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Buntinx E, Brochado L, Borja-Tabora C, Yu CY, Alberto ER, Montellano MEB, Carlos JC, Toloza LB, Hites M, Siber G, Clemens R, Ambrosino D, Qin H, Chen HL, Han HH, Hu B, Li P, Baccarini C, Smolenov I. Immunogenicity of an adjuvanted SARS-CoV-2 trimeric S-protein subunit vaccine (SCB-2019) in SARS-CoV-2-naïve and exposed individuals in a phase 2/3, double-blind, randomized study. Vaccine 2023; 41:1875-1884. [PMID: 36781334 PMCID: PMC9910015 DOI: 10.1016/j.vaccine.2023.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND We evaluated immunogenicity of SCB-2019, a subunit vaccine candidate containing a pre-fusion trimeric form of the SARS-CoV-2 spike (S)-protein adjuvanted with CpG-1018/alum. METHODS The phase 2/3, double-blind, randomized SPECTRA trial was conducted in five countries in participants aged ≥ 18 years, either SARS-CoV-2-naïve or previously exposed. Participants were randomly assigned to receive two doses of SCB-2019 or placebo administered intramuscularly 21 days apart. In the phase 2 part of the study, on days 1, 22, and 36, neutralizing antibodies were measured by pseudovirus and wild-type virus neutralization assays to SARS-CoV-2 prototype and variants, and ACE2-receptor-binding antibodies and SCB-2019-binding antibodies were measured by ELISA. Cell-mediated immunity was measured by intracellular cytokine staining via flow cytometry. RESULTS 1601 individuals were enrolled between 24 March and 13 September 2021 and received at least one vaccine dose. Immunogenicity analysis was conducted in a phase 2 subset of 691 participants, including 428 SARS-CoV-2-naïve (381 vaccine and 47 placebo recipients) and 263 SARS-CoV-2-exposed (235 vaccine and 28 placebo recipients). In SARS-CoV-2-naïve participants, GMTs of neutralizing antibodies against prototype virus increased 2 weeks post-second dose (day 36) compared to baseline (224 vs 12.7 IU/mL). Seroconversion rate was 82.5 %. In SARS-CoV-2-exposed participants, one SCB-2019 dose increased GMT of neutralizing antibodies by 48.3-fold (1276.1 IU/mL on day 22) compared to baseline. Seroconversion rate was 92.4 %. Increase was marginal post-second dose. SCB-2019 also showed cross-neutralization capability against nine variants, including Omicron, in SARS-CoV-2-exposed participants at day 36. SCB-2019 stimulated Th1-biased cell-mediated immunity to the S-protein in both naïve and exposed participants. The vaccine was well tolerated, no safety concerns were raised from the study. CONCLUSIONS A single dose of SCB-2019 was immunogenic in SARS-CoV-2-exposed individuals, whereas two doses were required to induce immune response in SARS-CoV-2-naïve individuals. SCB-2019 elicited a cross-neutralizing response against emergent SARS-CoV-2 variants at antibody levels associated with clinical protection, underlining its potential as a booster. CLINICALTRIALS gov: NCT04672395; EudraCT: 2020-004272-17.
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Affiliation(s)
| | | | | | - Charles Y. Yu
- De La Salle Medical and Health Sciences Institute, Cavite City, Philippines
| | | | | | - Josefina C. Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | - Maya Hites
- Clinic of Infectious Diseases, Cliniques universitaires de Bruxelles Hôpital Erasme, Bruxelles, Belgium
| | | | - Ralf Clemens
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | | | | | - Branda Hu
- Clover Biopharmaceuticals, Boston, MA, USA
| | - Ping Li
- Clover Biopharmaceuticals, Boston, MA, USA
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Bravo L, Smolenov I, Han HH, Li P, Hosain R, Rockhold F, Clemens SAC, Roa C, Borja-Tabora C, Quinsaat A, Lopez P, López-Medina E, Brochado L, Hernández EA, Reynales H, Medina T, Velasquez H, Toloza LB, Rodriguez EJ, de Salazar DIM, Rodríguez CA, Sprinz E, Cerbino-Neto J, Luz KG, Schwarzbold AV, Paiva MS, Carlos J, Montellano MEB, de Los Reyes MRA, Yu CY, Alberto ER, Panaligan MM, Salvani-Bautista M, Buntinx E, Hites M, Martinot JB, Bhorat QE, Badat A, Baccarini C, Hu B, Jurgens J, Engelbrecht J, Ambrosino D, Richmond P, Siber G, Liang J, Clemens R. Efficacy of the adjuvanted subunit protein COVID-19 vaccine, SCB-2019: a phase 2 and 3 multicentre, double-blind, randomised, placebo-controlled trial. Lancet 2022; 399:461-472. [PMID: 35065705 PMCID: PMC8776284 DOI: 10.1016/s0140-6736(22)00055-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/05/2021] [Accepted: 12/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND A range of safe and effective vaccines against SARS CoV 2 are needed to address the COVID 19 pandemic. We aimed to assess the safety and efficacy of the COVID-19 vaccine SCB-2019. METHODS This ongoing phase 2 and 3 double-blind, placebo-controlled trial was done in adults aged 18 years and older who were in good health or with a stable chronic health condition, at 31 sites in five countries (Belgium, Brazil, Colombia, Philippines, and South Africa). The participants were randomly assigned 1:1 using a centralised internet randomisation system to receive two 0·5 mL intramuscular doses of SCB-2019 (30 μg, adjuvanted with 1·50 mg CpG-1018 and 0·75 mg alum) or placebo (0·9% sodium chloride for injection supplied in 10 mL ampoules) 21 days apart. All study staff and participants were masked, but vaccine administrators were not. Primary endpoints were vaccine efficacy, measured by RT-PCR-confirmed COVID-19 of any severity with onset from 14 days after the second dose in baseline SARS-CoV-2 seronegative participants (the per-protocol population), and the safety and solicited local and systemic adverse events in the phase 2 subset. This study is registered on EudraCT (2020-004272-17) and ClinicalTrials.gov (NCT04672395). FINDINGS 30 174 participants were enrolled from March 24, 2021, until the cutoff date of Aug 10, 2021, of whom 30 128 received their first assigned vaccine (n=15 064) or a placebo injection (n=15 064). The per-protocol population consisted of 12 355 baseline SARS-CoV-2-naive participants (6251 vaccinees and 6104 placebo recipients). Most exclusions (13 389 [44·4%]) were because of seropositivity at baseline. There were 207 confirmed per-protocol cases of COVID-19 at 14 days after the second dose, 52 vaccinees versus 155 placebo recipients, and an overall vaccine efficacy against any severity COVID-19 of 67·2% (95·72% CI 54·3-76·8), 83·7% (97·86% CI 55·9-95·4) against moderate-to-severe COVID-19, and 100% (97·86% CI 25·3-100·0) against severe COVID-19. All COVID-19 cases were due to virus variants; vaccine efficacy against any severity COVID-19 due to the three predominant variants was 78·7% (95% CI 57·3-90·4) for delta, 91·8% (44·9-99·8) for gamma, and 58·6% (13·3-81·5) for mu. No safety issues emerged in the follow-up period for the efficacy analysis (median of 82 days [IQR 63-103]). The vaccine elicited higher rates of mainly mild-to-moderate injection site pain than the placebo after the first (35·7% [287 of 803] vs 10·3% [81 of 786]) and second (26·9% [189 of 702] vs 7·4% [52 of 699]) doses, but the rates of other solicited local and systemic adverse events were similar between the groups. INTERPRETATION Two doses of SCB-2019 vaccine plus CpG and alum provides notable protection against the entire severity spectrum of COVID-19 caused by circulating SAR-CoV-2 viruses, including the predominating delta variant. FUNDING Clover Biopharmaceuticals and the Coalition for Epidemic Preparedness Innovations.
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Affiliation(s)
- Lulu Bravo
- University of the Philippines Manila, Ermita, Manila, Philippines
| | | | | | - Ping Li
- Clover Biopharmaceuticals, Cambridge, MA, USA
| | | | - Frank Rockhold
- Duke University Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | | | - Camilo Roa
- Manila Doctors Hospital, Manila, Philippines
| | | | | | - Pio Lopez
- Centro de Estudios en Infectología Pediátrica, Universidad Del Valle Clínica Imbanaco, Cali, Colombia
| | - Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica, Universidad Del Valle Clínica Imbanaco, Cali, Colombia
| | | | | | | | - Tatiana Medina
- Center of Attention in Medical Research, Bogotá, Colombia
| | | | | | | | | | | | - Eduardo Sprinz
- Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Maria Sanali Paiva
- Atena Institute of Clinical Research, Rio Grande do Norte, Natal, Brazil
| | - Josefina Carlos
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines
| | | | | | - Charles Y Yu
- De La Salle Medical and Health Sciences Institute, Cavite City, Philippines
| | | | - Mario M Panaligan
- Infection Control Service, St Luke's Medical Center, Taguig, Philippines
| | | | | | - Maya Hites
- Clinic of Infectious Diseases, CUB-Hôpital Erasme, Bruxelles, Belgium
| | - Jean-Benoit Martinot
- Pulmonology Department, CHU Universite Catholique de Louvain Namur Site Sainte-Elisabeth, Namur, Belgium
| | - Qasim E Bhorat
- Soweto Clinical Trials Centre, Johannesburg, South Africa
| | - Aysha Badat
- Wits Clinical Research, Soweto, Johannesburg, South Africa
| | | | - Branda Hu
- Clover Biopharmaceuticals, Cambridge, MA, USA
| | - Jaco Jurgens
- DJW Research, Noordheuwel, Krugersdorp, Gauteng, South Africa
| | - Jan Engelbrecht
- Dr JM Engelbrecht Trial Site, Vergelegen Mediclinic, Western Cape, South Africa
| | | | - Peter Richmond
- Division of Paediatrics, University of Western Australia, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute and Perth Children's Hospital, Perth, WA, Australia
| | | | | | - Ralf Clemens
- Global Research in Infectious Diseases, Rio de Janeiro, Brazil.
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Iglesias Pertuz S, Aroca-Martinez G, Velez Verbel MDLA, Cadena Osorio A, Cadena-Bonfanti A, Correa-Monterrosa M, Lemus Castro J, Brochado L, Armesto W, Camargo Vasquez T, Martínez Bula E, Turizo Turizo E, Avendaño Echavez LG, Hernández-Agudelo S, Peña Vargas W, Riascos W, Palmera J, Sierra A, Varón Suárez F, Gómez Giraldo L, González-Torres H, Navarro Quiroz E, Vásquez Obeso E, Ángel Depine S, Ospino Herrera D. Reporte de 4 casos COVID-19 hospitalizados en unidad de cuidados intensivos en una institución hospitalaria en Barranquilla, Colombia. Rev Colomb Nefrol 2020. [DOI: 10.22265/acnef.7.supl.2.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Iglesias Pertuz S, Aroca-Martinez G, Velez Verbel MDLA, Cadena Osorio A, Cadena-Bonfanti A, Correa-Monterrosa M, Lemus Castro J, Brochado L, Armesto W, Camargo Vasquez T, Martínez Bula E, Turizo Turizo E, Avendaño Echavez LG, Hernández-Agudelo S, Peña Vargas W, Riascos W, Palmera J, Sierra A, Varón Suárez F, Gómez Giraldo L, González-Torres H, Navarro Quiroz E, Vásquez Obeso E, Ángel Depine S, Ospino Herrera D. Reporte de 4 casos COVID-19 hospitalizados en unidad de cuidados intensivos en una institución hospitalaria en Barranquilla, Colombia. Rev Colomb Nefrol 2020. [DOI: 10.22265/acnef.7.supl2.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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