Access to Services of the EURIPRED Infrastructure

TransNational Access (TNA)

APPLICATION FORMNumber:

(for internal use only)

New application/ Resubmission of application (please delete as appropriate)

  1. Personal details of applicant (Principal Investigator only)

Name
Job title
Organisation
Postal address
Tel
e-mail
  1. Description of Laboratory/ User group

Please briefly describe your laboratory/ group in relation to this application
Relevant publication (maximum 5 – full reference of peer-reviewed articles only)
  1. TNA service requested (please select the following servicesand fill in the detail of requests where appropriate)

a. Reference Standards/ Reagents

Please select from the list of available reference standards/ reagents (available on EURIPRED website). Each available preparation should have a designated code and information of the content of each pre-filled container (vial/ ampoule).

Name of reference standard/ reagent / Code / Number of units*

*One unit is defined as the provision of specified reference preparation in one pre-filled vial/ ampoule.

Total number of access units requested (max. 20):

b. Vaccine adjuvant & formulations

Each unit of access in particular condition corresponds to the formulation study (in vitro characterization, short term stability) of one adjuvant (usually from the VFL portfolio) with one antigen (usually from the user). Multipleantigen-adjuvant combinations can be provided simultaneously.

Number of access units requested:

Adjuvant class

Aluminium salts

Liposomes

Oil-in-water emulsion

Saponins

TLR-4 agonists

Water-in-oil emulsion

Combination adjuvants

Adjuvant from user

Other (please specify)

Description of the work to date
Please give a short description of the relevant work that you have previously conducted on the antigen and/ or adjuvant.
Description of the antigen
Please provide the following information on your vaccine candidate: name of antigen / nature of antigen (e.g. protein, peptide, VLP, whole virus) / theoretical an apparent MW (DA) / theoretical and apparent pI / known phosphate groups / protein concentration (μg/mL) / purity (%) / buffer composition and final pH / presence of excipients (e.g. thiomersal, stabilizers, pH indicator) / stability (e.g. x weeks at 4°C, 25°C, 37°C) / assays which can be used for characterization (indicate reference if possible)
Description of requested vaccine formulation
Please give a short description of the adjuvant chosen above (name, amount, desired outcome) and the vaccine formulation (buffer system, composition). Please indicate if you need specific recommendation on the choice of adjuvant.

c. Microarray facility for screening and evaluation

Each access session will include a theoretical and hands-on introduction to JPT's peptide microarray platform for monitoring the humoral immune response. The practical work will include the screening of samples provided by the users (i.e. sera; up to 24 samples), as well as data evaluation and interpretation. Access will be enabled to JPT’s microarray screening facility to groups of up to 12 users.

Description of serum samples for analyses / Number of samples

Total number of samplesfor analysis:

Total number of users attending the course (max 12):

  1. Project description (max. two A4 pages) - Project refers to the tasks, experiments or investigation which you are planning to carry out using the service from EURIPRED infrastructure. The project description should clearly summarise the aim of the project, the scientific background including the scientific rationale, and the overall methodological approaches (including statistics where appropriate) proposed to solve the main scientific problems. Please also include a summary of expected results. For a competitive evaluation it is important that the description of the objectives and the methodological approach can be easily evaluated. These should be clearly structured.

Project Title
Project design – Background, objective(s) and scientific rationale
Reasons for requesting service as stated in Section 3
Expected impacts and outcomes of the project

Terms and Conditions for Transnational Access (TNA)

Publicity

The Project Management shall ensure that the users have the same rights and obligations with regard to publicity as referred to for the access provider in Article II.12 (Annex II to Grant Agreement). Users should make suitable publicity in their publications and reports about the support given by the European Community for the access provided to them, referring to EURIPRED grant agreement no: 312661.

Reporting

a)The Users selected commit to complete a User Report Form sent by Project Management to comment on the services received no later than 45 days after leaving the site or receiving the samples. The reports will be included in the EURIPRED periodic reports to the EC which will be published on the EURIPRED website. Details about the report format will be provided to the Users in due course.

b)A user questionnaire to measure user satisfaction must be filled in no later than 45 days after leaving the EURIPRED service provider site or receiving the shipment. This can be found at:

c)The existence of any subsequent publications or patents where the support of EURIPRED has been cited must be communicated to both the EURIPRED service provider and to the EURIPRED Project Management ().

Unpredictable problems

Neither EURIPRED nor the service provider can take responsibility for unpredictable delays or problems that may arise leading up to or during your project and which may affect your planned research. This would include damage to instruments; illness; etc.

Submission of an application confirms that the applicant agrees to the terms and conditions outlined above if the application is successful.

European Research Infrastructures for Poverty Related Diseases09 December 2015

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