Clinical Immunization Safety Assessment (CISA) Project: Pilot Study to Assess the Effect of Prophylactic Antipyretics on Immune Responses and Fever After IIV



Status:Completed
Conditions:Infectious Disease
Therapuetic Areas:Immunology / Infectious Diseases
Healthy:No
Age Range:Any
Updated:4/21/2016
Start Date:October 2013
End Date:March 2014

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Pilot Study to Assess the Effect of Prophylactic Antipyretics on Immune Responses and Rates of Fever After 2013-2014 Inactivated Influenza Vaccine (IIV) in Young Children

The study team aims to conduct a double-blind, placebo-controlled, pilot study to assess the
effect of prophylactic antipyretics on the immune responses and rates of fever after
inactivated influenza vaccine (IIV) in children 12 through 35 months of age. In this pilot,
40 healthy children, 12 through 35 months of age, including some children at risk of febrile
seizure, will be randomized to receive prophylactic acetaminophen or oral placebo
immediately following and every 4 to 6 hours in the 24 hours after receipt of a dose of IIV.
Data derived from the pilot study will be used to assess the feasibility of conducting a
larger scale study. Feasibility will include assessments of the speed and ease of study
recruitment and adherence to and completion of study assessments. Children will be followed
for the occurrence of fever, fussiness, changes in appetite and sleep patterns, and use of
medical services on the day of and day following vaccination. Antibody to influenza antigens
contained in the 2013-2014 vaccine as measured by hemagglutination inhibition (HAI) antibody
will be assessed at baseline and four weeks following vaccination. The proportions of
children experiencing fever, having solicited reactions, using medical services,
demonstrating a serologic response corresponding to seroprotection and seroconversion to
each of the IIV antigens will be determined for groups of children receiving acetaminophen
and placebo. Likewise geometric mean HAI titers (GMT) and corresponding 95% confidence
intervals for each IIV antigen will be calculated for both vaccine groups.


Inclusion Criteria:

To be eligible for inclusion in the study the following enrollment criteria must be met:

1. The child must be 12 through 35 months of age.

2. The child must only need a single dose of IIV during the current season. (Children
only need 1 dose of vaccine in 2013-14 if they received a total of 2 or more doses of
seasonal vaccine since July 1, 2010. Children who did not receive a total of 2 or
more doses of seasonal vaccine since July 1, 2010 require 2 doses in 2013-14).[19]

3. The parent/guardian must be willing and capable of providing written informed consent
for the child.

4. The parent/guardian must be available for follow-up and must at minimum have
telephone access.

5. The parent/guardian must agree to sign a medical release for the child so that study
personnel may obtain medical information about the child's health (if needed).

Exclusion Criteria:

Participants must not have any of the following:

1. History of receipt of current year's licensed influenza vaccine.

2. History of a severe allergic reaction (e.g. anaphylaxis) to any component of
influenza vaccine, including egg protein, formaldehyde, octylphenol ethoxylate,
gelatin, or thimerosal if using thimerosal containing vaccine.

3. History of a severe allergic reaction (e.g. anaphylaxis) following a prior dose of
influenza vaccine.

4. History of an allergic reaction following acetaminophen or ingredients in the
acetaminophen product.

5. History of an allergic reaction following ibuprofen or ingredients in the ibuprofen
product.

6. History of liver disease.

7. Currently taking the blood thinning drug warfarin (Coumadin).

8. Received any other licensed vaccines within 14 days (for inactivated vaccines) or 28
days (for live vaccines) prior to vaccination in this study or expects to receive a
licensed vaccine during the 28 days following the last vaccination in this study.
Concomitant vaccinations are not allowed.

9. Routine immunizations are delayed or will be delayed by not being able to receive a
concomitantly administered vaccine or a needed vaccine in the 28 days following
receipt of the influenza vaccine.

10. Received an experimental/investigational agent (vaccine, drug, biologic, device,
blood product, or medication) within 28 days prior to vaccination in this study, or
expects to receive an experimental/investigational agent within the follow-up time
period (28 days after the last vaccination in this study).

11. A moderate to severe acute illness and/or a reported temperature greater than or
equal to 100.0°F (37.8°C) within 72 hours prior to first dose of IIV or an axillary
temperature greater than or equal to 100.0°F (37.8°C) at the time of enrollment.
(This may result in a temporary delay of vaccination).

12. Receipt of an antipyretic medication (acetaminophen or ibuprofen) within 72 hours
prior to the first dose of IIV (This may result in a temporary delay of vaccination)
or is already planning to administer a prophylactic antipyretic medication on the day
of and the day following IIV (this exclusion does not apply if the caretaker
indicates he/she might administer antipyretics after vaccination to reduce a fever).

13. Immunosuppression as a result of an underlying illness or treatment, or use of
anti-cancer chemotherapy or radiation therapy within the preceding 36 months.

14. Long term (at least 14 days of prednisone 2 mg/kg/day or equivalent other
glucocorticoid), any parenteral steroids, high-dose inhaled steroids (>800 mcg/day of
beclomethasone dipropionate or equivalent) within the preceding 6 months (topical and
nasal steroids are allowed).

15. History of Guillain-Barré syndrome within 6 weeks of a prior dose of influenza
vaccine.

16. Has any condition that would, in the opinion of the site investigator, place the
participant at an unacceptable risk of injury or render the participant unable to
meet the requirements of the protocol.
We found this trial at
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Durham, North Carolina
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Durham, NC
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