Title

Immune Response Induced by a Vaccine Against Group B Streptococcus and Safety in Pregnant Women and Their Offsprings
A Phase II Randomized, Observer-Blind, Multi-Center, Controlled Study of a Trivalent Group B Streptococcus Vaccine in Healthy Pregnant Women
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    86
The study investigated the immune response induced by the Group B streptococcus vaccine in healthy pregnant women. In addition, the study investigated the amount of vaccine induced antibodies which were transferred to the newborn.
Study Started
Sep 30
2011
Primary Completion
Apr 30
2013
Study Completion
Oct 31
2013
Results Posted
Sep 08
2014
Estimate
Last Update
Sep 08
2014
Estimate

Biological Group B Streptococcus Trivalent Vaccine

Pregnant women who received one injection of Group B Streptococcus Trivalent Vaccine administered intramuscularly.

Biological Placebo

Pregnant women who received one injection of saline solution administered intramuscularly.

Group B Streptococcus Trivalent Vaccine Experimental

Pregnant women who received one injection of Group B Streptococcus Trivalent Vaccine.

Placebo Placebo Comparator

Pregnant women who received one injection of saline solution.

Criteria

Inclusion Criteria:

Healthy pregnant women 18-40 years of age at 24-35 weeks of gestation at screening.
Individuals who have given a written consent after the nature of the study has been explained according to local regulatory requirements.
Individuals in good health as determined by the outcome of medical history, physical examination and clinical judgment of the investigator.
Individuals who will be available for all scheduled visits (ie, not planning to leave the area before the end of the study period).

Exclusion Criteria:

Individuals who were unwilling and/or unable to give written informed consent to participate in the study.
Individuals with a history of severe allergic reactions after previous vaccinations such as anaphylactic shock, asthma, urticaria, or other allergic reaction or hypersensitivity to any vaccine component.

Individuals with any known or suspected impairment/alteration of immune function, either congenital or acquired or resulting from:

receipt of immunosuppressive therapy within 30 days prior to enrollment (any systemic corticosteroid administered for more than 5 days, or in a daily dose > 15 mg/kg/day prednisone or equivalent during any of 30 days prior to enrollment, or cancer chemotherapy).
receipt of immunostimulants.
receipt of parenteral immunoglobulin preparation, blood products, and /or plasma derivatives within 12 weeks prior to enrollment and for the full length of the study.

Note: Anti-D (Rho) Immunoglobulins (anti-RhD) given for Anti-D prophylaxis were to be allowed.

Individuals characterized as "high risk" pregnancies at investigator discretion, such as those who have:

gestational diabetes
preeclampsia/eclampsia
women at risk of preterm labor (except positivity for vaginal GBS)
History of previous pregnancy complications including delivery of preterm infant.
History of still-birth, late abortions and children with congenital anomalies.
Individuals who had received any other investigational agent or investigational intervention during the course of the study.
Individuals with acute infection including oral temperature ≥ 38°C were to be temporarily excluded. They could be enrolled once the infection had resolved (as judged by investigator).
HIV positive by history.

Individuals reporting any known or suspected serious acute, chronic or progressive disease (eg, any history of neoplasm, malignancy, including lymphoproliferative disorder, diabetes, cardiac disease, malnutrition, renal failure, autoimmune disease, HBV or HCV, blood disorders).

Note: Malignancies, highly likely to having been cured at the investigators discretion are allowed. (eg, no relapse since 5 years post last malignancy specific treatment).

Individuals with bleeding diathesis, or any condition that might have been associated with a prolonged bleeding time.
Individuals with behavioral or cognitive impairment or psychiatric disease that, in the opinion of the investigator, might have interfered with the subject's ability to participate in the study (eg, who were not able to comprehend or to follow all required study procedures for the whole period of the study).
Individuals with any progressive or severe neurologic disorder, seizure disorder, epilepsy or Guillain-Barré syndrome.
Individuals with history or any illness that, in the opinion of the investigator, might have posed additional risk to subjects due to participation in the study.
Individuals who were part of study personnel or close family members conducting this study.

Summary

Mothers GBS

Mothers Placebo

Infants GBS

Infants Placebo

All Events

Event Type Organ System Event Term Mothers GBS Mothers Placebo Infants GBS Infants Placebo

Geometric Mean of the Ratios Between Infant Antibody Level (μg/mL) and Maternal Antibody Level (μg/mL) at Time of Delivery

The Geometric mean transfer ratio of anti-GBS CPS antibodies against serotypes Ia, Ib and III at delivery is calculated as the geometric mean of the pairwise ratios between the antibody concentrations from infant at birth and to maternal serum concentration at delivery.

Mothers GBS

GBS Ia

0.81
Ratio (Geometric Mean)
95% Confidence Interval: 0.72 to 0.91

GBS Ib (N=40, 22)

0.77
Ratio (Geometric Mean)
95% Confidence Interval: 0.62 to 0.97

GBS III (N=40, 25)

0.68
Ratio (Geometric Mean)
95% Confidence Interval: 0.59 to 0.78

Mothers Placebo

GBS Ia

0.97
Ratio (Geometric Mean)
95% Confidence Interval: 0.85 to 1.11

GBS Ib (N=40, 22)

1.44
Ratio (Geometric Mean)
95% Confidence Interval: 1.06 to 1.94

GBS III (N=40, 25)

0.99
Ratio (Geometric Mean)
95% Confidence Interval: 0.83 to 1.18

Geometric Mean Concentrations (GMCs) of Antibodies in Mothers and Infants at Delivery/Birth

GMCs of anti-Group B Streptococcus (GBS) capsular polysaccharide (CPS) antibodies against serotypes Ia, Ib and III in mothers and in infants at delivery/birth are presented.

Mothers GBS

GBS Ia

5.39
µg/mL (Geometric Mean)
95% Confidence Interval: 2.97 to 9.77

GBS Ib (N=40, 22, 40, 22)

3.35
µg/mL (Geometric Mean)
95% Confidence Interval: 1.44 to 7.77

GBS III (N=40, 25, 40, 25)

2.45
µg/mL (Geometric Mean)
95% Confidence Interval: 1.15 to 5.2

Mothers Placebo

GBS Ia

0.41
µg/mL (Geometric Mean)
95% Confidence Interval: 0.2 to 0.85

GBS Ib (N=40, 22, 40, 22)

0.064
µg/mL (Geometric Mean)
95% Confidence Interval: 0.021 to 0.19

GBS III (N=40, 25, 40, 25)

0.056
µg/mL (Geometric Mean)
95% Confidence Interval: 0.022 to 0.14

Infants GBS

GBS Ia

4.37
µg/mL (Geometric Mean)
95% Confidence Interval: 2.39 to 7.99

GBS Ib (N=40, 22, 40, 22)

2.59
µg/mL (Geometric Mean)
95% Confidence Interval: 1.14 to 5.87

GBS III (N=40, 25, 40, 25)

1.65
µg/mL (Geometric Mean)
95% Confidence Interval: 0.78 to 3.5

Infants Placebo

GBS Ia

0.4
µg/mL (Geometric Mean)
95% Confidence Interval: 0.19 to 0.83

GBS Ib (N=40, 22, 40, 22)

0.092
µg/mL (Geometric Mean)
95% Confidence Interval: 0.032 to 0.27

GBS III (N=40, 25, 40, 25)

0.055
µg/mL (Geometric Mean)
95% Confidence Interval: 0.022 to 0.14

GMC (ELISA) of Anti-GBS CPS Antibodies in Infants

GMC (ELISA) of anti-GBS CPS antibodies against serotypes Ia, Ib and III in infants at birth and at 3 months of age are reported.

Infants GBS

GBS Ia (day 91 after birth)

1.28
μg/mL (Geometric Mean)
95% Confidence Interval: 0.76 to 2.16

GBS Ia (day of birth)

5.14
μg/mL (Geometric Mean)
95% Confidence Interval: 2.64 to 10.0

GBS Ib (day 91 after birth)

0.54
μg/mL (Geometric Mean)
95% Confidence Interval: 0.25 to 1.19

GBS Ib (day of birth; N=31, 20)

2.93
μg/mL (Geometric Mean)
95% Confidence Interval: 1.14 to 7.57

GBS III (day 91 after birth)

0.43
μg/mL (Geometric Mean)
95% Confidence Interval: 0.21 to 0.86

GBS III (day of birth; N=30, 22)

1.93
μg/mL (Geometric Mean)
95% Confidence Interval: 0.82 to 4.59

Infants Placebo

GBS Ia (day 91 after birth)

0.25
μg/mL (Geometric Mean)
95% Confidence Interval: 0.13 to 0.46

GBS Ia (day of birth)

0.33
μg/mL (Geometric Mean)
95% Confidence Interval: 0.15 to 0.71

GBS Ib (day 91 after birth)

0.063
μg/mL (Geometric Mean)
95% Confidence Interval: 0.025 to 0.16

GBS Ib (day of birth; N=31, 20)

0.1
μg/mL (Geometric Mean)
95% Confidence Interval: 0.031 to 0.32

GBS III (day 91 after birth)

0.065
μg/mL (Geometric Mean)
95% Confidence Interval: 0.029 to 0.15

GBS III (day of birth; N=30, 22)

0.065
μg/mL (Geometric Mean)
95% Confidence Interval: 0.024 to 0.18

GMRs of Anti-GBS CPS Antibody GMCs (ELISA) in Infants at 3 Months of Age Versus GMCs at Birth

GMRs of anti-GBS CPS antibody GMCs (ELISA) against serotypes Ia, Ib and III in infants at 3 months of age (day 91 after birth) versus GMCs at birth are reported.

Infants GBS

GBS Ia

0.25
Ratio (Geometric Mean)
95% Confidence Interval: 0.19 to 0.32

GBS Ib (N=31, 20 )

0.22
Ratio (Geometric Mean)
95% Confidence Interval: 0.16 to 0.29

GBS III (N=30, 22)

0.25
Ratio (Geometric Mean)
95% Confidence Interval: 0.19 to 0.32

Infants Placebo

GBS Ia

0.76
Ratio (Geometric Mean)
95% Confidence Interval: 0.57 to 1.01

GBS Ib (N=31, 20 )

0.54
Ratio (Geometric Mean)
95% Confidence Interval: 0.38 to 0.78

GBS III (N=30, 22)

0.85
Ratio (Geometric Mean)
95% Confidence Interval: 0.62 to 1.16

Percentages of Infant Subjects Showing Anti-diphtheria Antibodies GMCs (ELISA) Over 0.1 IU/mL at 1 Month After the Last Routine Infant Immunization

Percentages of infant subjects showing anti-diphtheria antibodies GMCs (ELISA) over 0.1 IU/mL in sera collected at 1 month after the last routine infant immunization (ie, either 5 months or 7 months after birth, depending on the vaccination schedule) are reported.

Infants GBS

100.0
Percentages of subjects
95% Confidence Interval: 91.0 to 100.0

Infants Placebo

100.0
Percentages of subjects
95% Confidence Interval: 87.0 to 100.0

Percentage of Maternal Subjects Reporting Solicited Local and Systemic Adverse Events (AEs)

Percentage of maternal subjects reporting solicited local and systemic AEs and other indicators of reactogenicity from day 1 to 7 after vaccination are reported.

Mothers GBS

Any local

40.0
Percentages of subjects

Any other

8.0
Percentages of subjects

Any systemic

46.0
Percentages of subjects

Arthralgia (N =49, 34)

4.0
Percentages of subjects

Chills (N =49, 34)

4.0
Percentages of subjects

Ecchymosis (>=25 mm; N =49, 34 )

2.0
Percentages of subjects

Erythema (>=25 mm; N =49, 34)

6.0
Percentages of subjects

Fatigue (N =49, 34)

31.0
Percentages of subjects

Fever, body temperature >38° C (N =49, 33)

Headache (N =49, 34)

16.0
Percentages of subjects

Induration (>=25 mm; N =49, 34)

6.0
Percentages of subjects

Malaise (N =49, 34)

14.0
Percentages of subjects

Myalgia (N =49, 34)

27.0
Percentages of subjects

Nausea (N =49, 34)

6.0
Percentages of subjects

Pain (N =49, 34)

35.0
Percentages of subjects

Rash (N =49, 34)

2.0
Percentages of subjects

Stayed home (N =49, 34)

2.0
Percentages of subjects

Swelling (>=25 mm; N =49, 34)

4.0
Percentages of subjects

Use of analgesics/antipyretics (N =49, 34)

6.0
Percentages of subjects

Mothers Placebo

Any local

24.0
Percentages of subjects

Any other

3.0
Percentages of subjects

Any systemic

38.0
Percentages of subjects

Arthralgia (N =49, 34)

9.0
Percentages of subjects

Chills (N =49, 34)

3.0
Percentages of subjects

Ecchymosis (>=25 mm; N =49, 34 )

Erythema (>=25 mm; N =49, 34)

Fatigue (N =49, 34)

26.0
Percentages of subjects

Fever, body temperature >38° C (N =49, 33)

Headache (N =49, 34)

21.0
Percentages of subjects

Induration (>=25 mm; N =49, 34)

Malaise (N =49, 34)

9.0
Percentages of subjects

Myalgia (N =49, 34)

3.0
Percentages of subjects

Nausea (N =49, 34)

9.0
Percentages of subjects

Pain (N =49, 34)

12.0
Percentages of subjects

Rash (N =49, 34)

3.0
Percentages of subjects

Stayed home (N =49, 34)

Swelling (>=25 mm; N =49, 34)

Use of analgesics/antipyretics (N =49, 34)

3.0
Percentages of subjects

Percentage of Maternal Subjects Reporting Unsolicited AEs and Serious Adverse Events (SAEs)

Percentage of maternal subjects reporting unsolicited AEs, SAEs, AEs requiring a non-routine physician's visit, AEs leading to withdrawal are reported.

Mothers GBS

AEs leading to withdrawal

Any SAE

14.0
Percentages of subjects

Any unsolicited AE

63.0
Percentages of subjects

Medically-attended AEs

51.0
Percentages of subjects

Mothers Placebo

AEs leading to withdrawal

Any SAE

23.0
Percentages of subjects

Any unsolicited AE

74.0
Percentages of subjects

Medically-attended AEs

54.0
Percentages of subjects

GMCs (Enzyme-linked Immunosorbent Assay, ELISA) Antibodies Against Serotypes Ia, Ib and III in Maternal Subjects

GMCs (ELISA) of anti-GBS CPS antibodies against serotypes Ia, Ib and III in maternal subjects at study day 1, study day 31 and at day 91 post-partum after one administration of GBS vaccine or placebo are reported.

Mothers GBS

GBS Ia (day 1)

0.28
µg/mL (Geometric Mean)
95% Confidence Interval: 0.19 to 0.41

GBS Ia (day 31; N=49, 32)

4.83
µg/mL (Geometric Mean)
95% Confidence Interval: 2.89 to 8.06

GBS Ia (day 91 post-delivery; N = 44, 34)

5.89
µg/mL (Geometric Mean)
95% Confidence Interval: 3.86 to 8.99

GBS Ib (day 1; N= 50, 34)

0.13
µg/mL (Geometric Mean)
95% Confidence Interval: 0.084 to 0.19

GBS Ib (day 31; N=49, 31)

1.68
µg/mL (Geometric Mean)
95% Confidence Interval: 0.97 to 2.92

GBS Ib (day 91 post-delivery; N= 44, 33)

3.46
µg/mL (Geometric Mean)
95% Confidence Interval: 2.33 to 5.14

GBS III (day 1)

0.11
µg/mL (Geometric Mean)
95% Confidence Interval: 0.07 to 0.16

GBS III (day 31; N= 49, 32)

1.46
µg/mL (Geometric Mean)
95% Confidence Interval: 0.83 to 2.57

GBS III (day 91 post-delivery; N=44, 34)

2.69
µg/mL (Geometric Mean)
95% Confidence Interval: 1.78 to 4.06

Mothers Placebo

GBS Ia (day 1)

0.37
µg/mL (Geometric Mean)
95% Confidence Interval: 0.24 to 0.58

GBS Ia (day 31; N=49, 32)

0.36
µg/mL (Geometric Mean)
95% Confidence Interval: 0.19 to 0.65

GBS Ia (day 91 post-delivery; N = 44, 34)

0.46
µg/mL (Geometric Mean)
95% Confidence Interval: 0.29 to 0.75

GBS Ib (day 1; N= 50, 34)

0.084
µg/mL (Geometric Mean)
95% Confidence Interval: 0.051 to 0.14

GBS Ib (day 31; N=49, 31)

0.14
µg/mL (Geometric Mean)
95% Confidence Interval: 0.069 to 0.27

GBS Ib (day 91 post-delivery; N= 44, 33)

0.17
µg/mL (Geometric Mean)
95% Confidence Interval: 0.11 to 0.27

GBS III (day 1)

0.093
µg/mL (Geometric Mean)
95% Confidence Interval: 0.056 to 0.15

GBS III (day 31; N= 49, 32)

0.12
µg/mL (Geometric Mean)
95% Confidence Interval: 0.06 to 0.23

GBS III (day 91 post-delivery; N=44, 34)

0.11
µg/mL (Geometric Mean)
95% Confidence Interval: 0.07 to 0.18

Percentages of Infants Reporting SAEs

Percentages of infants born from women who received either one injection of the study vaccine or placebo, reporting SAEs from birth until study termination are reported.

Infants GBS

24.0
Percentages of subjects

Infants Placebo

31.0
Percentages of subjects

Geometric Mean Ratios (GMRs) of Antibody GMCs (ELISA) in Maternal Subjects

GMRs of GMCs (ELISA) of anti-GBS CPS antibodies against serotypes Ia, Ib and III, in maternal subjects at study day 31, at delivery and at day 91 post-partum versus day 1 (baseline) after one administration of GBS vaccine or placebo are reported.

Mothers GBS

GBS Ia (Day 31/day 1; N=49, 32)

15.0
Ratio (Geometric Mean)
95% Confidence Interval: 9.12 to 25.0

GBS Ia (day 91 post-delivery/day 1; N= 44, 34)

19.0
Ratio (Geometric Mean)
95% Confidence Interval: 12.0 to 28.0

GBS Ia (Delivery/day 1)

16.0
Ratio (Geometric Mean)
95% Confidence Interval: 11.0 to 25.0

GBS Ib (Day 31/day 1; N=48, 30)

18.0
Ratio (Geometric Mean)
95% Confidence Interval: 9.94 to 32.0

GBS Ib (day 91 post-delivery/day 1; N=44, 32)

33.0
Ratio (Geometric Mean)
95% Confidence Interval: 22.0 to 48.0

GBS Ib (Delivery/day 1; N=50, 34)

23.0
Ratio (Geometric Mean)
95% Confidence Interval: 14.0 to 39.0

GBS III (Day 31/day 1; N=49, 32)

17.0
Ratio (Geometric Mean)
95% Confidence Interval: 9.17 to 30.0

GBS III (day 91 post-delivery/day 1; N=44, 34)

28.0
Ratio (Geometric Mean)
95% Confidence Interval: 18.0 to 43.0

GBS III (Delivery/day 1)

20.0
Ratio (Geometric Mean)
95% Confidence Interval: 12.0 to 33.0

Mothers GBS

GBS Ia (Day 31/day 1; N=49, 32)

15.0
Ratio (Geometric Mean)
95% Confidence Interval: 9.12 to 25.0

GBS Ia (day 91 post-delivery/day 1; N= 44, 34)

19.0
Ratio (Geometric Mean)
95% Confidence Interval: 12.0 to 28.0

GBS Ia (Delivery/day 1)

16.0
Ratio (Geometric Mean)
95% Confidence Interval: 11.0 to 25.0

GBS Ib (Day 31/day 1; N=48, 30)

18.0
Ratio (Geometric Mean)
95% Confidence Interval: 9.94 to 32.0

GBS Ib (day 91 post-delivery/day 1; N=44, 32)

33.0
Ratio (Geometric Mean)
95% Confidence Interval: 22.0 to 48.0

GBS Ib (Delivery/day 1; N=50, 34)

23.0
Ratio (Geometric Mean)
95% Confidence Interval: 14.0 to 39.0

GBS III (Day 31/day 1; N=49, 32)

17.0
Ratio (Geometric Mean)
95% Confidence Interval: 9.17 to 30.0

GBS III (day 91 post-delivery/day 1; N=44, 34)

28.0
Ratio (Geometric Mean)
95% Confidence Interval: 18.0 to 43.0

GBS III (Delivery/day 1)

20.0
Ratio (Geometric Mean)
95% Confidence Interval: 12.0 to 33.0

Mothers Placebo

GBS Ia (Day 31/day 1; N=49, 32)

1.22
Ratio (Geometric Mean)
95% Confidence Interval: 0.66 to 2.25

GBS Ia (day 91 post-delivery/day 1; N= 44, 34)

1.51
Ratio (Geometric Mean)
95% Confidence Interval: 0.94 to 2.42

GBS Ia (Delivery/day 1)

1.2
Ratio (Geometric Mean)
95% Confidence Interval: 0.72 to 2.01

GBS Ib (Day 31/day 1; N=48, 30)

1.14
Ratio (Geometric Mean)
95% Confidence Interval: 0.56 to 2.35

GBS Ib (day 91 post-delivery/day 1; N=44, 32)

1.53
Ratio (Geometric Mean)
95% Confidence Interval: 0.96 to 2.43

GBS Ib (Delivery/day 1; N=50, 34)

1.13
Ratio (Geometric Mean)
95% Confidence Interval: 0.63 to 2.05

GBS III (Day 31/day 1; N=49, 32)

1.19
Ratio (Geometric Mean)
95% Confidence Interval: 0.59 to 2.42

GBS III (day 91 post-delivery/day 1; N=44, 34)

1.11
Ratio (Geometric Mean)
95% Confidence Interval: 0.69 to 1.8

GBS III (Delivery/day 1)

1.08
Ratio (Geometric Mean)
95% Confidence Interval: 0.6 to 1.96

Mothers Placebo

GBS Ia (Day 31/day 1; N=49, 32)

1.22
Ratio (Geometric Mean)
95% Confidence Interval: 0.66 to 2.25

GBS Ia (day 91 post-delivery/day 1; N= 44, 34)

1.51
Ratio (Geometric Mean)
95% Confidence Interval: 0.94 to 2.42

GBS Ia (Delivery/day 1)

1.2
Ratio (Geometric Mean)
95% Confidence Interval: 0.72 to 2.01

GBS Ib (Day 31/day 1; N=48, 30)

1.14
Ratio (Geometric Mean)
95% Confidence Interval: 0.56 to 2.35

GBS Ib (day 91 post-delivery/day 1; N=44, 32)

1.53
Ratio (Geometric Mean)
95% Confidence Interval: 0.96 to 2.43

GBS Ib (Delivery/day 1; N=50, 34)

1.13
Ratio (Geometric Mean)
95% Confidence Interval: 0.63 to 2.05

GBS III (Day 31/day 1; N=49, 32)

1.19
Ratio (Geometric Mean)
95% Confidence Interval: 0.59 to 2.42

GBS III (day 91 post-delivery/day 1; N=44, 34)

1.11
Ratio (Geometric Mean)
95% Confidence Interval: 0.69 to 1.8

GBS III (Delivery/day 1)

1.08
Ratio (Geometric Mean)
95% Confidence Interval: 0.6 to 1.96

Total

172
Participants

Age, Continuous

0
days (Mean)
Standard Deviation: 0

Age, Continuous

29.8
years (Mean)
Standard Deviation: 5.1

Region of Enrollment

Sex: Female, Male

Overall Study

Mothers GBS

Mothers Placebo

Infants GBS

Infants Placebo

Drop/Withdrawal Reasons

Mothers GBS

Infants GBS