Co-Administration of AS03 Adjuvanted A/H7N9 IIV With IIV4
Co-Administration of AS03 Adjuvanted A/H7N9 IIV With IIV4
This is a randomized, un-blinded, Phase II study in males and non-pregnant females, who are
 in good health, 19 to 64 years of age. This study is designed to assess the safety,
 reactogenicity, and immunogenicity of a pre-pandemic AS03 (GSK) adjuvanted 2017 monovalent
 inactivated influenza A/H7N9 vaccine, when two doses are administered 21 days apart either
 sequentially or simultaneously (within 15 minutes) with licensed seasonal influenza vaccine.
 Subjects will be randomized into one of three treatment groups. The study will enroll
 approximately 150 individuals who have no history of influenza A/H7N9 infection or prior
 receipt of an influenza virus H7 subtype vaccine. Study duration is approximately 16 months
 with subject participation duration of approximately 13 months. The primary objectives of
 this study are: 1) to assess the safety and reactogenicity following sequential or
 simultaneous IM administration of 2 doses of AS03-adjuvanted 2017 H7N9 IIV and one dose of
 seasonal influenza vaccine (IIV4); 2) to assess the serum HAI and Neut antibody responses
 against A/H7N9 at approximately 21 days following receipt of two doses of AS03-adjuvanted
 2017 H7N9 IIV administered IM approximately 21 days apart; 3) to assess the serum HAI and
 Neut antibody responses against the seasonal influenza strains at approximately 21 days
 following receipt of IIV4.
This is a randomized, un-blinded, Phase II study in males and non-pregnant females, who are
 in good health, 19 to 64 years of age. This clinical trial is designed to assess the safety,
 reactogenicity, and immunogenicity of a pre-pandemic AS03 (GSK) adjuvanted 2017 monovalent
 inactivated influenza A/H7N9 vaccine (2017 H7N9 IIV) manufactured by Sanofi Pasteur (3.75 mcg
 of HA per dose with Phosphate Buffered Saline (PBS) diluent), when two doses are administered
 21 days apart either sequentially or simultaneously (within 15 minutes) with licensed
 seasonal influenza vaccine. Subjects will be randomized into one of three treatment groups.
 Group 1 will receive two doses of AS03-adjuvanted 2017 H7N9 IIV, each dose administered IM
 approximately 21 days apart, and one dose of licensed seasonal IIV4 will be administered IM
 simultaneously (within 15 minutes) with the first dose of AS03 adjuvanted 2017 H7N9 IIV.
 Group 2 will receive one dose of IIV4 approximately 21 days prior to the IM administration of
 two doses of AS03-adjuvanted 2017 H7N9 IIV; each dose of AS03-adjuvanted 2017 H7N9 IIV will
 be given approximately 21 days apart. Group 3 will receive one dose IM of IIV4 as an
 un-blinded comparator. The study will enroll approximately 150 individuals who have no
 history of influenza A/H7N9 infection or prior receipt of an influenza virus H7 subtype
 vaccine. Study duration is approximately 16 months with subject participation duration of
 approximately 13 months. The primary objectives of this study are: 1) to assess the safety
 and reactogenicity following sequential or simultaneous IM administration of 2 doses of
 AS03-adjuvanted 2017 H7N9 IIV and one dose of seasonal influenza vaccine (IIV4); 2) to assess
 the serum HAI and Neut antibody responses against A/H7N9 at approximately 21 days following
 receipt of two doses of AS03-adjuvanted 2017 H7N9 IIV administered IM approximately 21 days
 apart; 3) to assess the serum HAI and Neut antibody responses against the seasonal influenza
 strains at approximately 21 days following receipt of IIV4. The secondary objectives are: 1)
 to assess unsolicited non-SAEs following sequential or simultaneous IM administration of
 AS03-adjuvanted 2017 H7N9 IIV and seasonal influenza vaccine (IIV4); 2) to assess MAAEs,
 including NOCMCs and PIMMCs, following sequential or simultaneous IM administration of
 AS03-adjuvanted 2017 H7N9 IIV and IIV4; 3) to assess the HAI and Neut antibody responses at
 21 days following receipt of 1 dose of AS03-adjuvanted 2017 H7N9 IIV.
Inclusion Criteria:

 1. Provide written informed consent prior to initiation of any study procedures.

 2. Are able to understand and comply with planned study procedures and be available for
 all study visits.

 3. Are males or non-pregnant females, 19 -64 years of age, inclusive.

 4. Are in good health. - As determined by medical history and physical examination to
 evaluate acute or currently ongoing chronic medical diagnoses or conditions, defined
 as those that have been present for at least 90 days, which would affect the
 assessment of the safety of subjects or the immunogenicity of study vaccinations.
 Chronic medical diagnoses or conditions should be stable for the last 60 days (no
 hospitalizations, Emergency Room (ER), or urgent care for condition and no adverse
 symptoms that need medical intervention such as medication change/supplemental
 oxygen). This includes no change in chronic prescription medication, dose, or
 frequency as a result of deterioration of the chronic medical diagnosis or condition
 in the 60 days prior to enrollment. Any prescription change that is due to change of
 health care provider, insurance company, etc., or that is done for financial reasons,
 as long as in the same class of medication, will not be considered a deviation of this
 inclusion criterion. Any change in prescription medication due to improvement of a
 disease outcome, as determined by the site principal investigator or appropriate
 sub-investigator, will not be considered a deviation of this inclusion criterion.
 Subjects may be on chronic or as needed (prn) medications if, in the opinion of the
 site principal investigator or appropriate sub-investigator, they pose no additional
 risk to subject safety or assessment of reactogenicity and immunogenicity and do not
 indicate a worsening of medical diagnosis or condition. Similarly, medication changes
 subsequent to enrollment and study vaccination are acceptable provided there was no
 deterioration in the subject's chronic medical condition that necessitated a
 medication change, and there is no additional risk to the subject or interference with
 the evaluation of responses to study vaccination. Note: Topical, nasal, and inhaled
 medications (with the exception of inhaled corticosteroids as outlined in the Subject
 Exclusion Criteria), herbals, vitamins, and supplements are permitted.

 5. Oral temperature is less than 100.0°F.

 6. Pulse is 47 to 100 beats per minute (bpm), inclusive.

 7. Systolic blood pressure is 85 to 150 mmHg, inclusive (subjects <65 years of age), 85
 to 160 mmHg, inclusive (subjects = / > 65 years of age).

 8. Diastolic blood pressure is 55 to 95 mmHg, inclusive.

 9. ESR is less than 30 mm per hour.

 10. Women of childbearing potential must use an acceptable contraception method from 30
 days before first study vaccination until 60 days after last study vaccination.

 - Not sterilized via tubal ligation, bilateral oophorectomy, salpingectomy,
 hysterectomy, or successful Essure® placement (permanent, non-surgical, non-hormonal
 sterilization) with documented radiological confirmation test at least 90 days after
 the procedure, and still menstruating or <1 year of the last menses if menopausal.

 -- Includes non-male sexual relationships, abstinence from sexual intercourse with a
 male partner, monogamous relationship with vasectomized partner who has been
 vasectomized for 180 days or more prior to the subject receiving the first study
 vaccination, barrier methods such as condoms or diaphragms with spermicide or foam,
 effective intrauterine devices, NuvaRing®, and licensed hormonal methods such as
 implants, injectables, or oral contraceptives ("the pill").

 11. Women of childbearing potential must have a negative urine or serum pregnancy test
 within 24 hours prior to study vaccination.

 Exclusion Criteria:

 1. Have an acute illness, as determined by the site principal investigator or appropriate
 sub-investigator, within 72 hours prior to study vaccination.

 - An acute illness which is nearly resolved with only minor residual symptoms
 remaining is allowable if, in the opinion of the site principal investigator or
 appropriate sub-investigator, the residual symptoms will not interfere with the
 ability to assess safety parameters as required by the protocol.

 2. Have any medical disease or condition that, in the opinion of the site principal
 investigator or appropriate sub-investigator, is a contraindication to study
 participation.

 - Including acute or chronic medical disease or condition, defined as persisting for
 at least 90 days, that would place the subject at an unacceptable risk of injury,
 render the subject unable to meet the requirements of the protocol, or may interfere
 with the evaluation of responses or the subject's successful completion of this trial.

 3. Have immunosuppression as a result of an underlying illness or treatment, a recent
 history or current use of immunosuppressive or immunomodulating disease therapy.

 4. Use of anticancer chemotherapy or radiation therapy (cytotoxic) within 3 years prior
 to study vaccination.

 5. Have known active neoplastic disease or a history of any hematologic malignancy.
 Non-melanoma, treated, skin cancers are permitted.

 6. Have known human immunodeficiency virus (HIV), hepatitis B, or hepatitis C infection.

 7. Have known hypersensitivity or allergy to eggs, egg or chicken protein, squalene-based
 adjuvants, or other components of the study vaccine.

 8. Have a history of severe reactions following previous immunization with licensed or
 unlicensed influenza vaccines.

 9. Have a personal or family history of narcolepsy.

 10. Have a history of Guillian-Barre Syndrome (GBS).

 11. Have a history of convulsions or encephalomyelitis within 90 days prior to study
 vaccination.

 12. Have a history of Potentially Immune-Mediated Medical Conditions (PIMMCs).

 13. Have a history of alcohol or drug abuse within 5 years prior to study vaccination.

 14. Have any diagnosis, current or past, of schizophrenia, bipolar disease, or other
 psychiatric diagnosis that may interfere with subject compliance or safety
 evaluations.

 15. Have been hospitalized for psychiatric illness, history of suicide attempt, or
 confinement for danger to self or others within 10 years prior to study vaccination.

 16. Have taken oral or parenteral (including intra-articular) corticosteroids of any dose
 within 30 days prior to study vaccination.

 17. Have taken high-dose inhaled corticosteroids within 30 days prior to each study
 vaccination.

 - High-dose defined per age as using inhaled high dose per reference chart
 https://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/quick-refere
 nce-html#estimated-comparative-daily-doses

 18. Received a licensed live vaccine within 30 days prior to the first study vaccination,
 or plan to receive a licensed live vaccine within 30 days before or after each study
 vaccination.

 19. Received or plan to receive a licensed, inactivated, vaccine (excluding all flu
 vaccines) within 14 days before or after each study vaccination.

 20. Received or plan to receive the 2017-2018 inactivated seasonal flu vaccine prior to or
 during the clinical trial and for the remainder of the 2017-2018 season.

 21. Received Ig or other blood products (with exception of Rho D Ig) within 90 days prior
 to each study vaccination.

 22. Received an experimental agent within 30 days prior to the first study vaccination, or
 expect to receive an experimental agent during the 13-month trial-reporting period.

 - Including vaccine, drug, biologic, device, blood product, or medication.

 -- Other than from participation in this trial.

 23. Are participating or plan to participate in another clinical trial with an
 interventional agent that will be received during the 13-month trial-reporting period.

 - Including licensed or unlicensed vaccine, drug, biologic, device, blood product, or
 medication.

 24. Received or plan to receive an influenza A/H7 vaccine or have a history of influenza
 A/H7 subtype infection.

 - And assigned to a group receiving influenza A/H7 vaccine.

 25. Have traveled to mainland China and had substantial direct contact with live or
 freshly slaughtered poultry or pigeons within the past five years.

 - Substantial contact is defined as visited a poultry farm and/or a live poultry
 market.

 26. Occupational exposure to or substantial direct physical contact with birds in the past
 year and through the 21 days after the last study vaccination.

 - Exposure to free range chickens in the yard is exclusionary. Casual contact with
 birds at petting zoos or county or state fairs, or having pet birds does not exclude
 subjects from study participation.

 27. Female subjects who are breastfeeding or plan to breastfeed at any given time from the
 first study vaccination until 30 days after the last study vaccination.

 28. Plan to travel outside the US (continental US, Hawaii, and Alaska) from enrollment
 through 21 days after the last study vaccination.