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Device/Product name
Nuvaxovid
Active Ingredient
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recombinant spike protein (rS) with Matrix M adjuvant
Date of decision
Published
Submission type
New biological entity
ATC codes
J07BX03
Decision
Approved for provisional registration
What was the decision based on
The decision was based on quality (chemistry and manufacturing), nonclinical (pharmacology and toxicology), clinical (pharmacology, safety and efficacy) and risk management plan information submitted by the sponsor. The benefit-risk profile of Nuvaxovid was considered favourable for the therapeutic use approved.
What steps were involved in the decision process

Registration timeline

The following table summarises the key steps and dates for this application.

Data was provided as a rolling submission. Under normal circumstances, TGA's assessment (for both provisional and general registration) begins once all information to support registration is available. As part of the Department of Health's response to the pandemic, the TGA has agreed to accept rolling data for COVID-19 vaccines and treatments, to enable early evaluation of data as it comes to hand.

Description Date
Determination (Provisional) 19 January 2021
Submission dossier accepted and first round evaluation commenced 26 February 2021
Evaluation completed 5 January 2022
Delegate's overall benefit-risk assessment and request for Advisory Committee advice 5 January 2022
Sponsor's pre-Advisory Committee response 7 January 2022
Advisory Committee meeting 7 January 2022
Registration decision (Outcome) 19 January 2022
Completion of administrative activities and registration on ARTG 20 January 2022
Number of working days from submission dossier acceptance to registration decision* 175

*Statutory timeframe for standard applications is 255 working days

Date of entry onto ARTG
Original publication date
Black triangle scheme
Yes.As a provisionally registered product, this medicine will remain in the Black Triangle Scheme for the duration of its provisional registration
Dose forms
Suspension for injection
Strength
5 µg/0.5 mL
Other ingredients
Dibasic sodium phosphate heptahydrate, monobasic sodium phosphate monohydrate, sodium chloride, polysorbate 80, sodium hydroxide (for adjustment of pH), hydrochloric acid (for adjustment of pH), water for injections, adjuvant (Matrix M) (quillaja saponaria saponins fraction A, quillaja saponaria saponins fraction C, cholesterol, phosphatidyl choline, monobasic potassium phosphate, potassium chloride)
Containers
Multidose vial
Pack sizes
Ten vials
Routes of administration
Intramuscular injection
Dosage

Nuvaxovid is administered intramuscularly as a course of two doses of 0.5 mL each. It is recommended that the second dose is to be administered three weeks after the first dose, see Section 5.1 of the Product Information (PI).

There are no data available on the interchangeability of Nuvaxovid with other COVID-19 vaccines to complete the primary vaccination course. Individuals who have received a first dose of Nuvaxovid should receive the second dose of Nuvaxovid to complete the vaccination course, see Section 4.4 of the PI.

For precautions for administering the vaccine, see Section 4.4 of PI.

For further information refer to the Product Information.

Pregnancy category
B1Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.Studies in animals have not shown evidence of an increased occurrence of fetal damage.The use of any medicine during pregnancy requires careful consideration of both risks and benefits by the treating health professional. This must not be used as the sole basis of decision making in the use of medicines during pregnancy. The TGA does not provide advice on the use of medicines in pregnancy for specific cases. More information is available from obstetric drug information services in your State or Territory.
What was approved

Nuvaxovid (SARS-CoV-2 rS with matrix M adjuvant (NVX-CoV2373)) was approved for the following therapeutic use:

Active immunisation to prevent coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in individuals 18 years of age and older.

The use of this vaccine should be in accordance with official recommendations.

The decision has been made on the basis of short-term efficacy and safety data. Continued approval depends on the evidence of longer term efficacy and safety from ongoing clinical trials and post-market assessment.

What is this medicine and how does it work
Nuvaxovid is composed of purified full length severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recombinant spike (S) protein that is stabilised in its prefusion conformation. The addition of the saponin based Matrix-M adjuvant facilitates activation of the cells of the innate immune system, which enhances the magnitude of the S protein specific immune response. The two vaccine components elicit B- and T-cell immune responses to the S protein, including neutralising antibodies, which protect against coronavirus disease.
What post-market commitments will the sponsor undertake
  • The Nuvaxovid COVID-19 Vaccine (adjuvanted) EU-risk management plan (RMP) (version 1.0, dated 18 December 2021; DLP 20 December 2021), with Australian specific annex (version 1.0, dated 19 January 2022), included with Submission PM 2021-00623-1-2, and any subsequent revisions, as agreed with the TGA will be implemented in Australia.

    An obligatory component of risk management plans is routine pharmacovigilance. Routine pharmacovigilance includes the submission of periodic safety update reports (PSURs).

    Reports are to be provided in line with the current published list of EU reference dates and frequency of submission of PSURs until the period covered by such reports is not less than three years from the date of the approval letter, or the entire period of provisional registration, whichever is longer.

    The reports are to at least meet the requirements for PSURs as described in the European Medicines Agency's Guideline on Good Pharmacovigilance Practices (GVP) Module VII periodic safety update report (Rev 1), Part VII.B Structures and processes. Note that submission of a PSUR does not constitute an application to vary the registration. Each report must have been prepared within ninety calendar days of the data lock point for that report.

    Additional to the routine submission of the routine PSURs, expedited monthly Nuvaxovid COVID-19 Vaccine (adjuvanted) safety summary reports (including both global safety data and safety data for patients in Australia) are to be provided for the first 6 months post registration, and thereafter at intervals specified by the TGA.

    Nuvaxovid COVID-19 Vaccine (adjuvanted) is to be included in the Black Triangle Scheme. The PI and CMI for Nuvaxovid COVID-19 Vaccine (adjuvanted) must include the black triangle symbol and mandatory accompanying text for the products entire period of provisional registration.

  • Clinical conditions

    The following reports/data must be submitted to the TGA by the dates set out in the table below:

    Study Number Date when next interim clinical study report will be available Date when final clinical study report will be available

    2019nCoV-101 Part 1

    Not applicable

    First quarter of 2022

    2019nCoV-101 Part 2

    First quarter of 2022 (Day 217 data – including booster with third dose at Day 189)

    Fourth quarter of 2022

    2019CoV-501

    First quarter of 2022 (Day 236 data – including booster with third dose at Day 201 in about 1500 participants)

    Second quarter of 2022 (6 month data in all participants)

    Fourth quarter of 2022

    2019nCoV-302

    Second quarter of 2022 (6 month data in all participants)

    Fourth quarter of 2022

    2019nCoV-301

    Second quarter of 2022 (6 month data in all participants)

    Third quarter of 2023

    • The sponsor must investigate the need for a booster dose and submit data when available.
    • The sponsor must perform investigations on identifying an immunological correlate of protection.
    • The sponsor must investigate and provide results on the ability of the vaccine to neutralise emerging SARS-CoV-2 variants of concern.
    • The sponsor must provide real world post market global/local efficacy data, when available.
    • Studies addressing important safety concerns/important missing information (use in immunocompromised individual, pregnant women) must be submitted. However, this should be submitted as additional submissions, not as ‘conditions of original submission’.
  • Quality conditions
    • Medicine labels
      1. The medicines must not be supplied with labels other than the labels:
        1. that were considered and agreed to as part of the s.25 provisional registration decision, i.e. the labels referred to in the category 1 application and email from sponsor dated third quarter of 2021; or
        2. that are approved following a request to vary the entry in the Register under section 9D of the Act.
      2. The sponsor will develop Australian-specific labels for the medicines, that conform with all relevant Australian labelling requirements, and will take all reasonable steps to implement such labelling before the end of the provisional registration period for the medicine (noting that, consistent with paragraph 28(5)(aaa) of the Act, changes to such matters as labels that have been agreed to as part of an evaluation under section 25 of the Act may only occur following submission under section 9D of a 'variation' application and approval by the TGA).
      3. The sponsor will provide information to the TGA on the proposed strategies and planned timelines for Australian dedicated supplies, as soon as possible, and no later than first quarter of 2024.
  • GMP clearance for listed manufacturers: the sponsor must maintain the validity of all manufacturer GMP Clearances for the duration of product supply to Australia. Additionally, the conditions of GMP Clearance approval must be complied with at all times.
  • Post-approval stability protocol and stability commitment: The manufacturer must continue the ongoing stability studies presented in the stability studies protocol. Additionally, 1 batch of drug product per year must be placed on long term stability program and on accelerated stability testing where significant changes are made to the manufacturing process. The manufacturer must communicate any out of specifications stability test results to the TGA.
  • Stability (drug product)

    The sponsor must provide updated statistical results of long-term stability data for process validation (PV) and clinical stability batches as they become available to further support 6 months storage at 2 to 8°C with real-time stability data.

    NOTE: As per TGA guidelines, the sponsor should submit a formal (Category 3) application along with the supporting real-time (long-term) stability data for evaluation for any proposed extension to the shelf life post-provisional registration approval.

    The sponsor must provide updated protein concentration results for clinical long-term stability batches [Information redacted] together with the investigation report into the observed atypical protein concentration results when the report became available.

    The sponsor must provide commitment to review and update the stability testing parameters to include saponin integrity and particle size by dynamic light scattering (DLS).

  • The sponsor must not supply any batches that have a temperature deviation during shipment.
  • Batch release testing and compliance

    Independent batches of Nuvaxovid (SARS-CoV-2 rS [NVX-CoV2373]) COVID-19 vaccine imported into Australia must not be released for sale until samples and the manufacturer’s release data have been assessed and sponsor have received notification acknowledging release from the Laboratories Branch, TGA.

    For each independent batch of the product imported into Australia, the sponsor must supply the following:

    • A completed Request for Release Form, available from vaccines@health.gov.au.
    • Complete summary protocols for manufacture and QC, including all steps in production in the agreed format.
    • At least a 2 mL sample (as at least 4 × 500 μL aliquots) of each bulk drug substance batch used in the manufacture of the given drug product batch.
    • At least 20 (twenty) vials (samples) of each manufacturing batch of Nuvaxovid (SARS-CoV-2 rS [NVX-CoV2373]) COVID-19 vaccine with the Australian approved labels, PI and packaging (unless an exemption to supply these has been granted) representative of all batches of product seeking distribution in Australia.
    • At least 5 (five) vials (samples) of any further consignments of a manufacturing batch of Nuvaxovid (SARS-CoV-2 rS [NVX-CoV2373]) COVID-19 vaccine with the Australian approved labels, PI and packaging (unless an exemption to supply these has been granted). Further consignments cover batches previously supplied to TGA for the purposes of batch release testing but are seeking to be supplied again)
    • If the manufacturing batch has been released in Europe or United Kingdom a copy of the EU Official Control Authority Batch Release (OCABR) certificate (or equivalent from the UK) must be provided.
    • Any reagents, reference material and standards required to undertake testing, as requested by Laboratories Branch, TGA.

    Sponsors must provide all requested samples and data in sufficient time (at least 5 business days) prior to any distribution date to allow the TGA to perform testing and review.

    Distribution of each batch of vaccine is conditional upon fulfilment of these conditions and receipt of a letter from the Laboratories Branch acknowledging release.

    Samples and data should be forwarded to the Biotherapeutics Section, Laboratories Branch before release of each batch and with sufficient lead time to allow for Laboratories Branch testing.

    The shipments (including reagents) to TGA are the responsibility of the Australian sponsor/agent who will be required to facilitate the import and customs clearance process.

    Certified Product Details

    An electronic copy of the Certified Product Details (CPD) as described in Guidance 7: Certified Product Details of the Australian Regulatory Guidelines for Prescription Medicines (ARGPM) should be provided upon registration of the therapeutic good. In addition, an updated CPD, for the above products incorporating the approved changes is to be provided within one month of the date of approval letter. A template for preparation of CPD for biological prescription medicines and Vaccines can be obtained from the TGA website. The CPD should be sent as a single bookmarked PDF document to vaccines@health.gov.au as soon as possible after registration/approval of the product or any subsequent changes as indicated above.

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