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Tamim H, Hashim R, Jamil N, Chong LY, Johari Z. Clinical outcomes and risk factors for SARS-CoV-2 breakthrough cases following vaccination with BNT162b2, CoronaVac, or ChAdOx1-S: A retrospective cohort study in Malaysia. Heliyon 2024; 10:e29574. [PMID: 38699728 PMCID: PMC11063388 DOI: 10.1016/j.heliyon.2024.e29574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
Background The SARS-CoV-2 pandemic drove global vaccination. However, breakthrough infections raised concerns about vaccine performance, leading the World Health Organization (WHO) to recommend investigations thereof. This study aimed to evaluate the clinical outcomes (time to breakthrough infection, intensive care unit [ICU] admission, and in-hospital mortality) of hospitalised patients with SARS-CoV-2 breakthrough infection. This was the primary outcome and the risk factors associated with its severity were the secondary outcomes. Methods This retrospective cohort study at a multispecialty tertiary hospital in Selangor, Malaysia included 200 fully adult vaccinated patients, with confirmed SARS-CoV-2 infection, admitted from September 2021 to February 2022. Participants were selected by simple random sampling. Infection severity was categorised as CAT 2-3 (mild-moderate) and 4-5 (severe-critical). Results The time to breakthrough infection was significantly longer for BNT162B2 recipients (128.47 ± 46.21 days) compared to CoronaVac (94.09 ± 48.71 days; P = 0.001) and ChAdOx1-S recipients (90.80 ± 37.59 days; P = 0.019). No significant associations were found between SARS-CoV-2-related ICU admission, mortality, and the vaccines. Multivariable analysis identified vaccine type, variant of concern, ethnicity, and hypertension as significant predictors of severity. BNT162b2 and ChAdOx1-S recipients had significantly (81 % and 74 %, respectively) lower odds of CAT 4-5 infection compared to CoronaVac recipients. Indian patients had a significantly (83 %) lower chance of CAT 4-5 infection compared to Malay patients. Patients with breakthrough infections during the Omicron period had a significantly (58 %) lower risk of CAT 4-5 compared to those in the Delta period. The CAT 4-5 risk was significantly (nearly threefold) higher in hypertensive patients. Conclusion The results support the Malaysian Ministry of Health's recommended booster three months after primary vaccination and the WHO's recommended heterologous booster following CoronaVac. Certain ethnic groups, hypertensive patients, and viral variants may require attention in future pandemics.
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Affiliation(s)
- Hessa Tamim
- Faculty of Pharmacy, University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000, Cyberjaya, Selangor, Malaysia
| | - Rosnani Hashim
- Faculty of Pharmacy, University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000, Cyberjaya, Selangor, Malaysia
| | - Nurdiana Jamil
- Faculty of Pharmacy, University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000, Cyberjaya, Selangor, Malaysia
| | - Li Yin Chong
- Sultan Idris Shah Serdang Hospital, Jalan Puchong, 43000, Kajang, Selangor, Malaysia
| | - Zainol Johari
- Faculty of Pharmacy, University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000, Cyberjaya, Selangor, Malaysia
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Machado RRG, Candido ÉD, Aguiar AS, Chalup VN, Sanches PR, Dorlass EG, Amgarten DE, Pinho JRR, Durigon EL, Oliveira DBL. Immune Evasion of SARS-CoV-2 Omicron Subvariants XBB.1.5, XBB.1.16 and EG.5.1 in a Cohort of Older Adults after ChAdOx1-S Vaccination and BA.4/5 Bivalent Booster. Vaccines (Basel) 2024; 12:144. [PMID: 38400128 PMCID: PMC10892985 DOI: 10.3390/vaccines12020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/25/2024] Open
Abstract
The recently emerged SARS-CoV-2 Omicron sublineages, including the BA.2-derived XBB.1.5 (Kraken), XBB.1.16 (Arcturus), and EG.5.1 (Eris), have accumulated several spike mutations that may increase immune escape, affecting vaccine effectiveness. Older adults are an understudied group at significantly increased risk of severe COVID-19. Here we report the neutralizing activities of 177 sera samples from 59 older adults, aged 62-97 years, 1 and 4 months after vaccination with a 4th dose of ChAdOx1-S (Oxford/AstraZeneca) and 3 months after a 5th dose of Comirnaty Bivalent Original/Omicron BA.4/BA.5 vaccine (Pfizer-BioNTech). The ChAdOx1-S vaccination-induced antibodies neutralized efficiently the ancestral D614G and BA.4/5 variants, but to a much lesser extent the XBB.1.5, XBB.1.16, and EG.5.1 variants. The results showed similar neutralization titers between XBB.1.16 and EG.5.1 and were lower compared to XBB.1.5. Sera from the same individuals boosted with the bivalent mRNA vaccine contained higher neutralizing antibody titers, providing a better cross-protection against Omicron XBB.1.5, XBB.1.16 and EG.5.1 variants. Previous history of infection during the epidemiological waves of BA.1/BA.2 and BA.4/BA.5, poorly enhanced neutralization activity of serum samples against XBBs and EG.5.1 variants. Our data highlight the continued immune evasion of recent Omicron subvariants and support the booster administration of BA.4/5 bivalent vaccine, as a continuous strategy of updating future vaccine booster doses to match newly emerged SARS-CoV-2 variants.
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Affiliation(s)
- Rafael Rahal Guaragna Machado
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Érika Donizetti Candido
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Andressa Simoes Aguiar
- Dom Pedro II Geriatric and Convalescent Hospital, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 02265-002, SP, Brazil
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Vanessa Nascimento Chalup
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
| | - Patricia Romão Sanches
- Dom Pedro II Geriatric and Convalescent Hospital, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 02265-002, SP, Brazil
| | - Erick Gustavo Dorlass
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
| | | | - João Renato Rebello Pinho
- Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
- Laboratório de Medicina Laboratorial (LIM03), Department of Pathology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil
- Laboratório de Gastroenterologia Clínica e Experimental (LIM07), Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil
| | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
- Scientific Platform Pasteur-USP, São Paulo 05508-020, SP, Brazil
| | - Danielle Bruna Leal Oliveira
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
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Said EA, Al-Rubkhi A, Jaju S, Koh CY, Al-Balushi MS, Al-Naamani K, Al-Sinani S, Al-Busaidi JZ, Al-Jabri AA. Association of the Magnitude of Anti-SARS-CoV-2 Vaccine Side Effects with Sex, Allergy History, Chronic Diseases, Medication Intake, and SARS-CoV-2 Infection. Vaccines (Basel) 2024; 12:104. [PMID: 38276676 PMCID: PMC10820381 DOI: 10.3390/vaccines12010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Vaccination provides the best protection against the increasing infections of SARS-CoV-2. The magnitude and type of anti-SARS-CoV-2 vaccine side effects (SEs) depend on parameters that are not fully understood. In this cross-sectional study, the associations between different anti-SARS-CoV-2 vaccine SEs and age, sex, the presence of chronic diseases, medication intake, history of allergies, and infections with SARS-CoV-2 were investigated. Our survey used the Google platform and had 866 participants, contacted through e-mails, social media and chain referral sampling (margin of error ≈ 4.38%, 99% confidence). More than 99% of the participants received the BNT162b2 and ChAdOx1-S vaccines. Being female, having chronic diseases, taking medicines routinely and the presence of a SARS-CoV-2 infection (p < 0.05) were associated with strong SEs after the BNT162b2 vaccine second dose. Having a history of allergies and a female sex (p < 0.01) were associated with strong SEs after the ChAdOx1-S vaccine second dose. Furthermore, the results reveal, for the first time, the associations between having a history of allergies, chronic diseases, medication usage, and SEs of a strong magnitude for the BNT162b2 and ChAdOx1-S vaccines. Additionally, this study supports the association of the female sex and infection with SARS-CoV-2 with an increased potential of developing stronger SEs with certain anti-SARS-CoV-2 vaccines.
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Affiliation(s)
- Elias A. Said
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Afnan Al-Rubkhi
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Sanjay Jaju
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman;
| | - Crystal Y. Koh
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Mohammed S. Al-Balushi
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Khalid Al-Naamani
- Department of Medicine, Armed Forces Hospital, P.O. Box 726, Muscat 111, Oman
| | - Siham Al-Sinani
- Oman Medical Specialty Board, P.O. Box 1948, Muscat 130, Oman
| | - Juma Z. Al-Busaidi
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
| | - Ali A. Al-Jabri
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Muscat 123, Oman; (A.A.-R.)
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Black B, Thaw DB. Vaccinating against a Novel Pathogen: A Critical Review of COVID-19 Vaccine Effectiveness Evidence. Microorganisms 2023; 12:89. [PMID: 38257917 PMCID: PMC10820171 DOI: 10.3390/microorganisms12010089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
We study the experience with COVID-19 vaccination of an initially naïve population, which can inform planning for vaccination against the next novel, highly transmissible pathogen. We focus on the first two pandemic years (wild strain through Delta), because after the Omicron wave in early 2022, very few people were still SARS-CoV-2-naïve. Almost all were vaccinated, infected, or often both. We review the evidence on COVID-19 vaccine effectiveness (VE) and waning effectiveness over time and the relative effectiveness of the four principal vaccines used in developed Western countries: BNT162b2 (Pfizer-BioNTech), mRNA1273 (Moderna), Ad26.CoV2.S (Johnson&Johnson), and ChAdOx1-S (AstraZeneca). As a basis for our analysis, we conducted a PRISMA-compliant review of all studies on PubMed through 15 August 2022, reporting VE against four endpoints for these four vaccines: any infection, symptomatic infection, hospitalization, and death. The mRNA vaccines (BNT162b2, mRNA1273) had high initial VE against all endpoints but protection waned after approximately six months, with BNT162b2 declining faster than mRNA1273. Both mRNA vaccines outperformed the viral vector vaccines (Ad26.CoV2.S and ChAdOx1-S). A third "booster" dose, roughly six months after the initial doses, substantially reduced symptomatic infection, hospitalization, and death. In hindsight, a third dose should be seen as part of the normal vaccination schedule. Our analysis highlights the importance of the real-time population-level surveillance needed to assess evidence for waning, and the need for rapid regulatory response to this evidence.
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Affiliation(s)
- Bernard Black
- Pritzker School of Law and Kellogg School of Management, Northwestern University, Chicago, IL 60201, USA
| | - David B. Thaw
- School of Computing & Information and School of Law, University of Pittsburgh, Pittsburgh, PA 15260, USA
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5
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Costa Clemens SA, Marchevsky N, Kelly S, Felle S, Eldawi A, Rajasingam R, Mahmud R, Lambe T, Voysey M, Gonzalez I, Milan EP, Justino MC, Bibi S, Aley P, Clemens R, Pollard AJ. Immunogenicity, safety and reactogenicity of heterologous (third dose) booster vaccination with a full or fractional dose of two different COVID-19 vaccines: A phase 4, single-blind, randomized controlled trial in adults. Hum Vaccin Immunother 2023; 19:2233400. [PMID: 37438960 DOI: 10.1080/21645515.2023.2233400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
In this phase 4 study we assessed boosting with fractional doses of heterologous COVID-19 vaccines in Brazilian adults primed with two doses of CoronaVac (Sinovac/Butantan, São Paulo, Brazil) at least 4 months previously. Participants received either full-dose of ChAdOx1-S (Group 1, n = 232), a half dose of ChAdOx1-S (Group 2, n = 236), or a half dose of BNT162b2 (Group 3, n = 234). The primary objective was to show 80% seroresponse rates (SRR) 28 d after vaccination measured as IgG antibodies against a prototype SARS-CoV-2 spike-protein. Safety was assessed as solicited and unsolicited adverse events. At baseline all participants were seropositive, with high IgG titers overall. SRR at Day 28 were 34.3%, 27.1% and 71.2%, respectively, not meeting the primary objective of 80%, despite robust immune responses in all three groups with geometric mean-fold rise (GMFR) in IgG titers of 3.39, 2.99 and 7.42, respectively. IgG immune responses with similar GMFR were also observed against SARS-CoV-2 variants, Alpha, Beta, Delta, Gamma and D614G. In subsets (n = 35) of participants GMFR of neutralizing immune responses against live prototype SARS-CoV-2 virus and Omicron BA.2 were similar to the IgG responses as were pseudo-neutralizing responses against SARS-CoV-2 prototype and Omicron BA.4/5 variants. All vaccinations were well tolerated with no vaccine-related serious adverse events and mainly transient mild-to-moderate local and systemic reactogenicity. Heterologous boosting with full or half doses of ChAdOx1-S or a half dose of BNT162b2 was safe and immunogenic in CoronaVac-primed adults, but seroresponse rates were limited by high baseline immunity.
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Affiliation(s)
- Sue Ann Costa Clemens
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- Institute for Global Health, University of Siena, Siena, Italy
| | - Natalie Marchevsky
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Sarah Kelly
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Sally Felle
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Ahmed Eldawi
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Rupetha Rajasingam
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Rawan Mahmud
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Teresa Lambe
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- Chinese Academy of Medical Science Oxford Institute, University of Oxford, Oxford, UK
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | | | - Eveline Pipolo Milan
- Centro de Estudos e Pesquisa em Moléstias Infecciosas Ltda. (CEPCLIN), Natal, Brazil
| | - Maria Cleonice Justino
- Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Ananindeua, Pará, Brazil
| | - Sagida Bibi
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Parvinder Aley
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | | | - Andrew J Pollard
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
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Messina NL, Sperotto MG, Puga MAM, da Silva PV, de Oliveira RD, Moore CL, Pittet LF, Jamieson T, Dalcolmo M, dos Santos G, Jardim B, Lacerda MVG, Curtis N, Croda J. Impact of vaccine platform and BCG vaccination on antibody responses to COVID-19 vaccination. Front Immunol 2023; 14:1172851. [PMID: 37465688 PMCID: PMC10352084 DOI: 10.3389/fimmu.2023.1172851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/12/2023] [Indexed: 07/20/2023] Open
Abstract
Multiple factors, including vaccine platform and prior vaccinations, influence vaccine responses. We compared antibody responses to CoronaVac (Sinovac) and ChAdOx1-S (AstraZeneca-Oxford) vaccination in 874 healthcare workers in Brazil. As participants were randomised to BCG vaccination or placebo in the preceding 0-6 months as part of the BCG vaccination to reduce the impact of COVID-19 in healthcare workers (BRACE) trial, we also investigated the influence of recent BCG vaccination on antibody responses to these COVID-19 vaccines. Twenty-eight days after the second dose of each vaccine, ChAdOx1-S induced a stronger anti-spike IgG response than CoronaVac vaccination. Recent BCG vaccination did not impact IgG antibody responses to ChAdOx1-S or CoronaVac.
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Affiliation(s)
- Nicole L. Messina
- Infectious Diseases Group, Infection and Immunity Theme, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Mariana G. Sperotto
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Marco A. M. Puga
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Patricia V. da Silva
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Roberto D. de Oliveira
- State University of Mato Grosso do Sul, Dourados-Mato Grosso do Sul, Brazil
- Federal University of Grande Dourados, Dourados, Brazil
| | - Cecilia L. Moore
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Laure F. Pittet
- Infectious Diseases Group, Infection and Immunity Theme, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infectious Diseases, The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Tenaya Jamieson
- Infectious Diseases Group, Infection and Immunity Theme, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Margareth Dalcolmo
- Helio Fraga Reference Center, Oswaldo Cruz Foundation Ministry of Health, Rio de Janeiro, Rio de Janeiro, Brazil
- Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Glauce dos Santos
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruno Jardim
- Institute of Clinical Research Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Marcus V. G. Lacerda
- Institute of Clinical Research Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Nigel Curtis
- Infectious Diseases Group, Infection and Immunity Theme, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infectious Diseases, The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Julio Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Yale School of Public Health, New Haven, CT, United States
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Kohmer N, Stein S, Schenk B, Grikscheit K, Metzler M, Rabenau HF, Widera M, Herrmann E, Wicker S, Ciesek S. Heterologous prime-boost immunization with ChAdOx1-S and BNT162b2: reactogenicity and immunogenicity in a prospective cohort study. Int J Infect Dis 2023; 128:166-175. [PMID: 36587839 PMCID: PMC9800011 DOI: 10.1016/j.ijid.2022.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/23/2022] [Revised: 11/21/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Regarding reactogenicity and immunogenicity, heterologous COVID-19 vaccination regimens are considered as an alternative to conventional immunization schemes. METHODS Individuals receiving either heterologous (ChAdOx1-S [AstraZeneca, Cambridge, UK]/BNT162b2 [Pfizer-BioNTech, Mainz, Germany]; n = 306) or homologous (messenger RNA [mRNA]-1273 [Moderna, Cambridge, Massachusetts, USA]; n = 139) vaccination were asked to participate when receiving their second dose. Reactogenicity was assessed after 1 month, immunogenicity after 1, 3, and/or 6 months, including a third dose, through SARS-CoV-2 antispike immunoglobulin G, surrogate virus neutralization test, and a plaque reduction neutralization test against the Delta (B.1.167.2) and Omicron (B.1.1.529; BA.1) variants of concern. RESULTS The overall reactogenicity was lower after heterologous vaccination. In both cohorts, SARS-CoV-2 antispike immunoglobulin G concentrations waned over time with the heterologous vaccination demonstrating higher neutralizing activity than homologous mRNA vaccination after 3 months to low neutralizing levels in the Delta plaque reduction neutralization test after 6 months. At this point, 3.2% of the heterologous and 11.4% of the homologous cohort yielded low neutralizing activity against Omicron. After a third dose of an mRNA vaccine, ≥99% of vaccinees demonstrated positive neutralizing activity against Delta. Depending on the vaccination scheme and against Omicron, 60% to 87.5% of vaccinees demonstrated positive neutralizing activity. CONCLUSION ChAdOx1-S/BNT162b2 vaccination demonstrated an acceptable reactogenicity and immunogenicity profile. A third dose of an mRNA vaccine is necessary to maintain neutralizing activity against SARS-CoV-2. However, variants of concern-adapted versions of the vaccines would be desirable.
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Affiliation(s)
- Niko Kohmer
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany.
| | - Shivana Stein
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Barbara Schenk
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Katharina Grikscheit
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Melinda Metzler
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Marek Widera
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - Sabine Wicker
- Occupational Health Service, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany; German Centre for Infection Research, External Partner Site, Frankfurt, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Frankfurt, Germany.
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8
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Longueira Y, Ojeda DS, Battistelli RBA, Sanchez L, Oviedo Rouco S, Albano D, Guevara E, Valls V, Pando MA, Gamarnik AV. SARS-CoV-2-Specific IgG and IgA response in maternal blood and breastmilk of vaccinated naïve and convalescent lactating participants. Front Immunol 2022; 13:909995. [PMID: 36263055 PMCID: PMC9574440 DOI: 10.3389/fimmu.2022.909995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/01/2022] [Indexed: 12/31/2022] Open
Abstract
Background Recent studies have shown the presence of SARS-CoV-2-specific antibodies in the milk of breastfeeding mothers vaccinated with mRNA and convalescent. However, limited information is available in lactating women receiving other vaccine platforms used in developing countries, such as the inactivated SARS-CoV-2 vaccine BBIBP-CorV (Sinopharm) and the non-replicating adenovirus vaccines Sputnik V (Gamaleya Institute) and ChAdOx1-S (Oxford AstraZeneca). Methods Here, we evaluated anti-SARS-CoV-2 IgG and IgA levels in both serum and milk samples using a longitudinal and a cross-sectional cohort of 208 breastfeeding vaccinated women from Argentina with or without previous SARS-CoV-2 infection. Results The analysis showed that IgA levels remain constant in serum and milk of breastfeeding mothers between the first and second doses of vector-based vaccines (Sputnik V and ChAdOx1-S). After the second dose, anti-spike IgA was found positive in 100% of the serum samples and in 66% of breastmilk samples. In addition, no significant differences in milk IgA levels were observed in participants receiving BBIBP-CorV, Sputnik V or ChAdOx1-S. IgG levels in milk increased after the second dose of vector-based vaccines. Paired longitudinal samples taken at 45 and 120 days after the second dose showed a decrease in milk IgG levels over time. Study of IgA levels in serum and milk of vaccinated naïve of infection and vaccinated-convalescent breastfeeding participants showed significantly higher levels in vaccinated-convalescent than in participants without previous infection. Conclusion This study is relevant to understand the protection against SARS-CoV-2 by passive immunity in newborns and children who are not yet eligible to receive vaccination.
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Affiliation(s)
- Yesica Longueira
- CONICET – Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
| | - Diego S. Ojeda
- Laboratorio de Virología Molecular, Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina,Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina,*Correspondence: Andrea V. Gamarnik, ; Diego S. Ojeda,
| | - Rocio B. Antivero Battistelli
- CONICET – Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina,Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
| | - Lautaro Sanchez
- Laboratorio de Virología Molecular, Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina
| | - Santiago Oviedo Rouco
- Laboratorio de Virología Molecular, Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina
| | - Daniel Albano
- Banco de Leche Humana – Hospital Materno Infantil Ramón Sardá, Ciudad Autónoma de Buenos Aires, Argentina
| | - Eleonora Guevara
- Banco de Leche Humana – Hospital Materno Infantil Ramón Sardá, Ciudad Autónoma de Buenos Aires, Argentina
| | - Vanesa Valls
- Banco de Leche Humana – Hospital Materno Infantil Ramón Sardá, Ciudad Autónoma de Buenos Aires, Argentina
| | - María A. Pando
- CONICET – Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina,Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
| | - Andrea V. Gamarnik
- Laboratorio de Virología Molecular, Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina,*Correspondence: Andrea V. Gamarnik, ; Diego S. Ojeda,
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9
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Jarius S, Bieber N, Haas J, Wildemann B. MOG encephalomyelitis after vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2): case report and comprehensive review of the literature. J Neurol 2022; 269:5198-5212. [PMID: 35737110 PMCID: PMC9219396 DOI: 10.1007/s00415-022-11194-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND In around 20% of cases, myelin oligodendrocyte glycoprotein (MOG) immunoglobulin (IgG)-associated encephalomyelitis (MOG-EM; also termed MOG antibody-associated disease, MOGAD) first occurs in a postinfectious or postvaccinal setting. OBJECTIVE To report a case of MOG-EM with onset after vaccination with the Pfizer BioNTech COVID-19 mRNA vaccine BNT162b2 (Comirnaty®) and to provide a comprehensive review of the epidemiological, clinical, radiological, electrophysiological and laboratory features as well as treatment outcomes of all published patients with SARS-CoV-2 vaccination-associated new-onset MOG-EM. METHODS Case report and review of the literature. RESULTS In our patient, MOG-IgG-positive (serum 1:1000, mainly IgG1 and IgG2; CSF 1:2; MOG-specific antibody index < 4) unilateral optic neuritis (ON) occurred 10 days after booster vaccination with BNT162b2, which had been preceded by two immunizations with the vector-based Oxford AstraZeneca vaccine ChAdOx1-S/ChAdOx1-nCoV-19 (AZD1222). High-dose steroid treatment with oral tapering resulted in complete recovery. Overall, 20 cases of SARS-CoV2 vaccination-associated MOG-EM were analysed (median age at onset 43.5 years, range 28-68; female to male ratio = 1:1.2). All cases occurred in adults and almost all after immunization with ChAdOx1-S/ChAdOx1 nCoV-19 (median interval 13 days, range 7-32), mostly after the first dose. In 70% of patients, more than one CNS region (spinal cord, brainstem, supratentorial brain, optic nerve) was affected at onset, in contrast to a much lower rate in conventional MOG-EM in adults, in which isolated ON is predominant at onset and ADEM-like phenotypes are rare. The cerebrospinal fluid white cell count (WCC) exceeded 100 cells/μl in 5/14 (36%) patients with available data (median peak WCC 58 cells/μl in those with pleocytosis; range 6-720). Severe disease with tetraparesis, paraplegia, functional blindness, brainstem involvement and/or bladder/bowel dysfunction and a high lesion load was common, and treatment escalation with plasma exchange (N = 9) and/or prolonged IVMP therapy was required in 50% of cases. Complete or partial recovery was achieved in the majority of patients, but residual symptoms were significant in some. MOG-IgG remained detectable in 7/7 cases after 3 or 6 months. CONCLUSIONS MOG-EM with postvaccinal onset was mostly observed after vaccination with ChAdOx1-S/ChAdOx1 nCoV-19. Attack severity was often high at onset. Escalation of immunotherapy was frequently required. MOG-IgG persisted in the long term.
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Affiliation(s)
- S Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
- Otto Meyerhof Center, Im Neuenheimer Feld 350, 69120, Heidelberg, Germany.
| | - N Bieber
- Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - J Haas
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - B Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
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10
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Krashias G, Pafiti A, Deeba E, Christodoulou C, Pantzaris M, Lambrianides A. SARS CoV- 2 vaccination induces antibodies against cardiolipin. BMC Res Notes 2022; 15:292. [PMID: 36071440 PMCID: PMC9449922 DOI: 10.1186/s13104-022-06180-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/27/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Cases of thrombosis have been reported after administration of SARS-CoV-2 vaccines, with controversial results relating to Oxford-AstraZeneca's ChAdOx1-S. Despite such cases being rare, they still raised concerns for their involvement in coagulopathies. Anti-cardiolipin (aCL) IgG antibodies have been linked to venous and arterial thrombosis. The aim was to evaluate the concentration of aCL IgG antibodies in vaccinated and COVID-19 positive individuals using indirect ELISA and commercial sourced calibrators. RESULTS The concentration of aCL IgG antibodies was measured in the serum of COVID-19 positive (n = 37), ChAdOx1-S vaccinated (n = 37) and BioNTech Pfizer BNT162b2 vaccinated (n = 42) individuals. Samples from COVID-19 negative, unvaccinated individuals (n = 41) served as controls. The highest percentage of positivity was in the COVID-19 positive group (18.9%). Concerning vaccination, BNT162b2 had the highest percentage of positivity (11.9%) (p = 0.0037). Additionally, aCL concentrations were evaluated at different time points in both vaccinated groups (before, 3 weeks after and 3 months after the second dose). A significant difference in the levels of aCL IgG antibodies over time (p = 0.0391) was observed only in ChAdOx1-S individuals. Our study concluded that levels of aCL, after vaccination with either of the vaccines or following SARS-CoV-2 infection, were not clinically pathogenic for the risk of thrombosis.
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Affiliation(s)
- George Krashias
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Anna Pafiti
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,Neuroimmunology Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Elie Deeba
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Christina Christodoulou
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Marios Pantzaris
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,Neuroimmunology Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Anastasia Lambrianides
- Postgraduate School, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus. .,Neuroimmunology Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.
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11
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Pascuale CA, Varese A, Ojeda DS, Pasinovich ME, Lopez L, Rossi AH, Rodriguez PE, Miglietta EA, Mazzitelli I, Di Diego Garcia F, Sanchez L, Rouco SO, Gonzalez Lopez Ledesma MM, Zurano JP, Mazzitelli B, Scruzzi G, Barbero P, Cardozo D, Gallego S, Borda M, Diaz M, Ridao F, Rosales AB, Bhon J, Talia JM, Diangelo ME, Lacaze MA, Aime B, Gutierrez SI, Ercole R, Toro R, Tau L, Delaplace L, Compagnucci MF, Sartori C, Desimone I, Echegoyen C, Velazquez P, Testa C, Hozbor D, Docena G, Laino CH, Kreplak N, Pifano M, Barbas G, Rearte A, Vizzotti C, Castelli JM, Geffner J, Gamarnik AV; Laboratorio SeVa Group., Ministerio de Salud de la Provincia de Córdoba Group., UNC-Fac. Cs. Médicas-InViV Group., Ministerio de Salud de la Provincia de La Rioja Group., Ministerio de Salud de la Provincia de San Luis Group., Universidad Nacional de La Plata Group., Ministerio de Salud de la Provincia de Buenos Aires Group. Immunogenicity and reactogenicity of heterologous immunization against SARS CoV-2 using Sputnik V, ChAdOx1-S, BBIBP-CorV, Ad5-nCoV, and mRNA-1273. Cell Rep Med 2022; 3:100706. [PMID: 35926505 DOI: 10.1016/j.xcrm.2022.100706] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/01/2022] [Accepted: 07/11/2022] [Indexed: 12/15/2022]
Abstract
Heterologous vaccination against coronavirus disease 2019 (COVID-19) provides a rational strategy to rapidly increase vaccination coverage in many regions of the world. Although data regarding messenger RNA (mRNA) and ChAdOx1 vaccine combinations are available, there is limited information about the combination of these platforms with other vaccines widely used in developing countries, such as BBIBP-CorV and Sputnik V. Here, we assess the immunogenicity and reactogenicity of 15 vaccine combinations in 1,314 participants. We evaluate immunoglobulin G (IgG) anti-spike response and virus neutralizing titers and observe that a number of heterologous vaccine combinations are equivalent or superior to homologous schemes. For all cohorts in this study, the highest antibody response is induced by mRNA-1273 as the second dose. No serious adverse events are detected in any of the schedules analyzed. Our observations provide rational support for the use of different vaccine combinations to achieve wide vaccine coverage in the shortest possible time. Heterologous vaccine combinations are equivalent or superior to homologous schemes No serious adverse events are detected in any of the heterologous schedules analyzed The highest antibody response is induced by mRNA-1273 as heterologous second dose Heterologous schemes improve antibody response in individuals primed with BBIBP-CorV
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12
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Brdovčak MC, Materljan J, Šustić M, Ravlić S, Ružić T, Lisnić B, Miklić K, Brizić I, Matešić MP, Lisnić VJ, Halassy B, Rončević D, Knežević Z, Štefan L, Bertoglio F, Schubert M, Čičin-Šain L, Markotić A, Jonjić S, Krmpotić A. ChAdOx1-S adenoviral vector vaccine applied intranasally elicits superior mucosal immunity compared to the intramuscular route of vaccination. Eur J Immunol 2022; 52:936-945. [PMID: 35304741 PMCID: PMC9087383 DOI: 10.1002/eji.202249823] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/09/2022]
Abstract
COVID-19 vaccines prevent severe forms of the disease, but do not warrant complete protection against breakthrough infections. This could be due to suboptimal mucosal immunity at the site of virus entry, given that all currently approved vaccines are administered via the intramuscular route. In this study we assessed humoral and cellular immune responses in BALB/c mice after intranasal and intramuscular immunization with adenoviral vector ChAdOx1-S expressing full-length Spike protein of SARS-CoV-2. We showed that both routes of vaccination induced a potent IgG antibody response, as well as robust neutralizing capacity, but intranasal vaccination elicited a superior IgA antibody titer in the sera and in the respiratory mucosa. Bronchoalveolar lavage from intranasally immunized mice efficiently neutralized SARS-CoV-2, which has not been the case in intramuscularly immunized group. Moreover, substantially higher percentages of epitope-specific CD8 T cells exhibiting a tissue resident phenotype were found in the lungs of intranasally immunized animals. Finally, both intranasal and intramuscular vaccination with ChAdOx1-S efficiently protected the mice after the challenge with recombinant herpesvirus expressing the Spike protein. Our results demonstrate that intranasal application of adenoviral vector ChAdOx1-S induces superior mucosal immunity and therefore could be a promising strategy for putting the COVID-19 pandemic under control. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Maja Cokarić Brdovčak
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | - Jelena Materljan
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia.,Department of Histology and Embryology, University of Rijeka, Rijeka, 51000, Croatia
| | - Marko Šustić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | - Sanda Ravlić
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, 10000, Croatia
| | - Tina Ružić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | - Berislav Lisnić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | - Karmela Miklić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | - Ilija Brizić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | | | - Vanda Juranić Lisnić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | - Beata Halassy
- Centre for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, 10000, Croatia
| | | | | | - Leo Štefan
- JGL d.d. Jadran Galenski Laboratorij, Rijeka, 51 000, Croatia
| | - Federico Bertoglio
- Institute for Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Braunschweig, 38106, Germany
| | - Maren Schubert
- Institute for Biochemistry, Biotechnology and Bioinformatics, Technische Universität Braunschweig, Braunschweig, 38106, Germany
| | - Luka Čičin-Šain
- Helmholtz Center for Infection Research, Department of Viral Immunology, Braunschweig, 38124, Germany
| | - Alemka Markotić
- University Hospital for Infectious Diseases "Fran Mihaljević", Zagreb, 10000, Croatia
| | - Stipan Jonjić
- Center for Proteomics, University of Rijeka, Faculty of Medicine, Rijeka, 51000, Croatia
| | - Astrid Krmpotić
- Department of Histology and Embryology, University of Rijeka, Rijeka, 51000, Croatia
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Röltgen K, Nielsen SCA, Silva O, Younes SF, Zaslavsky M, Costales C, Yang F, Wirz OF, Solis D, Hoh RA, Wang A, Arunachalam PS, Colburg D, Zhao S, Haraguchi E, Lee AS, Shah MM, Manohar M, Chang I, Gao F, Mallajosyula V, Li C, Liu J, Shoura MJ, Sindher SB, Parsons E, Dashdorj NJ, Dashdorj ND, Monroe R, Serrano GE, Beach TG, Chinthrajah RS, Charville GW, Wilbur JL, Wohlstadter JN, Davis MM, Pulendran B, Troxell ML, Sigal GB, Natkunam Y, Pinsky BA, Nadeau KC, Boyd SD. Immune imprinting, breadth of variant recognition, and germinal center response in human SARS-CoV-2 infection and vaccination. Cell 2022; 185:1025-1040.e14. [PMID: 35148837 PMCID: PMC8786601 DOI: 10.1016/j.cell.2022.01.018] [Citation(s) in RCA: 199] [Impact Index Per Article: 99.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/03/2022] [Accepted: 01/20/2022] [Indexed: 01/07/2023]
Abstract
During the SARS-CoV-2 pandemic, novel and traditional vaccine strategies have been deployed globally. We investigated whether antibodies stimulated by mRNA vaccination (BNT162b2), including third-dose boosting, differ from those generated by infection or adenoviral (ChAdOx1-S and Gam-COVID-Vac) or inactivated viral (BBIBP-CorV) vaccines. We analyzed human lymph nodes after infection or mRNA vaccination for correlates of serological differences. Antibody breadth against viral variants is lower after infection compared with all vaccines evaluated but improves over several months. Viral variant infection elicits variant-specific antibodies, but prior mRNA vaccination imprints serological responses toward Wuhan-Hu-1 rather than variant antigens. In contrast to disrupted germinal centers (GCs) in lymph nodes during infection, mRNA vaccination stimulates robust GCs containing vaccine mRNA and spike antigen up to 8 weeks postvaccination in some cases. SARS-CoV-2 antibody specificity, breadth, and maturation are affected by imprinting from exposure history and distinct histological and antigenic contexts in infection compared with vaccination.
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Affiliation(s)
| | | | - Oscar Silva
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Sheren F Younes
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Maxim Zaslavsky
- Department of Pathology, Stanford University, Stanford, CA, USA
| | | | - Fan Yang
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Oliver F Wirz
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Daniel Solis
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Ramona A Hoh
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Aihui Wang
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Prabhu S Arunachalam
- Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA
| | - Deana Colburg
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Shuchun Zhao
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Emily Haraguchi
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Alexandra S Lee
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA
| | - Mihir M Shah
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA
| | - Monali Manohar
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA
| | - Iris Chang
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA
| | - Fei Gao
- Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA
| | - Vamsee Mallajosyula
- Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA
| | - Chunfeng Li
- Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA
| | - James Liu
- Stanford Health Library, Stanford, CA, USA
| | - Massa J Shoura
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Sayantani B Sindher
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA
| | - Ella Parsons
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA
| | | | | | | | | | | | - R Sharon Chinthrajah
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA; Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, Stanford, CA, USA
| | | | | | | | - Mark M Davis
- Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA; Department of Microbiology and Immunology, Stanford University, Stanford, CA, USA; Howard Hughes Medical Institute, Stanford University, Stanford, CA, USA
| | - Bali Pulendran
- Department of Pathology, Stanford University, Stanford, CA, USA; Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA; Department of Microbiology and Immunology, Stanford University, Stanford, CA, USA
| | - Megan L Troxell
- Department of Pathology, Stanford University, Stanford, CA, USA
| | | | | | - Benjamin A Pinsky
- Department of Pathology, Stanford University, Stanford, CA, USA; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA; Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, Stanford, CA, USA
| | - Scott D Boyd
- Department of Pathology, Stanford University, Stanford, CA, USA; Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA, USA.
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14
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Lijeskić O, Klun I, Stamenov Djaković M, Gligorić N, Štajner T, Srbljanović J, Djurković-Djaković O. Prospective Cohort Study of the Kinetics of Specific Antibodies to SARS-CoV-2 Infection and to Four SARS-CoV-2 Vaccines Available in Serbia, and Vaccine Effectiveness: A 3-Month Interim Report. Vaccines (Basel) 2021; 9:1031. [PMID: 34579268 PMCID: PMC8470459 DOI: 10.3390/vaccines9091031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 12/16/2022] Open
Abstract
Real-life data on the performance of vaccines against SARS-CoV-2 are still limited. We here present the rates of detection and levels of antibodies specific for the SARS-CoV-2 spike protein RBD (receptor binding domain) elicited by four vaccines available in Serbia, including BNT-162b2 (BioNTech/Pfizer), BBIBP-CorV (Sinopharm), Gam-COVID-Vac (Gamaleya Research Institute) and ChAdOx1-S (AstraZeneca), compared with those after documented COVID-19, at 6 weeks and 3 months post first vaccine dose or post-infection. Six weeks post first vaccine dose, specific IgG antibodies were detected in 100% of individuals fully vaccinated with BNT-162b2 (n = 100) and Gam-COVID-Vac (n = 12) and in 81.7% of BBIBP-CorV recipients (n = 148), while one dose of ChAdOx1-S (n = 24) induced specific antibodies in 75%. Antibody levels elicited by BNT-162b2 were higher, while those elicited by BBIBP-CorV were lower, than after SARS-CoV-2 infection. By 3 months post-vaccination, antibody levels decreased but remained ≥20-fold above the cut-off in BNT-162b2 but not in BBIBP-CorV recipients, when an additional 30% were seronegative. For all vaccines, antibody levels were higher in individuals with past COVID-19 than in naïve individuals. A total of twelve new infections occurred within the first 3 months post-vaccination, eight after the first dose of BNT-162b2 and ChAdOx1-S (one each) and BBIBP-CorV (six), and four after full vaccination with BBIBP-CorV, but none required hospitalization.
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Affiliation(s)
- Olivera Lijeskić
- Department of Microbiology and Parasitology, Institute for Medical Research, University of Belgrade, 11129 Belgrade, Serbia; (O.L.); (I.K.); (M.S.D.); (T.Š.); (J.S.)
| | - Ivana Klun
- Department of Microbiology and Parasitology, Institute for Medical Research, University of Belgrade, 11129 Belgrade, Serbia; (O.L.); (I.K.); (M.S.D.); (T.Š.); (J.S.)
| | - Marija Stamenov Djaković
- Department of Microbiology and Parasitology, Institute for Medical Research, University of Belgrade, 11129 Belgrade, Serbia; (O.L.); (I.K.); (M.S.D.); (T.Š.); (J.S.)
| | - Nenad Gligorić
- Faculty of Information Technology, Alfa BK University, 11070 Belgrade, Serbia;
- Zentrix Lab, 26000 Pančevo, Serbia
| | - Tijana Štajner
- Department of Microbiology and Parasitology, Institute for Medical Research, University of Belgrade, 11129 Belgrade, Serbia; (O.L.); (I.K.); (M.S.D.); (T.Š.); (J.S.)
| | - Jelena Srbljanović
- Department of Microbiology and Parasitology, Institute for Medical Research, University of Belgrade, 11129 Belgrade, Serbia; (O.L.); (I.K.); (M.S.D.); (T.Š.); (J.S.)
| | - Olgica Djurković-Djaković
- Department of Microbiology and Parasitology, Institute for Medical Research, University of Belgrade, 11129 Belgrade, Serbia; (O.L.); (I.K.); (M.S.D.); (T.Š.); (J.S.)
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15
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Singhatiraj E, Pongpirul K, Jongkaewwattana A, Hirankarn N. Intradermal ChAdOx1 Vaccine Following Two CoronaVac Shots: A Case Report. Vaccines (Basel) 2021; 9:990. [PMID: 34579227 PMCID: PMC8472992 DOI: 10.3390/vaccines9090990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
Inactivated SARS-CoV-2 vaccines are used in many countries with uncertain immunogenicity. Intradermal ChAdOx1 has been proposed as a resource-efficient heterologous third booster shot. A 52-year-old healthy male healthcare professional had received two intramuscular CoronaVac shots on 21 April and 23 May 2021, and volunteered to take a 0.1 mL ChAdOx1 vaccine intradermally on 29 June 2021, with minimal local reactions. The declining IgG levels against spike protein from the two CoronaVac shots increased to higher than 10,000 AU/mL two weeks after the intradermal ChAdOx1. Moreover, the neutralizing antibody increased from 66.77% to almost 100%. A ratio of 6.6:9.7 of IgA:IgG was observed. The 50% pseudovirus neutralization titer (PVNT50) against lentiviral pseudovirus bearing a codon-optimized spike gene (wild type, alpha, beta, and delta) were 1812.42, 822.99, 1025.42, 1347.13, respectively. The SARS-CoV-2-specific T cells to spike protein-peptide pools (532-788 SFU/106 PBMCs) were detected. In conclusion, the antibody and cellular responses to the intradermal ChAdOx1, as a third booster dose in a healthy volunteer who received two intramuscular CoronaVac shots, revealed a dramatic increase in the total antibodies, including IgG, IgA, as well as T cell responses against spike protein. The immune response from intradermal ChAdOx1 should be further investigated in a larger population.
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Affiliation(s)
- Ekachai Singhatiraj
- Department of Medicine, Bumrungrad International Hospital, Bangkok 10110, Thailand;
| | - Krit Pongpirul
- Department of Medicine, Bumrungrad International Hospital, Bangkok 10110, Thailand;
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anan Jongkaewwattana
- National Center for Genetic Engineering and Biotechnology (BIOTEC), National Science and Technology Development Agency (NSTDA), Pathumthani 12120, Thailand;
| | - Nattiya Hirankarn
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand;
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Al Bahrani S, Albarrak A, Alghamdi OA, Alghamdi MA, Hakami FH, Al Abaadi AK, Alkhrashi SA, Alghamdi MY, Almershad MM, Alenazi MM, El Gezery MH, Jebakumar AZ, Al-Tawfiq JA. Safety and Reactogenicity of the ChAdOx1 (AZD1222) COVID-19 Vaccine in Saudi Arabia. Int J Infect Dis 2021; 110:359-362. [PMID: 34320413 PMCID: PMC8310569 DOI: 10.1016/j.ijid.2021.07.052] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/09/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The Kingdom of Saudi Arabia was one of the first countries to implement a COVID-19 vaccination program. This study estimated the safety and reactogenicity of the ChAdOx1-S vaccine after the first dose administered to adults. METHODS This cross-sectional study included 1592 randomly selected vaccinees from April to May 2021. A questionnaire was delivered to the vaccinees via phone calls 7 and 21 days after the first vaccine dose. RESULTS Of the 1592 vaccinees who had the first dose, the mean age was 37.4 (± 9.6) years and 81% were males. Of all the vaccinees, 553 (34.7%) reported an adverse reaction on the first telephone call. The most common symptoms were: pain at the site of injection (485, 30.5%), musculoskeletal symptoms (438, 27.5%), skin rash (307, 19.2%), gastrointestinal symptoms (379, 23.8%) and fever (498, 31.3%). Men were more likely to report fever (76.9% vs. 23.1%; P = 0.005), skin rash (81.1% vs. 18.9%, P = 0.005) and pain at the injection site (77.3% vs. 22.7%, P < 0.0001). Post-vaccine COVID-19 infection was 0.5% and there were no hospitalizations. CONCLUSION This study observed no major side effects of the ChAdOx1-S vaccine and no reported breakthrough infection during the observation period.
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Affiliation(s)
- Salma Al Bahrani
- King Fahad Military Medical Complex, Dhahran, Saudi Arabia; Infectious Disease Unit, Specialty Internal Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ali Albarrak
- Infectious Disease Division, Internal Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | | | | | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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17
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Vallée A, Vasse M, Mazaux L, Bonan B, Amiel C, Zia-Chahabi S, Chan-Hew-Wai A, Farfour E, Camps E, Touche P, Barret F, Parquin F, Zucman D, Fourn E. An Immunogenicity Report for the Comparison between Heterologous and Homologous Prime-Boost Schedules with ChAdOx1-S and BNT162b2 Vaccines. J Clin Med 2021; 10:jcm10173817. [PMID: 34501264 PMCID: PMC8432244 DOI: 10.3390/jcm10173817] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There is a small amount of immunological data on COVID-19 heterologous vaccination schedules in humans. We assessed the immunogenicity of BNT162b2 (Pfizer/BioNTech) administered as a second dose in healthcare workers primed with ChAdOx1-S (Vaxzevria, AstraZeneca). METHODS 197 healthcare workers were included in a monocentric observational study in Foch hospital, France, between June and July 2021. The main outcome was the immunogenicity measured by serum SARS-CoV-2 IgG antibodies. RESULTS 130 participants received the ChAdOx1-S/BNT vaccine and 67 received the BNT/BNT vaccine. The geometric mean of IgG antibodies was significantly higher in the BNT/BNT vaccine group compared to the ChAdOx1-S/BNT vaccine group, namely 10,734.9, 95% CI (9141.1-12,589.3) vs. 7268.6, 95% CI (6501.3-8128.3), respectively (p < 0.001). However, after adjustment for time duration between the prime and second vaccinations, no significant difference was observed (p = 0.181). A negative correlation between antibody levels and time duration between second dose and serology test was observed for the BNT/BNT vaccine (p < 0.001), which remained significant after adjustment for all covariates (p < 0.001), but not for the ChAdOx1-S/BNT vaccine (p = 0.467). CONCLUSIONS Heterologous and homologous schedules of ChAdOx1-S and BNT vaccines present robust immune responses after the second vaccination. The results observed were equivalent after adjustment for covariates and emphasize the importance of flexibility in deploying mRNA and viral vectored vaccines. Nevertheless, applying the ChAdOx1-S schedule vaccination for the heterologous second dose of BNT was associated with decreased IgG antibody levels compared to the homologous BNT/BNT vaccination.
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Affiliation(s)
- Alexandre Vallée
- Department of Clinical Research and Innovation, Foch Hospital, 92150 Suresnes, France; (P.T.); (F.B.)
- Correspondence:
| | - Marc Vasse
- Biology Department, Foch Hospital, 92150 Suresnes, France; (M.V.); (L.M.); (S.Z.-C.); (E.F.)
- INSERM, UMR-S1176, Université Paris-Saclay, 94000 Le Kremlin-Bicêtre, France
| | - Laurence Mazaux
- Biology Department, Foch Hospital, 92150 Suresnes, France; (M.V.); (L.M.); (S.Z.-C.); (E.F.)
| | - Brigitte Bonan
- Hospital Pharmacy, Foch Hospital, 92150 Suresnes, France; (B.B.); (A.C.-H.-W.); (E.C.)
| | - Carline Amiel
- Service de Médecine du Travail, 92150 Suresnes, France;
| | - Sara Zia-Chahabi
- Biology Department, Foch Hospital, 92150 Suresnes, France; (M.V.); (L.M.); (S.Z.-C.); (E.F.)
| | - Aurélie Chan-Hew-Wai
- Hospital Pharmacy, Foch Hospital, 92150 Suresnes, France; (B.B.); (A.C.-H.-W.); (E.C.)
| | - Eric Farfour
- Biology Department, Foch Hospital, 92150 Suresnes, France; (M.V.); (L.M.); (S.Z.-C.); (E.F.)
| | - Eve Camps
- Hospital Pharmacy, Foch Hospital, 92150 Suresnes, France; (B.B.); (A.C.-H.-W.); (E.C.)
| | - Pauline Touche
- Department of Clinical Research and Innovation, Foch Hospital, 92150 Suresnes, France; (P.T.); (F.B.)
| | - Flavie Barret
- Department of Clinical Research and Innovation, Foch Hospital, 92150 Suresnes, France; (P.T.); (F.B.)
| | - François Parquin
- Thoracic Intensive Care Unit, Foch Hospital, 92150 Suresnes, France;
| | - David Zucman
- Réseau Ville-Hôpital, Service de Médecine Interne, Foch Hospital, 92150 Suresnes, France; (D.Z.); (E.F.)
| | - Erwan Fourn
- Réseau Ville-Hôpital, Service de Médecine Interne, Foch Hospital, 92150 Suresnes, France; (D.Z.); (E.F.)
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Bezbaruah R, Borah P, Kakoti BB, Al-Shar’I NA, Chandrasekaran B, Jaradat DMM, Al-Zeer MA, Abu-Romman S. Developmental Landscape of Potential Vaccine Candidates Based on Viral Vector for Prophylaxis of COVID-19. Front Mol Biosci 2021; 8:635337. [PMID: 33937326 PMCID: PMC8082173 DOI: 10.3389/fmolb.2021.635337] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, arose at the end of 2019 as a zoonotic virus, which is the causative agent of the novel coronavirus outbreak COVID-19. Without any clear indications of abatement, the disease has become a major healthcare threat across the globe, owing to prolonged incubation period, high prevalence, and absence of existing drugs or vaccines. Development of COVID-19 vaccine is being considered as the most efficient strategy to curtail the ongoing pandemic. Following publication of genetic sequence of SARS-CoV-2, globally extensive research and development work has been in progress to develop a vaccine against the disease. The use of genetic engineering, recombinant technologies, and other computational tools has led to the expansion of several promising vaccine candidates. The range of technology platforms being evaluated, including virus-like particles, peptides, nucleic acid (DNA and RNA), recombinant proteins, inactivated virus, live attenuated viruses, and viral vectors (replicating and non-replicating) approaches, are striking features of the vaccine development strategies. Viral vectors, the next-generation vaccine platforms, provide a convenient method for delivering vaccine antigens into the host cell to induce antigenic proteins which can be tailored to arouse an assortment of immune responses, as evident from the success of smallpox vaccine and Ervebo vaccine against Ebola virus. As per the World Health Organization, till January 22, 2021, 14 viral vector vaccine candidates are under clinical development including 10 nonreplicating and four replicating types. Moreover, another 39 candidates based on viral vector platform are under preclinical evaluation. This review will outline the current developmental landscape and discuss issues that remain critical to the success or failure of viral vector vaccine candidates against COVID-19.
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Affiliation(s)
- Rajashri Bezbaruah
- Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh, India
| | - Pobitra Borah
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Bibhuti Bhushan Kakoti
- Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh, India
| | - Nizar A. Al-Shar’I
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Da’san M. M. Jaradat
- Department of Chemistry, Faculty of Science, Al-Balqa Applied University, Al-Salt, Jordan
| | - Munir A. Al-Zeer
- Department of Applied Biochemistry, Institute of Biotechnology, Technical University of Berlin, Berlin, Germany
| | - Saeid Abu-Romman
- Department of Biotechnology, Faculty of Agricultural Technology, Al-Balqa Applied University, Al-Salt, Jordan
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