Blood serum was collected immediately before administration of study vaccines and approximately 28 days and 1 year later. After study initiation, the protocol was amended to request an additional blood specimen at six months post-co-administration from additionally consented participants. Primary immunogenicity objective outcomes were the proportion of subjects with demonstrated seropositivity for JE and measles at 28 days post-co-administration.

Serum neutralizing antibodies to the Bejing-1 JE strain were measured by plaque I-BET151 research buy reduction neutralization test (PRNT) where the neutralizing titer was measured as the inverse dilution at which plaque counts were

reduced by 50%. Seropositivity for JE was then defined as a neutralizing antibody titer of ≥1:10, as recommended by the WHO [4]. Serum anti-measles immunoglobulin class G (IgG) antibodies were measured by enzyme-linked immunosorbent screening assay assay (ELISA) (Serion ELISA classic Measles Virus IgG, Serion GmbH, Würzburg, Germany). Seropositivity for measles was defined per the manufacturer’s instruction as an antibody concentration of >200 mIU/mL; “borderline” was 150–200 mIU/mL. Secondary immunogenicity outcomes included the geometric mean titer (GMT) of serum neutralizing antibody to JE and the geometric mean concentration (GMC) of anti-measles IgG at 28 days post-co-administration

of study vaccines. Additional secondary objectives were immunogenicity at 6 months post-co-administration and at 1 year post-co-administration. In a separate post-hoc analysis, immunogenicity was also analyzed counting as seropositive all infants with “borderline” anti-measles IgG concentrations. All adverse reactions and adverse events were captured from the time of co-administration of study vaccines until 28 days later. Serious adverse events (SAEs)—as defined by ICH GCP and with the additional tuclazepam criterion of “important medical events that may not result in death, be life threatening, or require hospitalization may be considered SAEs when, based upon appropriate medical judgment, may jeopardize the subject and may require medical or surgical intervention to prevent one of the outcomes listed by ICH GCP”—occurring at any time during the study were further documented. During the 7 days post-co-administration of study vaccines parents completed diary cards for solicited and unsolicited events; parents were given specific grading scales for solicited events and a generic grading scale to apply to unsolicited events. Study physicians visited the homes of study subjects 2 or 3 days post-vaccination to check that completion of diary cards was proceeding well and to assist parents with any questions or problems.