ID

33403

Descrizione

Study ID: 104065 Clinical Study ID: 104065 Study Title: Immune memory of GSK's DTPw-HBV/Hib vaccine by giving Plain PRP polysaccharide at 10 mths. Immuno & reacto of a booster dose of DTPw-HBV/Hib or DTPw-HBV or DTPw-HBV+Hib at 15-18 mths in infants previously primed with DTPw-HBV/Hib Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00169442  Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completet Generic Name: Combined Diphtheria, Tetanus, Whole Cell Pertussis, Hepatitis B, Haemophilus influenzae Type b Vaccine (KFT) Trade Name: Zilbrix/Hib Study Indication: Diphtheria; Haemophilus influenzae type b; Hepatitis B; Tetanus; Whole Cell Pertussis

Keywords

  1. 07/12/18 07/12/18 -
Titolare del copyright

GSK group of companies

Caricato su

7 dicembre 2018

DOI

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Licenza

Creative Commons BY-NC 3.0

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Immune memory of Combined Diphtheria, Tetanus, Whole Cell Pertussis, Hepatitis B, Haemophilus influenzae Type b Vaccine at infants (15 to 18 mths) - 104065

Visit 3: Solicited Adverse Events (DTPw-HBV Kft + HiberixTM)

Administrative data
Descrizione

Administrative data

Subject Number
Descrizione

Subject Number

Tipo di dati

integer

Date of Visit
Descrizione

Date of Visit

Tipo di dati

text

Protocol Number
Descrizione

Protocol Number

Tipo di dati

integer

Solicited Adverse Events - DTPw-HBV Kft vaccine
Descrizione

Solicited Adverse Events - DTPw-HBV Kft vaccine

Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?
Descrizione

Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?

Tipo di dati

text

Local Symptoms - Redness
Descrizione

Local Symptoms - Redness

Day
Descrizione

Day

Tipo di dati

integer

Redness
Descrizione

Redness

Tipo di dati

boolean

If Yes, record the size
Descrizione

If Yes, record the size

Tipo di dati

integer

Unità di misura
  • mm
mm
Ongoing after day 7?
Descrizione

Ongoing after day 7?

Tipo di dati

boolean

If Yes, record date of last day of symptoms
Descrizione

If Yes, record date of last day of symptoms

Tipo di dati

date

Medically attended visit
Descrizione

Medically attended visit

Tipo di dati

boolean

If Yes, record the visit type
Descrizione

If Yes, record the visit type

Tipo di dati

text

Local Symptoms - Swelling
Descrizione

Local Symptoms - Swelling

Day
Descrizione

Day

Tipo di dati

integer

Swelling
Descrizione

Swelling

Tipo di dati

boolean

If Yes, record the size
Descrizione

If Yes, record the size

Tipo di dati

integer

Unità di misura
  • mm
mm
Ongoing after day 7?
Descrizione

Ongoing after day 7?

Tipo di dati

boolean

If Yes, record date of last day of symptoms
Descrizione

If Yes, record date of last day of symptoms

Tipo di dati

date

Medically attended visit
Descrizione

Medically attended visit

Tipo di dati

boolean

If Yes, record the visit type
Descrizione

If Yes, record the visit type

Tipo di dati

text

Local Symptoms - Pain
Descrizione

Local Symptoms - Pain

Day
Descrizione

Day

Tipo di dati

integer

Pain
Descrizione

Pain

Tipo di dati

boolean

If Yes, record the intensity
Descrizione

If Yes, record the intensity

Tipo di dati

text

Ongoing after day 7?
Descrizione

Ongoing after day 7?

Tipo di dati

boolean

If Yes, record date of last day of symptoms
Descrizione

If Yes, record date of last day of symptoms

Tipo di dati

date

Medically attended visit
Descrizione

Medically attended visit

Tipo di dati

boolean

If Yes, record the visit type
Descrizione

If Yes, record the visit type

Tipo di dati

text

Solicited Adverse Events - HiberixTM vaccine
Descrizione

Solicited Adverse Events - HiberixTM vaccine

Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?
Descrizione

Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?

Tipo di dati

text

Local Symptoms - Redness
Descrizione

Local Symptoms - Redness

Day
Descrizione

Day

Tipo di dati

integer

Redness
Descrizione

Redness

Tipo di dati

boolean

If Yes, record the size
Descrizione

If Yes, record the size

Tipo di dati

integer

Unità di misura
  • mm
mm
Ongoing after day 7?
Descrizione

Ongoing after day 7?

Tipo di dati

boolean

If Yes, record date of last day of symptoms
Descrizione

If Yes, record date of last day of symptoms

Tipo di dati

date

Medically attended visit
Descrizione

Medically attended visit

Tipo di dati

boolean

If Yes, record the visit type
Descrizione

If Yes, record the visit type

Tipo di dati

text

Local Symptoms - Swelling
Descrizione

Local Symptoms - Swelling

Day
Descrizione

Day

Tipo di dati

integer

Swelling
Descrizione

Swelling

Tipo di dati

boolean

If Yes, record the size
Descrizione

If Yes, record the size

Tipo di dati

integer

Unità di misura
  • mm
mm
Ongoing after day 7?
Descrizione

Ongoing after day 7?

Tipo di dati

boolean

If Yes, record date of last day of symptoms
Descrizione

If Yes, record date of last day of symptoms

Tipo di dati

date

Medically attended visit
Descrizione

Medically attended visit

Tipo di dati

boolean

If Yes, record the visit type
Descrizione

If Yes, record the visit type

Tipo di dati

text

Local Symptoms - Pain
Descrizione

Local Symptoms - Pain

Day
Descrizione

Day

Tipo di dati

text

Pain
Descrizione

Pain

Tipo di dati

boolean

If Yes, record the intensity
Descrizione

If Yes, record the intensity

Tipo di dati

text

Ongoing after day 7?
Descrizione

Ongoing after day 7?

Tipo di dati

boolean

If Yes, record date of last day of symptoms
Descrizione

If Yes, record date of last day of symptoms

Tipo di dati

date

Medically attended visit
Descrizione

Medically attended visit

Tipo di dati

boolean

If Yes, record the visit type
Descrizione

If Yes, record the visit type

Tipo di dati

text

Similar models

Visit 3: Solicited Adverse Events (DTPw-HBV Kft + HiberixTM)

Name
genere
Description | Question | Decode (Coded Value)
Tipo di dati
Alias
Item Group
Administrative data
Subject Number
Item
Subject Number
integer
Date of Visit
Item
Date of Visit
text
Protocol Number
Item
Protocol Number
integer
Item Group
Solicited Adverse Events - DTPw-HBV Kft vaccine
Item
Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?
text
Code List
Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?
CL Item
Information not available (1)
CL Item
No Vaccine administered (2)
CL Item
No (3)
CL Item
Yes (please tick No/Yes for each symptom) (4)
Item Group
Local Symptoms - Redness
Item
Day
integer
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
Redness
Item
Redness
boolean
If Yes, record the size
Item
If Yes, record the size
integer
Ongoing after day 7?
Item
Ongoing after day 7?
boolean
If Yes, record date of last day of symptoms
Item
If Yes, record date of last day of symptoms
date
Medically attended visit
Item
Medically attended visit
boolean
Item
If Yes, record the visit type
text
Code List
If Yes, record the visit type
CL Item
Hospitalisation (1)
CL Item
Emergency room (2)
CL Item
Medical personnel (3)
Item Group
Local Symptoms - Swelling
Item
Day
integer
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
Swelling
Item
Swelling
boolean
If Yes, record the size
Item
If Yes, record the size
integer
Ongoing after day 7?
Item
Ongoing after day 7?
boolean
If Yes, record date of last day of symptoms
Item
If Yes, record date of last day of symptoms
date
Medically attended visit
Item
Medically attended visit
boolean
Item
If Yes, record the visit type
text
Code List
If Yes, record the visit type
CL Item
Hospitalisation (1)
CL Item
Emergency room (2)
CL Item
Medical personnel (3)
Item Group
Local Symptoms - Pain
Item
Day
integer
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
Pain
Item
Pain
boolean
Item
If Yes, record the intensity
text
Code List
If Yes, record the intensity
CL Item
None (1)
CL Item
Mild (2)
CL Item
Moderate (3)
CL Item
Severe (4)
Ongoing after day 7?
Item
Ongoing after day 7?
boolean
If Yes, record date of last day of symptoms
Item
If Yes, record date of last day of symptoms
date
Medically attended visit
Item
Medically attended visit
boolean
Item
If Yes, record the visit type
text
Code List
If Yes, record the visit type
CL Item
Hospitalisation (1)
CL Item
Emergency room (2)
CL Item
Medical personnel (3)
Item Group
Solicited Adverse Events - HiberixTM vaccine
Item
Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?
text
Code List
Has the subject experienced any of the following signs/symptoms at the administration site during the solicited period?
CL Item
Information not available (1)
CL Item
No Vaccine administered (2)
CL Item
No (3)
CL Item
Yes (please tick No/Yes for each symptom) (4)
Item Group
Local Symptoms - Redness
Item
Day
integer
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
Redness
Item
Redness
boolean
If Yes, record the size
Item
If Yes, record the size
integer
Ongoing after day 7?
Item
Ongoing after day 7?
boolean
If Yes, record date of last day of symptoms
Item
If Yes, record date of last day of symptoms
date
Medically attended visit
Item
Medically attended visit
boolean
Item
If Yes, record the visit type
text
Code List
If Yes, record the visit type
CL Item
Hospitalisation (1)
CL Item
Emergency room (2)
CL Item
Medical personnel (3)
Item Group
Local Symptoms - Swelling
Item
Day
integer
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
Swelling
Item
Swelling
boolean
If Yes, record the size
Item
If Yes, record the size
integer
Ongoing after day 7?
Item
Ongoing after day 7?
boolean
If Yes, record date of last day of symptoms
Item
If Yes, record date of last day of symptoms
date
Medically attended visit
Item
Medically attended visit
boolean
Item
If Yes, record the visit type
text
Code List
If Yes, record the visit type
CL Item
Hospitalisation (1)
CL Item
Emergency room (2)
CL Item
Medical personnel (3)
Item Group
Local Symptoms - Pain
Item
Day
text
Code List
Day
CL Item
Day 0 (1)
CL Item
Day 1 (2)
CL Item
Day 2 (3)
CL Item
Day 3 (4)
Pain
Item
Pain
boolean
Item
If Yes, record the intensity
text
Code List
If Yes, record the intensity
CL Item
None (1)
CL Item
Mild (2)
CL Item
Moderate (3)
CL Item
Severe (4)
Ongoing after day 7?
Item
Ongoing after day 7?
boolean
If Yes, record date of last day of symptoms
Item
If Yes, record date of last day of symptoms
date
Medically attended visit
Item
Medically attended visit
boolean
Item
If Yes, record the visit type
text
Code List
If Yes, record the visit type
CL Item
Hospitalisation (1)
CL Item
Emergency room (2)
CL Item
Medical personnel (3)

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