Immunogenicity and safety of COVID-19 booster vaccination: A population-based clinical trial to identify the best vaccination strategy

IF 4 3区医学 Q2 VIROLOGY Journal of Clinical Virology Pub Date : 2024-02-28 DOI:10.1016/j.jcv.2024.105661

Daniela Sieghart , Claudia A. Hana , Caroline Dürrschmid , Leonhard X. Heinz , Helmuth Haslacher , Markus Zlesak , Giulia Piccini , Alessandro Manenti , Emanuele Montomoli , Anselm Jorda , Clemens Fedrizzi , Timothy Hasenoehrl , Andrej Zdravkovic , Karolina Anderle , Ursula Wiedermann , Susanne Drapalik , Helmut Steinbrecher , Felix Bergmann , Christa Firbas , Galateja Jordakieva , Helga Radner

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Abstract

Background

Various SARS-CoV-2 variants of concerns (VOCs) characterized by higher transmissibility and immune evasion have emerged. Despite reduced vaccine efficacy against VOCs, currently available vaccines provide protection. Population-based evidence on the humoral immune response after booster vaccination is crucial to guide future vaccination strategies and in preparation for imminent COVID-19 waves.

Methods

This multicenter, population-based cohort study included 4697 individuals ≥18 years of age who received a booster vaccination. Antibody levels against SARS-CoV-2 receptor binding domain (RBD) and neutralizing antibodies against wild-type (WT) virus and Omicron variants were assessed at baseline (day of booster vaccination) and after four weeks. Safety was evaluated daily within the first week using a participant-completed electronic diary. Antibody levels were compared across different vaccination strategies, taking into account individual host factors.

Results

Our main model including 3838 participants revealed that individuals who received a booster with mRNA-1273 compared to BNT162b2 vaccine had a significantly higher increase (95 %CI) in anti-RBD-antibody levels (37,707 BAU/mL [34,575–40,839] vs. 27,176 BAU/mL [26,265–28,087]), and of neutralization levels against WT (1,681 [1490–1872] vs. 1141 [1004–1278] and Omicron variant (422 [369–474] vs. 329 [284–374]). Neutralizing antibody titres highly correlated with anti-RBD antibodies, with neutralizing capacity 4.4 fold higher against WT compared to Omicron. No differences in safety were found between the two booster vaccines.

Conclusion

Our study underlines the superiority of a booster vaccination with mRNA-1273, independent of the primary vaccination and therefore provides guidance on the vaccination strategy.

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COVID-19 加强免疫的免疫原性和安全性：确定最佳疫苗接种策略的人群临床试验

已经出现了各种 SARS-CoV-2 变异株（VOCs），其特点是传播性更强，免疫逃避能力更强。尽管疫苗对 VOCs 的效力有所降低，但目前可用的疫苗仍能提供保护。关于加强免疫后体液免疫反应的人群证据对于指导未来的疫苗接种策略和应对即将到来的 COVID-19 浪潮至关重要。这项多中心、基于人群的队列研究纳入了 4,697 名年龄≥18 岁、接受过加强免疫接种的人。在基线（加强接种当天）和四周后评估了针对 SARS-CoV-2 受体结合域 (RBD) 的抗体水平以及针对野生型 (WT) 病毒和 Omicron 变种的中和抗体。在第一周内，每天使用参与者填写的电子日记对安全性进行评估。考虑到个体宿主因素，我们对不同疫苗接种策略的抗体水平进行了比较。我们包括 3,838 名参与者的主要模型显示，与 BNT162b2 疫苗相比，接受 mRNA-1273 强化接种的个体的抗 RBD 抗体水平增幅（95%CI）明显更高（37,707 BAU/mL [34,575 - 40,839] vs. 27,176 BAU/mL [34,575 - 40,839] vs. 27,176 BAU/mL [34,575 - 40,839] ）。27,176 BAU/mL [26,265 - 28,087]），以及针对 WT 的中和水平（1,681 [1,490 - 1,872] vs. 1,141 [1,004 - 1,278] 和 Omicron 变体 (422 [369 - 474] vs. 329 [284 - 374]）。中和抗体滴度与抗 RBD 抗体高度相关，与 Omicron 相比，WT 的中和能力高出 4.4 倍。两种强化疫苗的安全性没有差异。我们的研究强调了使用 mRNA-1273 加强免疫的优越性，与初次接种无关，因此为疫苗接种策略提供了指导。

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来源期刊

Journal of Clinical Virology 医学-病毒学

CiteScore

22.70

自引率

1.10%

发文量

149

审稿时长

24 days

期刊介绍： The Journal of Clinical Virology, an esteemed international publication, serves as the official journal for both the Pan American Society for Clinical Virology and The European Society for Clinical Virology. Dedicated to advancing the understanding of human virology in clinical settings, the Journal of Clinical Virology focuses on disseminating research papers and reviews pertaining to the clinical aspects of virology. Its scope encompasses articles discussing diagnostic methodologies and virus-induced clinical conditions, with an emphasis on practicality and relevance to clinical practice. The journal publishes on topics that include: • new diagnostic technologies • nucleic acid amplification and serologic testing • targeted and metagenomic next-generation sequencing • emerging pandemic viral threats • respiratory viruses • transplant viruses • chronic viral infections • cancer-associated viruses • gastrointestinal viruses • central nervous system viruses • one health (excludes animal health)