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健康成年人适应 COVID-19 疫苗接种方案后对 SARS-CoV-2 的体液免疫反应:IMCOVAS 随机临床试验。

Humoral immune response against SARS-CoV-2 after adapted COVID-19 vaccine schedules in healthy adults: The IMCOVAS randomized clinical trial.

机构信息

Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.

Data Science Institute, UHasselt, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium.

出版信息

Vaccine. 2024 Nov 14;42(25):126117. doi: 10.1016/j.vaccine.2024.07.018. Epub 2024 Jul 16.


DOI:10.1016/j.vaccine.2024.07.018
PMID:39019657
Abstract

BACKGROUND: To overcome supply issues of COVID-19 vaccines, this partially single blind, multi-centric, vaccine trial aimed to evaluate humoral immunogenicity using lower vaccine doses, intradermal vaccination, and heterologous vaccine schedules. Also, the immunity after a booster vaccination was assessed. METHODOLOGY: 566 COVID-19-naïve healthy adults were randomized to 1 of 8 treatment arms consisting of combinations of BNT162b2, mRNA-1273, and ChAdOx1-S. Anti-Receptor-Binding Domain immunoglobulin G (RBD IgG) titers, neutralizing antibody titres, and avidity of the anti-RBD IgGs was assessed up to 1 year after study start. RESULTS: Prolonging the interval between vaccinations from 28 to 84 days and the use of a heterologous BNT162b2 + mRNA-1273 vaccination schedule led to a non-inferior immune response, compared to the reference schedule. A low dose of mRNA-1273 was sufficient to induce non-inferior immunity. Non-inferiority could not be demonstrated for intradermal vaccination. For all adapted vaccination schedules, anti-RBD IgG titres measured after a first booster vaccination were non-inferior to their reference schedule. CONCLUSION: This study suggests that reference vaccine schedules can be adapted without jeopardizing the development of an adequate immune response. Immunity after a booster vaccination did not depend on the dose or brand of the booster vaccine, which is relevant for future booster campaigns. The trial is registered in the European Union Clinical Trials Register (number 2021-001993-52) and on clinicaltrials.gov (NCT06189040).

摘要

背景:为克服 COVID-19 疫苗供应问题,本部分单盲、多中心疫苗试验旨在评估使用较低剂量疫苗、皮内接种和异源疫苗方案的体液免疫原性。此外,还评估了加强疫苗接种后的免疫情况。

方法:566 名 COVID-19 初治健康成年人被随机分配至 8 种治疗组中的 1 种,这些治疗组由 BNT162b2、mRNA-1273 和 ChAdOx1-S 的组合组成。在研究开始后长达 1 年的时间内,评估了抗受体结合域免疫球蛋白 G(RBD IgG)滴度、中和抗体滴度和抗 RBD IgG 的亲和力。

结果:与参考方案相比,将疫苗接种间隔从 28 天延长至 84 天以及使用异源 BNT162b2+mRNA-1273 接种方案可导致非劣效免疫反应。低剂量的 mRNA-1273 足以诱导非劣效免疫。皮内接种不能证明非劣效性。对于所有适应的接种方案,首次加强疫苗接种后的抗 RBD IgG 滴度均不劣于其参考方案。

结论:本研究表明,在不影响产生足够免疫反应的情况下,可以调整参考疫苗方案。加强疫苗接种后的免疫反应不依赖于加强疫苗的剂量或品牌,这对未来的加强疫苗接种活动具有重要意义。该试验在欧盟临床试验注册中心(编号 2021-001993-52)和临床试验.gov (NCT06189040)上注册。

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Humoral immune response against SARS-CoV-2 after adapted COVID-19 vaccine schedules in healthy adults: The IMCOVAS randomized clinical trial.

Vaccine. 2024-11-14

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引用本文的文献

[1]
Exponential decline, ceiling effect, downregulation, and T-cell response in immunoglobulin G antibody levels after messenger RNA vaccine boosters: a case report.

J Med Case Rep. 2024-12-20

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