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Safety,tolerability, and immunogenicity of V114 pneumococcal vaccine compared with PCV13 in a 2+1 regimen in healthy infants: A phase III study (PNEU-PED-EU-2)
Affiliation:1. Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark;2. Faculty of Medicine and Health Technology, Tampere University, and FVR – Finnish Vaccine Research, Tampere, Finland;3. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy;4. Finnish Vaccine Research, Tampere, Finland;5. The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences of the Ben-Gurion University of the Negev, Beer-Sheva, Israel;6. School of Medicine, University of Western Australia, Perth, Australia;7. Merck & Co., Inc., Rahway, NJ, USA;8. MSD, Zürich, Switzerland;9. MSD (UK) Limited, London, United Kingdom
Abstract:
BackgroundThis phase III study evaluated safety, tolerability, and immunogenicity of V114 (15-valent pneumococcal conjugate vaccine) in healthy infants. V114 contains all 13 serotypes in PCV13 and additional serotypes 22F and 33F.MethodsHealthy infants were randomized to two primary doses and one toddler dose (2+1 regimen) of V114 or PCV13 at 3, 5, and 12 months of age; diphtheria, tetanus, pertussis (DTaP), inactivated poliovirus (IPV), Haemophilus influenzae type b (Hib), hepatitis B (HepB) vaccine was administered concomitantly. Adverse events (AEs) were collected on Days 1–14 following each vaccination. Serotype-specific anti-pneumococcal immunoglobulin G (IgG) was measured 30 days post-primary series, immediately prior to toddler dose, and 30 days post-toddler dose. Primary objectives included non-inferiority of V114 to PCV13 for 13 shared serotypes and superiority of V114 to PCV13 for serotypes 22F and 33F.Results1191 healthy infants were randomized to V114 (n = 595) or PCV13 (n = 596). Proportions of participants with solicited AEs and serious AEs were comparable between groups. V114 met non-inferiority criteria for 13 shared serotypes, based on difference in proportions with serotype-specific IgG ≥0.35 μg/mL (lower bound of two-sided 95% confidence interval [CI] >−10.0) and IgG geometric mean concentration (GMC) ratios (lower bound of two-sided 95% CI >0.5) at 30 days post-toddler dose. V114 met superiority criteria for serotypes 22F and 33F, based on response rates (lower bound of two-sided 95% CI >10.0) and IgG GMC ratios (lower bound of two-sided 95% CI >2.0) at 30 days post-toddler dose.Antibody responses to DTaP-IPV-Hib-HepB met non-inferiority criteria, based on antigen-specific response rates.ConclusionA two-dose primary series plus toddler dose of V114 was well-tolerated in healthy infants. Compared with PCV13, V114 provided non-inferior immune responses to 13 shared serotypes and superior immune responses to additional serotypes 22F and 33F.
Keywords:Clinical trial  Pneumococcal infections  Pneumococcal vaccines  Child  Infant  AE"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0035"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  adverse event  APaT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0045"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  all-participants-as-treated  CI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0055"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  confidence interval  COVID-19"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0065"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  coronavirus disease 2019  CV"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0075"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  coefficient of variation  DTaP"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0085"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  diphtheria, tetanus, and pertussis  GMC"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0095"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  geometric mean concentration  GMT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0105"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  geometric mean titer  HBsAg"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0115"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  HepB surface antigen  HepB"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0125"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  hepatitis B  Hib"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0135"  },"  $$"  :[{"  #name"  :"  text"  ,"  $$"  :[{"  #name"  :"  italic"  ,"  _"  :"  Haemophilus influenzae"  },{"  #name"  :"  __text__"  ,"  _"  :"   type b  IgG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0165"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  immunoglobulin G  IgM"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  ce.keyword_rxx_34p_swb"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  immunoglobulin M  IPD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0145"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  invasive pneumococcal disease  IPV"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0155"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  inactivated poliovirus  mMOPA"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0175"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  microcolony multiplexed OPA  MMR"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0185"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  measles, mumps, and rubella  OPA"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0195"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  opsonophagocytic activity  PCV"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0205"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  pneumococcal conjugate vaccine  PD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0215"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  pneumococcal disease  SAE"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0225"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  serious adverse event  WHO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0235"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  World Health Organization
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