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Phase 2 N=108 Randomized Double-blind Prevention

Phase 2 Shigella Vaccine and Challenge

Immunisation · Shigella Infection

Enrolled (actual)
108
Serious AEs
0.0%
Results posted
Apr 2025
Primary outcome: Primary: The Proportion of Participants With Shigellosis Following Challenge With Shigella Sonnei 53G Through Day 63 in the Pooled Group of Participants Receiving Two Doses of 10^6 Cfu or 5x10^5 Cfu of WRSs2 Compared to Participants Receiving Two Doses of Placebo. — 0.09; 0.81 proportion of participants — p=<0.001

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Placebo (Other); Shigella sonnei strain 53G (Biological); WRSs2 (Biological)
Age
Adult · 18+ yrs
Sex
All
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Primary completion
Mar 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
The Proportion of Participants With Shigellosis Following Challenge With Shigella Sonnei 53G Through Day 63 in the Pooled Group of Participants Receiving Two Doses of 10^6 Cfu or 5x10^5 Cfu of WRSs2 Compared to Participants Receiving Two Doses of Placebo.
0.09; 0.81 <0.001 sig
SECONDARY
The Proportion of Participants With Shigellosis Following Challenge With S. Sonnei 53G Through Day 63 in Participants Receiving 1 Dose of 10^6 Cfu, 2 Doses of 10^6 Cfu, or 2 Doses of 5x10^5 Cfu of WRSs2 Compared to Those Receiving Two Doses of Placebo.
0.19; 0; 0; 0.81
SECONDARY
Number and Percentage of Participants With Solicited Systemic Adverse Events (AEs) Through 7 Days After Each Study Vaccination.
17; 22; 11; 27; 13; 17
SECONDARY
Number and Percentage of Participants With Vaccine-related Unsolicited AEs Through 28 Days Post Last Vaccination
2; 5; 2; 0
SECONDARY
Number and Percentage of Participants With SAEs Through Study Day 180 or Until Resolution or Stabilization Even if This Extends Beyond the Study-reporting Period.
0; 0; 0; 0
SECONDARY
Number of Participants With >=4-fold Rise From Pre-vaccination in Anti-LPS (Lipopolysaccharide) IgG (Immunoglobulin G)
16; 19; 0; 0; 13; 12
SECONDARY
Number of Participants With >=4-fold Rise From Pre-vaccination in Anti-Invaplex IgG (Immunoglobulin G)
16; 13; 0; 0; 16; 11
SECONDARY
Number of Participants With >=4-fold Rise From Pre-vaccination in Anti-LPS (Lipopolysaccharide) IgA (Immunoglobulin A)
19; 24; 0; 0; 12; 18
SECONDARY
Number of Participants With >=4-fold Rise From Pre-vaccination in Anti-Invaplex IgA (Immunoglobulin A)
20; 24; 0; 0; 14; 21
SECONDARY
Maximum Anti-LPS (Lipopolysaccharide) and Anti-Invaplex Serum IgG (Immunoglobulin G) and IgA (Immunoglobulin A) Titer Post-vaccination Through Day 56
1758.6; 1837.9; 997.4; 423.8; 5467.2; 5571.5
SECONDARY
Peak Fold-rise From Pre-vaccination in Anti-LPS (Lipopolysaccharide) and Anti-Invaplex Serum IgG (Immunoglobulin G) and IgA (Immunoglobulin A) Titer
5.0; 4.1; 3.2; 1.2; 7.8; 3.3
SECONDARY
Number of Participants With >=4-fold Rise From Pre-challenge in Anti-LPS (Lipopolysaccharide) IgG (Immunoglobulin G)
1; 0; 0; 3; 2; 1
SECONDARY
Number of Participants With >=4-fold Rise From Pre-challenge in Anti-Invaplex IgG (Immunoglobulin G)
1; 0; 0; 4; 4; 1
SECONDARY
Number of Participants With >=4-fold Rise From Pre-challenge in Anti-LPS (Lipopolysaccharide) IgA (Immunoglobulin A)
2; 0; 1; 13; 7; 7
SECONDARY
Number of Participants With >=4-fold Rise From Pre-challenge in Anti-Invaplex IgA (Immunoglobulin A)
3; 0; 0; 13; 5; 8
SECONDARY
Maximum Anti-LPS (Lipopolysaccharide) and Anti-Invaplex Serum IgG (Immunoglobulin G) and IgA (Immunoglobulin A) Titer Post-challenge Through Day 113
1233.8; 1175.8; 843.8; 2145.3; 4525.5; 4887.8
SECONDARY
Peak Fold-rise From Pre-challenge in Anti-LPS (Lipopolysaccharide) and Anti-Invaplex Serum IgG (Immunoglobulin G) and IgA (Immunoglobulin A) Titer
1.8; 1.2; 1.1; 6.1; 1.9; 1.2
SECONDARY
Number of Participants Shedding Vaccine Strain in Their Stool by Culture Prior to Challenge
0; 0; 0; 0; 15; 14
SECONDARY
Number of Participants Shedding 53G in Their Stool by Culture Post-challenge
0; 0; 3; 0; 0; 1
SECONDARY
Mean Duration of Shedding Vaccine Strain Post-vaccination Through Day 56 by Culture.
21.9; 15.9; 13.3; 1.0
SECONDARY
Mean Duration of Shedding 53G Post-challenge Through Day 65 by Culture.
2.6; 2.6; 2.5; 3.1

Summary

This is a trial to evaluate the safety, reactogenicity, immunogenicity and efficacy of a 10^6 cfu dose of an oral live-attenuated S. sonnei vaccine candidate, WRSs2, in up to 120 healthy males and non-pregnant females aged 18-49, inclusive. This is a two-phase study, an outpatient WRSs2 vaccination phase and an inpatient S. sonnei 53G challenge phase. After the initiation of the study, two participants had Grade 3 diarrhea and/or vomiting in the days following vaccination. The vaccination dose was reduced to 5X10^5, enrollment was changed to 2 arms and randomized 2:1 (vaccine: placebo). Participants with morbid obesity were excluded and weight loss medications prohibited. The Primary Objective of this study is to estimate combined vaccine efficacy of 2 doses of WRSs2 (10^6 cfu or 5X10^5 cfu) in preventing shigellosis, following challenge with S. sonnei strain 53G.

Eligibility Criteria

Inclusion Criteria

  • Provide informed consent prior to initiation of any study procedures.
  • Are able to understand and comply with planned study procedures and be available for all study visits.
  • Is 18-49 years of age inclusive and in sufficiently good health* to be safely enrolled in this study as determined by medical history, medication use, and abbreviated physical exam.

*Good health is defined by the absence of any exclusionary medical conditions. If the subject has another current, ongoing medical condition, the condition cannot meet any of the following criteria: 1) first diagnosed within 3 months of enrollment; 2) is worsening in terms of clinical outcome in last 6 months; or 3) involves need for medication that may pose a risk to subject's safety or impede assessment of adverse events or immunogenicity if they participate in the study. Topical, nasal, and inhaled medications (with the exception of inhaled corticosteroids as outlined in the Subject Exclusion Criteria, herbals, vitamins, and supplements are permitted.

  • Oral temperature is less than 100.4 degrees Fahrenheit.
  • Pulse is 50 to 100 beats per minute (bpm), inclusive.
  • Systolic blood pressure is 90 to 140 mmHg, inclusive.
  • Diastolic blood pressure is 55 to 90 mmHg, inclusive.
  • Females of childbearing potential** may enroll if subject has practiced adequate contraception*** = / > 30 days prior to enrollment and agrees to continue adequate contraception for the entire study.

**Child-bearing potential is defined as not sterilized via tubal ligation, bilateral oophorectomy, salpingectomy, hysterectomy, or successful Essure(R) placement (permanent, non-surgical, non-hormonal sterilization) with documented radiological confirmation test at least 90 days after the procedure, and still menstruating or 1:2500) for anti S. sonnei LPS IgG ELISA titer at screening.

  • Has a history of diarrhea in the 14 days prior to enrollment.
  • Have fewer than 3 stools per week or more than 3 stools per day as the usual frequency.
  • Recent history/current use of immunosuppressive/immunomodulating disease therapy.
  • Known hypersensitivity to ciprofloxacin or trimethoprim-sulfamethoxazole; sodium bicarbonate; or any components of vaccine, placebo, or challenge material.
  • Received or plan to receive a licensed live vaccine within 30 days prior to enrollment.
  • Received or plan to receive a licensed, inactivated, Coronavirus disease 2019 (COVID-19) vaccine or an influenza vaccine within +-7 days from receipt of study product.
  • Have a history of severe reactions following previous immunization with any licensed or unlicensed vaccine.
  • Received Ig or other blood products (with exception of Rho D Ig) within 90 days prior to enrollment.
  • Have taken oral or parenteral (including intra-articular) corticosteroids of any dose, or high-dose inhaled corticosteroids**within 30 days prior to enrollment.

** High-dose defined per age as using inhaled high dose per reference chart Estimated Comparative Daily Dosages https://www.nhlbi.nih.gov/files/docs/guidelines/asthma\_qrg.pdf

  • Have taken systemic antibiotics within 7 days prior to enrollment.
  • Have taken prescription and/or OTC medication containing loperamide, acetaminophen, aspirin, ibuprofen, or other non-steroidal anti-inflammatory < / = 48 hours prior to enrollment.
  • Have a history of alcohol or drug abuse within 1 year prior to enrollment.
  • Have been hospitalized for psychiatric illness, history of suicide attempt, or confinement for danger to self or others within 5 years prior to enrollment.
  • Work or plan to work in either a health care setting, day care center, or as a food handler or have known daily contact with individuals with possible increased susceptibility****** to Shigella within 14 days after discharge from inpatient challenge.

****** Immunocompromised, elderly persons aged 70 years or more, diapered individuals, persons with disabilities, children < 2 years old, a woman known to

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04242264). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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