A Phase 2 interventional study of Monovalent Subvirion A/H1N1 Influenza vaccine and Monovalent Subvirion A/H1N1 Influenza vaccine in Influenza and Swine-origin A/H1N1 Influenza, sponsored by Sanofi Pasteur, a Sanofi Company. Completed at 20 sites in United States. Open to participants aged 6 Months to 9 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2016-04-14.
Sponsored by Sanofi Pasteur, a Sanofi Company · Phase 2, Interventional, and Prevention
The purpose of the study is to evaluate different doses of the Influenza A/H1N1 pandemic vaccine in toddlers and children.
Primary Objectives:
Participants will receive two injections of their randomized vaccine on Day 0 and Day 21, respectively.
2,214 studies on the registry are indexed under Influenza, Human; 163 are open to participants now.
This study's enrollment of 474 is above the median of 238 across 1,853 interventional studies indexed under Influenza, Human.
Browse Influenza, Human studies →Sanofi Pasteur, a Sanofi Company is the lead sponsor of 366 studies on the registry; 4 are open to participants now.
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All subjects:
Subjects aged 3 to 9 years:
Subjects aged 6 to 35 months:
Exclusion Criteria :
Participants will receive A/H1N1 vaccine formulation 1
Biological: Monovalent Subvirion A/H1N1 Influenza vaccine
Participants will receive A/H1N1 vaccine formulation 2
Biological: Monovalent Subvirion A/H1N1 Influenza vaccine
Participants will receive a placebo vaccine
Biological: Normal saline solution (placebo)
0.5 mL, Intramuscular Day 0 and Day 21 (3 to 9 years); 0.25 mL, Intramuscular on Day 0 and Day 21 (6 months to 35 Months)
0.5 mL, Intramuscular Day 0 and Day 21 (3 to 9 years); 0.25 mL, Intramuscular on day 0 and Day 21 (6 months to 35 Months)
0.5 mL, Intramuscular Day 0 and Day 21 (3 to 9 years); 0.25 mL, Intramuscular on day 0 and Day 21 (6 months to 35 Months)
Number of Participants With Antibody Titers ≥ 10 1/Dilution (1/Dil) Against A/California (H1N1 Vaccine) Strain - Age 6 to 35 Months
Pre- and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
Time frame: Pre-vaccination (Day 0) and 21 days post-vaccination
Number of Participants With Antibody Titers ≥ 40 1/Dilution (1/Dil) Against A/California (H1N1 Vaccine) Strain - Age 6 to 35 Months
Seroprotection: Antibody titer of ≥ 40 1/dil. Antibody titers were determined by the hemagglutination inhibition (HAI) test.
Time frame: Pre-vaccination (Day 0) and Day 21 post-vaccination
Geometric Mean Titers (GMT) of Antibodies Against A/California (H1N1 Vaccine) Strain - Age 6 to 35 Months
Pre-vaccination and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
Time frame: Pre-vaccination (Day 0) and 21 days post-vaccination
Number of Participants With Antibody Titers ≥ 10 1/Dilution (1/Dil) Against A/California (H1N1 Vaccine) Strain - Age 3 to 9 Years
Pre-vaccination and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
Time frame: Pre-vaccination (Day 0) and 21 days post-vaccination
Number of Participants With Antibody Titers ≥ 40 1/Dilution (1/Dil) Against A/California (H1N1 Vaccine) Strain - Age 3 to 9 Years
Seroprotection: Antibody titer ≥ 40 1/dil. Antibody titers were determined by the hemagglutination inhibition (HAI) test.
Time frame: Pre-vaccination (Day 0) and Day 21 post-vaccination
Geometric Mean Titers (GMT) of Antibodies Against A/California (H1N1 Vaccine) Strain - Age 3 to 9 Years
Pre-vaccination and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
Time frame: Pre-vaccination (Day 0) and Day 21 post-vaccination
Number of Participants With At Least One Solicited Injection Site or Systemic Reaction Following Vaccination - Age 6 to 23 Months
Solicited Injection Site Reactions: Tenderness, erythema (redness), swelling, induration (hardening), ecchymosis (bruising). Solicited systemic reactions: Fever (temperature), vomiting, crying abnormal, drowsiness, appetite lost, irritability.
Time frame: Days 0 to 7 post-vaccination
Number of Participants With At Least One Solicited Injection Site or Systemic Reaction Following Vaccination - Age 24 to 35 Months
Solicited Injection Site Reactions: Pain, erythema (redness), swelling, induration (hardening), ecchymosis (bruising). Solicited systemic reactions: Fever (temperature), headache, malaise (feeling unwell), myalgia (muscle aches and pains), shivering.
Time frame: Days 0 to 7 post-vaccination
Number of Participants With At Least One Solicited Injection Site or Systemic Reaction Following Vaccination - Age 3 to 9 Years
Solicited Injection Site Reactions: Pain, erythema (redness), swelling, induration (hardening), ecchymosis (bruising). Solicited systemic reactions: Fever (temperature), headache, malaise (feeling unwell), myalgia (muscle aches and pains), shivering.
Time frame: Days 0 to 7 post vaccination
Participants were enrolled from 06 August 2009 to 13 August 2009 at 19 US clinical centers.
| Milestone | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Started | 215 | 208 | 51 |
| Completed | 209 | 198 | 51 |
| Not completed | 6 | 10 | 0 |
| Withdrew: Adverse event | 2 | 0 | 0 |
| Withdrew: Protocol violation | 3 | 7 | 0 |
| Withdrew: Withdrawal by subject | 1 | 3 | 0 |
Pre- and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
| Participants | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Pre-Vaccination 1 (Day 0) Titers at ≥ 10 1/dil | 5 | 2 | 0 |
| Post-Vaccination 1 (Day 21) Titers at ≥ 10 1/dil | 72 | 79 | 0 |
| Post-Vaccination 2 (Day 42) Titers at ≥ 10 1/dil | 90 | 87 | 1 |
Seroprotection: Antibody titer of ≥ 40 1/dil. Antibody titers were determined by the hemagglutination inhibition (HAI) test.
| Participants | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Pre-Vaccination 1 (Day 0) Titers at ≥ 40 1/dil | 5 | 2 | 0 |
| Post-Vaccination 1 (Day 21) Titers at ≥ 40 1/dil | 43 | 42 | 0 |
| Post-Vaccination 2 (Day 42) Titers at ≥ 40 1/dil | 84 | 86 | 1 |
Pre-vaccination and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
| Titers | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Pre-Vaccination 1 (Day 0) GMT | 5.99 (5.10 to 7.04) | 5.48 (4.84 to 6.20) | 5.00 (5.00 to 5.00) |
| Post-Vaccination 1 (Day 21) GMT | 33.3 (23.8 to 46.5) | 45.1 (32.8 to 62.0) | 5.08 (4.92 to 5.24) |
| Post-Vaccination 2 (Day 42) GMT | 368 (271 to 500) | 586 (451 to 763) | 5.64 (4.39 to 7.24) |
Pre-vaccination and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
| Participants | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Pre-Vaccination 1(Day 0) Titers at ≥ 10 1/dil | 7 | 4 | 7 |
| Post-Vaccination 1 (Day 21) Titers at ≥ 10 1/dil | 91 | 88 | 8 |
| Post-Vaccination 2 (Day 42) Titers at ≥ 10 1/dil | 98 | 91 | 8 |
Seroprotection: Antibody titer ≥ 40 1/dil. Antibody titers were determined by the hemagglutination inhibition (HAI) test.
| Participants | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Pre-Vaccination 1 (Day 0) Titers at ≥ 40 1/dil | 5 | 3 | 5 |
| Post-Vaccination 1 (Day 21) Titers at ≥ 40 1/dil | 64 | 68 | 5 |
| Post-Vaccination 2 (Day 42) Titers at ≥ 40 1/dil | 95 | 90 | 6 |
Pre-vaccination and post-vaccination antibody titers were determined by the hemagglutination inhibition (HAI) test.
| Titers | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Pre-Vaccination 1 (Day 0) GMT | 6.01 (5.20 to 6.94) | 5.54 (5.03 to 6.10) | 11.9 (6.17 to 22.9) |
| Post-Vaccination 1 (Day 21) GMT | 74.8 (53.5 to 105) | 104 (77.1 to 140) | 12.1 (6.53 to 22.3) |
| Post-Vaccination 2 (Day 42) GMT | 459 (348 to 605) | 586 (454 to 756) | 14.3 (7.02 to 29.3) |
Solicited Injection Site Reactions: Tenderness, erythema (redness), swelling, induration (hardening), ecchymosis (bruising). Solicited systemic reactions: Fever (temperature), vomiting, crying abnormal, drowsiness, appetite lost, irritability.
| Participants | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Any Solicited Injection Site Reaction - Any Dose | 33 | 23 | 11 |
| Grade (Grd) 3 Injection Site Reaction - Any Dose | 1 | 1 | 0 |
| Any Tenderness - Post Dose 1 | 24 | 14 | 5 |
| Any Tenderness - Post Dose 2 | 19 | 11 | 7 |
| Any Tenderness - Any Dose | 28 | 20 | 10 |
| Grd 3 Tenderness-Crying or movement less, Any Dose | 0 | 1 | 0 |
| Any Erythema - Post Dose 1 | 13 | 4 | 1 |
| Any Erythema - Post Dose 2 | 12 | 5 | 2 |
| Any Erythema - Any Dose | 19 | 7 | 3 |
| Grade 3 Erythema (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Swelling - Post Dose 1 | 4 | 5 | 0 |
| Any Swelling - Post Dose 2 | 3 | 3 | 1 |
| Any Swelling - Any Dose | 6 | 6 | 1 |
| Grade 3 Swelling (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Induration - Post Dose 1 | 6 | 3 | 1 |
| Any Induration - Post Dose 2 | 4 | 3 | 0 |
| Any Induration - Any Dose | 6 | 5 | 1 |
| Grade 3 Induration (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Ecchymosis - Post Dose 1 | 3 | 3 | 0 |
| Any Ecchymosis - Post Dose 2 | 2 | 2 | 0 |
| Any Ecchymosis - Any Dose | 4 | 4 | 0 |
| Grade 3 Ecchymosis (≥ 5 cm) Any Dose | 1 | 0 | 0 |
| Any Solicited Systemic Reaction - Any Dose | 31 | 32 | 11 |
| Any Grade 3 Solicited Systemic Reaction - Any Dose | 3 | 4 | 0 |
| Any Fever - Post Dose 1 | 6 | 2 | 0 |
| Any Fever - Post Dose 2 | 0 | 5 | 1 |
| Any Fever - Any Dose | 6 | 6 | 1 |
| Grade 3 Fever ( ≥102.1 ºF or ≥39.0 ºC) - Any Dose | 0 | 1 | 0 |
| Any Vomiting - Post Dose 1 | 1 | 4 | 0 |
| Any Vomiting - Post Dose 2 | 2 | 3 | 0 |
| Any Vomiting - Any Dose | 3 | 6 | 0 |
| Grade 3 Vomiting (> 6 episodes/24 hr) Any Dose | 0 | 3 | 0 |
| Any Crying Abnormal - Post Dose 1 | 17 | 12 | 5 |
| Any Crying Abnormal - Post Dose 2 | 8 | 9 | 4 |
| Any Crying Abnormal - Any Dose | 20 | 14 | 7 |
| Grade 3 Crying Abnormal (>3 hr) Any Dose | 3 | 2 | 0 |
| Any Drowsiness - Post Dose 1 | 8 | 11 | 3 |
| Any Drowsiness - Post Dose 2 | 8 | 7 | 2 |
| Any Drowsiness - Any Dose | 11 | 11 | 3 |
| Grade 3 Drowsiness (Sleeps most of time) Any Dose | 0 | 1 | 0 |
| Any Appetite Lost - Post Dose 1 | 8 | 12 | 3 |
| Any Appetite Lost - Post Dose 2 | 5 | 9 | 3 |
| Any Appetite Lost - Any Dose | 10 | 14 | 4 |
| Grd 3 Appetite Lost (Refused 3 meals) Any Dose | 0 | 1 | 0 |
| Any Irritability - Post Dose 1 | 23 | 22 | 7 |
| Any Irritability - Post Dose 2 | 14 | 17 | 6 |
| Any Irritability - Any Dose | 26 | 25 | 9 |
| Grade 3 Irritability (Inconsolable) Any Dose | 0 | 2 | 0 |
Solicited Injection Site Reactions: Pain, erythema (redness), swelling, induration (hardening), ecchymosis (bruising). Solicited systemic reactions: Fever (temperature), headache, malaise (feeling unwell), myalgia (muscle aches and pains), shivering.
| Participants | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Any Solicited Injection Site Reaction - Any Dose | 19 | 20 | 5 |
| Grade (Grd) 3 Injection Site Reaction - Any Dose | 0 | 2 | 0 |
| Any Pain - Post Dose 1 | 12 | 12 | 3 |
| Any Pain - Post Dose 2 | 10 | 16 | 2 |
| Any Pain - Any Dose | 17 | 19 | 3 |
| Grade 3 Pain (Incapacitating) - Any Dose | 0 | 2 | 0 |
| Any Erythema - Post Dose 1 | 5 | 7 | 3 |
| Any Erythema - Post Dose 2 | 3 | 9 | 1 |
| Any Erythema - Any Dose | 6 | 12 | 3 |
| Grade 3 Erythema (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Swelling - Post Dose 1 | 1 | 3 | 0 |
| Any Swelling - Post Dose 2 | 0 | 3 | 0 |
| Any Swelling - Any Dose | 1 | 4 | 0 |
| Grade 3 Swelling (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Induration - Post Dose 1 | 2 | 4 | 1 |
| Any Induration - Post Dose 2 | 1 | 3 | 1 |
| Any Induration - Any Dose | 2 | 6 | 1 |
| Grade 3 Induration (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Ecchymosis - Post Dose 1 | 1 | 3 | 2 |
| Any Ecchymosis - Post Dose 2 | 2 | 3 | 0 |
| Any Ecchymosis - Any Dose | 3 | 6 | 2 |
| Grade 3 Ecchymosis (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Solicited Systemic Reaction - Any Dose | 14 | 13 | 3 |
| Any Grade 3 Solicited Systemic Reaction - Any Dose | 1 | 2 | 1 |
| Any Fever - Post Dose 1 | 1 | 1 | 1 |
| Any Fever - Post Dose 2 | 3 | 1 | 0 |
| Any Fever - Any Dose | 4 | 2 | 1 |
| Grade 3 Fever (≥ 102.1 ºF or ≥ 39.0 ºC) -Any Dose | 1 | 1 | 1 |
| Any Headache - Post Dose 1 | 1 | 1 | 1 |
| Any Headache - Post Dose 2 | 0 | 1 | 1 |
| Any Headache - Any Dose | 1 | 2 | 1 |
| Grd 3 Headache (Prevents daily activity) Any Dose | 0 | 0 | 0 |
| Any Malaise - Post Dose 1 | 7 | 6 | 3 |
| Any Malaise - Post Dose 2 | 5 | 6 | 2 |
| Any Malaise - Any Dose | 10 | 9 | 3 |
| Grd 3 Malaise (Prevents daily activity) Any Dose | 1 | 1 | 0 |
| Any Myalgia - Post Dose 1 | 4 | 3 | 2 |
| Any Myalgia - Post Dose 2 | 0 | 2 | 2 |
| Any Myalgia - Any Dose | 4 | 5 | 2 |
| Grd 3 Myalgia (Prevents Daily Activity) Any Dose | 0 | 0 | 0 |
| Any Shivering - Post Dose 1 | 1 | 1 | 0 |
| Any Shivering - Post Dose 2 | 0 | 0 | 0 |
| Any Shivering - Any Dose | 1 | 1 | 0 |
| Grade 3 Shivering (Prevents activity) - Any Dose | 0 | 0 | 0 |
Solicited Injection Site Reactions: Pain, erythema (redness), swelling, induration (hardening), ecchymosis (bruising). Solicited systemic reactions: Fever (temperature), headache, malaise (feeling unwell), myalgia (muscle aches and pains), shivering.
| Participants | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Any Solicited Injection Site Reaction - Any Dose | 70 | 59 | 16 |
| Grade 3 Injection Site Reaction - Any Dose | 3 | 3 | 0 |
| Any Pain - Post Dose 1 | 48 | 42 | 12 |
| Any Pain - Post Dose 2 | 34 | 31 | 8 |
| Any Pain - Any Dose | 63 | 54 | 16 |
| Grade 3 Pain (Incapacitating) - Any Dose | 2 | 0 | 0 |
| Any Erythema - Post Dose 1 | 14 | 14 | 2 |
| Any Erythema - Post Dose 2 | 10 | 5 | 2 |
| Any Erythema - Any Dose | 19 | 15 | 2 |
| Grade 3 Erythema (≥ 5 cm) Any Dose | 1 | 1 | 0 |
| Any Swelling - Post Dose 1 | 5 | 10 | 1 |
| Any Swelling - Post Dose 2 | 5 | 3 | 0 |
| Any Swelling - Any Dose | 8 | 11 | 1 |
| Grade 3 Swelling (≥ 5 cm) Any Dose | 1 | 3 | 0 |
| Any Induration - Post Dose 1 | 7 | 8 | 4 |
| Any Induration - Post Dose 2 | 7 | 2 | 0 |
| Any Induration - Any Dose | 11 | 8 | 4 |
| Grade 3 Induration (≥ 5 cm) Any Dose | 1 | 0 | 0 |
| Any Ecchymosis - Post Dose 1 | 9 | 9 | 1 |
| Any Ecchymosis - Post Dose 2 | 6 | 4 | 1 |
| Any Ecchymosis - Any Dose | 13 | 11 | 2 |
| Grade 3 Ecchymosis (≥ 5 cm) Any Dose | 0 | 0 | 0 |
| Any Solicited Systemic Reaction - Any Dose | 51 | 38 | 12 |
| Any Grade 3 Solicited Systemic Reaction - Any Dose | 5 | 7 | 2 |
| Any Fever - Post Dose 1 | 2 | 1 | 1 |
| Any Fever - Post Dose 2 | 4 | 5 | 1 |
| Any Fever - Any Dose | 6 | 6 | 2 |
| Grade 3 Fever (≥ 102.1 ºF or ≥ 39.0 ºC) - Any Dose | 1 | 3 | 1 |
| Any Headache - Post Dose 1 | 15 | 11 | 5 |
| Any Headache - Post Dose 2 | 13 | 10 | 3 |
| Any Headache - Any Dose | 23 | 19 | 7 |
| Gr 3 Headache (Prevents daily activity) Any Dose | 0 | 4 | 0 |
| Any Malaise - Post Dose 1 | 18 | 12 | 7 |
| Any Malaise - Post Dose 2 | 16 | 14 | 5 |
| Any Malaise - Any Dose | 29 | 24 | 10 |
| Gr 3 Malaise (Prevents daily activity) Any Dose | 3 | 6 | 1 |
| Any Myalgia - Post Dose 1 | 19 | 9 | 1 |
| Any Myalgia - Post Dose 2 | 14 | 11 | 3 |
| Any Myalgia - Any Dose | 32 | 18 | 3 |
| Gr 3 Malaise (Prevents daily activity) Any Dose | 2 | 0 | 0 |
| Any Shivering - Post Dose 1 | 1 | 3 | 1 |
| Any Shivering - Post Dose 2 | 0 | 5 | 1 |
| Any Shivering - Any Dose | 1 | 8 | 2 |
| Grade 3 Shivering (Prevents activity) - Any Dose | 1 | 2 | 0 |
Collected over Adverse events data were collected from the day of vaccination to up to 6 months post-vaccination.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| A/H1N1 Vaccine Group 1 | — | 1/219 (0.5%) | 110/219 (50.2%) |
| A/H1N1 Vaccine Group 2 | — | 0/204 (0%) | 104/204 (51%) |
| Placebo Group | — | 1/51 (2%) | 27/51 (52.9%) |
| Event | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Humerus fractureInjury, poisoning and procedural complications | 0/219 | 0/204 | 1/51 |
| FuruncleInfections and infestations | 1/219 | 0/204 | 0/51 |
| Event | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group |
|---|---|---|---|
| Injection site painGeneral disorders | 80/156 | 73/145 | 19/33 |
| Injectiuon site tendernessGeneral disorders | 28/61 | 20/55 | 10/18 |
| IrritabilityPsychiatric disorders | 26/61 | 25/55 | 9/18 |
| MalaiseGeneral disorders | 39/156 | 33/145 | 13/33 |
| Crying abnormalPsychiatric disorders | 20/61 | 14/55 | 7/18 |
| Appetite lostMetabolism and nutrition disorders | 10/61 | 14/55 | 4/18 |
| HeadacheNervous system disorders | 24/156 | 21/145 | 8/33 |
| MyalgiaMusculoskeletal and connective tissue disorders | 36/156 | 23/145 | 5/33 |
| Injection site erythemaGeneral disorders | 44/217 | 34/201 | 8/51 |
| DrowsinessNervous system disorders | 11/61 | 11/55 | 3/18 |
| Age, Categorical(Participants) | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group | Total |
|---|---|---|---|---|
| <=18 years | 215 | 208 | 51 | 474 |
| Between 18 and 65 years | 0 | 0 | 0 | 0 |
| >=65 years | 0 | 0 | 0 | 0 |
| Age, Continuous(Years) | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group | Total |
|---|---|---|---|---|
| Mean | 4.1 ± 2.8 | 4.3 ± 2.8 | 3.7 ± 2.7 | 4.2 ± 2.8 |
| Sex: Female, Male(Participants) | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group | Total |
|---|---|---|---|---|
| Female | 111 | 99 | 24 | 234 |
| Male | 104 | 109 | 27 | 240 |
| Region of Enrollment(participants) | A/H1N1 Vaccine Group 1 | A/H1N1 Vaccine Group 2 | Placebo Group | Total |
|---|---|---|---|---|
| United States | 215 | 208 | 51 | 474 |
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Sanofi Pasteur, a Sanofi Company