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Yi Y, Han X, Cui X, Wang P, Wang X, Liu H, Wang Y, Zhu N, Li Y, Lin Y, Li X. Safety and Immunogenicity of the Inactivated COVID-19 Vaccine Booster in People Living with HIV in China. Vaccines (Basel) 2023; 11:1019. [PMID: 37376408 DOI: 10.3390/vaccines11061019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/29/2023] Open
Abstract
Current knowledge regarding the long-term humoral response of people infected with human immunodeficiency virus to the third dose of inactivated coronavirus disease (COVID-19) vaccine is incomplete. As a result, concerns remain about the safety and efficacy of the vaccination. To improve our understanding of the safety and immunogenicity of the COVID-19 inactivated vaccine booster in people living with HIV (PLWH), a prospective study was conducted on participants who had not yet received a third dose of the COVID-19 inactivated vaccine, had no history of SARS-CoV-2 infection, and had received a second dose of the vaccine more than six months prior. The primary safety outcomes included the incidence of adverse reactions, changes in CD4+ T-cell count, viral load, blood routine examination, liver and kidney function examination, blood sugar, and blood lipid examination. The pseudovirus-neutralizing antibody responses to the D614G variant, Delta variant, and Omicron variants BA.5 and BF.7 were evaluated before vaccination, 14 days, 28 days, 3 months, and 6 months after vaccination to evaluate the immune response of PLWH to the injection of inactivated vaccine booster and the safety of the vaccine. In conclusion, COVID-19 vaccine booster shots were effective in PLWH, resulting in an increase in the number of CD4+ T-cells, neutralizing antibodies that lasted up to six months, and higher levels of neutralizing antibodies lasting approximately 3 months. However, the vaccine protection against the two variants of BA.5 and BF.7 was significantly lower than that of D614G and Delta.
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Affiliation(s)
- Yunyun Yi
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Xiaoxu Han
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research, Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Xinyu Cui
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Peng Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Xin Wang
- Center of Integrative Medicine, Peking University Ditan Teaching Hospital, Beijing 100015, China
| | - Hui Liu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Yuqi Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Na Zhu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Yanyan Li
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Yingying Lin
- Center of Integrative Medicine, Peking University Ditan Teaching Hospital, Beijing 100015, China
| | - Xin Li
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
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2
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Fu Y, Zhao J, Han P, Zhang J, Wang Q, Wang Q, Wei X, Yang L, Ren T, Zhan S, Li L. Cost-effectiveness of COVID-19 vaccination: A systematic review. J Evid Based Med 2023. [PMID: 37186130 DOI: 10.1111/jebm.12525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/17/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE The COVID-19 vaccination strategy has been widely used to protect population health worldwide. This study aims to summarize the cost-effectiveness evidence of economic evaluation of COVID-19 vaccination strategies to provide evidence supporting the usage of COVID-19 vaccination, especially where the supply of COVID-19 vaccine is limited. METHODS A systematic literature review was performed by searching both English and Chinese databases, including PubMed, Embase, Science Direct, Web of Science, Medline, Scopus, and CNKI. Articles published from January 1, 2020 to August 1, 2022 (PROSPERO registration number: CRD42022355442). RESULTS Of the 1035 papers identified, a total of 28 English studies that met the preset criteria were included. COVID-19 vaccination and booster vaccination were cost-effective or cost-saving regardless of the vaccine type; vaccine efficacy, vaccine price, vaccine supply or prioritization, and vaccination pace were the influential factors of cost-effectiveness among different population groups. When supply is adequate, mass vaccination should be encouraged, while when supply is inadequate, prioritizing the high risk and the elderly is more cost-effective. CONCLUSIONS COVID-19 vaccination strategies are economically favorable in a wide range of countries and population groups, and further research on suitable strategies for booster COVID-19 vaccination is needed.
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Affiliation(s)
- Yaqun Fu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Jingyu Zhao
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Peien Han
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Jiawei Zhang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Quan Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Brown School, Washington University in St. Louis, St. Louis MO, U.S., St. Louis, United States
| | - Qingbo Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Xia Wei
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Li Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Tao Ren
- School of Public Health, Peking University, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing, China
| | - Liming Li
- Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
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3
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Chen Y, Zhang X, Gong L, Liang Z, Hu X, Xing B, Liao Y, Yuan L, Chen G, Lv H. Safety, immunogenicity and immune-persistence of heterologous prime-boost immunization with BBIBP-CorV and ZF2001 against SARS-CoV-2 in healthy adults aged 18 years or older. Expert Rev Vaccines 2023; 22:1079-1090. [PMID: 37877219 DOI: 10.1080/14760584.2023.2274491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Because SARS-CoV-2 mutations and immunity wane over time, a third dose of heterologous COVID-19 vaccine is proposed for individuals primed with inactivated COVID-19 vaccine. RESEARCH DESIGN AND METHODS We conducted a single-center, open-label trial to assess the safety, immunogenicity, and immune-persistence of a heterologous BBIBP-CorV/ZF2001 prime-boost vaccination in Chinese adults. 480 participants who had been primed with two doses of BBIBP-CorV, received a third dose of ZF2001 after an interval of 3-4, 5-6, or 7-9 months. RESULTS The overall incidence of adverse reactions within 30 days after vaccination was 5.83%. No serious adverse reactions were reported. The respective geometric mean titers (GMTs) of neutralizing antibodies for 3-4, 5-6, and 7-9 months groups at baseline were 2.06, 2.02, and 2.10; which increased to 55.42, 63.45, and 62.06 on day 14; then decreased to 17.53, 23.79, and 26.73 on day 30; before finally waning to 8.29, 9.24, and 9.51 on day 180. After the booster, the three groups showed no significant differences in GMTs. GMTs were lower in older participants than younger participants. CONCLUSIONS A heterologous BBIBP-CorV/ZF2001 prime-boost vaccination was safe and immunogenic. Prime-boost intervals did not affect the immune response. The immune response was weaker in older adults than younger adults. CLINICAL TRIAL IDENTIFIER NCT05205083.
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Affiliation(s)
- Yingping Chen
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xinpei Zhang
- Office, Shangyu District Center for Disease Control and Prevention, Shaoxing, China
| | - Lihui Gong
- Clinical Department, Anhui Zhifei Longcom Biopharmaceutical Co. Ltd, Hefei, China
| | - Zhenzhen Liang
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaosong Hu
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Bo Xing
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yuting Liao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, China
| | - Lingfeng Yuan
- Clinical Department, Anhui Zhifei Longcom Biopharmaceutical Co. Ltd, Hefei, China
| | - Gang Chen
- Clinical Department, Anhui Zhifei Longcom Biopharmaceutical Co. Ltd, Hefei, China
| | - Huakun Lv
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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4
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Xu K, Wang Z, Qin M, Gao Y, Luo N, Xie W, Zou Y, Wang J, Ma X. A systematic review and meta-analysis of the effectiveness and safety of COVID-19 vaccination in older adults. Front Immunol 2023; 14:1113156. [PMID: 36936964 PMCID: PMC10020204 DOI: 10.3389/fimmu.2023.1113156] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
In the coronavirus disease 2019 (COVID-19) pandemic, vaccinations were essential in preventing COVID-19 infections and related mortality in older adults. The objectives of this study were to evaluate the effectiveness and safety of the COVID-19 vaccines in older adults. We systematically searched the electronic bibliographic databases of PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, Research Square, and OpenGrey, as well as other sources of gray literature, for studies published between January 1, 2020, and October 1, 2022. We retrieved 22 randomized controlled trials (RCTs), with a total of 3,404,696 older adults (aged over 60 years) participating, that were included in the meta-analysis. No significant publication bias was found. In the cumulative meta-analysis, we found that the COVID-19 vaccines were effective in preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (OR = 0.38, 95% CI = 0.23-0.65, p = 0.0004) and in reducing the number of COVID-19-related deaths (OR = 0.16, 95% CI = 0.10-0.25, p < 0.00001) in elderly people. Antibody seroconversion (AS) and geometric mean titer (GMT) levels significantly increased in vaccinated older adults [OR = 24.42, 95% CI = 19.29-30.92; standardized mean difference (SMD) = 0.92, 95% CI = 0.64-1.20, respectively]. However, local and systemic adverse events after COVID-19 vaccine administration were found in older adults (OR = 2.57, 95% CI = 1.83-3.62, p < 0.00001). Although vaccination might induce certain adverse reactions in the elderly population, the available evidence showed that the COVID-19 vaccines are effective and tolerated, as shown by the decrease in COVID-19-related deaths in older adults. It needs to be made abundantly clear to elderly people that the advantages of vaccination far outweigh any potential risks. Therefore, COVID-19 vaccination should be considered as the recommended strategy for the control of this disease by preventing SARS-CoV-2 infection and related deaths in older adults. More RCTs are needed to increase the certainty of the evidence and to verify our conclusions. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319698, identifier CRD42022319698.
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Affiliation(s)
- Kun Xu
- School of Health Management, Xihua University, Chengdu, China
| | - Zihan Wang
- Faculty of Geosciences and Environmental Engineering, Southwest Jiaotong University, Chengdu, China
| | - Maorong Qin
- School of Health Management, Xihua University, Chengdu, China
| | - Yangyu Gao
- School of Health Management, Xihua University, Chengdu, China
| | - Na Luo
- School of Health Management, Xihua University, Chengdu, China
| | - Wanting Xie
- School of Health Management, Xihua University, Chengdu, China
| | - Yihan Zou
- School of Health Management, Xihua University, Chengdu, China
| | - Jie Wang
- School of Food and Biological Engineering, Xihua University, Chengdu, China
| | - Xingming Ma
- School of Health Management, Xihua University, Chengdu, China
- Health Promotion Center, Xihua University, Chengdu, China
- *Correspondence: Xingming Ma,
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5
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Graña C, Ghosn L, Evrenoglou T, Jarde A, Minozzi S, Bergman H, Buckley BS, Probyn K, Villanueva G, Henschke N, Bonnet H, Assi R, Menon S, Marti M, Devane D, Mallon P, Lelievre JD, Askie LM, Kredo T, Ferrand G, Davidson M, Riveros C, Tovey D, Meerpohl JJ, Grasselli G, Rada G, Hróbjartsson A, Ravaud P, Chaimani A, Boutron I. Efficacy and safety of COVID-19 vaccines. Cochrane Database Syst Rev 2022; 12:CD015477. [PMID: 36473651 PMCID: PMC9726273 DOI: 10.1002/14651858.cd015477] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Different forms of vaccines have been developed to prevent the SARS-CoV-2 virus and subsequent COVID-19 disease. Several are in widespread use globally. OBJECTIVES: To assess the efficacy and safety of COVID-19 vaccines (as a full primary vaccination series or a booster dose) against SARS-CoV-2. SEARCH METHODS We searched the Cochrane COVID-19 Study Register and the COVID-19 L·OVE platform (last search date 5 November 2021). We also searched the WHO International Clinical Trials Registry Platform, regulatory agency websites, and Retraction Watch. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing COVID-19 vaccines to placebo, no vaccine, other active vaccines, or other vaccine schedules. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. We used GRADE to assess the certainty of evidence for all except immunogenicity outcomes. We synthesized data for each vaccine separately and presented summary effect estimates with 95% confidence intervals (CIs). MAIN RESULTS: We included and analyzed 41 RCTs assessing 12 different vaccines, including homologous and heterologous vaccine schedules and the effect of booster doses. Thirty-two RCTs were multicentre and five were multinational. The sample sizes of RCTs were 60 to 44,325 participants. Participants were aged: 18 years or older in 36 RCTs; 12 years or older in one RCT; 12 to 17 years in two RCTs; and three to 17 years in two RCTs. Twenty-nine RCTs provided results for individuals aged over 60 years, and three RCTs included immunocompromized patients. No trials included pregnant women. Sixteen RCTs had two-month follow-up or less, 20 RCTs had two to six months, and five RCTs had greater than six to 12 months or less. Eighteen reports were based on preplanned interim analyses. Overall risk of bias was low for all outcomes in eight RCTs, while 33 had concerns for at least one outcome. We identified 343 registered RCTs with results not yet available. This abstract reports results for the critical outcomes of confirmed symptomatic COVID-19, severe and critical COVID-19, and serious adverse events only for the 10 WHO-approved vaccines. For remaining outcomes and vaccines, see main text. The evidence for mortality was generally sparse and of low or very low certainty for all WHO-approved vaccines, except AD26.COV2.S (Janssen), which probably reduces the risk of all-cause mortality (risk ratio (RR) 0.25, 95% CI 0.09 to 0.67; 1 RCT, 43,783 participants; high-certainty evidence). Confirmed symptomatic COVID-19 High-certainty evidence found that BNT162b2 (BioNtech/Fosun Pharma/Pfizer), mRNA-1273 (ModernaTx), ChAdOx1 (Oxford/AstraZeneca), Ad26.COV2.S, BBIBP-CorV (Sinopharm-Beijing), and BBV152 (Bharat Biotect) reduce the incidence of symptomatic COVID-19 compared to placebo (vaccine efficacy (VE): BNT162b2: 97.84%, 95% CI 44.25% to 99.92%; 2 RCTs, 44,077 participants; mRNA-1273: 93.20%, 95% CI 91.06% to 94.83%; 2 RCTs, 31,632 participants; ChAdOx1: 70.23%, 95% CI 62.10% to 76.62%; 2 RCTs, 43,390 participants; Ad26.COV2.S: 66.90%, 95% CI 59.10% to 73.40%; 1 RCT, 39,058 participants; BBIBP-CorV: 78.10%, 95% CI 64.80% to 86.30%; 1 RCT, 25,463 participants; BBV152: 77.80%, 95% CI 65.20% to 86.40%; 1 RCT, 16,973 participants). Moderate-certainty evidence found that NVX-CoV2373 (Novavax) probably reduces the incidence of symptomatic COVID-19 compared to placebo (VE 82.91%, 95% CI 50.49% to 94.10%; 3 RCTs, 42,175 participants). There is low-certainty evidence for CoronaVac (Sinovac) for this outcome (VE 69.81%, 95% CI 12.27% to 89.61%; 2 RCTs, 19,852 participants). Severe or critical COVID-19 High-certainty evidence found that BNT162b2, mRNA-1273, Ad26.COV2.S, and BBV152 result in a large reduction in incidence of severe or critical disease due to COVID-19 compared to placebo (VE: BNT162b2: 95.70%, 95% CI 73.90% to 99.90%; 1 RCT, 46,077 participants; mRNA-1273: 98.20%, 95% CI 92.80% to 99.60%; 1 RCT, 28,451 participants; AD26.COV2.S: 76.30%, 95% CI 57.90% to 87.50%; 1 RCT, 39,058 participants; BBV152: 93.40%, 95% CI 57.10% to 99.80%; 1 RCT, 16,976 participants). Moderate-certainty evidence found that NVX-CoV2373 probably reduces the incidence of severe or critical COVID-19 (VE 100.00%, 95% CI 86.99% to 100.00%; 1 RCT, 25,452 participants). Two trials reported high efficacy of CoronaVac for severe or critical disease with wide CIs, but these results could not be pooled. Serious adverse events (SAEs) mRNA-1273, ChAdOx1 (Oxford-AstraZeneca)/SII-ChAdOx1 (Serum Institute of India), Ad26.COV2.S, and BBV152 probably result in little or no difference in SAEs compared to placebo (RR: mRNA-1273: 0.92, 95% CI 0.78 to 1.08; 2 RCTs, 34,072 participants; ChAdOx1/SII-ChAdOx1: 0.88, 95% CI 0.72 to 1.07; 7 RCTs, 58,182 participants; Ad26.COV2.S: 0.92, 95% CI 0.69 to 1.22; 1 RCT, 43,783 participants); BBV152: 0.65, 95% CI 0.43 to 0.97; 1 RCT, 25,928 participants). In each of these, the likely absolute difference in effects was fewer than 5/1000 participants. Evidence for SAEs is uncertain for BNT162b2, CoronaVac, BBIBP-CorV, and NVX-CoV2373 compared to placebo (RR: BNT162b2: 1.30, 95% CI 0.55 to 3.07; 2 RCTs, 46,107 participants; CoronaVac: 0.97, 95% CI 0.62 to 1.51; 4 RCTs, 23,139 participants; BBIBP-CorV: 0.76, 95% CI 0.54 to 1.06; 1 RCT, 26,924 participants; NVX-CoV2373: 0.92, 95% CI 0.74 to 1.14; 4 RCTs, 38,802 participants). For the evaluation of heterologous schedules, booster doses, and efficacy against variants of concern, see main text of review. AUTHORS' CONCLUSIONS Compared to placebo, most vaccines reduce, or likely reduce, the proportion of participants with confirmed symptomatic COVID-19, and for some, there is high-certainty evidence that they reduce severe or critical disease. There is probably little or no difference between most vaccines and placebo for serious adverse events. Over 300 registered RCTs are evaluating the efficacy of COVID-19 vaccines, and this review is updated regularly on the COVID-NMA platform (covid-nma.com). Implications for practice Due to the trial exclusions, these results cannot be generalized to pregnant women, individuals with a history of SARS-CoV-2 infection, or immunocompromized people. Most trials had a short follow-up and were conducted before the emergence of variants of concern. Implications for research Future research should evaluate the long-term effect of vaccines, compare different vaccines and vaccine schedules, assess vaccine efficacy and safety in specific populations, and include outcomes such as preventing long COVID-19. Ongoing evaluation of vaccine efficacy and effectiveness against emerging variants of concern is also vital.
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Affiliation(s)
- Carolina Graña
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Lina Ghosn
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Theodoros Evrenoglou
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Alexander Jarde
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | | | | | | | | | | | | | - Hillary Bonnet
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Rouba Assi
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | | | - Melanie Marti
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Declan Devane
- Evidence Synthesis Ireland, Cochrane Ireland and HRB-Trials Methodology Research Network, National University of Ireland, Galway, Ireland
| | - Patrick Mallon
- UCD Centre for Experimental Pathogen Host Research and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Jean-Daniel Lelievre
- Department of Clinical Immunology and Infectious Diseases, Henri Mondor Hospital, Vaccine Research Institute, Université Paris Est Créteil, Paris, France
| | - Lisa M Askie
- Quality Assurance Norms and Standards Department, World Health Organization, Geneva, Switzerland
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | | | - Mauricia Davidson
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Carolina Riveros
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | | | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Giacomo Grasselli
- Department of Anesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Asbjørn Hróbjartsson
- Centre for Evidence Based Medicine Odense (CEBMO) and Cochrane Denmark, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Philippe Ravaud
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Anna Chaimani
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
| | - Isabelle Boutron
- Cochrane France, Paris, France
- Centre of Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Université de Paris, Paris, France
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6
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Ai J, Zhang Y, Zhang H, Zhang Q, Fu Z, Lin K, Song J, Zhao Y, Fan M, Wang H, Zhou Y, Chen X, Qiu C, Zhang W. Safety and immunogenicity of a third-dose homologous BBIBP-CorV boosting vaccination: interim results from a prospective open-label study. Emerg Microbes Infect 2022; 11:639-647. [PMID: 35034582 PMCID: PMC8881062 DOI: 10.1080/22221751.2022.2025746] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A COVID-19 booster vaccination is being comprehensively evaluated globally due to the emerging concern of reduced protection rate of previous vaccination and circulating Variants of Concern (VOC). But the safety and immunogenicity of homologous BBIBP-CorV boosting vaccination are yet to be thoroughly evaluated. We conducted this prospective, open-label study in Huashan Hospital using a third 6.5U BBIBP-CorV administered at an interval of 4–8 months following the previous two doses in healthy adults. Safety, anti-RBD response and neutralizing titers against SARS-CoV-2 and VOCs were examined. Sixty-three and forty participants entered the booster and the control group, respectively. A significant increase in IFN-γ SFU per million PBMCs was observed on day 14 against N peptide (20 vs. 5, P < 0.001). On day 14, pVNT GMTs increased over 15 folds of the baseline levels against prototype to reach 404.54 titers and over 9–13 folds against 4 VOCs and continuously increased by day 28. sVNT GMTs increased 112.51 and 127.45 folds by days 14 and 28 compared to the baseline level. Median anti-RBD antibody and IgG level significantly increased from 11.12 to 2607.50 BAU/ml and 4.07 to 619.20 BAU/ml on day 14. On day 14, females showed a significantly higher cell-mediated immune response against S1 peptide. The 7–8 months interval group had a higher humoral response than the 4–6 months interval group. No severe adverse event was reported. A third homologous BBIBP-CorV boosting vaccination was safe and highly immunogenic for healthy adults and broadened participants’ immunity against VOCs.
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Affiliation(s)
- Jingwen Ai
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yi Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Haocheng Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Qiran Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Zhangfan Fu
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Ke Lin
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Jieyu Song
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yuanhan Zhao
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Mingxiang Fan
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Hongyu Wang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yang Zhou
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Xiaohua Chen
- Department of Infectious Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Chao Qiu
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Wenhong Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.,Key Laboratory of Medical Molecular Virology (MOE/MOH) Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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7
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Yang B, Huang X, Gao H, Leung NH, Tsang TK, Cowling BJ. Immunogenicity, efficacy, and safety of SARS-CoV-2 vaccine dose fractionation: a systematic review and meta-analysis. BMC Med 2022; 20:409. [PMID: 36284331 PMCID: PMC9595080 DOI: 10.1186/s12916-022-02600-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Dose fractionation of a coronavirus disease 2019 (COVID-19) vaccine could effectively accelerate global vaccine coverage, while supporting evidence of efficacy, immunogenicity, and safety are unavailable, especially with emerging variants. METHODS We systematically reviewed clinical trials that reported dose-finding results and estimated the dose-response relationship of neutralizing antibodies (nAbs) of COVID-19 vaccines using a generalized additive model. We predicted the vaccine efficacy against both ancestral and variants, using previously reported correlates of protection and cross-reactivity. We also reviewed and compared seroconversion to nAbs, T cell responses, and safety profiles between fractional and standard dose groups. RESULTS We found that dose fractionation of mRNA and protein subunit vaccines could induce SARS-CoV-2-specific nAbs and T cells that confer a reasonable level of protection (i.e., vaccine efficacy > 50%) against ancestral strains and variants up to Omicron. Safety profiles of fractional doses were non-inferior to the standard dose. CONCLUSIONS Dose fractionation of mRNA and protein subunit vaccines may be safe and effective, which would also vary depending on the characteristics of emerging variants and updated vaccine formulations.
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Affiliation(s)
- Bingyi Yang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Xiaotong Huang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Huizhi Gao
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Nancy H Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tim K Tsang
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. .,Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong, China.
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8
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Cost-Effectiveness of COVID-19 Sequential Vaccination Strategies in Inactivated Vaccinated Individuals in China. Vaccines (Basel) 2022; 10:vaccines10101712. [PMID: 36298577 PMCID: PMC9610874 DOI: 10.3390/vaccines10101712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 01/24/2023] Open
Abstract
To effectively prevent and control the COVID-19 pandemic, countries have adopted a booster vaccination strategy. This study aimed to estimate the cost-effectiveness of sequential booster COVID-19 vaccination compared to two-dose inactivated vaccination in China from a societal perspective. A Markov model was developed to estimate the cost-effectiveness of sequential vaccination, including two doses of an inactivated vaccine followed by a booster shot of an inactivated vaccine, adenovirus vectored vaccine, protein subunit vaccine, or mRNA vaccine. The incremental effects of a booster shot with an inactivated vaccine, protein subunit vaccine, adenovirus vectored vaccine, and mRNA vaccine were 0.0075, 0.0110, 0.0208, and 0.0249 QALYs and saved costs of US$163.96, US$261.73, US$583.21, and US$724.49, respectively. Under the Omicron virus pandemic, the sequential vaccination among adults and the elderly (aged 60-69, 70-79, over 80) was consistently cost-saving, and a booster shot of the mRNA vaccine was more cost-saving. The results indicate that the sequential vaccination strategy is cost-effective in addressing the COVID-19 pandemic, and improving vaccination coverage among the elderly is of great importance in avoiding severe cases and deaths.
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9
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Zhang L, Chen H, Yang S, Zhao Y, Shen X, He X, Ye H, Wang D, Lou J, Wang Y, Wu S. The impact of CoronaVac on the neutralization breadth and magnitude of the antibody response to SARS-CoV-2 viruses. Front Immunol 2022; 13:990071. [PMID: 36203574 PMCID: PMC9530635 DOI: 10.3389/fimmu.2022.990071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
Although immune response enhancement has been reported after primary and booster vaccines of CoronaVac, neutralization breadth of SARS-CoV-2 variants is still unclear. In the present study, we examined the neutralization magnitude and breadth of SARS-CoV-2 variants including Beta (B.1.351), Delta (B.1.617.2) and Omicron (B.1.1.529) in 33 convalescent COVID-19 patients and a cohort of 55 medical staff receiving primary CoronaVac vaccines and an additional homologous booster dose. Results showed that, as compared with the two-dose primary vaccination, the homologous booster dose achieved 2.24-, 3.98-, 4.58- and 2.90-fold increase in neutralization titer against wild-type, Beta, Delta, and Omicron, respectively. After booster dose, neutralization titer reduction for variants was less than that after the primary vaccine or that for convalescents. The proportion of recipients able to neutralize 2 or more variants increased from 36.36% post the primary vaccination to 87.27% after the booster. Significant increase in neutralization breadth of 1.24 (95% confidence interval (CI), 0.89–1.59) variants was associated with a log10 increase in neutralization titer against the wild-type. In addition, anti-RBD IgG level was identified as an excellent surrogate for positive neutralization of SARS-CoV-2 and neutralization breadth of variants. These findings highlight the value of an additional homologous CoronaVac dose in broadening the cross-neutralization against SARS-CoV-2 variants, and are critical for informing the booster dose vaccination efforts.
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Affiliation(s)
- Lu Zhang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Hongquan Chen
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Su Yang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Yang Zhao
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Xiaoyun Shen
- Key Laboratory of Endoscopic Technology Research, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaowen He
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Haohui Ye
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Deqin Wang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Jiazhou Lou
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Yinshan Wang
- Health Care Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shengjun Wu
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
- *Correspondence: Shengjun Wu,
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10
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Li Z, Liu S, Li F, Li Y, Li Y, Peng P, Li S, He L, Liu T. Efficacy, immunogenicity and safety of COVID-19 vaccines in older adults: a systematic review and meta-analysis. Front Immunol 2022; 13:965971. [PMID: 36177017 PMCID: PMC9513208 DOI: 10.3389/fimmu.2022.965971] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/24/2022] [Indexed: 01/08/2023] Open
Abstract
BackgroundOlder adults are more susceptible to severe health outcomes for coronavirus disease 2019 (COVID-19). Universal vaccination has become a trend, but there are still doubts and research gaps regarding the COVID-19 vaccination in the elderly. This study aimed to investigate the efficacy, immunogenicity, and safety of COVID-19 vaccines in older people aged ≥ 55 years and their influencing factors.MethodsRandomized controlled trials from inception to April 9, 2022, were systematically searched in PubMed, EMBASE, the Cochrane Library, and Web of Science. We estimated summary relative risk (RR), rates, or standardized mean difference (SMD) with 95% confidence interval (CI) using random-effects meta-analysis. This study was registered with PROSPERO (CRD42022314456).ResultsOf the 32 eligible studies, 9, 21, and 25 were analyzed for efficacy, immunogenicity, and safety, respectively. In older adults, vaccination was efficacious against COVID-19 (79.49%, 95% CI: 60.55−89.34), with excellent seroconversion rate (92.64%, 95% CI: 86.77−96.91) and geometric mean titer (GMT) (SMD 3.56, 95% CI: 2.80−4.31) of neutralizing antibodies, and provided a significant protection rate against severe disease (87.01%, 50.80−96.57). Subgroup and meta-regression analyses consistently found vaccine types and the number of doses to be primary influencing factors for efficacy and immunogenicity. Specifically, mRNA vaccines showed the best efficacy (90.72%, 95% CI: 86.82−93.46), consistent with its highest seroconversion rate (98.52%, 95% CI: 93.45−99.98) and GMT (SMD 6.20, 95% CI: 2.02−10.39). Compared to the control groups, vaccination significantly increased the incidence of total adverse events (AEs) (RR 1.59, 95% CI: 1.38−1.83), including most local and systemic AEs, such as pain, fever, chill, etc. For inactivated and DNA vaccines, the incidence of any AEs was similar between vaccination and control groups (p > 0.1), while mRNA vaccines had the highest risk of most AEs (RR range from 1.74 to 7.22).ConclusionCOVID-19 vaccines showed acceptable efficacy, immunogenicity and safety in older people, especially providing a high protection rate against severe disease. The mRNA vaccine was the most efficacious, but it is worth surveillance for some AEs it caused. Increased booster coverage in older adults is warranted, and additional studies are urgently required for longer follow-up periods and variant strains.
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Affiliation(s)
- Zejun Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shouhuan Liu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Fengming Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yifeng Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Yilin Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Pu Peng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sai Li
- College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Li He
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu, ; Li He,
| | - Tieqiao Liu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu, ; Li He,
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11
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Sutton N, San Francisco Ramos A, Beales E, Smith D, Ikram S, Galiza E, Hsia Y, Heath PT. Comparing Reactogenicity of COVID-19 vaccines: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:1301-1318. [PMID: 35796029 DOI: 10.1080/14760584.2022.2098719] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES A number of vaccines have now been developed against COVID-19. Differences in reactogenicity and safety profiles according to the vaccine technologies employed are becoming apparent from clinical trials. METHODS Five databases (Medline, EMBASE, Science Citation Index, Cochrane Central Register of Controlled Trials, London School of Hygiene and Tropical Medicine COVID-19 vaccine tracker) were searched for relevant randomised controlled trials between 1 January 2020 and 12 January 2022 according to predetermined criteria with no language limitations. RESULTS Forty-two datasets were identified, with 20 vaccines using four different technologies (viral vector, inactivated, mRNA and protein sub-unit). Adults and adolescents over 12 years were included. Control groups used saline placebos, adjuvants, and comparator vaccines. The most consistently reported solicited adverse events were fever, fatigue, headache, pain at injection site, redness, and swelling. Both doses of mRNA vaccines, the second dose of protein subunit and the first dose of adenovirus vectored vaccines were the most reactogenic, while the inactivated vaccines were the least reactogenic. CONCLUSIONS The different COVID-19 vaccines currently available appear to have distinct reactogenicity profiles, dependent on the vaccine technology employed. Awareness of these differences may allow targeted recommendations for specific populations. Greater standardization of methods for adverse event reporting will aid future research in this field.
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Affiliation(s)
- Natalina Sutton
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Alberto San Francisco Ramos
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Emily Beales
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - David Smith
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Sabina Ikram
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Eva Galiza
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
| | - Yingfen Hsia
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE.,Queen's University Belfast, School of Pharmacy 97 Lisburn Rd Belfast BT9 7BL Northern Ireland
| | - Paul T Heath
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, Institute for Infection and Immunity, St George's, University of London, Jenner Wing, Cranmer Terrace, London SW17 0RE
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12
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Dadras O, Mehraeen E, Karimi A, Tantuoyir MM, Afzalian A, Nazarian N, Mojdeganlou H, Mirzapour P, Shamsabadi A, Dashti M, Ghasemzadeh A, Vahedi F, Shobeiri P, Pashaei Z, SeyedAlinaghi S. Safety and Adverse Events Related to Inactivated COVID-19 Vaccines and Novavax;a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e54. [PMID: 36033990 PMCID: PMC9397598 DOI: 10.22037/aaem.v10i1.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Knowledge of the safety of vaccines is crucial, both to prevent and cure them and to decrease the public hesitation in receiving vaccines. Therefore, this study aimed to systematically review the adverse events reported for inactivated vaccines and Novavax. Methods In this systematic review, the databases of PubMed, Scopus, Cochrane, and Web of Science were searched on September 15, 2021. Then we identified the eligible studies using a two-step title/abstract and full-text screening process. Data on the subjects, studies, and types of adverse events were extracted and entered in a word table, including serious, mild, local, and systemic adverse events as well as the timing of side effects' appearance. Results Adverse effects of inactivated coronavirus vaccines side effects were reported from phases 1, 2, and 3 of the vaccine trials. The most common local side effects included injection site pain and swelling, redness, and pruritus. Meanwhile, fatigue, headache, muscle pain, fever, and gastrointestinal symptoms including abdominal pain and diarrhea were among the most common systemic adverse effects. Conclusion This systematic review indicates that inactivated COVID-19 vaccines, including Sinovac, Sinopharm, and Bharat Biotech, as well as the protein subunit vaccines (Novavax) can be considered as safe choices due to having milder side effects and fewer severe life-threatening adverse events.
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Affiliation(s)
- Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , , ,School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand. E-mail:
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran. E-mail:
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Marcarious M. Tantuoyir
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , , ,Biomedical Engineering Unit, University of Ghana Medical Center (UGMC), Accra, Ghana. E-mail:
| | - Arian Afzalian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Newsha Nazarian
- School of Medicine, Islamic Azad University, Tehran, Iran. E-mail:
| | - Hengameh Mojdeganlou
- Department of Pathology, Urmia University of Medical Sciences,Urmia, Iran. E-mail:
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , ,
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran. E-mail:
| | - Mohsen Dashti
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail: ,
| | - Afsaneh Ghasemzadeh
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail: ,
| | - Farzin Vahedi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fax: +98-21-66947984, E-mail: , , ,
| | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , ,
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. E-mail: , , ,Corresponding Author: SeyedAhmad SeyedAlinaghi, Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. , Tel: 0098 (021) 66581583, ORCID:0000-0003-3210-7905
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13
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Dadras O, SeyedAlinaghi S, Karimi A, Shojaei A, Amiri A, Mahdiabadi S, Fakhfouri A, Razi A, Mojdeganlou H, Mojdeganlou P, Barzegary A, Pashaei Z, Afsahi AM, Shobeiri P, Mehraeen E. COVID-19 Vaccines' Protection Over Time and the Need for Booster Doses; a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e53. [PMID: 36033989 PMCID: PMC9397599 DOI: 10.22037/aaem.v10i1.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction Controversies existed regarding the duration of COVID-19 vaccines' protection and whether receiving the usual vaccine doses would be sufficient for long-term immunity. Therefore, we aimed to systematically review the studies regarding the COVID-19 vaccines' protection three months after getting fully vaccinated and assess the need for vaccine booster doses. Methods The relevant literature was searched using a combination of keywords on the online databases of PubMed, Scopus, Web of Science, and Cochrane on September 17th, 2021. The records were downloaded and the duplicates were removed. Then, the records were evaluated in a two-step process, consisting of title/abstract and full-text screening processes, and the eligible records were selected for the qualitative synthesis. We only included original studies that evaluated the efficacy and immunity of COVID-19 vaccines three months after full vaccination. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement to ensure the reliability of results. Results Out of the 797 retrieved records, 12 studies were included, 10 on mRNA-based vaccines and two on inactivated vaccines. The majority of included studies observed acceptable antibody titers in most of the participants even after 6 months; however,it appeared that the titers could also decrease in a considerable portion of people. Due to the reduction in antibody titers and vaccine protection, several studies suggested administering the booster dose, especially for older patients and those with underlying conditions, such as patients with immunodeficiencies. Conclusion Studies indicated that vaccine immunity decreases over time, making people more susceptible to contracting the disease. Besides, new variants are emerging, and the omicron variant is continuing to spread and escape from the immune system, indicating the importance of a booster dose.
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Affiliation(s)
- Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. ,School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shojaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Ava Amiri
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Mahdiabadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Armin Razi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Paniz Mojdeganlou
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran. ,Corresponding Author:EsmaeilMehraeen, Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran. Postal Code: 5681761351, Tel: +98-45-32426801, Fax: +98-45-32422305, E-mail:
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14
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Immunogenicity Following Two Doses of the BBIBP-CorV Vaccine and a Third Booster Dose with a Viral Vector and mRNA COVID-19 Vaccines against Delta and Omicron Variants in Prime Immunized Adults with Two Doses of the BBIBP-CorV Vaccine. Vaccines (Basel) 2022; 10:vaccines10071071. [PMID: 35891235 PMCID: PMC9317843 DOI: 10.3390/vaccines10071071] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 12/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) booster vaccination is being comprehensively evaluated globally due to waning immunity and the emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Therefore, this study aimed to evaluate antibody responses in individuals vaccinated with two doses of the BBIBP-CorV vaccine and to explore the boosting effect of the different vaccine platforms in BBIBP-CorV-primed healthy adults, including a viral vector vaccine (AZD122) and mRNA vaccines (BNT162b2 and mRNA-1273). The results showed that in the BBIBP-CorV prime group, the total receptor-binding domain (RBD) immunoglobulin (Ig) and anti-RBD IgG levels waned significantly at three months after receiving the second dose. However, after the booster, RBD-specific binding antibody levels increased. Neutralizing antibody measured by a surrogate neutralization test showed inhibition over 90% against the SARS-CoV-2 delta variant but less than 70% against the omicron variant after the third dose on day 28. All booster vaccines could induce the total IFN-ɣ T-cell response. The reactogenicity was acceptable and well-tolerated without serious adverse events. This study supports the administration of the third dose with either a viral vector or mRNA vaccine for BBIBP-CorV-primed individuals to stimulate antibody and T-cell responses.
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15
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Tabarsi P, Anjidani N, Shahpari R, Roshanzamir K, Fallah N, Andre G, Petrovsky N, Barati S. Immunogenicity and Safety of SpikoGen®, an Adjuvanted Recombinant SARS-CoV-2 Spike Protein vaccine as a Homologous and Heterologous Booster Vaccination: A Randomized Placebo-Controlled Trial. Immunology 2022; 167:340-353. [PMID: 35758850 PMCID: PMC9349507 DOI: 10.1111/imm.13540] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022] Open
Abstract
SpikoGen® is a subunit recombinant spike protein vaccine combined with Advax-CpG55.2™ adjuvant. This COVID-19 vaccine was shown to be safe, immunogenic, and efficacious in previous clinical trials. This study aimed to assess the safety and immunogenicity of SpikoGen® vaccine as a homologous and heterologous booster vaccination. This double-blind and randomized placebo-controlled (5:1) trial was performed on 300 already vaccinated participants. SpikoGen® or saline placebo was administered as a booster dose to participants who had received a full 2-dose COVID-19 vaccination course. Immunogenicity assessments were done 14 days after the booster dose with the primary immunogenicity outcome seroconversion rate of neutralizing antibodies. Safety outcomes included the incidence of solicited adverse events up to seven days after the booster dose. SpikoGen® vaccine induced a robust humoral response both as a homologous and heterologous booster, when compared to the placebo. At day 14, seroconversion of neutralizing antibodies was 76% (95% CI; 69% to 82%) in the SpikoGen® group vs. 3% (95% CI; 0% to 13%) in the placebo group. The most common local and systemic reported adverse events were injection site pain and fatigue and no serious adverse events were reported. The SpikoGen®-booster induced cross-neutralization of other SARS-CoV-2 variants. Irrespective of the primary vaccine course received, SpikoGen® vaccine showed promising effects as both a homologous and heterologous booster dose. This vaccine had also a good safety profile with no vaccine-associated serious adverse events. On the basis of these results, SpikoGen® vaccine has recently been approved as a booster dose.
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Affiliation(s)
- Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Centre, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ramin Shahpari
- Medical Department, Orchid Pharmed Company, Tehran, Iran
| | - Khashayar Roshanzamir
- CinnaGen Medical Biotechnology Research Center, Alborz University of Medical Sciences
| | - Newsha Fallah
- Medical Department, Orchid Pharmed Company, Tehran, Iran
| | | | | | - Saghar Barati
- Medical Department, Orchid Pharmed Company, Tehran, Iran
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16
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Lee JK, Shin OS. Coronavirus disease 2019 (COVID-19) vaccine platforms: how novel platforms can prepare us for future pandemics: a narrative review. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2022; 39:89-97. [PMID: 35152616 PMCID: PMC8913917 DOI: 10.12701/jyms.2021.01669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 11/14/2022]
Abstract
More than 2 years after the explosion of the coronavirus disease 2019 (COVID-19) pandemic, extensive efforts have been made to develop safe and efficacious vaccines against infections with severe acute respiratory syndrome coronavirus 2. The pandemic has opened a new era of vaccine development based on next-generation platforms, including messenger RNA (mRNA)-based technologies, and paved the way for the future of mRNA-based therapeutics to provide protection against a wide range of infectious diseases. Multiple vaccines have been developed at an unprecedented pace to protect against COVID-19 worldwide. However, important knowledge gaps remain to be addressed, especially in terms of how vaccines induce immunogenicity and efficacy in those who are elderly. Here, we discuss the various vaccine platforms that have been utilized to combat COVID-19 and emphasize how these platforms can be a powerful tool to react quickly to future pandemics.
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Affiliation(s)
- Jae Kyung Lee
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ok Sarah Shin
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- Corresponding author: Ok Sarah Shin, MD Department of Biomedical Sciences, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea Tel: +82-2-2626-3280 • Fax: +82-2-2626-1962 • E-mail:
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17
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Hernández-Bernal F, Ricardo-Cobas MC, Martín-Bauta Y, Navarro-Rodríguez Z, Piñera-Martínez M, Quintana-Guerra J, Urrutia-Pérez K, Urrutia-Pérez K, Chávez-Chong CO, Azor-Hernández JL, Rodríguez-Reinoso JL, Lobaina-Lambert L, Colina-Ávila E, Bizet-Almeida J, Rodríguez-Nuviola J, del Valle-Piñera S, Ramírez-Domínguez M, Tablada-Ferreiro E, Alonso-Valdés M, Lemos-Pérez G, Guillén-Nieto GE, Palenzuela-Díaz A, Noa-Romero E, Limonta-Fernández M, Fernández-Ávila JM, Ali-Mros NA, del Toro-Lahera L, Remedios-Reyes R, Ayala-Ávila M, Muzio-González VL. Safety, tolerability, and immunogenicity of a SARS-CoV-2 recombinant spike RBD protein vaccine: A randomised, double-blind, placebo-controlled, phase 1-2 clinical trial (ABDALA Study). EClinicalMedicine 2022; 46:101383. [PMID: 35434578 PMCID: PMC8994669 DOI: 10.1016/j.eclinm.2022.101383] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Multiple vaccine candidates against COVID-19 are currently being evaluated. We evaluate the safety and immunogenicity protein of a novel SARS-CoV-2 virus receptor-binding domain (RBD) vaccine. METHODS A phase 1-2, randomised, double-blind, placebo-controlled trial was carried out in "Saturnino Lora" Hospital, Santiago de Cuba, Cuba. Subjects (healthy or those with controlled chronic diseases) aged between 19 and 80 years, who gave written informed consent were eligible. Subjects were randomly assigned (1:1:1, in blocks) to three groups: placebo, 25 µg and 50 µg RBD vaccine (Abdala). The product was administered intramuscularly, 0·5 mL in the deltoid region. During the first phase, two immunization schedules were studied: 0-14-28 days (short) and 0-28-56 days (long). In phase 2, only the short schedule was evaluated. The organoleptic characteristics and presentations of vaccine and placebo were identical. All participants (subjects, clinical researchers, statisticians, laboratory technicians, and monitors) remained masked during the study period. The main endpoints were safety and the proportion of subjects with seroconversion of anti-RBD IgG antibodies, analysed by intention to treat and per protocol, respectively. The trial is registered with the Cuban Public Registry of Clinical Trials, RPCEC00000346. FINDINGS Between Dec 7, 2020, and Feb 9, 2021, 792 subjects were included; 132 (66 in each vaccination schedule, divided into 22 for each group) in phase 1, and 660 (220 in each group plus 66 from the short scheme of phase 1) in phase 2. The product was well tolerated. No severe adverse events were reported. During phase 1, the incidence of adverse events in the 25 µg, 50 µg, and placebo arms for the short schedule were 6/22 (27·3%), 6/22 (27·3%), 3/22 (13·6%), respectively, and for the long schedule were 8/22 (36·4%), 9/22 (40·9%), 4/22 (18·2%), respectively. In phase 2, adverse reactions were reported by 53/242 (21·9%), 75/242 (31·0%) and 41/242 (16·9%) participants in the 25 µg, 50 µg, and placebo group, respectively. Adverse reactions were minimal, mostly mild, and from the injection site, which resolved in the first 24-48 hours. In phase 1, seroconversion at day 56 was seen in 95·2% of the participants (20/21) in the 50 μg group, 81% (17/21) in the 25 μg group, and none in the placebo group (0/22). For the long schedule, seroconversion at day 70 was seen in 100% of the participants (21/21) in the 50 μg group, 94·7% (18/19) in the 25 μg group, and none in the placebo group (0/22). In phase 2, seroconversion of anti-RBD IgG antibodies at day 56 was seen in 89·2% of the participants in the 50 μg group (214/240; 95% CI 84·5-92·82), 77·7% in the 25 μg group (185/238; 72·0-82·9) and 4·6% in the placebo group (11/239; 2·3-8·1). Compared with the placebo arm, the differences in the proportion of participants with seroconversion were 73·1% (95% CI 66·8-79·5) and 84·6% (79·4-89·7) in the 25 μg and 50 μg groups, respectively. The seroconversion rate in the 50 μg group was significantly higher than in the 25 μg group (p=0·0012). INTERPRETATION The Abdala vaccine was safe, well tolerated, and induced humoral immune responses against SARS-CoV-2. These results, in the context of the emergency COVID-19 pandemic, support the 50 μg dose, applied in a 0-14-28 days schedule, for further clinical trials to confirm vaccine efficacy. FUNDING Centre for Genetic Engineering and Biotechnology (CIGB), Havana, Cuba.
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Affiliation(s)
- Francisco Hernández-Bernal
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
- Corresponding author: Dr. Francisco Hernández-Bernal, Clinical Research Direction, Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba.
| | | | - Yenima Martín-Bauta
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | | | | | | | - Karen Urrutia-Pérez
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | | | | | | | | | | | | | | | | | | | | | | | - Marel Alonso-Valdés
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | - Gilda Lemos-Pérez
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | | | | | - Enrique Noa-Romero
- Civilian Defense Scientific Research Centre, San José de las Lajas, Mayabeque, Cuba
| | | | | | | | | | | | - Marta Ayala-Ávila
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
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Castaldo M, Waliszewska-Prosół M, Koutsokera M, Robotti M, Straburzyński M, Apostolakopoulou L, Capizzi M, Çibuku O, Ambat FDF, Frattale I, Gadzhieva Z, Gallo E, Gryglas-Dworak A, Halili G, Jusupova A, Koperskaya Y, Leheste AR, Manzo ML, Marcinnò A, Marino A, Mikulenka P, Ong BE, Polat B, Popovic Z, Rivera-Mancilla E, Roceanu AM, Rollo E, Romozzi M, Ruscitto C, Scotto di Clemente F, Strauss S, Taranta V, Terhart M, Tychenko I, Vigneri S, Misiak B, Martelletti P, Raggi A. Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. J Headache Pain 2022; 23:41. [PMID: 35361131 PMCID: PMC8969402 DOI: 10.1186/s10194-022-01400-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/05/2022] [Indexed: 12/15/2022] Open
Abstract
Background Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are used to reduce the risk of developing Coronavirus Disease 2019 (COVID-19). Despite the significant benefits in terms of reduced risk of hospitalization and death, different adverse events may present after vaccination: among them, headache is one of the most common, but nowadays there is no summary presentation of its incidence and no description of its main features. Methods We searched PubMed and EMBASE covering the period between January 1st 2020 and August 6th, 2021, looking for record in English and with an abstract and using three main search terms (with specific variations): COVID-19/SARS-CoV-2; Vaccination; headache/adverse events. We selected manuscript including information on subjects developing headache after injection, and such information had to be derived from a structured form (i.e. no free reporting). Pooled estimates and 95% confidence intervals were calculated. Analyses were carried out by vaccine vs. placebo, by first vs. second dose, and by mRNA-based vs. “traditional” vaccines; finally, we addressed the impact of age and gender on post-vaccine headache onset. Results Out of 9338 records, 84 papers were included in the review, accounting for 1.57 million participants, 94% of whom received BNT162b2 or ChAdOx1. Headache was generally the third most common AE: it was detected in 22% (95% CI 18–27%) of subjects after the first dose of vaccine and in 29% (95% CI 23–35%) after the second, with an extreme heterogeneity. Those receiving placebo reported headache in 10–12% of cases. No differences were detected across different vaccines or by mRNA-based vs. “traditional” ones. None of the studies reported information on headache features. A lower prevalence of headache after the first injection of BNT162b2 among older participants was shown. Conclusions Our results show that vaccines are associated to a two-fold risk of developing headache within 7 days from injection, and the lack of difference between vaccine types enable to hypothesize that headache is secondary to systemic immunological reaction than to a vaccine-type specific reaction. Some descriptions report onset within the first 24 h and that in around one-third of the cases, headache has migraine-like features with pulsating quality, phono and photophobia; in 40–60% of the cases aggravation with activity is observed. The majority of patients used some medication to treat headache, the one perceived as the most effective being acetylsalicylic acid. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01400-4.
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19
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Yuniar CT, Pratiwi B, Ihsan AF, Laksono BT, Risfayanti I, Fathadina A, Jeong Y, Kim E. Adverse Events Reporting Quality of Randomized Controlled Trials of COVID-19 Vaccine Using the CONSORT Criteria for Reporting Harms: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10020313. [PMID: 35214773 PMCID: PMC8875800 DOI: 10.3390/vaccines10020313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Assessing the quality of evidence from vaccine clinical trials is essential to ensure the safety and efficacy of the vaccine and further enhance public acceptance. This study aims to summarize and critically evaluate the quality of harm reporting on randomized controlled trials for the COVID-19 vaccine and determine the factors associated with reporting quality. Methods: We systematically searched the literature using PRISMA guidelines for randomized controlled trials (RCT) on COVID-19 Vaccine until 30 December 2021. Published articles were searched from electronic databases such as PubMed, Science Direct, Google Scholar, and Bibliovid. Bias analysis was performed using RoB-2 tools. The quality of reporting was assessed by the Consolidated Standards of Reporting Trials (CONSORT) harm extension modified into 21 items. Results: A total of 61 RCT studies (402,014 patients) were analyzed. Over half the studies demonstrated adequate reporting (59.02%), and 21 studies (34.4%) reported a low risk of bias. All studies reported death and serious adverse events (AEs), but only six studies mentioned how to handle the recurrent AEs. Reporting of AEs in subgroup analysis was also poor (25%). Conclusion: The RCTs on the COVID-19 vaccine were less biased with good quality on reporting harm based on the modified CONSORT harm extension. However, study quality must be considered, especially for a balance of information between effectivity and safety.
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Affiliation(s)
- Cindra Tri Yuniar
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Bhekti Pratiwi
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Ardika Fajrul Ihsan
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Bambang Tri Laksono
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Iffa Risfayanti
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Annisa Fathadina
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Yeonseon Jeong
- Clinical Data Analysis, Evidence-Based Clinical Research Laboratory, Department of Health Science & Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
| | - Eunyoung Kim
- Clinical Data Analysis, Evidence-Based Clinical Research Laboratory, Department of Health Science & Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
- Correspondence: ; Tel.: +82-2-820-5791
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20
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Zhang N, Li K, Liu Z, Nandakumar KS, Jiang S. A Perspective on the Roles of Adjuvants in Developing Highly Potent COVID-19 Vaccines. Viruses 2022; 14:v14020387. [PMID: 35215980 PMCID: PMC8875727 DOI: 10.3390/v14020387] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/05/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
Several countries have made unremitting efforts to develop an optimal vaccine in the fight against coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With the increasing occurrence of SARS-CoV-2 variants, current vaccines show decreased neutralizing activities, especially towards the Omicron variant. In this context, adding appropriate adjuvants to COVID-19 vaccines can substantially reduce the number of required doses and improve efficacy or cross-neutralizing protection. We mainly focus on research progress and achievements associated with adjuvanted COVID-19 subunit and inactivated vaccines. We further compare the advantages and disadvantages of different adjuvant formulations in order to provide a scientific reference for designing an effective strategy for future vaccine development.
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Affiliation(s)
- Naru Zhang
- Department of Clinical Medicine, School of Medicine, Zhejiang University City College, Hangzhou 310015, China;
- Correspondence: (N.Z.); (S.J.)
| | - Kangchen Li
- Department of Clinical Medicine, School of Medicine, Zhejiang University City College, Hangzhou 310015, China;
| | - Zezhong Liu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China;
| | - Kutty Selva Nandakumar
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, 17177 Stockholm, Sweden;
| | - Shibo Jiang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China;
- Correspondence: (N.Z.); (S.J.)
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21
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Zhang Y, Yang Y, Qiao N, Wang X, Ding L, Zhu X, Liang Y, Han Z, Liu F, Zhang X, Yang X. Early assessment of the safety and immunogenicity of a third dose (booster) of COVID-19 immunization in Chinese adults. Front Med 2022; 16:93-101. [PMID: 35122211 PMCID: PMC8815383 DOI: 10.1007/s11684-021-0914-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/20/2021] [Indexed: 12/15/2022]
Abstract
Inducing durable and effective immunity against severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) via vaccination is essential to combat the current pandemic of coronavirus disease 2019 (COVID-19). It has been noticed that the strength of anti-COVID-19 vaccination-induced immunity fades over time, which calls for an additional vaccination regime, as known as booster immunization, to restore immunity among previously vaccinated populations. Here we report a pilot open-label trial of a third dose of BBIBP-CorV, an inactivated SARS-CoV-2 vaccine (Vero cell), on 136 participants aged between 18 to 63 years. Safety and immunogenicity in terms of neutralizing antibody titers and cytokine/chemokine responses were analyzed as the main endpoint until day 28. While systemic reactogenicity was either absent or mild, SARS-CoV-2-specific neutralizing antibody titers rapidly arose in all participants within 4 weeks, surpassing the peak antibody titers elicited by the initial two-dose immunization regime. Broad increases of cellular immunity-associated cytokines and chemokines were also detected in the majority of participants after the third vaccination. Furthermore, in an exploratory study, a newly developed recombinant protein vaccine, NVSI-06-08 (CHO Cells), was found to be safe and even more effective than BBIBP-CorV in eliciting humoral immune responses in BBIBP-CorV-primed individuals. Together, these results indicate that a third immunization schedule with either homologous or heterologous vaccine showed favorable safety profiles and restored potent SARS-CoV-2-specific immunity, providing support for further trials of booster vaccination in larger populations.
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Affiliation(s)
- Yuntao Zhang
- China National Biotec Group Company Limited, Beijing, 100024, China
| | - Yunkai Yang
- China National Biotec Group Company Limited, Beijing, 100024, China
| | - Niu Qiao
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xuewei Wang
- China National Biotec Group Company Limited, Beijing, 100024, China
| | - Ling Ding
- Beijing Institute of Biological Products, China National Biotec Group Company Limited, Beijing, 100176, China
| | - Xiujuan Zhu
- Beijing Institute of Biological Products, China National Biotec Group Company Limited, Beijing, 100176, China
| | - Yu Liang
- National Vaccine and Serum Institute, China National Biotec Group Company Limited, Beijing, 101111, China
| | - Zibo Han
- National Vaccine and Serum Institute, China National Biotec Group Company Limited, Beijing, 101111, China
| | - Feng Liu
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xinxin Zhang
- Department of Infectious Diseases, Research Laboratory of Clinical Virology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Xiaoming Yang
- China National Biotec Group Company Limited, Beijing, 100024, China.
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22
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Peng XL, Cheng JSY, Gong HL, Yuan MD, Zhao XH, Li Z, Wei DX. Advances in the design and development of SARS-CoV-2 vaccines. Mil Med Res 2021; 8:67. [PMID: 34911569 PMCID: PMC8674100 DOI: 10.1186/s40779-021-00360-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 11/15/2021] [Indexed: 01/18/2023] Open
Abstract
Since the end of 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. The RNA genome of SARS-CoV-2, which is highly infectious and prone to rapid mutation, encodes both structural and nonstructural proteins. Vaccination is currently the only effective method to prevent COVID-19, and structural proteins are critical targets for vaccine development. Currently, many vaccines are in clinical trials or are already on the market. This review highlights ongoing advances in the design of prophylactic or therapeutic vaccines against COVID-19, including viral vector vaccines, DNA vaccines, RNA vaccines, live-attenuated vaccines, inactivated virus vaccines, recombinant protein vaccines and bionic nanoparticle vaccines. In addition to traditional inactivated virus vaccines, some novel vaccines based on viral vectors, nanoscience and synthetic biology also play important roles in combating COVID-19. However, many challenges persist in ongoing clinical trials.
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Affiliation(s)
- Xue-Liang Peng
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Ji-Si-Yu Cheng
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Hai-Lun Gong
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Meng-Di Yuan
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Xiao-Hong Zhao
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
| | - Zibiao Li
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634 Singapore
| | - Dai-Xu Wei
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of Life Sciences and Medicine, Northwest University, Xi’an, 710069 China
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23
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Fumagalli MJ, Castro-Jorge LA, Fraga-Silva TFDC, de Azevedo PO, Capato CF, Rattis BAC, Hojo-Souza NS, Floriano VG, de Castro JT, Ramos SG, da Fonseca BAL, Bonato VLD, Gazzinelli RT, Figueiredo LTM. Protective Immunity against Gamma and Zeta Variants after Inactivated SARS-CoV-2 Virus Immunization. Viruses 2021; 13:2440. [PMID: 34960708 PMCID: PMC8707686 DOI: 10.3390/v13122440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 01/08/2023] Open
Abstract
The persistent circulation of SARS-CoV-2 represents an ongoing global threat due to the emergence of new viral variants that can sometimes evade the immune system of previously exposed or vaccinated individuals. We conducted a follow-up study of adult individuals that had received an inactivated SARS-CoV-2 vaccine, evaluating antibody production and neutralizing activity over a period of 6 months. In addition, we performed mice immunization with inactivated SARS-CoV-2, and evaluated the immune response and pathological outcomes against Gamma and Zeta variant infection. Vaccinated individuals produced high levels of antibodies with robust neutralizing activity, which was significantly reduced against Gamma and Zeta variants. Production of IgG anti-S antibodies and neutralizing activity robustly reduced after 6 months of vaccination. Immunized mice demonstrated cellular response against Gamma and Zeta variants, and after viral infection, reduced viral loads, IL-6 expression, and histopathological outcome in the lungs. TNF levels were unchanged in immunized or not immunized mice after infection with the Gamma variant. Furthermore, serum neutralization activity rapidly increases after infection with the Gamma and Zeta variants. Our data suggest that immunization with inactivated WT SARS-CoV-2 induces a promptly responsive cross-reactive immunity response against the Gamma and Zeta variants, reducing COVID-19 pathological outcomes.
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Affiliation(s)
- Marcilio Jorge Fumagalli
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
| | - Luiza Antunes Castro-Jorge
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | | | - Patrick Orestes de Azevedo
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
| | - Carlos Fabiano Capato
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | - Bruna Amanda Cruz Rattis
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (B.A.C.R.); (S.G.R.)
| | - Natália Satchiko Hojo-Souza
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
| | - Vitor Gonçalves Floriano
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | - Julia Teixeira de Castro
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
| | - Simone Gusmão Ramos
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (B.A.C.R.); (S.G.R.)
| | - Benedito Antônio Lopes da Fonseca
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | - Vânia Luiza Deperon Bonato
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil;
| | - Ricardo Tostes Gazzinelli
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
- Platform of Translational Medicine, Fundação Oswaldo Cruz, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil
| | - Luiz Tadeu Moraes Figueiredo
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
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Recombinant protein subunit vaccine booster following two-dose inactivated vaccines dramatically enhanced anti-RBD responses and neutralizing titers against SARS-CoV-2 and Variants of Concern. Cell Res 2021; 32:103-106. [PMID: 34815511 PMCID: PMC8609258 DOI: 10.1038/s41422-021-00590-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022] Open
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