Safety and immunogenicity of a booster dose of a 3-antigen Staphylococcus aureus vaccine (SA3Ag) in healthy adults: A randomized phase 1 study

J Infect. 2016 Nov;73(5):437-454. doi: 10.1016/j.jinf.2016.08.004. Epub 2016 Aug 9.

Abstract

Objective: A 2-stage, phase 1, randomized, placebo-controlled study in healthy adults to assess immunogenicity and safety of a booster dose at three dose levels of a 3-antigen Staphylococcus aureus vaccine (SA3Ag) containing recombinant clumping factor A (ClfA) and capsular polysaccharides 5 and 8 (CP5 and CP8) conjugated to a diphtheria toxoid.

Methods: Six months after initial single vaccination, in Stage 2, SA3Ag recipients were randomized (1:1) to booster vaccination or placebo, while Stage 1 placebo recipients received placebo again. Pre- and post-vaccination blood samples were analyzed.

Results: In Stage 2 (n = 345), pre-booster CP5 and CP8 titers remained high with no increase post-booster. ClfA titers remained high after initial vaccination and increased post-booster, approaching the peak response to the initial dose. Post-booster local reactions were more frequent and of greater severity than reported after the initial vaccination, particularly for the high-dose level recipients. Post hoc analysis showed no dose-response pattern and no obvious association between diphtheria toxoid titers and local reactions after initial or booster vaccination.

Conclusion: Immune responses after the initial vaccination persisted for the 12 months studied, with little additional response after the booster dose at 6 months. Post-booster injection site reactions were more frequent and more severe but self-limiting. CLINICALTRIALS.

Gov identifier: NCT01018641.

Keywords: Capsular polysaccharide conjugates; Clumping factor A; Functional antibodies; Staphylococcus aureus; Vaccine.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Antigens, Viral
  • Bacterial Capsules / immunology*
  • Bacterial Vaccines / pharmacology*
  • Coagulase / immunology
  • Diphtheria Toxin / immunology
  • Double-Blind Method
  • Female
  • Humans
  • Immunization, Secondary
  • Male
  • Middle Aged
  • Placebos
  • Staphylococcal Infections / immunology*
  • Staphylococcal Infections / prevention & control*
  • Staphylococcus aureus / immunology*
  • Vaccination / methods
  • Young Adult

Substances

  • Antigens, Viral
  • Bacterial Vaccines
  • ClfA protein, Staphylococcus aureus
  • Coagulase
  • Diphtheria Toxin
  • Placebos
  • capsular polysaccharide, type 5, Staphylococcus aureus
  • capsular polysaccharide, type 8, Staphylococcus aureus

Associated data

  • ClinicalTrials.gov/NCT01018641