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Point-of-Use Mixing of Influenza H5N1 Vaccine and MF59 Adjuvant for Pandemic Vaccination Preparedness: Antibody Responses and Safety. A Phase 1 Clinical Trial.


ABSTRACT:

Background

Avian influenza A/H5N1 has threatened human health for nearly 2 decades. Avian influenza A vaccine without adjuvant is poorly immunogenic. A flexible rapid tactic for mass vaccination will be needed if a pandemic occurs.

Methods

A multicenter, randomized, blinded phase 1 clinical trial evaluated safety and antibody responses after point-of-use mixing of influenza A/Indonesia/05/2005 (H5N1) vaccine with MF59 adjuvant. Field-site pharmacies mixed 3.75, 7.5, or 15 mcg of antigen with or without MF59 adjuvant just prior to intramuscular administration on days 0 and 21 of healthy adults aged 18-49 years.

Results

Two hundred and seventy subjects were enrolled. After vaccination, titers of hemagglutination inhibition antibody ≥1:40 were achieved in 80% of subjects receiving 3.75 mcg + MF59 vs only 14% receiving 15 mcg without adjuvant (P < .0001). Peak hemagglutination inhibition antibody geometric mean titers for vaccine + MF59 were ∼65 regardless of antigen dose, and neutralizing titers were 2- to 3-fold higher. Vaccine + MF59 produced cross-reactive antibody responses against 4 heterologous H5N1 viruses. Excellent safety and tolerability were demonstrated.

Conclusions

Point-of-use mixing of H5N1 antigen and MF59 adjuvant achieved target antibody titers in a high percentage of subjects and was safe. The feasibility of the point-of-use mixing should be studied further.

SUBMITTER: Mulligan MJ 

PROVIDER: S-EPMC4324215 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Publications

Point-of-Use Mixing of Influenza H5N1 Vaccine and MF59 Adjuvant for Pandemic Vaccination Preparedness: Antibody Responses and Safety. A Phase 1 Clinical Trial.

Mulligan Mark J MJ   Bernstein David I DI   Frey Sharon S   Winokur Patricia P   Rouphael Nadine N   Dickey Michelle M   Edupuganti Srilatha S   Spearman Paul P   Anderson Edwin E   Graham Irene I   Noah Diana L DL   Mangal Brian B   Kim Sonnie S   Hill Heather H   Whitaker Jenifer J   Emery William W   Beck Allison A   Stephens Kathy K   Hartwell Brooke B   Ogilvie Melinda M   Rimann Nayoka N   Osinski Eileen E   Destefano Ellen E   Gajadhar Theda T   Strudwick Amanda A   Pierce Karen K   Lai Lilin L   Yue Ling L   Wang Dongli D   Ying Carl C   Cline Amy A   Foltz Tara T   Wagner Nancy N   Dull Geraldine G   Pacatte Thomas T   Taggart Barbara B   Johnson Valerie V   Haller Logan L   Looney Candi C   Li Shixiong S   May Megan M   Myers Bridgette B   May Rachel R   Parker Lawanda L   Cochran Nertaissa N   Bowen Donna D   Bell Michelle M   Scoggins Jeffery J   Burns Angela A   Stablein Claire C   Wolff Mark M   Jolles Bernadette B   Leung Brenda B   Lambert Linda L   Shorer Shy S   Buchanan Wendy W   Murray Suzanne S   Chang Soju S   Gorman Richard R  

Open forum infectious diseases 20141118 3


<h4>Background</h4>Avian influenza A/H5N1 has threatened human health for nearly 2 decades. Avian influenza A vaccine without adjuvant is poorly immunogenic. A flexible rapid tactic for mass vaccination will be needed if a pandemic occurs.<h4>Methods</h4>A multicenter, randomized, blinded phase 1 clinical trial evaluated safety and antibody responses after point-of-use mixing of influenza A/Indonesia/05/2005 (H5N1) vaccine with MF59 adjuvant. Field-site pharmacies mixed 3.75, 7.5, or 15 mcg of a  ...[more]

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