Institute of General Practice, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Universitätsstraße 29, Erlangen, Germany.
Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Schloßgarten 4, Erlangen, Germany.
BMC Infect Dis. 2022 May 31;22(1):504. doi: 10.1186/s12879-022-07443-x.
Due to safety signals after vaccination with COVID-19 vector vaccines, several states recommended to complete the primary immunization series in individuals having received one dose of ChAdOx1 (AstraZeneca) with an mRNA vaccine. However, data on safety and reactogenicity of this heterologous regimen are still scarce. The aim of this study was therefore to compare the reactogenicity and the frequency of medical consultations after boost vaccination in a heterologous regimen with ChAdOx1 and mRNA-vaccines (BNT162b2, BioNTech/Pfizer or mRNA-1273, Moderna) to homologous regimens with ChAdOx1 or mRNA-vaccines, respectively.
In an observational cohort study reactogenicity and safety were assessed 14-19 days (short-term) and 40 to 56 days (long-term) after the boost vaccination using web-based surveys. In the short-term survey solicited and unsolicited reactions were assessed, while the long-term survey focussed on health problems leading to medical consultation after the vaccination, including those that were not suspected to be vaccine-related.
In total, 9146 participants completed at least one of the surveys (ChAdOx1/ChAdOx1: n = 552, ChAdOx1/mRNA: n = 2382, mRNA/mRNA: n = 6212). In the short-term survey, 86% with ChAdOx1/mRNA regimen reported at least one reaction, in the ChAdOx1/ChAdOx1 and mRNA/mRNA cohorts 58% and 76%, respectively (age and sex adjusted p < 0.0001). In the long-term survey, comparable proportions of individuals reported medical consultation (ChAdOx1/ChAdOx1 vs. ChAdOx1/mRNA vs. mRNA/mRNA: 15% vs. 18% vs. 16%, age and sex adjusted p = 0.398). Female gender was associated with a higher reactogenicity and more medical consultations. Younger age was associated with a higher reactogenicity, whereas elderly people reported more medical consultations.
Although the short-term reactogenicity was higher with the heterologous regimen than with the homologous regimens, other factors such as higher efficacy and limited resources during the pandemic may prevail in recommending specific regimens.
由于接种 COVID-19 载体疫苗后的安全信号，一些州建议在已接种一剂 ChAdOx1（阿斯利康）的个体中完成初级免疫系列，用 mRNA 疫苗。然而，关于这种异源方案的安全性和反应原性的数据仍然很少。因此，本研究的目的是比较 ChAdOx1 和 mRNA 疫苗（BNT162b2、BioNTech/Pfizer 或 mRNA-1273、Moderna）异源方案与 ChAdOx1 或 mRNA 疫苗同源方案的反应原性和接种后医疗咨询的频率。
在一项观察性队列研究中，使用基于网络的调查在加强接种后 14-19 天（短期）和 40-56 天（长期）评估反应原性和安全性。在短期调查中，评估了有征和无征反应，而长期调查则侧重于接种后导致医疗咨询的健康问题，包括那些不怀疑与疫苗相关的问题。
共有 9146 名参与者完成了至少一项调查（ChAdOx1/ChAdOx1：n=552，ChAdOx1/mRNA：n=2382，mRNA/mRNA：n=6212）。在短期调查中，86%的 ChAdOx1/mRNA 方案报告至少有一种反应，而在 ChAdOx1/ChAdOx1 和 mRNA/mRNA 队列中分别为 58%和 76%（年龄和性别调整后 p<0.0001）。在长期调查中，报告医疗咨询的个体比例相似（ChAdOx1/ChAdOx1 与 ChAdOx1/mRNA 与 mRNA/mRNA：15%与 18%与 16%，年龄和性别调整后 p=0.398）。女性性别与更高的反应原性和更多的医疗咨询有关。年龄较小与更高的反应原性相关，而老年人报告更多的医疗咨询。
尽管异源方案的短期反应原性高于同源方案，但在推荐特定方案时，可能会有其他因素如更高的疗效和大流行期间的有限资源起作用。
