
    End point values
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Number of subjects analysed
    103
    29
    4
    1
    102
    10
    22
    Units: EU/mL
    geometric mean (confidence interval 95%)
        Anti-PT IgG
    9.13 (6.96 to 12.0)
    9.01 (6.03 to 13.5)
    10.9 (-99999 to 99999)
    11.3 (-99999 to 99999)
    7.08 (5.76 to 8.71)
    12.1 (5.83 to 25.0)
    26.5 (17.2 to 40.8)
        Anti-FHA IgG
    48.0 (38.8 to 59.2)
    37.1 (26.2 to 52.5)
    39.7 (-99999 to 99999)
    23.7 (-99999 to 99999)
    42.5 (35.8 to 50.4)
    52.3 (25.3 to 108)
    104 (63.4 to 170)
        Anti-PRN IgG
    7.63 (5.83 to 10.0)
    2.81 (1.88 to 4.22)
    3.98 (-99999 to 99999)
    1.00 (-99999 to 99999)
    1.65 (1.41 to 1.93)
    4.46 (1.86 to 10.7)
    3.36 (2.05 to 5.50)
        Anti-FIM 2 & 3 IgG
    38.7 (30.5 to 49.1)
    15.1 (9.00 to 25.2)
    9.33 (-99999 to 99999)
    7.48 (-99999 to 99999)
    2.11 (1.71 to 2.60)
    13.0 (3.68 to 46.0)
    1.83 (1.10 to 3.03)
    No statistical analyses for this end point

    Primary: Geometric Mean Concentrations of Total Immunoglobulin G Anti-pertussis Antibodies Against Pertussis Antigens

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    End point title
    Geometric Mean Concentrations of Total Immunoglobulin G Anti-pertussis Antibodies Against Pertussis Antigens [2]
    End point description
    GMCs of IgG anti-pertussis antibodies: anti-PT toxin, anti-FHA, anti-PRN and anti-FIM types 2 and 3 were measured by multiplexed MSD ECL assay. Results were expressed in EU/mL. Analysis was performed on FAS. Here, 'number of subjects analysed' = subjects with available data for this endpoint and '-99999 and 99999' were used as a space filler which denotes that 95% CI was not computable due to the low number of subjects.
    End point type
    Primary
    End point timeframe
    Day 30 (post-vaccination)
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: As the endpoint was descriptive in nature, no statistical analysis was reported.
    End point values
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Number of subjects analysed
    101
    29
    4
    1
    102
    10
    22
    Units: EU/mL
    geometric mean (confidence interval 95%)
        Anti-PT IgG
    102 (82.9 to 124)
    141 (107 to 187)
    142 (-99999 to 99999)
    110 (-99999 to 99999)
    117 (98.1 to 138)
    117 (49.7 to 276)
    148 (108 to 201)
        Anti-FHA IgG
    410 (351 to 479)
    379 (306 to 470)
    233 (-99999 to 99999)
    199 (-99999 to 99999)
    366 (318 to 422)
    439 (239 to 806)
    549 (387 to 779)
        Anti-PRN IgG
    484 (370 to 632)
    250 (174 to 361)
    410 (-99999 to 99999)
    438 (-99999 to 99999)
    74.0 (50.4 to 109)
    174 (52.3 to 577)
    87.1 (36.5 to 208)
        Anti-FIM 2 & 3 IgG
    2097 (1750 to 2513)
    1039 (648 to 1664)
    1542 (-99999 to 99999)
    1133 (-99999 to 99999)
    168 (117 to 242)
    1226 (527 to 2853)
    78.9 (39.6 to 157)
    No statistical analyses for this end point

    Primary: Geometric Mean Concentrations of Total Immunoglobulin G Anti-diphteria Antibodies

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    End point title
    Geometric Mean Concentrations of Total Immunoglobulin G Anti-diphteria Antibodies [3]
    End point description
    GMCs of IgG anti-diphteria antibodies were measured by multiplexed MSD ECL assay. Results were expressed in international units per millilitre (IU/mL). Analysis was performed on FAS. Here, '-99999 and 99999' were used as a space filler which denotes that 95% CI was not computable due to the low number of subjects.
    End point type
    Primary
    End point timeframe
    Day 0 (pre-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: As the endpoint was descriptive in nature, no statistical analysis was reported.
    End point values
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Number of subjects analysed
    103
    29
    4
    1
    102
    10
    22
    Units: IU/mL
        geometric mean (confidence interval 95%)
    0.104 (0.075 to 0.147)
    0.123 (0.056 to 0.271)
    0.432 (-99999 to 99999)
    0.050 (-99999 to 99999)
    0.279 (0.202 to 0.386)
    0.039 (0.009 to 0.174)
    0.103 (0.036 to 0.298)
    No statistical analyses for this end point

    Primary: Geometric Mean Concentrations of Total Immunoglobulin G Anti-diphteria Antibodies

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    End point title
    Geometric Mean Concentrations of Total Immunoglobulin G Anti-diphteria Antibodies [4]
    End point description
    GMCs of IgG anti-diphteria antibodies were measured by multiplexed MSD ECL assay. Results were expressed in IU/mL. Analysis was performed on FAS. Here, 'number of subjects analysed' = subjects with available data for this endpoint; and '-99999 and 99999' were used as a space filler which denotes that 95% CI was not computable due to the low number of subjects.
    End point type
    Primary
    End point timeframe
    Day 30 (post-vaccination)
    Notes
    [4] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: As the endpoint was descriptive in nature, no statistical analysis was reported.
    End point values
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Number of subjects analysed
    101
    29
    4
    1
    102
    10
    22
    Units: IU/mL
        geometric mean (confidence interval 95%)
    2.03 (1.69 to 2.44)
    2.06 (1.48 to 2.89)
    3.79 (-99999 to 99999)
    6.49 (-99999 to 99999)
    4.79 (4.03 to 5.68)
    0.913 (0.206 to 4.04)
    2.49 (1.44 to 4.32)
    No statistical analyses for this end point

    Primary: Geometric Mean Concentrations of Total Immunoglobulin G Anti-tetanus Antibodies

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    End point title
    Geometric Mean Concentrations of Total Immunoglobulin G Anti-tetanus Antibodies [5]
    End point description
    GMCs of IgG anti-tetanus antibodies were measured by multiplexed MSD ECL assay. Results were expressed in IU/mL. Analysis was performed on FAS. Here, '-99999 and 99999' were used as a space filler which denotes that 95% CI was not computable due to the low number of subjects.
    End point type
    Primary
    End point timeframe
    Day 0 (pre-vaccination)
    Notes
    [5] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: As the endpoint was descriptive in nature, no statistical analysis was reported.
    End point values
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Number of subjects analysed
    103
    29
    4
    1
    102
    10
    22
    Units: IU/mL
        geometric mean (confidence interval 95%)
    0.706 (0.483 to 1.03)
    1.51 (0.716 to 3.17)
    2.38 (-99999 to 99999)
    0.040 (-99999 to 99999)
    0.528 (0.374 to 0.746)
    0.112 (0.025 to 0.494)
    0.319 (0.126 to 0.809)
    No statistical analyses for this end point

    Primary: Geometric Mean Concentrations of Total Immunoglobulin G Anti-tetanus Antibodies

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    End point title
    Geometric Mean Concentrations of Total Immunoglobulin G Anti-tetanus Antibodies [6]
    End point description
    GMCs of IgG anti-tetanus antibodies were measured by multiplexed MSD ECL assay. Results were expressed in IU/mL. Analysis was performed on FAS. Here, 'number of subjects analysed' = subjects with available data for this endpoint; and '-99999 and 99999' were used as a space filler which denotes that 95% CI was not computable due to the low number of subjects.
    End point type
    Primary
    End point timeframe
    Day 30 (post-vaccination)
    Notes
    [6] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: As the endpoint was descriptive in nature, no statistical analysis was reported.
    End point values
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Number of subjects analysed
    101
    29
    4
    1
    102
    10
    22
    Units: IU/mL
        geometric mean (confidence interval 95%)
    14.8 (12.8 to 17.2)
    13.7 (10.3 to 18.2)
    11.5 (-99999 to 99999)
    13.3 (-99999 to 99999)
    9.99 (8.58 to 11.6)
    9.69 (3.91 to 24.0)
    8.65 (5.08 to 14.7)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Unsolicited adverse event (AE) data were collected from Day 0 up to 30 days after vaccination. Solicited reactions data were collected within 7 days after vaccination. Serious adverse events data were collected throughout the study (i.e., up to Day 30)
    Adverse event reporting additional description
    Analysis was performed on safety analysis set which included all subjects who received the study vaccine and had any safety data available.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.1
    Reporting groups
    Reporting group title
    Group 1: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 2: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (3 doses of wP vaccine followed by 1 dose of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 3: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (2 doses of wP vaccine followed by 2 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 4: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (1 dose of wP vaccine followed by 3 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 5: Adacel Quadra® vaccine
    Reporting group description
    Subjects primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 6: Adacel Quadra® vaccine (HIV positive)
    Reporting group description
    Subjects with HIV infection and primed with primary pertussis vaccination (4 doses of wP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Reporting group title
    Group 7: Adacel Quadra® vaccine (HIV positive)
    Reporting group description
    Subjects with HIV infection and primed with primary pertussis vaccination (4 doses of aP vaccine during first 2 years of life) received a single dose of Adacel Quadra® vaccine as IM injection on Day 0.

    Serious adverse events
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 103 (0.00%)
    0 / 29 (0.00%)
    0 / 4 (0.00%)
    0 / 1 (0.00%)
    0 / 102 (0.00%)
    0 / 10 (0.00%)
    0 / 22 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Group 1: Adacel Quadra® vaccine Group 2: Adacel Quadra® vaccine Group 3: Adacel Quadra® vaccine Group 4: Adacel Quadra® vaccine Group 5: Adacel Quadra® vaccine Group 6: Adacel Quadra® vaccine (HIV positive) Group 7: Adacel Quadra® vaccine (HIV positive)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    88 / 103 (85.44%)
    20 / 29 (68.97%)
    3 / 4 (75.00%)
    1 / 1 (100.00%)
    71 / 102 (69.61%)
    8 / 10 (80.00%)
    21 / 22 (95.45%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    43 / 103 (41.75%)
    6 / 29 (20.69%)
    3 / 4 (75.00%)
    1 / 1 (100.00%)
    23 / 102 (22.55%)
    4 / 10 (40.00%)
    4 / 22 (18.18%)
         occurrences all number
    45
    6
    3
    1
    24
    4
    4
    General disorders and administration site conditions
    Injection Site Erythema
         subjects affected / exposed
    23 / 103 (22.33%)
    3 / 29 (10.34%)
    0 / 4 (0.00%)
    0 / 1 (0.00%)
    13 / 102 (12.75%)
    2 / 10 (20.00%)
    5 / 22 (22.73%)
         occurrences all number
    23
    3
    0
    0
    13
    2
    5
    Injection Site Pain
         subjects affected / exposed
    74 / 103 (71.84%)
    18 / 29 (62.07%)
    3 / 4 (75.00%)
    0 / 1 (0.00%)
    62 / 102 (60.78%)
    5 / 10 (50.00%)
    17 / 22 (77.27%)
         occurrences all number
    74
    18
    3
    0
    62
    5
    17
    Injection Site Swelling
         subjects affected / exposed
    29 / 103 (28.16%)
    9 / 29 (31.03%)
    0 / 4 (0.00%)
    0 / 1 (0.00%)
    27 / 102 (26.47%)
    3 / 10 (30.00%)
    11 / 22 (50.00%)
         occurrences all number
    29
    9
    0
    0
    27
    3
    11
    Malaise
         subjects affected / exposed
    31 / 103 (30.10%)
    1 / 29 (3.45%)
    0 / 4 (0.00%)
    1 / 1 (100.00%)
    5 / 102 (4.90%)
    1 / 10 (10.00%)
    6 / 22 (27.27%)
         occurrences all number
    31
    1
    0
    1
    5
    1
    6
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    1 / 103 (0.97%)
    2 / 29 (6.90%)
    0 / 4 (0.00%)
    0 / 1 (0.00%)
    1 / 102 (0.98%)
    0 / 10 (0.00%)
    2 / 22 (9.09%)
         occurrences all number
    1
    2
    0
    0
    1
    0
    3
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    25 / 103 (24.27%)
    1 / 29 (3.45%)
    0 / 4 (0.00%)
    0 / 1 (0.00%)
    1 / 102 (0.98%)
    1 / 10 (10.00%)
    3 / 22 (13.64%)
         occurrences all number
    25
    1
    0
    0
    1
    1
    3
    Infections and infestations
    Upper Respiratory Tract Infection
         subjects affected / exposed
    4 / 103 (3.88%)
    0 / 29 (0.00%)
    0 / 4 (0.00%)
    0 / 1 (0.00%)
    6 / 102 (5.88%)
    1 / 10 (10.00%)
    4 / 22 (18.18%)
         occurrences all number
    4
    0
    0
    0
    6
    1
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    26 Sep 2019
    Following changes were made: The word 'minutes' was added as per EC's comment; Added statement: "The parents or their child may withdraw their consent to the storage of samples at any time during the study. If at the age of 18, the child decides to withdraw his/her consent for the storage of his/her samples, he/she will have to contact the site who will inform the sponsor of the study to destroy his/her samples."; throughout the study the age of subject was changed from 8 through 12 years to 9 through 13 years; To align to Art 46 of Regulation (EC) No 1901/2006 for pediatric studies and also to the public disclosure of the study results modalities, the study results should be submitted no later than 6 months after the last visit of last subject (LVLS). As the cell-mediated immunity (CMI) results would be available later than 6 months after the LVLS, it was decided to release a first CSR with available data 6 months after the LVLS and the final clinical study report (CSR) when the CMI results are available; Text was updated to reflect that there was no coordinating investigator but there was a principal investigator; Planned study timelines were updated; Updated the exclusion criteria text to reflect: If the subject has a primary physician who is not the Investigator, the site must obtain the subject’s / subject’s parent or legal guardian’s consent prior to contacting this physician and informing him/her of the subject’s participation in the study; Updated text to reflect: All statistical analyses will be performed under the responsibility of the Sponsor’s Biostatistics Platform using the SAS® software, Version 9.4 or newer (SAS Institute, Cary, North Carolina, USA); Updated table of study procedures.
    14 Oct 2020
    Following changes were made: The cover page was updated with details of the new regional trial manager; Number of subjects was corrected throughout; Corrected and clarified the synopsis and immunogenicity endpoints; Updated identity of study product; Updated visit procedures; Updated planned study calender; Updated randomisation and allocation procedures to provide clarification of subject number; Updated blood samples for CMI; Clarified sample storage and shipment to Global Clinical Immunology (GCI); Corrected sample storage and shipment to research-Eu Marcy l'Etoile, France; Corrected future use of stored serum samples for research; Updated immunogenicity assessment method. Updated the cover page to replace the age of subjects by the years of birth, updated details of the new medical study leader and global safety office; Updated synopsis, study design, schedule of study procedures and methodology; Updated inclusion and exclusion criteria; Updated background section, recruitment procedures, identity of study product; timelines in the planned study calendar section were updated.
    18 Oct 2022
    Following changes were made: Updated title page to reflect changes within the company; Replaced 'subject' with 'participant', 'trial' with 'study' and Research-EU Human Immunology Platform was replaced by Vaccine R&D, Clinical Exploratory Research Platform throughout the document; Clarified regarding the number of subjects concerned by blood sampling for the humoral immune response; Updated the study calender; Clarified on the HIV treatment medications; Updated the immunogenicity endpoints due to the development of a more sensitive assay; The exploratory assay for the quantification of the memory B cells by Fluorospot was suppressed because of the difficult interpretation of the results for IgM and IgA secreting cells. The dual color Fluorospot was replaced by a more sensitive triple Fluorospot to measure interferon (IFN)-γ, Interleukin (IL)-17, and IL-4 to interrogate the Th profile. The Luminex assay on culture supernatant was also suppressed as this assay is redundant and less sensitive than the Fluorospot assay.

    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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