Safety, Tolerability, Immunogenicity and Efficacy of NDV-3A Vaccine in Preventing Recurrent Vulvovaginal Candidiasis

The purpose of the Phase 1b portion of this study is to compare the NDV-3A vaccine, the NDV-3
vaccine and the placebo head-to-head in the patient population of interest (women with RVVC)
to evaluate safety and immunogenicity. The study size for comparing safety and immunogenicity
(N=15 per group) is based on the dose comparison design used in study NDV3-001 (clinical
trials.gov Identifier NCT01273922).

The primary purpose of the Phase 2a portion of this study is to further evaluate safety,
tolerability, and immunogenicity of the NDV-3A vaccine compared to placebo in a patient
population of interest (women with RVVC). The secondary purpose is to determine whether the
NDV-3A vaccine decreases the recurrence rate of VVC in 18-50 year old women with RVVC when
compared to placebo. The study size for evaluating efficacy (N=87 per group) is based on
assuming a 50% rate of VVC recurrences over the 6 month post-vaccination period in the
placebo group and a 50% vaccine efficacy.

Inclusion Criteria:

- Has been informed of the nature of the study and has agreed to and is able to read,
review, and sign the informed consent document prior to Screening.

- Is a female between 18-50 years of age, inclusive, at the time of vaccination on an
acceptable form of birth control.

- Has a current episode of VVC (at Screening/Day -14) that can be confirmed with acute
signs and symptoms of VVC (Composite Questionnaire score of ≥3) and a positive vaginal
mycological culture for C. albicans.

- Has a history of 2 or more documented episodes of VVC in the 12 months prior to
Screening, including at least one of the previous episodes confirmed by positive
results from a diagnostic lab test specific for the presence of Candida. Additional
episodes may be self-reported.

- Has a normal Papanicolaou (Pap) smear from the previous 12 months, or has no
clinically significant abnormalities on a Pap smear taken at study entry as judged and
documented by the investigator(s).

- Is in general good health as judged and documented by the investigator(s)

Exclusion Criteria:

- Reports receiving any systemic or topical vaginal antifungal therapy for 4 weeks prior
to study entry.

- Mycological results from Study Day -14 or earlier cultures taken within 4 weeks prior
to vaccination that show other yeast species (e.g., C. glabrata, C. tropicalis, etc.)
as the cause of vaginitis.

- Has other active infectious cause(s) of vulvovaginitis (e.g., bacterial vaginosis,
Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhea, symptomatic Herpes
Simplex Virus-1 (HSV-1), symptomatic HSV-2, or symptomatic human papilloma virus) at
Screening or other vaginal or vulvar conditions that would confound the interpretation
of clinical response as judged by the investigator(s).

- Will be under treatment or surgery at the start of the study for cervical
intraepithelial neoplasia (CIN) or cervical carcinoma.

- Reports any presence or history of a clinically significant disorder involving the
cardiovascular, respiratory, renal, gastrointestinal, immunologic, hematologic,
endocrine, or neurologic system(s), diagnosed diabetes mellitus (controlled or not) or
psychiatric disease that would confound the interpretation of clinical response as
judged by the investigator(s).

- Reports a history of allergic response(s) or other serious reactions to nickel,
aluminum, or yeast products

- Reports a history of clinically significant allergies including food or drug
allergies, anaphylaxis (or other serious reaction) to vaccines.

- Has a known history of or active infection with hepatitis B, hepatitis C, or human
immunodeficiency virus (HIV).

- Reports receiving or planning to receive any investigational drug, investigational
vaccine, or investigational device within 4 weeks prior to vaccination, and at any
other time during their participation in the study.

- Reports receiving or planning to receive any other live vaccine within 3 weeks prior
to vaccination and for 3 weeks after vaccination.

- Reports having or shows evidence of a recent history of drug or alcohol abuse.

- Reports the use or planned use of any immunosuppressive drugs, including systemic or
topical vaginal corticosteroids, within 4 weeks prior to vaccination, with the
exception of topical steroids (e.g., Over-The-Counter hydrocortisone) used elsewhere
on the body.

- Reports the use or planned use of any medications or treatments that may alter immune
responses to the study vaccine within 3 weeks prior to vaccination

- Reports receiving any blood products within 3 months prior to vaccination and
throughout the study.

- Reports donating blood/plasma within 4 weeks prior to vaccination.

- Is pregnant or intends to become pregnant over the course of the study, breastfeeding,
or has any other medical and/or social (e.g., non-compliant) reason which, in the
opinion of the investigator(s), would prevent participation in the study.