Persistence of immunogenicity after seven COVID-19 vaccines given as third dose boosters following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK: Three month analyses of the COV-BOOST trial
Research output: Contribution to journal › Article › peer-review
Standard Standard
In: Journal of Infection, Vol. 84, No. 6, 06.2022, p. 795-813.
Research output: Contribution to journal › Article › peer-review
HarvardHarvard
APA
CBE
MLA
VancouverVancouver
Author
RIS
TY - JOUR
T1 - Persistence of immunogenicity after seven COVID-19 vaccines given as third dose boosters following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK: Three month analyses of the COV-BOOST trial
AU - Liu, Xinxue
AU - Munro, Alasdair P. S.
AU - Feng, Shuo
AU - Janani, Leila
AU - Aley, Parvinder K.
AU - Babbage, Gavin
AU - Baxter, David
AU - Bula, Marcin
AU - Cathie, Katrina
AU - Chatterjee, Krishna
AU - Dejnirattisai, Wanwisa
AU - Dodd, Kate
AU - Enever, Yvanne
AU - Qureshi, Ehsaan
AU - Goodman, Anna L.
AU - Harndahl, Linda
AU - Haughney, John
AU - Hicks, Alexander
AU - van der Klaauw, Agatha A.
AU - Kwok, Jonathan
AU - Libri, Vincenzo
AU - Llewelyn, Martin J.
AU - McGregor, Alastair C.
AU - Minassian, Angela M.
AU - Moore, Patrick
AU - Mughal, Mehmood
AU - Mujadidi, Yama F.
AU - Holliday, Kyra
AU - Osanlou, Orod
AU - Osanlou, Rostam
AU - Owens, Daniel R.
AU - Pacurar, Mihaela
AU - Palfreeman, Adrian
AU - Pan, Daniel
AU - Rampling, Tommy
AU - Regan, Karen
AU - Saich, Stephen
AU - Serafimova, Teona
AU - Saralaya, Dinesh
AU - Screaton, Gavin R.
AU - Sharma, Sunil
AU - Sheridan, Ray
AU - Sturdy, Ann
AU - Supasa, Piyada
AU - Thomson, Emma C.
AU - Todd, Shirley
AU - Twelves, Chris
AU - Read, Robert C.
AU - Charlton, Sue
AU - Hallis, Bassam
AU - Ramsay, Mary
AU - Andrews, Nick
AU - Lambe, Teresa
AU - Nguyen-Van-Tam, Jonathan S.
AU - Cornelius, Victoria
AU - Snape, Matthew D.
AU - Faust, Saul N.
PY - 2022/6
Y1 - 2022/6
N2 - OBJECTIVES: To evaluate the persistence of immunogenicity three months after third dose boosters.METHODS: COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of seven COVID-19 vaccines used as a third booster dose. The analysis was conducted using all randomised participants who were SARS-CoV-2 naïve during the study.RESULTS: Amongst the 2883 participants randomised, there were 2422 SARS-CoV-2 naïve participants until D84 visit included in the analysis with median age of 70 (IQR: 30-94) years. In the participants who had two initial doses of ChAdOx1 nCov-19 (Oxford-AstraZeneca; hereafter referred to as ChAd), schedules using mRNA vaccines as third dose have the highest anti-spike IgG at D84 (e.g. geometric mean concentration of 8674 ELU/ml (95% CI: 7461-10,085) following ChAd/ChAd/BNT162b2 (Pfizer-BioNtech, hearafter referred to as BNT)). However, in people who had two initial doses of BNT there was no significant difference at D84 in people given ChAd versus BNT (geometric mean ratio (GMR) of 0.95 (95%CI: 0.78, 1.15). Also, people given Ad26.COV2.S (Janssen; hereafter referred to as Ad26) as a third dose had significantly higher anti-spike IgG at D84 than BNT (GMR of 1.20, 95%CI: 1.01,1.43). Responses at D84 between people who received BNT (15 μg) or BNT (30 μg) after ChAd/ChAd or BNT/BNT were similar, with anti-spike IgG GMRs of half-BNT (15 μg) versus BNT (30 μg) ranging between 0.74-0.86. The decay rate of cellular responses were similar between all the vaccine schedules and doses.CONCLUSIONS: 84 days after a third dose of COVID-19 vaccine the decay rates of humoral response were different between vaccines. Adenoviral vector vaccine anti-spike IgG concentrations at D84 following BNT/BNT initial doses were similar to or even higher than for a three dose (BNT/BNT/BNT) schedule. Half dose BNT immune responses were similar to full dose responses. While high antibody tires are desirable in situations of high transmission of new variants of concern, the maintenance of immune responses that confer long-lasting protection against severe disease or death is also of critical importance. Policymakers may also consider adenoviral vector, fractional dose of mRNA, or other non-mRNA vaccines as third doses.
AB - OBJECTIVES: To evaluate the persistence of immunogenicity three months after third dose boosters.METHODS: COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of seven COVID-19 vaccines used as a third booster dose. The analysis was conducted using all randomised participants who were SARS-CoV-2 naïve during the study.RESULTS: Amongst the 2883 participants randomised, there were 2422 SARS-CoV-2 naïve participants until D84 visit included in the analysis with median age of 70 (IQR: 30-94) years. In the participants who had two initial doses of ChAdOx1 nCov-19 (Oxford-AstraZeneca; hereafter referred to as ChAd), schedules using mRNA vaccines as third dose have the highest anti-spike IgG at D84 (e.g. geometric mean concentration of 8674 ELU/ml (95% CI: 7461-10,085) following ChAd/ChAd/BNT162b2 (Pfizer-BioNtech, hearafter referred to as BNT)). However, in people who had two initial doses of BNT there was no significant difference at D84 in people given ChAd versus BNT (geometric mean ratio (GMR) of 0.95 (95%CI: 0.78, 1.15). Also, people given Ad26.COV2.S (Janssen; hereafter referred to as Ad26) as a third dose had significantly higher anti-spike IgG at D84 than BNT (GMR of 1.20, 95%CI: 1.01,1.43). Responses at D84 between people who received BNT (15 μg) or BNT (30 μg) after ChAd/ChAd or BNT/BNT were similar, with anti-spike IgG GMRs of half-BNT (15 μg) versus BNT (30 μg) ranging between 0.74-0.86. The decay rate of cellular responses were similar between all the vaccine schedules and doses.CONCLUSIONS: 84 days after a third dose of COVID-19 vaccine the decay rates of humoral response were different between vaccines. Adenoviral vector vaccine anti-spike IgG concentrations at D84 following BNT/BNT initial doses were similar to or even higher than for a three dose (BNT/BNT/BNT) schedule. Half dose BNT immune responses were similar to full dose responses. While high antibody tires are desirable in situations of high transmission of new variants of concern, the maintenance of immune responses that confer long-lasting protection against severe disease or death is also of critical importance. Policymakers may also consider adenoviral vector, fractional dose of mRNA, or other non-mRNA vaccines as third doses.
KW - COVID-19 vaccine
KW - Third dose
KW - Heterologous boost
KW - Homologous boost
KW - Fractional dose
KW - Immunogenicity
KW - Persistence
U2 - 10.1016/j.jinf.2022.04.018
DO - 10.1016/j.jinf.2022.04.018
M3 - Article
C2 - 35405168
VL - 84
SP - 795
EP - 813
JO - Journal of Infection
JF - Journal of Infection
SN - 0163-4453
IS - 6
ER -