Persistence of immune responses after heterologous and homologous third COVID-19 vaccine dose schedules in the UK: eight-month analyses of the COV-BOOST trial
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Author
Liu, XinxueMunro, Alasdair P S
Wright, Annie
Feng, Shuo
Janani, Leila
Aley, Parvinder K
Babbage, Gavin
Baker, Jonathan
Baxter, David
Bawa, Tanveer
Bula, Marcin
Cathie, Katrina
Chatterjee, Krishna
Dodd, Kate
Enever, Yvanne
Fox, Lauren
Qureshi, Ehsaan
Goodman, Anna L
Green, Christopher A
Haughney, John
Hicks, Alexander
Jones, Christine E
Kanji, Nasir
van der Klaauw, Agatha A
Libri, Vincenzo
Llewelyn, Martin J
Mansfield, Rebecca
Maallah, Mina
McGregor, Alastair C
Minassian, Angela M
Moore, Patrick
Mughal, Mehmood
Mujadidi, Yama F
Belhadef, Hanane Trari
Holliday, Kyra
Osanlou, Orod
Osanlou, Rostam
Owens, Daniel R
Pacurar, Mihaela
Palfreeman, Adrian
Pan, Daniel
Rampling, Tommy
Regan, Karen
Saich, Stephen
Saralaya, Dinesh
Sharma, Sunil
Sheridan, Ray
Stokes, Matthew
Thomson, Emma C
Todd, Shirley
Twelves, Chris
Read, Robert C
Charlton, Sue
Hallis, Bassam
Ramsay, Mary
Andrews, Nick
Lambe, Teresa
Nguyen-Van-Tam, Jonathan S
Cornelius, Victoria
Snape, Matthew D
Faust, Saul N
Publication date
2023-04-20Subject
Microbiology. ImmunologyPractice of medicine
Communicable diseases
Respiratory medicine
Public health. Health statistics. Occupational health. Health education
Metadata
Show full item recordAbstract
Background: COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of seven COVID-19 vaccines used as a third booster dose in June 2021. Monovalent messenger RNA (mRNA) COVID-19 vaccines were subsequently widely used for the third and fourth-dose vaccination campaigns in high-income countries. Real-world vaccine effectiveness against symptomatic infections following third doses declined during the Omicron wave. This report compares the immunogenicity and kinetics of responses to third doses of vaccines from day (D) 28 to D242 following third doses in seven study arms. Methods: The trial initially included ten experimental vaccine arms (seven full-dose, three half-dose) delivered at three groups of six sites. Participants in each site group were randomised to three or four experimental vaccines, or MenACWY control. The trial was stratified such that half of participants had previously received two primary doses of ChAdOx1 nCov-19 (Oxford-AstraZeneca; hereafter referred to as ChAd) and half had received two doses of BNT162b2 (Pfizer-BioNtech, hereafter referred to as BNT). The D242 follow-up was done in seven arms (five full-dose, two half-dose). The BNT vaccine was used as the reference as it was the most commonly deployed third-dose vaccine in clinical practice in high-income countries. The primary analysis was conducted using all randomised and baseline seronegative participants who were SARS-CoV-2 naïve during the study and who had not received a further COVID-19 vaccine for any reason since third dose randomisation. Results: Among the 817 participants included in this report, the median age was 72 years (IQR: 55-78) with 50.7% being female. The decay rates of anti-spike IgG between vaccines are different among both populations who received initial doses of ChAd/ChAd and BNT/BNT. In the population that previously received ChAd/ChAd, mRNA vaccines had the highest titre at D242 following their vaccine dose although Ad26. COV2. S (Janssen; hereafter referred to as Ad26) showed slower decay. For people who received BNT/BNT as their initial doses, a slower decay was also seen in the Ad26 and ChAd arms. The anti-spike IgG became significantly higher in the Ad26 arm compared to the BNT arm as early as 3 months following vaccination. Similar decay rates were seen between BNT and half-BNT; the geometric mean ratios ranged from 0.76 to 0.94 at different time points. The difference in decay rates between vaccines was similar for wild-type live virus-neutralising antibodies and that seen for anti-spike IgG. For cellular responses, the persistence was similar between study arms. Conclusions: Heterologous third doses with viral vector vaccines following two doses of mRNA achieve more durable humoral responses compared with three doses of mRNA vaccines. Lower doses of mRNA vaccines could be considered for future booster campaigns.Citation
Liu X, Munro APS, Wright A, Feng S, Janani L, Aley PK, Babbage G, Baker J, Baxter D, Bawa T, Bula M, Cathie K, Chatterjee K, Dodd K, Enever Y, Fox L, Qureshi E, Goodman AL, Green CA, Haughney J, Hicks A, Jones CE, Kanji N, van der Klaauw AA, Libri V, Llewelyn MJ, Mansfield R, Maallah M, McGregor AC, Minassian AM, Moore P, Mughal M, Mujadidi YF, Belhadef HT, Holliday K, Osanlou O, Osanlou R, Owens DR, Pacurar M, Palfreeman A, Pan D, Rampling T, Regan K, Saich S, Saralaya D, Sharma S, Sheridan R, Stokes M, Thomson EC, Todd S, Twelves C, Read RC, Charlton S, Hallis B, Ramsay M, Andrews N, Lambe T, Nguyen-Van-Tam JS, Cornelius V, Snape MD, Faust SN; COV-BOOST study group. Persistence of immune responses after heterologous and homologous third COVID-19 vaccine dose schedules in the UK: eight-month analyses of the COV-BOOST trial. J Infect. 2023 Jul;87(1):18-26. doi: 10.1016/j.jinf.2023.04.012. Epub 2023 Apr 20Type
ArticleAdditional Links
http://www.sciencedirect.com/science/journal/01634453PMID
37085049Journal
The Journal of InfectionPublisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.jinf.2023.04.012