Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan.
Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
J Formos Med Assoc. 2022 Apr;121(4):766-777. doi: 10.1016/j.jfma.2022.02.020. Epub 2022 Mar 16.
BACKGROUND/PURPOSE: Efficacy and safety data of heterologous prime-boost vaccination against SARS-CoV-2 remains limited.
We recruited adult volunteers for homologous or heterologous prime-boost vaccinations with adenoviral (ChAdOx1, AstraZeneca) and/or mRNA (mRNA-1273, Moderna) vaccines. Four groups of prime-boost vaccination schedules were designed: Group 1, ChAdOx1/ChAdOx1 8 weeks apart; Group 2, ChAdOx1/mRNA-1273 8 weeks apart; Group 3, ChAdOx1/mRNA-1273 4 weeks apart; and Group 4, mRNA-1273/mRNA-1273 4 weeks apart. The primary outcome was serum anti-SARS-CoV-2 IgG titers and neutralizing antibody titers against B.1.1.7 (alpha) and B.1.617.2 (delta) variants on day 28 after the second dose. Adverse events were recorded up until 84 days after the second dose.
We enrolled 399 participants with a median age of 41 years and 75% were female. On day 28 after the second dose, the anti-SARS-CoV-2 IgG titers of both heterologous vaccinations (Group 2 and Group 3) were significantly higher than that of homologous ChAdOx1 vaccination (Group 1), and comparable with homologous mRNA-1273 vaccination (Group 4). The heterologous vaccination group had better neutralizing antibody responses against the alpha and delta variant as compared to the homologous ChAdOx1 group. Most of the adverse events (AEs) were mild and transient. AEs were less frequent when heterologous boosting was done at 8 weeks rather than at 4 weeks.
Heterologous ChAdOx1/mRNA-1273 vaccination provided higher immunogenicity than homologous ChAdOx1 vaccination and comparable immunogenicity with the homologous mRNA-1273 vaccination. Our results support the safety and efficacy of heterologous prime-boost vaccination using the ChAdOx1 and mRNA-1273 COVID-19 vaccines. (ClinicalTrials.gov number, NCT05074368).
背景/目的：针对 SARS-CoV-2 的异源加强免疫接种的疗效和安全性数据仍然有限。
我们招募了成年志愿者进行腺病毒（ChAdOx1，阿斯利康）和/或 mRNA（mRNA-1273，莫德纳）疫苗的同源或异源加强免疫接种。设计了四种加强免疫接种方案：第 1 组，ChAdOx1/ChAdOx1 间隔 8 周；第 2 组，ChAdOx1/mRNA-1273 间隔 8 周；第 3 组，ChAdOx1/mRNA-1273 间隔 4 周；第 4 组，mRNA-1273/mRNA-1273 间隔 4 周。主要结局是第二剂后 28 天血清抗 SARS-CoV-2 IgG 滴度和针对 B.1.1.7（alpha）和 B.1.617.2（delta）变体的中和抗体滴度。记录第二剂后 84 天内的不良事件。
我们招募了 399 名中位年龄为 41 岁的参与者，其中 75%为女性。第二剂后 28 天，两种异源疫苗（第 2 组和第 3 组）的 SARS-CoV-2 IgG 滴度均明显高于同源 ChAdOx1 疫苗（第 1 组），与同源 mRNA-1273 疫苗（第 4 组）相当。与同源 ChAdOx1 组相比，异源疫苗组对 alpha 和 delta 变体的中和抗体反应更好。大多数不良事件（AE）为轻度和短暂的。异源加强免疫接种间隔 8 周而非 4 周时，AE 发生频率更低。
ChAdOx1/mRNA-1273 异源加强免疫接种比同源 ChAdOx1 疫苗提供更高的免疫原性，与同源 mRNA-1273 疫苗的免疫原性相当。我们的结果支持使用 ChAdOx1 和 mRNA-1273 COVID-19 疫苗进行异源加强免疫接种的安全性和有效性。（临床试验注册号，NCT05074368）。
