INCLUSION CRITERIA:
A subject must meet all of the following criteria:
1. 18 to 60 years old.
2. Available for clinical follow-up through Week 48.
3. Immunized with the current season FDA-approved influenza vaccine prior to enrollment at the specified interval [14 days to 24 weeks prior to enrollment for the inactivated influenza vaccine OR 30 days to 24 weeks prior to enrollment for the live-attenuated influenza vaccine (FluMist (Trademark))]
4. Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process.
5. Complete an AoU prior to enrollment and verbalize understanding of all questions answered incorrectly.
6. Able and willing to complete the informed consent process.
7. Willing to donate blood for sample storage to be used for future research.
8. In good general health without clinically significant medical history.
9. Physical examination and laboratory results without clinically significant findings and a Body Mass Index (BMI) less than 40 within the 28 days prior to enrollment.
Laboratory Criteria within 28 days prior to enrollment:
10. Hemoglobin greater than or equal to 11.5 g/dL for women; greater than or equal to 13.5 g/dL for men
11. White blood cells (WBC) = 3,300-12,000 cells/mm(3)
12. Differential either within institutional normal range or accompanied by site physician approval
13. Total lymphocyte count greater than or equal to 800 cells/mm(3)
14. Platelets = 125,000 - 400,000/mm(3)
15. Alanine aminotransferase (ALT) less than 1.25 x upper limit of normal (ULN)
16. Serum creatinine less than or equal to 1 x ULN (less than or equal to 1.3 mg/dL for females; less than or equal to 1.4 mg/dL for males)
17. Normal urinalysis, defined as negative glucose, negative or trace protein and no clinically significant blood in the urine.
18. Negative FDA-approved HIV blood test. [Note: Results of HIV enzyme-linked immunosorbent assay (ELISA) will be documented, but a negative HIV polymerase chain reaction (PCR) test result will be sufficient for eligibility screening of subjects with positive HIV ELISA that is due to prior participation in an HIV vaccine study]
19. Negative hepatitis B surface antigen (HBsAg)
20. Negative anti-hepatitis C virus (HCV) antibody and negative HCV PCR.
Female-Specific Criteria:
21. Negative beta-HCG pregnancy test (urine or serum) for women presumed to be of reproductive potential.
22. A female subject must meet one of the following criteria:
No reproductive potential because of menopause [one year without menses] or because of a hysterectomy, bilateral oophorectomy, or tubal ligation,
OR
Agrees to be heterosexually inactive at least 21 days prior to enrollment and through Week 28 of the study,
OR
Agrees to consistently practice contraception at least 21 days prior to enrollment and through Week 28 of the study by one of the following methods:
- condoms, male or female, with or without a spermicide;
- diaphragm or cervical cap with spermicide;
- intrauterine device;
- contraceptive pills, patch, implant or any other FDA-approved contraceptive method;
- male partner has previously undergone a vasectomy.
EXCLUSION CRITERIA:
A subject will be excluded if one or more of the following conditions apply.
Women Specific:
1. Breast-feeding or planning to become pregnant during the first 28 weeks after enrollment in the study.
Subject has received any of the following substances:
2. Immunosuppressive medications, cytotoxic medications, inhaled corticosteroids, or long-acting beta-agonists within the 12 weeks prior to enrollment. [With the exceptions that use of corticosteroid nasal spray for rhinitis; topical corticosteroids for an acute uncomplicated dermatitis; or short-acting beta-agonists in controlled asthmatics; or a short course (duration of 10 days or less or a single injection) of corticosteroids for a non-chronic condition at least 2 weeks prior to enrollment in this study will not exclude study participation.]
3. Blood products within 120 days prior to HIV screening
4. Immunoglobulin within 60 days prior to HIV screening
5. Live attenuated vaccines within 30 days prior to initial study vaccine administration
6. Investigational research agents within 30 days prior to initial study vaccine administration
7. Medically indicated subunit or killed vaccines, e.g. influenza, pneumococcal, or allergy treatment with antigen injections, within 14 days of initial study vaccine administration
8. Current anti-TB prophylaxis or therapy
9. Previous H5 avian influenza investigational vaccine.
Subject has a history of any of the following clinically significant conditions:
10. Autoimmune disease or immunodeficiency.
11. Contraindication to receiving an FDA approved current seasonal influenza vaccination (e.g., egg allergy)
12. Serious adverse reactions to vaccines such as anaphylaxis, urticaria (hives), respiratory difficulty, angioedema, or abdominal pain.
13. Hereditary angioedema (HAE), acquired angioedema (AAE), or idiopathic forms of angioedema.
14. Asthma that is unstable or required emergent care, urgent care, hospitalization or intubation during the past two years or that requires the use of oral or intravenous corticosteroids.
15. Diabetes mellitus (type I or II), with the exception of gestational diabetes.
16. Thyroidectomy or thyroid disease that required medication within the past 12 months.
17. Idiopathic urticaria within the past 2 years
18. Hypertension that is not well controlled by medication or is more than 145/95 at enrollment.
19. Bleeding disorder diagnosed by a doctor (e.g. factor deficiency, coagulopathy, or platelet disorder requiring special precautions) or significant bruising or bleeding difficulties with IM injections or blood draws.
20. Malignancy that is active or treated malignancy for which there is not reasonable assurance of sustained cure or malignancy that is likely to recur during the period of the study.
21. Seizure disorder other than: 1) febrile seizures under the age of two, 2) seizures secondary to alcohol withdrawal more than 3 years ago, or 3) a singular seizure not requiring treatment within the last 3 years.
22. Asplenia, functional asplenia or any condition resulting in the absence or removal of the spleen.
23. Allergic reaction to aminoglycoside antibiotics.
24. Guillain-Barr Syndrome.
25. Psychiatric condition that precludes compliance with the protocol; past or present psychoses; past or present bipolar disorder; disorder requiring lithium; or within 5 years prior to enrollment, a history of suicide plan or attempt.
26. Any medical, psychiatric, social condition, occupational reason or other responsibility that, in the judgment of the investigator, is a contraindication to protocol participation or impairs a volunteer's ability to give informed consent.
National Institutes of Health Clinical Center
Bethesda, Maryland 20892. Last update: 01/30/2009