Real-world data on immune responses following heterologous prime-boost COVID-19 vaccination schedule with Pfizer and AstraZeneca vaccines in England - 05/05/22
, Heather J Whitaker b, Annabel A Powell a, Linda Power a, Corinne Whillock a, Helen Campbell a, Ruth Simmons a, Lenesha Warrener c, Mary E Ramsay a, Shamez N Ladhani a, d, Kevin E Brown a, Gayatri Amirthalingam a
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Abstract |
Background |
There are limited data on immune responses to heterologous COVID-19 immunisation schedules, especially following an extended ≥12-week interval between doses.
Methods |
SARS-CoV-2 infection-naïve and previously-infected adults receiving ChAd-BNT (ChAdOx1 nCoV-19, AstraZeneca followed by BNT162b2, Pfizer-BioNTech) or BNT-ChAd as part of the UK national immunisation programme provided blood samples at 30 days and 12 weeks after their second dose. Geometric mean concentrations (GMC) of anti-SARS-CoV-2 spike (S-antibody) and nucleoprotein (N-antibody) IgG antibodies and geometric mean ratios (GMR) were compared with a contemporaneous cohort receiving homologous ChAd-ChAd or BNT-BNT.
Results |
During March-October 2021, 75,827 individuals were identified as having received heterologous vaccination, 9,489 invited to participate, 1,836 responded (19.3%) and 656 were eligible. In previously-uninfected adults, S-antibody GMC at 30 days post-second dose were lowest for ChAd-ChAd (862 [95% CI, 694 – 1069]) and significantly higher for ChAd-BNT (6233 [5522–7035]; GMR 6.29; [5.04–7.85]; p<0.001), BNT-ChAd (4776 [4066–5610]; GMR 4.55 [3.56–5.81]; p<0.001) and BNT-BNT (5377 [4596–6289]; GMR 5.66 [4.49–7.15]; p<0.001). By 12 weeks after dose two, S-antibody GMC had declined in all groups and remained significantly lower for ChAd-ChAd compared to ChAd-BNT (GMR 5.12 [3.79–6.92]; p<0.001), BNT-ChAd (GMR 4.1 [2.96–5.69]; p<0.001) and BNT-BNT (GMR 6.06 [4.32–8.50]; p<0.001). Previously infected adults had higher S-antibody GMC compared to infection-naïve adults at all time-points and with all vaccine schedules.
Conclusions |
These real-world findings demonstrate heterologous schedules with adenoviral-vector and mRNA vaccines are highly immunogenic and may be recommended after a serious adverse reaction to one vaccine product, or to increase programmatic flexibility where vaccine supplies are constrained.
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Vol 84 - N° 5
P. 692-700 - mai 2022 Retour au numéro
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