This is a Phase 2/3 open-label study to evaluate the safety and immunogenicity of abooster dose of the XBB.1.5 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)recombinant (r) spike (S) protein nanoparticle vaccine (SARS-CoV-2 rS) adjuvanted withMatrix-M™ in previously mRNA COVID-19 vaccinated adult participants ≥18 years of age andbaseline SARS CoV-2 seropositive COVID-19 vaccine naïve participants ≥18 years of age.
Novavax, Inc. developed a recombinant prototype COVID-19 vaccine constructed from the
full-length ancestral (Wuhan) SARS CoV-2 S glycoprotein (GP) adjuvanted with the
saponin-based Matrix-M adjuvant (NVX-CoV2373). Subsequently, the SARS CoV 2 Omicron
variant and subvariants emerged with enhanced transmissibility and the most significant
number of mutations in any strain to date. Current evidence demonstrates that variant
strain mutations such as those in the Omicron XBB.1.5 sublineage confer the ability to
evade both natural and vaccine-induced neutralizing antibodies.
Part 1 of the study aims to investigate the safety and immunogenicity of the Novavax
XBB.1.5 SARS-CoV-2 rS vaccine (NVX-CoV2601) adjuvanted with Matrix-M in previously
COVID-19 mRNA vaccinated participants to determine if it induces superior antibody
responses compared to a historical control of the prototype vaccine (original Wuhan
strain), NVX-CoV2373.
Part 2 of the study aims to investigate the safety and immunogenicity of 1 dose of NVX
CoV2601 in baseline SARS-CoV-2 seropositive COVID-19 vaccine naïve participants to
determine if it induces non-inferior antibody responses compared to 1 booster dose of
NVX-CoV2601 in previously COVID-19 mRNA vaccinated individuals participating in Part 1.
Part 1:
Approximately 330 previously mRNA COVID-19 vaccinated participants will receive a booster
dose of XBB.1.5 Omicron subvariant vaccine (NVX-CoV2601) on Day 0. Immunogenicity and
28-day safety data will be used for an interim analysis, while participants remain on the
study for immunogenicity and safety data collection up to Day 180 post-vaccination.
Part 2:
After completion of Part 1, approximately 330 unvaccinated participants with a clinical
history of COVID-19-like disease during the previous year will receive a booster dose of
NVX-CoV2601 on Day 0. Immunogenicity and 28-day safety data will be used for an interim
analysis, while participants remain on the study for immunogenicity and safety data
collection up to Day 180 post vaccination.
Biological: XBB.1.5 Vaccine (Booster)
Omicron sub variant XBB.1.5 SARS-CoV-2 rS /Matrix-M Adjuvant the monovalent [5 μg/50 μg]
NVX-CoV2601) XBB.1.5 Vaccine (Booster)
Other Name: Omicron sub variant XBB.1.5 vaccine( booster) SARS-CoV-2 rS /Matrix-M Adjuvant
Biological: XBB.1.5 Vaccine (single dose)
Omicron sub variant XBB.1.5 SARS-CoV-2 rS /Matrix-M Adjuvant the monovalent [5 μg/50 μg]
NVX-CoV2601) XBB.1.5 Vaccine ( single dose)
Other Name: Omicron sub variant XBB.1.5 vaccine(single dose) SARS-CoV-2 rS /Matrix-M Adjuvant
Inclusion Criteria:
1. Adults ≥ 18 years of age at time of study vaccination.
  2. Part 1: Previously vaccinated with ≥ 3 doses of the Moderna and/or Pfizer /BioNTech
     prototype monovalent and/or BA.4/5 containing bivalent COVID-19 vaccines with the
     last dose administered ≥ 90 days prior to study vaccination.
Part 2: Clinical history of COVID-19-like disease during the previous year.
  3. Willing and able to give informed consent prior to study enrollment and to comply
     with study procedures.
  4. Female participants of childbearing potential (defined as any participant who has
     experienced menarche and who is NOT surgically sterile [ie, hysterectomy, bilateral
     tubal ligation, or bilateral oophorectomy] or postmenopausal [defined as amenorrhea
     ≥ 12 consecutive months]) must agree to be heterosexually in-active from at least 28
     days prior to enrollment and through the end of the study OR agree to consistently
     use a medically acceptable method of contraception listed below from ≥ 28 days prior
     to enrollment and through the end of the study.
1. Condoms (male or female) with spermicide (if acceptable in country)
2. Diaphragm with spermicide
3. Cervical cap with spermicide
4. Intrauterine device
5. Oral or patch contraceptives
       6. Norplant®, Depo-Provera®, or other in country regulatory approved contraceptive
          method that is designed to protect against pregnancy.
       7. Abstinence, as a form of contraception, is acceptable if in line with the
          participant's lifestyle NOTE: Periodic abstinence (eg, calendar, ovulation,
          sympto-thermal, post-ovulation methods) and withdrawal are not acceptable
          methods of contraception.
  5. Is medically stable, as determined by the investigator (based on review of health
     status, vital signs [to include body temperature], medical history, and physical
     examination [to include body weight]). Vital signs must be within medically
     acceptable ranges prior to study vaccination.
  6. Agrees to not participate in any research involving receipt of investigational
     products (drug/biologic/device) including other SARS-CoV-2 prevention or treatment
     trials for the duration of the study.
NOTE: For participants who become hospitalized with COVID-19, participation in
investigational treatment studies is permitted.
Exclusion Criteria:
  1. Received COVID-19 vaccines other than Moderna and/or Pfizer-BioNTech in the past,
     inclusive of clinical trial COVID-19 vaccines.
  2. Participation in research involving receipt of investigational products
     (drug/biologic/device) within 90 days prior to study vaccination (Day 0).
  3. Received influenza vaccination within 14 days prior to study vaccination, or any
     other vaccine within 30 days prior to study vaccination.
4. Any known allergies to products contained in the investigational product.
5. Any history of anaphylaxis to any prior vaccine.
  6. Autoimmune or immunodeficiency disease/condition (iatrogenic or congenital)
     requiring ongoing immunomodulatory therapy.
     NOTE: Stable endocrine disorders (eg, thyroiditis, pancreatitis), including stable
     diabetes mellitus with no history of diabetic ketoacidosis are NOT excluded.
  7. Chronic administration (defined as > 14 continuous days) of immunosuppressant,
     systemic glucocorti-coids, or other immune-modifying drugs within 90 days prior to
     study vaccination (Day 0).
     NOTE: An immunosuppressant dose of glucocorticoid is defined as a systemic dose ≥ 10
     mg of prednisone per day or equivalent. The use of topical or intranasal
     glucocorticoids is permitted. Topical tacrolimus and ocular cyclosporin are
     permitted. Use of inhaled glucocorticoids is prohibited.
  8. Received any prohibited medication (see Section 7.4.1), immunoglobulin,
     blood-derived products, or immunosuppressant drugs within 90 days prior to study
     vaccination (Day 0).
  9. Active cancer (malignancy) on chemotherapy within 3 years prior to first study
     vaccination (with the exception of adequately treated non-melanomatous skin
     carcinoma or lentigo malign and uterine cervical carcinoma in situ without evidence
     of disease, at the discretion of the investigator).
 10. Participants who are breastfeeding, pregnant, or who plan to become pregnant prior
     to the end of study.
 11. Suspected or known history of alcohol abuse or drug addiction within 2 years prior
     to study vaccination that, in the opinion of the investigator, might interfere with
     protocol compliance.
 12. Any other condition that, in the opinion of the investigator, would pose a health
     risk to the participant if enrolled or could interfere with evaluation of the study
     vaccine or interpretation of study results (includ-ing neurologic or psychiatric
     conditions likely to impair the quality of safety reporting).
 13. Study team member or immediate family member of any study team member (inclusive of
     Sponsor, clinical research organization [CRO], and study site personnel involved in
     the conduct or planning of the study).
14. Known history of myocarditis or pericarditis.
 15. Respiratory symptoms in the past 3 days (ie, cough, sore throat, difficulty
     breathing).
 16. Temperature of > 38°C within 24 hours of planned study vaccination (site measured or
     participant meas-ured).
17. Blood pressure of ≥ 160/100 mmHg.
AMR
Mobile	4076598, Alabama	4829764, United States
Benchmark Research
Sacramento	5389489, California	5332921, United States
Lynn Institute of the Rockies
Colorado Springs	5417598, Colorado	5417618, United States
AMR LLC-Miami
Coral Gables	4151871, Florida	4155751, United States
AMR
Fort Myers	4155995, Florida	4155751, United States
Health Awareness,LLC
Jupiter	4160610, Florida	4155751, United States
Tekton Research
Lawrenceville	4205196, Georgia	4197000, United States
Alliance for Multispecialty RSCH
Newton	4276248, Kansas	4273857, United States
Tekton Research
Wichita	4281730, Kansas	4273857, United States
AMR New Orleans
New Orleans	4335045, Louisiana	4331987, United States
University of Maryland
Baltimore	4347778, Maryland	4361885, United States
AMR
Kansas City	4393217, Missouri	4398678, United States
Sundance Clinical Research
St Louis	4407066, Missouri	4398678, United States
Velocity Clinical Research
Norfolk	5073965, Nebraska	5073708, United States
AMR
Las Vegas	5506956, Nevada	5509151, United States
AXCES Research
Albuquerque	5454711, New Mexico	5481136, United States
Rochester Clinical Research
Rochester	5134086, New York	5128638, United States
Tekton Research
Yukon	4556165, Oklahoma	4544379, United States
DM Clinical Research
Philadelphia	4560349, Pennsylvania	6254927, United States
AMR
Knoxville	4634946, Tennessee	4662168, United States
Benchmark Research
Austin	4671654, Texas	4736286, United States
Tekton Research
Austin	4671654, Texas	4736286, United States
Tekton Research
Beaumont	4672989, Texas	4736286, United States
Pan American clinical Research,LLC
Brownsville	4676740, Texas	4736286, United States
Benchmark Research
Fort Worth	4691930, Texas	4736286, United States
Research For Your Health
Plano	4719457, Texas	4736286, United States
Tekton Research
San Antonio	4726206, Texas	4736286, United States
AMR Layton Research Centre
Layton	5777107, Utah	5549030, United States
Health Research of Hampton Roads
Newport News	4776024, Virginia	6254928, United States
University of Washington
Seattle	5809844, Washington	5815135, United States
Clinical Development, Study Director
 Novavax, Inc.