A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy Adults

<b>Background/Objectives:</b> Circulating influenza strains antigenically differing from vaccine antigens increase disease burden by decreasing vaccine efficacy. Nucleoside-modified mRNA (modRNA) influenza vaccines may facilitate rapid production allowing later antigen selection and impr...

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Main Authors: Angela Branche, Mark J. Mulligan, Alok Maniar, Orlando Puente, Islamiat Oladipupo, Graham Crowther, Agnieszka M. Zareba, Zhuobiao Yi, Ingrid Scully, Emily Gomme, Kenneth Koury, Nicholas Kitchin, Pirada Suphaphiphat Allen, Annaliesa S. Anderson, Alejandra Gurtman, Kelly Lindert
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Language:English
Published: MDPI AG 2025-04-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/4/383
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author Angela Branche
Mark J. Mulligan
Alok Maniar
Orlando Puente
Islamiat Oladipupo
Graham Crowther
Agnieszka M. Zareba
Zhuobiao Yi
Ingrid Scully
Emily Gomme
Kenneth Koury
Nicholas Kitchin
Pirada Suphaphiphat Allen
Annaliesa S. Anderson
Alejandra Gurtman
Kelly Lindert
author_facet Angela Branche
Mark J. Mulligan
Alok Maniar
Orlando Puente
Islamiat Oladipupo
Graham Crowther
Agnieszka M. Zareba
Zhuobiao Yi
Ingrid Scully
Emily Gomme
Kenneth Koury
Nicholas Kitchin
Pirada Suphaphiphat Allen
Annaliesa S. Anderson
Alejandra Gurtman
Kelly Lindert
author_sort Angela Branche
collection DOAJ
description <b>Background/Objectives:</b> Circulating influenza strains antigenically differing from vaccine antigens increase disease burden by decreasing vaccine efficacy. Nucleoside-modified mRNA (modRNA) influenza vaccines may facilitate rapid production allowing later antigen selection and improved antigenic similarity compared to circulating strains. We studied different influenza modRNA vaccine (IRV) formulations and dose levels. <b>Methods:</b> This phase 1/2 randomized study evaluated IRV safety/tolerability and immunogenicity in healthy 18- through 85-year-olds. Based on safety and immunogenicity for different IRV doses, schedules, and valencies versus the quadrivalent influenza vaccine (QIV; Fluzone High-Dose Quadrivalent, Sanofi Pasteur) in phase 1 (65–85-year-olds), quadrivalent IRV (qIRV) was further evaluated in 65- through 85-year-olds and 18- through 64-year-olds in phase 2, leading to phase 3 dose selection. <b>Results:</b> Phase 1 (65–85-year-olds) safety/tolerability and immunogenicity findings supported qIRV 30-µg and 60-µg phase 2 assessment (18–85-year-olds, N = 610). qIRV was well tolerated. Injection site pain was the most frequently reported local reaction. Reactogenicity event incidences ≤ 7 days postvaccination for qIRV were generally higher versus QIV, observed more frequently in 18- through 64-year-olds than 65- through 85-year-olds, and showed dose-related trends (60 μg > 30 μg). qIRV and QIV adverse event profiles in 65- through 85-year-olds were similar. There were higher postvaccination hemagglutination inhibition assay geometric mean titers and fold rises and seroconversion rates observed with qIRV versus QIV for A strains, with no consistent pattern for B strains. Cell-mediated immune responses to qIRV by Day 7 showed overall higher T-cell responses against all strains versus QIV. Antibody and cell-mediated immune responses showed comparable trends across qIRV doses in 18- through 85-year-olds; a dose-related pattern was observed in 65- through 85-year-olds (60 μg > 30 μg). <b>Conclusions:</b> Phase 3 investigations of qIRV 60 µg in older adults and qIRV 30 µg in younger adults are warranted (ClinicalTrials.gov Identifier: NCT05052697).
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spelling doaj-art-3ad75e1a6cd54b5ba3a9770e441cab982025-08-20T02:18:20ZengMDPI AGVaccines2076-393X2025-04-0113438310.3390/vaccines13040383A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy AdultsAngela Branche0Mark J. Mulligan1Alok Maniar2Orlando Puente3Islamiat Oladipupo4Graham Crowther5Agnieszka M. Zareba6Zhuobiao Yi7Ingrid Scully8Emily Gomme9Kenneth Koury10Nicholas Kitchin11Pirada Suphaphiphat Allen12Annaliesa S. Anderson13Alejandra Gurtman14Kelly Lindert15Department of Medicine, Division of Infectious Diseases, University of Rochester, Rochester, NY 14642, USANew York University (NYU) Vaccine Center, NYU Grossman School of Medicine, New York, NY 10016, USAVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAMiami Dade Medical Research Institute, Miami, FL 33176, USAVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAVaccine Research and Development, Pfizer Ltd., Hurley SL6 6RJ, UKVaccine Research and Development, Pfizer Inc., Collegeville, PA 19426, USAVaccine Research and Development, Pfizer Inc., Collegeville, PA 19426, USAVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAVaccine Research and Development, Pfizer Ltd., Hurley SL6 6RJ, UKVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAVaccine Research and Development, Pfizer Inc., Pearl River, NY 10965, USAVaccine Research and Development, Pfizer Inc., Cambridge, MA 02139, USA<b>Background/Objectives:</b> Circulating influenza strains antigenically differing from vaccine antigens increase disease burden by decreasing vaccine efficacy. Nucleoside-modified mRNA (modRNA) influenza vaccines may facilitate rapid production allowing later antigen selection and improved antigenic similarity compared to circulating strains. We studied different influenza modRNA vaccine (IRV) formulations and dose levels. <b>Methods:</b> This phase 1/2 randomized study evaluated IRV safety/tolerability and immunogenicity in healthy 18- through 85-year-olds. Based on safety and immunogenicity for different IRV doses, schedules, and valencies versus the quadrivalent influenza vaccine (QIV; Fluzone High-Dose Quadrivalent, Sanofi Pasteur) in phase 1 (65–85-year-olds), quadrivalent IRV (qIRV) was further evaluated in 65- through 85-year-olds and 18- through 64-year-olds in phase 2, leading to phase 3 dose selection. <b>Results:</b> Phase 1 (65–85-year-olds) safety/tolerability and immunogenicity findings supported qIRV 30-µg and 60-µg phase 2 assessment (18–85-year-olds, N = 610). qIRV was well tolerated. Injection site pain was the most frequently reported local reaction. Reactogenicity event incidences ≤ 7 days postvaccination for qIRV were generally higher versus QIV, observed more frequently in 18- through 64-year-olds than 65- through 85-year-olds, and showed dose-related trends (60 μg > 30 μg). qIRV and QIV adverse event profiles in 65- through 85-year-olds were similar. There were higher postvaccination hemagglutination inhibition assay geometric mean titers and fold rises and seroconversion rates observed with qIRV versus QIV for A strains, with no consistent pattern for B strains. Cell-mediated immune responses to qIRV by Day 7 showed overall higher T-cell responses against all strains versus QIV. Antibody and cell-mediated immune responses showed comparable trends across qIRV doses in 18- through 85-year-olds; a dose-related pattern was observed in 65- through 85-year-olds (60 μg > 30 μg). <b>Conclusions:</b> Phase 3 investigations of qIRV 60 µg in older adults and qIRV 30 µg in younger adults are warranted (ClinicalTrials.gov Identifier: NCT05052697).https://www.mdpi.com/2076-393X/13/4/383influenzavaccinationmodRNAimmunogenicitysafetytolerability
spellingShingle Angela Branche
Mark J. Mulligan
Alok Maniar
Orlando Puente
Islamiat Oladipupo
Graham Crowther
Agnieszka M. Zareba
Zhuobiao Yi
Ingrid Scully
Emily Gomme
Kenneth Koury
Nicholas Kitchin
Pirada Suphaphiphat Allen
Annaliesa S. Anderson
Alejandra Gurtman
Kelly Lindert
A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy Adults
Vaccines
influenza
vaccination
modRNA
immunogenicity
safety
tolerability
title A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy Adults
title_full A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy Adults
title_fullStr A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy Adults
title_full_unstemmed A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy Adults
title_short A Phase 1/2 Randomized Study to Evaluate the Safety, Tolerability, and Immunogenicity of Nucleoside-Modified Messenger RNA Influenza Vaccines in Healthy Adults
title_sort phase 1 2 randomized study to evaluate the safety tolerability and immunogenicity of nucleoside modified messenger rna influenza vaccines in healthy adults
topic influenza
vaccination
modRNA
immunogenicity
safety
tolerability
url https://www.mdpi.com/2076-393X/13/4/383
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