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CompletedNCT00504231Updated Jul 13, 2012Results posted

Intradermal Influenza Vaccine Study in Elders

A Phase 2 interventional study of Fluzone Influenza Vaccine (2007-2008) in Influenza, sponsored by PATH. Completed. Open to participants aged 65 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2012-07-13.

Sponsored by PATH · Phase 2, Interventional, and Prevention

Phase
Phase 2
Study type
Interventional
Enrollment
257
Allocation
Randomized
Ages
65 Years and older
Sex
All
01

Study summary

This randomized trial compared the immunogenicity of 60% dose intradermal (ID) influenza vaccination to standard intramuscular (IM) vaccination of full-dose or 60% dose vaccine. Pre- and postvaccination measurements in the hemagglutination inhibition antibody (HAI) titer were compared. Participants who received reduced-dose vaccine were revaccinated with full-dose IM vaccine.

Read the detailed description

This study was an open-label randomized trial consisting of community-dwelling adults 65 years and older living in Puget Sound area in Washington State. Subjects were enrolled and randomly assigned to receive licensed, 2007-2008 Northern Hemisphere TIV vaccine (Fluzone, lot U2440AA; Sanofi Pasteur) containing concentrations of hemagglutinin of each of A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), and B/Malaysia/2506/2004 (B): 15 ug/0.5 mL by the IM route, 9 ug/0.3 mL by the ID or IM route, or 4.5 ug/0.15 mL given twice by ID route to the nondominant arm. A block randomization scheme (1:1:1:1), stratified by sex, was used. For IM vaccination, 0.3 mL or 0.5 mL of vaccine was removed from a multidose (5 mL) vial through a 25-gauge, 1-inch detachable needle (Becton Dickinson) and was injected into the deltoid muscle at a 90 degree angle to the skin. For ID vaccination, 0.3 mL or 0.15 mL was drawn by a TB syringe through a 25-gauge, 5/8-inch needle (Terumo Medical). The needle was inserted at a 15 degree angle to the skin overlying the deltoid of the arm. The vaccine was slowly injected until all material was expelled and induration appeared. Subjects randomized to the 0.15-mL group received 2 side-by-side ID injections 3 cm apart. Participants returned at 4 weeks to determine postvaccination antibody titers. At this follow-up visit, those assigned to reduced dose IM or ID influenza vaccinations then received full-dose IM influenza vaccination. These participants returned in another 4 weeks to repeat HAI titers. A nonrandomized subset of subjects (based on availability and willingness to participate) returned at 14 days after initial vaccination for T cell assays in an exploratory substudy to examine cellular immune response.

02

Conditions studied

  • Influenza

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Keywords

  • influenza
  • prevention
  • intradermal
  • vaccine
  • delivery
  • elderly
03

In context

Influenza, Human

2,214 studies on the registry are indexed under Influenza, Human; 163 are open to participants now.

This study's enrollment of 257 is close to the median of 238 across 1,853 interventional studies indexed under Influenza, Human.

Browse Influenza, Human studies →

Lead sponsor

PATH is the lead sponsor of 111 studies on the registry; 7 are open to participants now.

Of its 10 completed or terminated interventional studies of FDA-regulated products, 10 (100%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
65 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Ambulatory, medically stable persons 65 years of age or older
  • Able to read and understand informed consent
  • Available during the trial period and for follow-up
  • Able to understand and comply with planned study procedures
  • Able to be contacted by telephone for follow-up of adverse events

Exclusion criteria

Exclusion Criteria:

  • Known allergy to eggs or other components of vaccine (i.e., thimerosal)
  • History of Guillain-Barré Syndrome (GBS)
  • Has a confirmed or suspected immunodeficient or immunosuppressive condition (including congenital or acquired immunosuppressive therapy, and human immunodeficiency virus [HIV])
  • End-stage renal disease requiring hemodialysis
  • Active neoplastic disease or history of any hematologic malignancy (except localized skin or prostate cancer that is stable in the absence of therapy)
  • Acute or chronic condition that (in the opinion of the investigator) would render vaccination unsafe or would interfere with the evaluation of responses (including but not limited to the following: known chronic liver disease, significant renal disease, oxygen-dependent chronic lung disease, New York Heart Association Functional Class III or IV, unstable or progressive neurologic disorder, insulin controlled diabetes mellitus)
  • Use of experimental vaccines within the month prior to study entry, or expected use of experimental or licensed vaccines or blood/blood products during the duration of the study.
  • Receipt of immunoglobulin or other blood product within 3 months prior to enrollment
  • Receipt of other licensed vaccines within the preceding 4 weeks
  • History of a severe reaction following influenza vaccination
  • Current or planned participation in a research study of an investigational drug. Participation in research studies that involve use of licensed drugs, for either approved or investigational indications, will be permitted with the approval of the PI, as will participation in research studies that do not involve vaccines or medications.
  • Current use or previous chronic administration, defined as >14 days during the previous six months, of immunosuppressants or other immune-modifying drugs. (For oral or injected corticosteroids, the immune-modifying dose is defined as prednisone or its equivalent >10 mg/day or >800mcg per day of inhaled beclomethasone dipropionate or equivalent ). Topical steroids are allowed.
  • Use of cytotoxic therapy in the previous 2 years.
  • Plans to receive cytotoxic therapy during the study period.
  • Concurrent moderate to severe illness. Need to defer vaccination until recovery. (Vaccination is not contraindicated in subjects with mild illnesses or with low-grade fever).
05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
257 participants (actual)

Study arms

  • Experimental
    0.3 mL Influenza Vaccine ID

    60% dose - 0.3 mL delivered intradermally with needle and syringe

    Biological: Fluzone Influenza Vaccine (2007-2008)

  • Experimental
    0.15 mL twice Influenza Vaccine ID

    60% dose - 0.15 mL delivered twice intradermally with needle and syringe

    Biological: Fluzone Influenza Vaccine (2007-2008)

  • Active comparator
    0.5 mL Influenza Vaccine by IM

    100% dose - 0.5mL delivered intramuscularly with needle and syringe

    Biological: Fluzone Influenza Vaccine (2007-2008)

  • Experimental
    0.3 mL Influenza Vaccine IM

    60% dose - 0.3 mL delivered intramuscularly with needle and syringe

    Biological: Fluzone Influenza Vaccine (2007-2008)

Interventions

  • BiologicalFluzone Influenza Vaccine (2007-2008)

    Manufactured by Sanofi Pasteur

    Also known as: Fluzone

06

What researchers measure

Primary outcomes

  1. Seroprotection Pre- and Post- Vaccination

    Seroprotection before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) Intramuscular (IM) or Reduced-Dose (9 mg) Intradermal (ID) Injections for A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)

    Time frame: 1 month

Secondary outcomes

  1. Geometric Mean Titer (GMT) Pre- and Post- Vaccination

    GMT before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) IM or Reduced-Dose (9 mg) ID Injections. A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)

    Time frame: 1 month

  2. Assessment of Reactogenicity

    Maximum solicited systemic and local signs and symptoms during the week after initial vaccination, by Dose and Randomization Assignment

    Time frame: 1 week

07

Results

Posted Jul 13, 2012

Participant flow

Participant flow — Overall Study
MilestoneFull-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 ID
Started65646465
Completed65646365
Not completed0010
Withdrew: Discrepant chart documentation re route0010

Outcome measures

PrimarySeroprotection Pre- and Post- Vaccination

Seroprotection before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) Intramuscular (IM) or Reduced-Dose (9 mg) Intradermal (ID) Injections for A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)

Time frame:
1 month
Reported as:
Number · % of Participants
Seroprotection Pre- and Post- Vaccination
% of ParticipantsFull-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 ID
A/H1N1 Seroprotection Prevaccination18.5 (34.6 to 66.5)12.5 (40.0 to 73.4)19.115.4
A/H1N1 Seroprotection 4 weeks after vaccination65.657.868.967.2
A/H3N2 Seroprotection Prevaccination47.746.949.247.7
A/H3N2 Seroprotection 4 weeks after vaccination76.675.075.475.0
B Seroprotection Prevaccination15.412.514.320.0
B Seroprotection 4 weeks after vaccination26.617.216.525.0
SecondaryGeometric Mean Titer (GMT) Pre- and Post- Vaccination

GMT before and 4 Weeks after Vaccination by Full- or Reduced-Dose (9 mg) IM or Reduced-Dose (9 mg) ID Injections. A/Solomon Islands/3/2006 (A/H1N1), A/Wisconsin/67/2005 (A/H3N2), B/Malaysia/2506/2004 (B)

Time frame:
1 month
Reported as:
Geometric mean · GMT
Geometric Mean Titer (GMT) Pre- and Post- Vaccination
GMTFull-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 ID
A/H1N1 Prevaccination12.5 (9.8 to 16.0)11.3 (8.9 to 14.3)13.6 (10.7 to 17.4)11.2 (9.1 to 13.9)
A/H1N1 4 weeks after vaccination54.2 (40.0 to 73.4)41.8 (29.5 to 59.2)48.0 (34.6 to 66.5)48.6 (36.2 to 65.2)
A/H3N2 Prevaccination33.7 (23.9 to 47.6)27.1 (20.1 to 36.4)29.4 (21.1 to 40.8)29.0 (21.2 to 39.7)
A/H3N2 4 weeks after vaccination79.1 (57.6 to 108.6)62.4 (46.6 to 83.5)57.5 (42.4 to 78.1)72.6 (53.2 to 99.1)
B Prevaccination10.7 (8.6 to 13.2)10.1 (8.2 to 12.5)9.8 (7.8 to 12.3)12.8 (9.9 to 16.5)
B 4 weeks after vaccination16.5 (12.7 to 21.4)12.4 (10.0 to 15.5)10.8 (8.5 to 13.8)15.9 (12.1 to 20.9)
SecondaryAssessment of Reactogenicity

Maximum solicited systemic and local signs and symptoms during the week after initial vaccination, by Dose and Randomization Assignment

Time frame:
1 week
Reported as:
Number · participants
Assessment of Reactogenicity
participantsFull-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 ID
Fever, >=38.0C and <39.0C0103
Fever, >=390001
Chills, present but easily tolerated1116
Chills, interferes with normal activities1101
Fatigue, present but easily tolerated4638
Fatigue, interferes with normal activity2106
General body ache/pain, present but easily tolerat65311
General body ache/pain, interferes with normal a1224
Headache, present but easily tolerated10549
Headache, interferes with normal activity0105
Nausea, present but easily tolerated3223
Nausea, interferes with normal activity1100
Redness or Discoloration, <=8 cm974552
Redness or Discoloration, >8 cm0034
Localized swelling, <=8 cm1343744
Localized swelling, >8 cm0034
Pain at injection site, present but easily tolerat711714
Pain at injection site, interferes with normal act0000
Itching at injection site, present but tolerated451519
Itching at injection site, interferes with normal0002
Arm motion limitation, some limitiation1100
Arm motion limitation, interferes normal activity0000

Adverse events

Non-serious events are listed at a 1% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Full-dose 0.5 mL IM—0/65 (0%)0/65 (0%)
60% Dose 0.3 mL IM—2/64 (3.1%)0/64 (0%)
60% Dose 0.3 mL ID—1/64 (1.6%)0/64 (0%)
60% Dose 0.15 mL x 2 ID—3/65 (4.6%)0/65 (0%)
Most frequent serious events
Most frequent serious events
EventFull-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 ID
Acute coronary syndromeCardiac disorders0/651/640/640/65
AppendicitisGastrointestinal disorders0/651/640/640/65
anemia and arrhythmiaCardiac disorders0/650/641/640/65
small bowel obstructionGastrointestinal disorders0/650/640/641/65
complicated fallInjury, poisoning and procedural complications0/650/640/641/65
nausea and vomitingGastrointestinal disorders0/650/640/641/65

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Full-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 IDTotal
<=18 years00000
Between 18 and 65 years00000
>=65 years65646365257
Age Continuous
Age Continuous(years)Full-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 IDTotal
Mean75.6 ± 6.875.2 ± 7.773.6 ± 6.374.7 ± 6.374.8 ± 6.8
Sex: Female, Male
Sex: Female, Male(Participants)Full-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 IDTotal
Female1111111144
Male54535254213
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Full-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 IDTotal
Hispanic or Latino01113
Not Hispanic or Latino65636264254
Unknown or Not Reported00000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Full-dose 0.5 mL IM60% Dose 0.3 mL IM60% Dose 0.3 mL ID60% Dose 0.15 mL x 2 IDTotal
American Indian or Alaska Native00000
Asian20226
Native Hawaiian or Other Pacific Islander00000
Black or African American423514
White56605553224
More than one race00000
Unknown or Not Reported323513
08

Study locations

No study locations are listed for this record.

09

References and documents

Publications

  • Chi RC, Rock MT, Neuzil KM. Immunogenicity and safety of intradermal influenza vaccination in healthy older adults. Clin Infect Dis. 2010 May 15;50(10):1331-8. doi: 10.1086/652144. PubMed 20377407 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 13, 2012, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00504231
Lead sponsor
PATH
Collaborators
VA Puget Sound Health Care System, Seattle Institute for Biomedical and Clinical Research
Responsible party
Sponsor
First posted
Jul 19, 2007
Start date
Sep 2007
Primary completion
Jan 2008
Completion
Jan 2008
Results posted
Jul 13, 2012
Last update
Jul 13, 2012

Study contacts

Ru-Chien Chi, MD
principal investigator · VAPSHCS
Kathy Neuzil, MD
principal investigator · PATH

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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