ID

33079

Descrição

Study ID: 104020 Clinical Study ID: 104020 Study Title: Blinded, randomised study to assess the immunogenicity and safety of GlaxoSmithKline (GSK) Biologicals’ live attenuated measles-mumps-rubella-varicella candidate vaccine when given to healthy children in their second year of life Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00126997 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 4 Study Recruitment Status: Completed Generic Name: Combined Measles, Mumps, Rubella, Varicella Vaccine Trade Name: Priorix Tetra Study Indication: Measles; Mumps; Rubella; Varicella

Palavras-chave

Versões (1)
  1. 26/11/2018 26/11/2018 -
Titular dos direitos

GSK group of companies

Transferido a

26 de novembro de 2018

DOI

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Licença

Creative Commons BY-NC 3.0
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Immunogenicity of Combined Measles, Mumps, Rubella, Varicella Vaccine for healthy 2 y.o children - 104020

Inglês

Concomitant Vaccination Form

1 Formulários  
Administrative data
Descrição

Administrative data

Subject Number
Descrição

Subject Number

Tipo de dados

integer

Concomitant Vaccination
Descrição

Concomitant Vaccination

Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?
Descrição

Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?

Tipo de dados

boolean

If Yes, please record concomitant vaccination with trade name and /or generic name, route and vaccine administration date
Descrição

If Yes, please record concomitant vaccination with trade name and /or generic name, route and vaccine administration date

Tipo de dados

text

Trade Name / Generic Name
Descrição

Trade Name / Generic Name

Trade / Generic Name
Descrição

Trade / Generic Name

Tipo de dados

text

Route
Descrição

Route

Tipo de dados

text

Administration Date
Descrição

Administration Date

Tipo de dados

date

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Similar models

Concomitant Vaccination Form

1 Formulários
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Administrative data
Subject Number
Item
Subject Number
integer
Item Group
Concomitant Vaccination
Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?
Item
Has any vaccine other than the study vaccine(s) been administered during the timeframe as specified in the protocol?
boolean
If Yes, please record concomitant vaccination with trade name and /or generic name, route and vaccine administration date
Item
If Yes, please record concomitant vaccination with trade name and /or generic name, route and vaccine administration date
text
Item Group
Trade Name / Generic Name
Trade / Generic Name
Item
Trade / Generic Name
text
Item
Route
text
Route
Code List
Route
CL Item
Intradermal (ID) (1)
CL Item
Inhalation (IH) (2)
CL Item
Intramuscular (IM) (3)
CL Item
Intravenous (IV) (4)
CL Item
Intranasal (NA) (5)
CL Item
Other (OTH) (6)
CL Item
Parenteral (PE) (7)
CL Item
Oral (PO) (8)
CL Item
Subcutaneous (SC) (9)
CL Item
Sublingual (SL) (10)
CL Item
Transdermal (TD) (11)
CL Item
Unknown (UNK) (12)
Administration Date
Item
Administration Date
date
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