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Impact of a Fourth Hexavalent Vaccine After Hematopoietic Stem Cell Transplantation

NCT03402776 — Phase 3, Unknown, 200 participants, University Hospital, Grenoble

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Impact of a Fourth Hexavalent Vaccine Dose During Primary Vaccination After Haematopoietic Stem Cell Transplantation

RegistryNCT03402776, acronym EVaxAll
StatusUnknown
PhasePhase 3
Study typeInterventional; randomized, parallel, masking: none, prevention
Enrollment200 (Estimated)
SponsorUniversity Hospital, Grenoble (Other); collaborators: Centre Hospitalier Universitaire de Nice, University Hospital, Clermont-Ferrand, University Hospital of Saint-Etienne, Centre Hospitalier Universitaire de Besancon
ConditionsHaemopoietic Stem Cell Transplantation, Allograft
Interventions4th dose of hexavalent vaccine 1 month after the 3rd dose (Drug)
Datesstart 2018-05-01, primary completion 2020-05-31 (estimated), completion 2021-05-01 (estimated), first posted 2018-01-18, last updated 2018-06-06
Locations1 site in France

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-Summary

It is recommended for patients who underwent an hematopoietic stem cell transplantation to receive 6 months after the graft 3 injections of hexavalent vaccine (diphteria-tetanus- poliomyelitis-pertussis-Hib-HBV) within 2 months followed by a booster dose one month after. The patients included in the study will have a measure of their antibody level against 5 pathogens (diphteria toxin, tetanus toxin, Haemophilus influenza b, hepatitis B virus, poliomyelitis virus) one month after the 3rd injection of hexavalent vaccine. If the antibody response is not sufficient, they will be randomized for a 4th dose in the following month. The antibody response will be again measured one month after the 1 year booster dose.

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+Detailed description

It is recommended for patients who underwent an hematopoietic stem cell transplantation to receive, 6 months after the graft, 3 injections of hexavalent vaccine (diphteria-tetanus- poliomyelitis-pertussis-Hib-HBV) within 2 months, followed by a booster dose one yrar after. However, this strategy do not constantly lead to efficient antibody levels.

the investigators aim to determine whether a 4th dose in the initial vaccine schedule (month 0, 1, 2, and 3) allows to obtain a better response.

After informed consent, the investigators will recruit 6 months after the graft 200 patients who had received an hematopoietic stem cell transplantation . The participants will have a measure of their antibody level against 5 pathogens (diphteria toxin, tetanus toxin, Haemophilus influenza b, hepatitis B virus, poliomyelitis virus) at month 0 (before the 1st hexavalent vaccine injection), and one month after the 3rd injection of this vaccine. If the antibody response is not sufficient, they will be randomized for a 4th dose in the following month.

The one year booster dose will be then injected to all participants, and the antibody response will be again measured one month after this dose. The primary endpoint is to compare the antibody levels at this date in patients who had an unsufficient immune response after the 3rd dose and who received or not a 4rth dose in the initial vaccine schedule.

+Arms and interventions

ArmTypeInterventionsDescription
good resp. after 3 vacc. inject.No interventionno randomization for a 4th dose.
bad resp. after 3 vacc. inj., 4th injExperimentalDrug: 4th dose of hexavalent vaccine 1 month after the 3rd doseAfter randomization, these patients will receive a 4th dose one month after the 3rd dose.
bad resp. after 3 vacc. inj., no 4th injNo interventionAfter randomization, these patients will not receive a 4th dose one month after the 3rd dose.
  • 4th dose of hexavalent vaccine 1 month after the 3rd dose (Drug): 4th dose of hexavalent vaccine 1 month after the 3rd dose

+Outcome measures

Primary outcomes

  • antibody response 1 month after the one year booster dose [1 month after the one year booster dose]: antibody level against 5 pathogens (diphteria toxin, tetanus toxin, Haemophilus influenza b, hepatitis B virus, poliomyelitis virus) one month after the 3rd injection of hexavalent vaccine

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* having received an HSTC 6 months before (not more than 2 years)
* not receiving immunosuppressive therapy at inclusion

Exclusion Criteria:

* having received an HSTC 6 months more than 2 years before
* receiving immunosuppressive therapy at inclusion

+Locations (1)

FacilityCityCountryStatus
University HospitalGrenobleFranceRecruiting

+Publications

  • Results publication: Epaulard O, Carre M, Hermet E, Corbin V, Tavernier E, Botelho-Nevers E, Daguindau E, Brunel AS, Rohrlich PS, Risso K, Gallet S, Gonnet N, Touati S, Manceau M, Thiebault A. Antibody response to tetanus, diphtheria, poliomyelitis, hepatitis B, and H. influenzae b vaccines in allogeneic hematopoietic stem cell transplant adult recipients: A multicenter trial. PLoS One. 2025 Oct 27;20(10):e0335224. doi: 10.1371/journal.pone.0335224. eCollection 2025. PMID 41144397

+Investigators

  • Olivier EPAULARD, MD, PhD, Principal investigator, University Hospital, Grenoble

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