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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Homologous and Heterologous Covid-19 Booster Vaccinations
New England Journal of Medicine, Volume 386, No. 11, Year 2022
Notification
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Description
BACKGROUND Although the three vaccines against coronavirus disease 2019 (Covid-19) that have received emergency use authorization in the United States are highly effective, breakthrough infections are occurring. Data are needed on the serial use of homologous boosters (same as the primary vaccine) and heterologous boosters (different from the primary vaccine) in fully vaccinated recipients. METHODS In this phase 1–2, open-label clinical trial conducted at 10 sites in the United States, adults who had completed a Covid-19 vaccine regimen at least 12 weeks earlier and had no reported history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection received a booster injection with one of three vaccines: mRNA-1273 (Moderna) at a dose of 100 μg, Ad26.COV2.S (Johnson & Johnson–Janssen) at a dose of 5×1010 virus particles, or BNT162b2 (Pfizer–BioNTech) at a dose of 30 μg. The primary end points were safety, reactogenicity, and humoral immunogenicity on trial days 15 and 29. RESULTS Of the 458 participants who were enrolled in the trial, 154 received mRNA-1273, 150 received Ad26.COV2.S, and 153 received BNT162b2 as booster vaccines; 1 participant did not receive the assigned vaccine. Reactogenicity was similar to that reported for the primary series. More than half the recipients reported having injection-site pain, malaise, headache, or myalgia. For all combinations, antibody neutralizing titers against a SARS-CoV-2 D614G pseudovirus increased by a factor of 4 to 73, and binding titers increased by a factor of 5 to 55. Homologous boosters increased neutralizing antibody titers by a factor of 4 to 20, whereas heterologous boosters increased titers by a factor of 6 to 73. Spike-specific T-cell responses increased in all but the homologous Ad26.COV2.S-boosted subgroup. CD8+ T-cell levels were more durable in the Ad26.COV2.S-primed recipients, and heterologous boosting with the Ad26.COV2.S vaccine substantially increased spike-specific CD8+ T cells in the mRNA vaccine recipients. CONCLUSIONS Homologous and heterologous booster vaccines had an acceptable safety profile and were immunogenic in adults who had completed a primary Covid-19 vaccine regimen at least 12 weeks earlier. (Funded by the National Institute of Allergy and Infectious Diseases; DMID 21-0012 ClinicalTrials.gov number, NCT04889209). Copyright © 2022 Massachusetts Medical Society.
Authors & Co-Authors
Atmar, Robert L.
United States, Houston
Baylor College of Medicine
Lyke, Kirsten E.
United States, Baltimore
University of Maryland School of Medicine
Deming, Meagan E.
Unknown Affiliation
Jackson, Lisa A.
Unknown Affiliation
Branche, Angela R.
Unknown Affiliation
El-Sahly, Hana Mohammed
Unknown Affiliation
Martin, Judith Marie
Unknown Affiliation
Johnston, Christine M.
Unknown Affiliation
Rupp, Richard E.
Unknown Affiliation
Mulligan, Mark J.
Unknown Affiliation
Frenck, Robert W.
Unknown Affiliation
Babu, Tara M.
Unknown Affiliation
Edupuganti, Srilatha
Unknown Affiliation
Coler, Rhea N.
Unknown Affiliation
Posavad, Christine M.
Unknown Affiliation
Szydlo, Daniel W.
Unknown Affiliation
Zemanek, Jillian A.
Unknown Affiliation
Brown, Elizabeth R.
Unknown Affiliation
Suthar, Mehul S.
Unknown Affiliation
McElrath, Margaret Juliana
Unknown Affiliation
McDermott, Adrian B.
Unknown Affiliation
O’Connell, Sarah E.
Unknown Affiliation
Montefiori, David Charles
Unknown Affiliation
Eaton, Amanda
Unknown Affiliation
Neuzil, Kathleen Maletic
Unknown Affiliation
Stephens, David
Unknown Affiliation
Beigel, John H.
Unknown Affiliation
Statistics
Citations: 309
Authors: 27
Affiliations: 2
Identifiers
Doi:
10.1056/NEJMoa2116414
ISSN:
00284793
Research Areas
Covid