Safety and immunogenicity of homologous versus heterologous booster dose with AZD1222, mRNA-1273, or MVC-COV1901 SARS-CoV-2 vaccines in adults: An observer-blinded, multi-center, phase 2 randomized trial

Lila Estephan, Ying Chin Lin, Yi Tsung Lin, Yen Hsu Chen, Sung Ching Pan, Szu Min Hsieh, Paal Fure Torkehagen, Yi Jen Weng, Hao Yuan Cheng, Josue Antonio Estrada, Alexander Waits, Charles Chen, Chia En Lien

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Objectives: To report the safety and immunogenicity profile of a protein subunit vaccine (MVC-COV1901) compared to AZD1222 and mRNA-1273 when given as a third (booster) dose to individuals who have completed different primary vaccine regimens. Methods: Individuals were classified according to their primary vaccine regimens, including two-dose MVC-COV1901, AZD1222, or mRNA-1273. A third dose of either half-dose MVC-COV1901, full-dose MVC-COV1901, standard-dose AZD1222, half-dose mRNA-1273 was administered in a 1:1:1:1 treatment ratio to individuals with an interval range of 84–365 days after the second dose. Endpoints included safety, humoral immunogenicity, and cell-mediated immune response on trial days 15 and 29. Exploratory endpoint included testing against variants of concern (Omicron). Results: Overall, 803 participants were randomized and boosted − 201 received half-dose MVC-COV1901, 196 received full-dose MVC-COV1901, 203 received AZD1222, and 203 received half-dose mRNA-1273. Reactogenicity was mild to moderate, and less in the MVC-COV1901 booster group. Heterologous boosting provided the best immunogenic response. Boosting with mRNA-1273 in MVC-COV1901 primed individuals induced the highest antibody titers, even against Omicron, and cell-mediated immune response. Conclusions: Overall, MVC-COV1901 as a booster showed the best safety profiles. MVC-COV1901 as a primary series, with either homologous or heterologous booster, elicited the highest immunogenic response. ClinicalTrials.gov

Original languageEnglish
Pages (from-to)3497-3505
Number of pages9
JournalVaccine
Volume41
Issue number23
DOIs
Publication statusPublished - May 26 2023

Keywords

  • Booster
  • COVID-19
  • MVC-COV1901
  • Omicron strain
  • SARS-CoV-2 vaccine
  • Subunit vaccine

ASJC Scopus subject areas

  • Molecular Medicine
  • General Immunology and Microbiology
  • General Veterinary
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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