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RecruitingNCT07050732STRIVEUpdated Dec 12, 2025

Immunogenicity of RSVPreF3 Vaccine in Immunocompromised Persons

A Phase 2 interventional study of Arexvy (2 doses total) and Arexvy (3 doses total) in Respiratory Syncytial Virus (RSV), sponsored by Johns Hopkins University. Recruiting at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-12-12.

Sponsored by Johns Hopkins University · Phase 2, Interventional, and Prevention

From the registry’s dates

  • Started Dec 2025; still recruiting 10 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
170
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This clinical trial is being done to learn more about how well a vaccine (Arexvy®) for respiratory syncytial virus, also known as RSV, works in people with weakened immune systems. The main questions it aims to answer are:

  • Does 1 or 2 doses of Arexvy work better in people with weakened immune systems?
  • What medical problems do participants have after receiving Arexvy?

Participants with weakened immune systems will:

  • Receive 3 study vaccines over the course of 1 year
  • Keep a diary of symptoms for 7 days after each vaccine
  • Have 3 in-person follow up study visits for checkups and tests over the course of 1.5 years
  • Have 6 phone follow up study visits over the course of 1.5 years
Read the detailed description

People with weakened immune systems will be randomized to either:

  1. Receive one dose of Arexvy followed by a placebo vaccine (sterile saline) 60 days later, or
  2. Receive one dose of Arexvy followed by another dose of Arexvy 60 days later

Both groups will also receive another dose of Arexvy 1 year after the first dose.

A small group of people without weakened immune systems will also be enrolled in the study. This group will receive one dose of Arexvy.

02

Conditions studied

  • Respiratory Syncytial Virus (RSV)
03

In context

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,783 studies on the registry; 313 are open to participants now.

Of its 203 completed or terminated interventional studies of FDA-regulated products, 140 (69%) have results posted.

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

04

Who can participate

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

Inclusion criteria

  • Able to understand and provide informed consent
  • Willing and able to comply with the requirements and restrictions in the protocol, including study visits and study-related procedures
  • Medically stable in the opinion of the Investigator at the time of first study vaccination
  • Life expectancy ≥ 365 days in the opinion of the Investigator at the time of first study vaccination
  • Included in at least one of the groups below:

    1. Cellular therapy recipients (CTR):

      • Individuals ≥ 18 years of age at the time of first study vaccination
      • History of at least one of the following: i. Autologous stem cell transplant received more than 90 days prior to first study vaccination, ii. Allogeneic stem cell transplant received more than 90 days prior to first study vaccination, iii. Chimeric antigen receptor T cell (CAR-T) therapy received more than 90 days prior to first study vaccination
    2. Solid organ transplant recipients (SOTR):

      • Individuals ≥ 18 years of age at the time of first study vaccination
      • Received an ABO-compatible, single-organ type, solid organ transplant (lung, heart, kidney, liver) at least 90 days prior to first study vaccination, and are on at least 2 systemic immunosuppressive agents at time of first study vaccination
    3. Healthy comparator (HC):

      • Individuals ≥ 60 years of age at the time of first study vaccination or 50-59 years of age at the time of first study vaccination and at increased risk of severe RSV disease
      • No history of (a) or (b) above, and considered healthy or with chronic and stable medical conditions in the opinion of the Investigator, without immune compromise
  • Participants of childbearing potential if practicing adequate contraception or abstinence from 1 month prior to first study vaccination and agree to continue adequate contraception or abstinence through at least 1 month after last study vaccination. All participants of childbearing potential must have a negative pregnancy test on the day of first study vaccination, prior to administration.

Exclusion criteria

Exclusion Criteria:

  • Known history of hypersensitivity to any vaccine or history of a life-threatening reaction to a vaccine
  • Previous vaccination with any licensed or investigational RSV vaccine
  • Acute or chronic clinically significant/unstable neurological disease (such as uncontrolled seizures, strokes, Guillain-Barré Syndrome (GBS)
  • Vaccination with any inactivated, subunit, or split influenza vaccine or COVID-19 vaccine within 14 days prior to first study vaccination, or vaccination with any other licensed or investigational vaccine within 30 days prior to first study vaccination
  • Receipt of investigational or approved monoclonal antibodies against RSV within 90 days prior to first study vaccination
  • Moderate or severe acute illness/infection (in opinion of the Investigator) or febrile illness (temperature ≥ 38.0°C [≥ 100.4°F]) on the day of first study vaccination. A prospective participant should not be enrolled in the study until the condition has resolved or the febrile event has subsided.
  • Any medical condition that in the opinion of the Investigator would make intramuscular injection unsafe
  • Receipt of immunoglobulins or plasma products within 90 days prior to first study vaccination
  • Receipt of B-cell depleting medications (e.g., Rituximab, ocrelizumab, ofatumumab, belimumab, epratuzumab, antithymocyte globulin) within 90 days prior to first study vaccination
  • Currently pregnant or breastfeeding or planning to become pregnant, discontinue contraception, or breastfeed during the study period
  • Any of the following:

    1. Cellular therapy recipients (CTR):

      • Graft-versus-host disease (GVHD) requiring systemic treatment with at least 0.5 mg/kg per day of prednisone or equivalent at time of first study vaccine
    2. Solid organ transplant recipients (SOTR):

      • History of any of the following within 90 days prior to first study vaccination: allograft rejection, post-transplant lymphoproliferative disease, treatment for either of these conditions
    3. Healthy comparator (HC):

      • Any confirmed/suspected immunosuppressive or immunodeficient condition resulting from disease or immunosuppressive or cytotoxic therapy, based on medical history
  • Any other conditions which, in the opinion of the Investigator, may pose additional risks from participation in the study, may interfere with the individual's ability to comply with study requirements or may impact the quality or interpretation of the data obtained from the study
05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
170 participants (estimated)

Study arms

  • Experimental
    Arm 1: Arexvy + Placebo

    One dose of adjuvanted RSVPreF3 (Arexvy) at enrollment followed by placebo vaccine at Day 60 plus a re-vaccination Arexvy dose at 1 year (Day 365)

    Biological: Arexvy (2 doses total) · Other: Placebo

  • Experimental
    Arm 2: Arexvy + Arexvy

    One dose of adjuvanted RSVPreF3 (Arexvy) at enrollment followed by a second dose of Arexvy at Day 60 plus a re-vaccination Arexvy dose at 1 year (Day 365)

    Biological: Arexvy (3 doses total)

  • Experimental
    Arm 3: Healthy Comparators

    One dose of adjuvanted RSVPreF3 (Arexvy) at enrollment

    Biological: Arexvy (1 dose total)

Interventions

  • BiologicalArexvy (2 doses total)

    Arexvy at enrollment, Arexvy at Day 365

    Also known as: adjuvanted RSVPreF3

  • BiologicalArexvy (3 doses total)

    Arexvy at enrollment, Day 60, and Day 365

    Also known as: adjuvanted RSVPreF3

  • BiologicalArexvy (1 dose total)

    Arexvy at enrollment

    Also known as: adjuvanted RSVPreF3

  • OtherPlacebo

    Placebo vaccine at day 60

06

What researchers measure

Primary outcomes

  1. Geometric Mean Titer (GMT) (ED60 RSV A and B)

    Immune response elicited by adjuvanted RSVPreF3 (Arexvy) in immunocompromised adults as determined by titers of neutralizing antibody estimated dilution 60 (ED60) against RSV A and B

    Time frame: At 30 days post 1st and 2nd dose in Arm 1 and Arm 2

  2. Immune response elicited by adjuvanted RSVPreF3 (Arexvy) in immunocompromised adults as determined by titers of neutralizing antibody ED60 against RSV A and B

    Mean Geometric Increase (MGI): Geometric mean of individual ratio of post-vaccine ED60 of RSV A and B over baseline titer (also called Geometric Mean Fold Rise \[GMFR\])

    Time frame: At 30 days post 2nd dose (Arm 2) and 30 days post 1st dose (Arm 1)

Secondary outcomes

  1. Proportion of participants reporting reactions at injection site

    Solicited local reactions including pain at injection site, erythema, and swelling

    Time frame: Within 7 days of study vaccine administration

  2. Proportion of participants reporting systemic events

    Solicited systemic events including headache, fever, myalgia, arthralgia

    Time frame: Within 7 days of study vaccine administration

  3. Proportion of participants reporting adverse events

    Proportion of participants reporting adverse events

    Time frame: Through 30 days after each study vaccine administration

  4. Adverse events of special interest

    Proportion of participants reporting adverse events of special interest

    Time frame: From enrollment to last study visit, approximately 18 months for Arms 1 and 2 and 12 months for Arm 3

  5. Serious adverse events

    Proportion of participants reporting serious adverse events

    Time frame: Through 6 months following each study vaccine administration

  6. Individual titers (ED60) for RSV-A and RSV-B #1

    GMT

    Time frame: 30 days post one year re-vaccination (Arm 1 and Arm 2)

  7. Individual titers (ED60) for RSV-A and RSV-B #2

    GMT

    Time frame: 30 days post 1st dose (Pooled Arm 1 and Arm 2; and Arm 3)

  8. Individual titers (ED60) for RSV-A and RSV-B #3

    GMFR

    Time frame: 30 days post 1st dose (Pooled Arm 1 and Arm 2; and Arm 3)

  9. Individual titers (ED60) for RSV-A and RSV-B #4

    GMFR

    Time frame: 30 days post 2nd dose (Arm 2)

  10. Individual titers (ED60) for RSV-A and RSV-B #5

    Seroresponse rate (% of participants with at least a 4-fold increase from baseline in RSV A and RSV B ED60)

    Time frame: At 30 days after each study vaccine administration

  11. Individual titers (ED60) for RSV-A and RSV-B #6

    GMFR

    Time frame: At 30 days post a one year re-vaccination (Arm 1 and Arm 2)

  12. Cell mediated immunity (RSV F specific CD4+ and CD8+ T cell response (T cells producing ≥ 2 cytokines, expressed as % of live CD3+)) #1

    Median cell mediated immunity (CMI)

    Time frame: At 30 days post 2nd dose (Arm 2) and 30 days post 1st dose (pooled Arm 1 and 2; and Arm 3)

  13. Cell mediated immunity (RSV F specific CD4+ and CD8+ T cell response (T cells producing ≥ 2 cytokines, expressed as % of live CD3+)) #2

    Median CMI

    Time frame: At 30 days post 1st dose (Pooled Arm 1 and Arm 2; and Arm 3)

  14. Cell mediated immunity (RSV F specific CD4+ and CD8+ T cell response (T cells producing ≥ 2 cytokines, expressed as % of live CD3+)) #3

    Median CMI

    Time frame: At 30 days post one year re-vaccination (Arm 1 and Arm 2)

07

Study locations

1 of 1 sites recruiting
  • Johns Hopkins University
    Baltimore, Maryland 21205, United States
    • John Baddley, MD · Contact · jbaddle1@jh.edu · 443-287-1964
    • John Baddley, MD · Principal investigator
    Recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 12, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07050732
Lead sponsor
Johns Hopkins University
Collaborators
GlaxoSmithKline
Responsible party
Sponsor
First posted
Jul 3, 2025
Start date
Dec 4, 2025
Primary completion
Nov 2026 (estimated)
Completion
Apr 2028 (estimated)
Last update
Dec 12, 2025

Study contacts

John Baddley, MD
Contact
jbaddle1@jh.edu
443-287-1964
John Baddley, MD
principal investigator · Johns Hopkins University

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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