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Antibody response of heterologous vs homologous mRNA vaccine boosters against the SARS-CoV-2 Omicron variant: interim results from the PRIBIVAC study, A Randomized Clinical Trial.


ABSTRACT:

Background

Waning antibody levels post-vaccination and the emergence of variants of concern (VOCs) capable of evading protective immunity has raised the need for booster vaccinations. However, which combination of COVID-19 vaccines offers the strongest immune response against Omicron variant is unknown.

Methods

This randomized, subject-blinded, controlled trial assessed the reactogenicity and immunogenicity of different COVID-19 vaccine booster combinations. 100 BNT162b2-vaccinated individuals were enrolled and randomized 1: 1 to either homologous (BNT162b2 + BNT162b2 + BNT162b2; 'BBB') or heterologous mRNA booster vaccine (BNT162b2 + BNT162b2 + mRNA-1273; 'BBM'). Primary endpoint was the level of neutralizing antibodies against SARS-CoV-2 wild-type and VOCs at Day 28.

Results

51 participants were allocated to BBB and 49 to BBM; 50 and 48 respectively were analyzed for safety and immunogenicity outcomes. At Day 28 post-boost, mean SARS-CoV-2 spike antibody titers were lower with BBB (22,382  IU/mL 95% CI, 18,210 to 27,517) vs BBM (29,751  IU/mL 95% CI, 25,281 to 35,011, p = 0.034) as was the median level of neutralizing antibodies: BBB 99.0% (IQR 97.9 to 99.3%) vs BBM 99.3% (IQR 98.8 to 99.5%, p = 0.021). On sub-group analysis, significant differences in mean spike antibody titer and live Omicron neutralization titer was only observed in older adults. Median surrogate neutralizing antibody level against all VOCs was also significantly higher with BBM in older adults, and against Omicron was BBB 72.8% (IQR 54.0 to 84.7%) vs BBM 84.3% (IQR 78.1 to 88.7%, p = 0.0073). Both vaccines were well tolerated.

Conclusions

Heterologous mRNA-1273 booster vaccination induced a stronger neutralizing response against the Omicron variant in older individuals compared with homologous BNT123b2.

SUBMITTER: Poh XY 

PROVIDER: S-EPMC9129205 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Antibody Response of Heterologous vs Homologous Messenger RNA Vaccine Boosters Against the Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variant: Interim Results from the PRIBIVAC Study, a Randomized Clinical Trial.

Poh Xuan Ying XY   Tan Chee Wah CW   Lee I Russel IR   Chavatte Jean-Marc JM   Fong Siew-Wai SW   Prince Tessa T   Hartley Catherine C   Yeoh Aileen Y Y AYY   Rao Suma S   Chia Po Ying PY   Ong Sean W X SWX   Lee Tau Hong TH   Sadarangani Sapna P SP   Lin Ray J H RJH   Lim Clarissa C   Teo Jefanie J   Lim Daniel R X DRX   Chia Wanni W   Hiscox Julian A JA   Ng Lisa F P LFP   Ren Ee Chee EC   Lin Raymond T P RTP   Renia Laurent L   Lye David Chien DC   Wang Lin-Fa LF   Young Barnaby E BE  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20221201 12


<h4>Background</h4>Waning antibody levels post-vaccination and the emergence of variants of concern (VOCs) capable of evading protective immunity have raised the need for booster vaccinations. However, which combination of coronavirus disease 2019 (COVID-19) vaccines offers the strongest immune response against the Omicron variant is unknown.<h4>Methods</h4>This randomized, participant-blinded, controlled trial assessed the reactogenicity and immunogenicity of different COVID-19 vaccine booster  ...[more]

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