Siddiqui Amna, Adnan Alishba, Abbas Munib, Taseen Shafaq, Ochani Sidhant, Essar Mohammad Yasir
Department of MBBS Karachi Medical and Dental College Karachi City Pakistan.
Department of MBBS Khairpur Medical College Khairpur Mir's Pakistan.
Health Sci Rep. 2022 Feb 23;5(2):e531. doi: 10.1002/hsr2.531. eCollection 2022 Mar.
The heterologous prime-boost vaccination technique is not novel as it has a history of deployment in previous outbreaks.
Hence, this narrative review aims to provide critical insight for reviving the heterologous prime-boost immunization strategy for SARS-CoV-2 vaccination relative to a brief positive outlook on the mix-dose approach deployed in previous and existing outbreaks (ie, Ebola virus disease (EVD), malaria, tuberculosis, hepatitis B, HIV and influenza virus).
A Boolean search was carried out to find the literature in MEDLINE-PubMed, Clinicaltrials, and Cochrane Central Register of Controlled Trials databases up till December 22, 2021, using the specific keywords that include "SARS-CoV2", "COVID-19", "Ebola," "Malaria," "Tuberculosis," "Human Immunodeficiency Virus," "Hepatitis B," "Influenza," "Mix and match," "Heterologous prime-boost," with interposition of "OR" and "AND." Full text of all the related articles in English language with supplementary appendix was retrieved. In addition, the full text of relevant cross-references was also retrieved.
Therefore, as generally evident by the primary outcomes, that is, safety, reactogenicity, and immunogenicity reported and updated by preclinical and clinical studies for addressing previous and existing outbreaks so far, including COVID-19, it is understood that heterologous prime-boost immunization has been proven successful for eliciting a more efficacious immune response as of yet in comparison to the traditional homologous prime-boost immunization regimen.
Accordingly, with increasing cases of COVID-19, many countries such as Germany, Pakistan, Canada, Thailand, and the United Kingdom have started administering the heterologous vaccination as the technique aids to rationalize the usage of the available vaccines to aid in the global race to vaccinate majority to curb the spread of COVID-19 efficiently. However, the article emphasizes the need for more large controlled trials considering demographic details of vaccine recipients, which would play an essential role in clearing the mistrust about safety concerns to pace up the acceptance of the technique across the globe.
Consequently, by combatting the back-to-back waves of COVID-19 and other challenging variants of concerns, including Omicron, the discussed approach can also help in addressing the expected evolution of priority outbreaks as coined by WHO, that is, "Disease X" in 2018 with competency, which according to WHO can turn into the "next pandemic" or the "next public health emergency," thus would eventually lead to eradicating the risk of "population crisis."
异源初免-加强疫苗接种技术并非新鲜事物，在以往疫情中就有应用历史。
因此，本叙述性综述旨在深入剖析，以重启针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗接种的异源初免-加强免疫策略，同时简要展望既往及现有疫情（即埃博拉病毒病、疟疾、结核病、乙型肝炎、人类免疫缺陷病毒和流感病毒）中采用的混合剂量接种方法的积极前景。
截至2021年12月22日，在医学文献数据库（MEDLINE-PubMed）、临床试验数据库和Cochrane对照试验中央注册库中进行布尔检索，使用特定关键词，包括“SARS-CoV2”“2019冠状病毒病”“埃博拉”“疟疾”“结核病”“人类免疫缺陷病毒”“乙型肝炎”“流感”“混合搭配”“异源初免-加强”，并插入“OR”和“AND”。检索所有英文相关文章的全文及补充附录。此外，还检索了相关交叉引用文献的全文。
因此，从主要结果来看，即临床前和临床研究报告及更新的、针对包括2019冠状病毒病在内的既往及现有疫情的安全性、反应原性和免疫原性，可知与传统同源初免-加强免疫方案相比，异源初免-加强免疫已被证明能成功引发更有效的免疫反应。
相应地，随着2019冠状病毒病病例增加，德国、巴基斯坦、加拿大、泰国和英国等许多国家已开始实施异源疫苗接种，因为该技术有助于合理使用现有疫苗，助力全球大规模接种竞赛，以有效遏制2019冠状病毒病传播。然而，本文强调需要更多考虑疫苗接种者人口统计学细节的大型对照试验，这对于消除对安全问题的疑虑、加快该技术在全球的接受度将起到至关重要的作用。
因此，通过应对2019冠状病毒病的接连浪潮以及其他具有挑战性的相关变体，包括奥密克戎，所讨论的方法也有助于应对世界卫生组织（WHO）提出的优先疫情的预期演变，即2018年的“X疾病”，据WHO称，它可能演变成“下一次大流行”或“下一次公共卫生紧急事件”，从而最终消除“人口危机”的风险。
