Safety and Immunogenicity of a Monovalent Inactivated Influenza H3N2 Variant (H3N2v) Vaccine in Pediatric Populations

This is a Phase II open-label study in approximately 240 (up to 400) healthy males and
non-pregnant females, 6 months to 17 years old, inclusive. This study is designed to assess
the safety, reactogenicity, and immunogenicity of two doses administered intramuscularly
approximately 21 days apart of an unadjuvanted subvirion monovalent inactivated influenza
H3N2 variant (H3N2v) vaccine (MIV) manufactured by sanofi pasteur. Subjects will be
stratified by age (approximately 120 (up to 200) subjects 6-35 months old, approximately 60
(up to 100) subjects 3-8 years old, and approximately 60 (up to 100) subjects 9-17 years
old). Subjects in the 6-35 months old cohort will be randomized to receive either two doses
of H3N2v MIV, administered intramuscularly as 7.5 micrograms (mcg) of hemagglutinin
(HA)/0.25 milliliter (mL) dose (approximately 60 (up to 100) subjects), approximately 21
days apart, or two doses of H3N2v MIV, administered intramuscularly as 15mcg HA/0.5mL dose
(approximately 60 (up to 100) subjects), approximately 21 days apart. All subjects in the
3-8 years old cohort and 9-17 years old cohort will receive two doses of H3N2v MIV,
delivered intramuscularly as 15mcg HA/0.5mL dose, approximately 21 days apart. Subjects may
receive licensed seasonal influenza vaccine prior to (>2 weeks if given the inactivated
vaccine or >4 weeks if given the live, attenuated vaccine) the first H3N2v vaccination.
Alternatively, subjects may receive licensed seasonal influenza vaccine at any time after
completion of Visit 05 or following an early termination visit. Safety will be measured by
the occurrence of solicited injection site and systemic reactogenicity from the time of each
H3N2v vaccination through 7 days after each H3N2v vaccination. Unsolicited non-serious
adverse events (AEs) will be collected from the time of the H3N2V vaccination (Day 0 (Visit
01)) through approximately 21 days after the last H3N2v vaccination (approximately Day 42
(Visit 05) for subjects who receive two H3N2v vaccinations; approximately Day 21 (Visit 03)
for subjects who receive only one H3N2v vaccination). After approximately 21 days after the
last H3N2v vaccination, non-serious AEs will be limited to new-onset chronic medical
conditions, which will be documented through approximately 7 months after the first H3N2v
vaccination (Visit 08). Serious adverse events (SAEs) will be collected from the time of the
first H3N2v vaccination (Day 0 (Visit 01)) through approximately 7 months after the first
H3N2v vaccination (Visit 08). Immunogenicity testing will include performing
hemagglutination inhibition (HAI) and neutralizing (Neut) antibody assays on serum obtained
prior to each H3N2v vaccination (Day 0 (Visit 01) and approximately Day 21 (Visit03)) and
approximately 21 days after the second H3N2v vaccination (Visit 05).

Inclusion Criteria:

1. Parent(s)/legal guardian(s) must provide written informed consent (parental
permission) and subjects must provide written assent as appropriate for age per local
IRB and 45 CFR 46 requirements prior to initiation of any study procedures.

2. Parent(s)/legal guardian(s) and subjects as appropriate must be willing and able to
comply with planned study procedures and be available for all study visits.

3. Are males or non-pregnant females aged 6 months to 17 years old, inclusive.

4. Are in good health, as determined by medical history and targeted physical
examination based on medical history.

5. Axillary temperature is less than 100°F, or oral temperature is less than 101°F.

6. Females of childbearing potential (status as determined by local IRB guidelines for
minimum age requirements, and/or by occurrence of menarche and not having reached
menopause >/=1 year or not having been surgically sterilized via tubal ligation,
bilateral oophorectomy or hysterectomy) must agree to practice adequate contraception
(abstinence from sexual intercourse with males, monogamous relationship with a
vasectomized partner who was vasectomized at least 6 months prior to the subject
receiving the first H3N2v vaccination, barrier methods such as condoms or diaphragms
with spermicide or foam, effective intrauterine devices (IUDs), NuvaRing®, successful
Essure® placement (permanent, non-surgical, non-hormonal sterilization) with
documented confirmation test at least 3 months after the procedure, licensed hormonal
methods such as implants, injectables or oral contraceptives ("the pill"), and any
other Food and Drug Administration (FDA) approved birth control method) for at least
30 days prior to the first H3N2v vaccination through at least 30 days after the last
H3N2v vaccination. Method of contraception will be captured on the appropriate data
collection form.

7. Females of childbearing potential must have a negative urine or serum pregnancy test
within 24 hours prior to each H3N2v vaccination.

Exclusion Criteria:

1. Have an acute illness, including an axillary temperature greater than or equal to
100°F or an oral temperature greater than or equal to 101°F, within 3 days prior to
each H3N2v vaccination.

2. Have any condition that, in the opinion of the site principal investigator or
appropriate sub-investigator, would place the subject at an unacceptable risk of
injury, render them unable to meet the requirements of the protocol or confound the
interpretation of results.

3. Have immunosuppression as a result of an underlying illness or treatment, or use of
anticancer chemotherapy or radiation therapy within the preceding 36 months.

4. Have known active neoplastic disease or a history of any hematologic malignancy.

5. Have known HIV, hepatitis B, or hepatitis C infection.

6. Have a known allergy to eggs, egg or chicken protein, or other components of the
H3N2v MIV (including octylphenol ethoxylate (Triton® X-100), gelatin, formaldehyde,
and phosphate buffered saline).

7. Have a history of severe reactions following previous immunization with licensed
influenza virus vaccines.

8. Have a history of Guillain-Barré Syndrome.

9. Have a history of alcohol or drug abuse in the past 5 years.

10. Have any diagnosis, current or past, of schizophrenia, bipolar disease, or other
major psychiatric diagnosis or a static or progressive neurodevelopmental disorder
(e.g. Cerebral palsy with mental retardation).

11. Have been hospitalized for psychiatric illness, history of suicide attempt, or
confinement for danger to self or others, within the past 10 years.

12. Have taken oral or parenteral corticosteroids of any dose within the past 4 weeks.

13. Have taken high-dose inhaled corticosteroids within the past 4 weeks. High dose
defined as >840mcg/day (children 12-17 years of age) or >672mcg/day (children <12
years of age) of beclomethasone dipropionate CFC or equivalent.

14. Have used any topical steroid daily for more than 3 weeks within the past 3 months.

15. Received any licensed live vaccine within 4 weeks or any licensed inactivated vaccine
within 2 weeks prior to the first H3N2v vaccination or planned receipt of any vaccine
within 42 days after the first H3N2v vaccination. This is inclusive of licensed
seasonal influenza vaccines and routine childhood immunizations provided outside the
scope of this study.The initiation of this protocol does not take precedence over
routine childhood immunizations.

16. Received immunoglobulin or other blood products (with exception of Rho D
immunoglobulin) within 3 months prior to each H3N2v vaccination.

17. Received an experimental agent (vaccine, drug, biologic, device, blood product, or
medication) within 1 month prior to the first H3N2v vaccination.

18. Are participating or plan to participate in another clinical trial with an
interventional agent (licensed or unlicensed vaccine, drug, biologic, device, blood
product, or medication) during the 7-month study period.

19. Are enrolled or plan to enroll in another clinical trial that has a study
intervention such as a drug, biologic, device, blood product, or medication that
could interfere with the safety assessment of the investigational product at any time
during the 7-month study period.

20. Participated in an influenza A/H3N2v vaccine study in the past in a group receiving
vaccine (does not apply to documented placebo recipients) or have a history of
A/H3N2v infection prior to enrollment.

21. Plan to travel outside the US (continental US, Hawaii and Alaska) in the time between
the first H3N2v vaccination and 42 days after the first H3N2v vaccination.

22. Females who are breastfeeding or plan to breastfeed at any given time during the
7-month study period.

23. Occupational exposure to or substantial direct physical contact with pigs in the past
year or during the 42 days after the first H3N2v vaccination. Casual contact with
pigs at petting zoos or county or state fairs, for example,does not exclude subjects
from study participation.