Efficacy and Immunogenicity of Norovirus GI.1/GII.4 Bivalent Virus-like Particle Vaccine in Adults

The vaccine being tested in this study is called NoV GI.1/GII.4 bivalent virus-like particle
(VLP) vaccine adjuvanted with aluminum hydroxide. The norovirus vaccine is being tested to
prevent acute gastroenteritis (AGE) due to genotype-specific (GI.1 and GII.4) norovirus
strains in healthy participants recruited from US military training installations. This study
will look at the illness rate of AGE occurring > 7 days after dosing due to genotype-specific
(GI.1 or GII.4) NoV strains represented in the vaccine.

The study will enroll between 2800 and 8700 patients. Participants will be randomly assigned
(by chance, like flipping a coin) to one of the two treatment groups—which will remain
undisclosed to the patient and study doctor during the study (unless there is an urgent
medical need):

- NoV GI.1/GII.4 bivalent VLP vaccine

- Placebo (dummy inactive solution) - this is a liquid that looks similar to the study
drug but has no active ingredient

All participants will receive one dose of study medication on Day 1 administered via
intramuscular injection.

This multi-center trial will be conducted in the United States at select military locations.
The overall time to participate in this study is up to 45 days for participants in the Navy
53 days for participants in the Air Force, and 72 days for participants in the Marines.
Participants will make multiple visits to the clinic, including a final visit on the last day
of study participation (Day 45, 53 or 72) for a follow-up assessment.

Inclusion Criteria:

1. Participant signs and dates a written, informed consent form and any required privacy
authorization prior to the initiation of any trial procedures after the nature of the
trial has been explained according to local regulatory requirements.

2. Male or female participants, 18 to 49 years of age.

3. Is in good health at the time of entry into the trial as determined by medical history
and the clinical judgment of the investigator.

4. Can comply with trial procedures and are available for the duration of follow-up.

Exclusion Criteria:

1. Pregnancy.

2. Has known hypersensitivity to any of the Norovirus (NoV) GI.1/GII.4 bivalent
virus-like particle (VLP) vaccine components (including excipients).

3. Has known hypersensitivity or allergy to any of the licensed required concomitant
vaccine components to be administered (including excipients of these vaccines).

4. Has any condition or circumstance that the investigator determines would interfere
with trial evaluation or interpretation.

5. Has known or suspected impairment or alteration of immune function.

6. Has a history of acute gastroenteritis (AGE) within 14 days of enrollment.

7. Has a history of body temperature of 38.0°C (100.4°F) or higher within 3 days of
intended trial vaccination.

8. Has received blood, blood products, and/or plasma derivatives or any parenteral
immunoglobulin antibody preparation in the past 3 months.

9. Immunosuppressive therapy within 3 months or systemic (e.g., oral or parenteral)
corticosteroid treatment within 60 days prior to investigational trial dose
administration.

10. Is participating in any clinical trial with another investigational product 30 days
prior to the first trial visit or intending to participate in another clinical trial
at any time during the conduct of this trial.

11. Participants who are first-degree relatives of individuals involved in the conduct of
the trial.

12. Has any history of progressive or severe neurologic disorder, seizure disorder or
neuro-inflammatory disease (e.g. Guillain-Barré syndrome).

13. Has history or any illness that, in the opinion of the investigator, might interfere
with the results of the trial or pose additional risk to the participants due to
participation in the trial.

14. Has received any other vaccines within 14 days (for inactivated vaccines) or 28 days
(for live vaccines) prior to enrollment in this trial with the exception of routine
immunizations as per Military Procedures.

15. If female of childbearing potential, sexually active, and has not used any of the
"acceptable contraceptive methods" for at least 2 months prior to trial entry:

1. Of childbearing potential is defined as status post onset of menarche and not
meeting any of the following conditions: menopausal for at least 2 years, status
after bilateral tubal ligation for at least 1 year, status after bilateral
oophorectomy, or status after hysterectomy.

2. Acceptable birth control methods are defined as one or more of the following:

- Hormonal contraceptive (such as oral, injection, transdermal patch, implant,
cervical ring).

- Barrier (condom with spermicide or diaphragm with spermicide) each and every
time during intercourse.

- Intrauterine device (IUD).

- Monogamous relationship with vasectomized partner. Partner must have been
vasectomized for at least six months prior to the participants' trial entry.

16. If female of childbearing potential and sexually active, refusal to use an "acceptable
contraceptive method" from Day 1 through 6 months after the last dose of trial
vaccine. In addition, they must be advised not to donate ova during this period.

17. Has any positive or indeterminate pregnancy test.