Immunogenicity and Safety of an AS03-Adjuvanted H7N9 Pandemic Influenza Vaccine in a Randomized Trial in Healthy Adults.
BACKGROUND
Almost 700 cases of human infection with avian influenza A/H7N9 have been reported since 2013. Pandemic preparedness strategies include H7N9 vaccine development.


METHODS
We evaluated an inactivated H7N9 vaccine in an observer-blind study in healthy adults aged 18-64 years. Participants (420) were randomized to receive 1 of 4 AS03-adjuvanted vaccines (low or medium dose of hemagglutinin with AS03Aor AS03B), one nonadjuvanted vaccine, or placebo. The coprimary immunogenicity objective determined whether adjuvanted vaccines elicited an immune response against the vaccine-homologous virus, 21 days after the second vaccine dose per US and European licensure criteria in the per-protocol cohort (n = 389).


RESULTS
All adjuvanted vaccines met regulatory acceptance criteria. In groups receiving adjuvanted formulations, seroconversion rates were ≥85.7%, seroprotection rates ≥91.1%, and geometric mean titers ≥92.9% versus 23.2%, 28.6%, and 17.2 for the nonadjuvanted vaccine. The AS03 adjuvant enhanced immune response at antigen-sparing doses. Injection site pain occurred more frequently with adjuvanted vaccines (in ≤98.3% of vaccinees) than with the nonadjuvanted vaccine (40.7%) or placebo (20.0%). None of the 20 serious adverse events reported were related to vaccination.


CONCLUSIONS
Two doses of AS03-adjuvanted H7N9 vaccine were well tolerated and induced a robust antibody response at antigen-sparing doses in healthy adults.


BACKGROUND
NCT01999842.
GSK, Collegeville.
Anuradha
A
Madan
Clinical Research Atlanta, Stockbridge, Georgia.
Nathan
N
Segall
Colchester Research Group, Truro, Nova Scotia.
Murdo
M
Ferguson
QT Research, Sherbrooke, Quebec, Canada.
Louise
L
Frenette
Seattle Women's: Health, Research, Gynecology, University of Washington, Seattle.
Robin
R
Kroll
GSK Vaccines, Wavre, Belgium.
Damien
D
Friel
GSK Pharmaceuticals, Bangalore, India.
Jyoti
J
Soni
GSK Vaccines, King of Prussia, Pennsylvania.
Ping
P
Li
GSK Vaccines, King of Prussia, Pennsylvania.
Bruce L
BL
Innis
GSK Vaccines, King of Prussia, Pennsylvania.
Anne
A
Schuind
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D004338:Drug Combinations; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007115:Immunization Schedule; D064766:Influenza A Virus, H7N9 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010919:Placebos / Q000008:administration & dosage; D011136:Polysorbates / Q000008:administration & dosage*; D016037:Single-Blind Method; D013185:Squalene / Q000008:administration & dosage*; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D055815:Young Adult; D024502:alpha-Tocopherol / Q000008:administration & dosage*
D000276:Adjuvants, Immunologic; D000914:Antibodies, Viral; D004338:Drug Combinations; D007252:Influenza Vaccines; D010919:Placebos; D011136:Polysorbates; D015164:Vaccines, Inactivated; D013185:Squalene; C550253:AS03 adjuvant; D024502:alpha-Tocopherol
AS03; H7N9; adjuvant system; antigen sparing; influenza; pandemic; vaccine