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Persistence of immunogenicity after seven COVID-19 vaccines given as third dose boosters following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK: Three month analyses of the COV-BOOST trial

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Title: Persistence of immunogenicity after seven COVID-19 vaccines given as third dose boosters following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK: Three month analyses of the COV-BOOST trial
Authors: Liu, X
Munro, APS
Feng, S
Janani, L
Aley, PK
Babbage, G
Baxter, D
Bula, M
Cathie, K
Chatterjee, K
Dejnirattisai, W
Dodd, K
Enever, Y
Qureshi, E
Goodman, AL
Green, CA
Harndahl, L
Haughney, J
Hicks, A
Van der Klaauw, AA
Kwok, J
Libri, V
Llewelyn, MJ
McGregor, AC
Minassian, AM
Moore, P
Mughal, M
Mujadidi, YF
Holliday, K
Osanlou, O
Osanlou, R
Owens, DR
Pacurar, M
Palfreeman, A
Pan, D
Rampling, T
Regan, K
Saich, S
Serafimova, T
Saralaya, D
Screaton, GR
Sharma, S
Sheridan, R
Sturdy, A
Supasa, P
Thomson, EC
Todd, S
Twelves, C
Read, RC
Charlton, S
Hallis, B
Ramsay, M
Andrews, N
Lambe, T
Nguyen-Van-Tam, JS
Cornelius, V
Snape, MD
Faust, SN
COV-BOOST study group
Item Type: Journal Article
Abstract: OBJECTIVES: To evaluate the persistence of immunogenicity three months after third dose boosters. METHODS: COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of seven COVID-19 vaccines used as a third booster dose. The analysis was conducted using all randomised participants who were SARS-CoV-2 naïve during the study. RESULTS: Amongst the 2883 participants randomised, there were 2422 SARS-CoV-2 naïve participants until D84 visit included in the analysis with median age of 70 (IQR: 30-94) years. In the participants who had two initial doses of ChAdOx1 nCov-19 (Oxford-AstraZeneca; hereafter referred to as ChAd), schedules using mRNA vaccines as third dose have the highest anti-spike IgG at D84 (e.g. geometric mean concentration of 8674 ELU/ml (95% CI: 7461-10,085) following ChAd/ChAd/BNT162b2 (Pfizer-BioNtech, hearafter referred to as BNT)). However, in people who had two initial doses of BNT there was no significant difference at D84 in people given ChAd versus BNT (geometric mean ratio (GMR) of 0.95 (95%CI: 0.78, 1.15). Also, people given Ad26.COV2.S (Janssen; hereafter referred to as Ad26) as a third dose had significantly higher anti-spike IgG at D84 than BNT (GMR of 1.20, 95%CI: 1.01,1.43). Responses at D84 between people who received BNT (15 μg) or BNT (30 μg) after ChAd/ChAd or BNT/BNT were similar, with anti-spike IgG GMRs of half-BNT (15 μg) versus BNT (30 μg) ranging between 0.74-0.86. The decay rate of cellular responses were similar between all the vaccine schedules and doses. CONCLUSIONS: 84 days after a third dose of COVID-19 vaccine the decay rates of humoral response were different between vaccines. Adenoviral vector vaccine anti-spike IgG concentrations at D84 following BNT/BNT initial doses were similar to or even higher than for a three dose (BNT/BNT/BNT) schedule. Half dose BNT immune responses were similar to full dose responses. While high antibody tires are desirable in situations of high transmission of new variants of concern, the maintenance of immune responses that confer long-lasting protection against severe disease or death is also of critical importance. Policymakers may also consider adenoviral vector, fractional dose of mRNA, or other non-mRNA vaccines as third doses.
Issue Date: 1-Jun-2022
Date of Acceptance: 5-Apr-2022
URI: http://hdl.handle.net/10044/1/97555
DOI: 10.1016/j.jinf.2022.04.018
ISSN: 0163-4453
Publisher: British Infection Association
Start Page: 795
End Page: 813
Journal / Book Title: Journal of Infection
Volume: 84
Issue: 6
Copyright Statement: © 2022 The Author(s). Published by Elsevier Ltd on behalf of The British Infection Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: COVID-19 vaccine
Fractional dose
Heterologous boost
Homologous boost
Immunogenicity
Persistence
Third dose
Ad26COVS1
Adult
Aged
Aged, 80 and over
Antibodies, Viral
BNT162 Vaccine
COVID-19
COVID-19 Vaccines
ChAdOx1 nCoV-19
Humans
Immunogenicity, Vaccine
Immunoglobulin G
Middle Aged
SARS-CoV-2
United Kingdom
Viral Vaccines
mRNA Vaccines
COV-BOOST study group
Humans
Immunoglobulin G
Viral Vaccines
Antibodies, Viral
Adult
Aged
Aged, 80 and over
Middle Aged
United Kingdom
Immunogenicity, Vaccine
COVID-19
SARS-CoV-2
COVID-19 Vaccines
mRNA Vaccines
BNT162 Vaccine
Ad26COVS1
ChAdOx1 nCoV-19
COVID-19 vaccine
Fractional dose
Heterologous boost
Homologous boost
Immunogenicity
Persistence
Third dose
Ad26COVS1
Adult
Aged
Aged, 80 and over
Antibodies, Viral
BNT162 Vaccine
COVID-19
COVID-19 Vaccines
ChAdOx1 nCoV-19
Humans
Immunogenicity, Vaccine
Immunoglobulin G
Middle Aged
SARS-CoV-2
United Kingdom
Viral Vaccines
mRNA Vaccines
Microbiology
1103 Clinical Sciences
Publication Status: Published
Conference Place: England
Online Publication Date: 2022-04-09
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine
Imperial College London COVID-19
School of Public Health



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