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Journal of Infection

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The latform Trial n VID-19 priming and sting (PICOBOO): The immunogenicity, reactogenicity, and safety of licensed COVID-19 vaccinations administered as a second booster in BNT162b2 primed individuals aged 18-<50 and 50-<70 years old - 06/12/24

Doi : 10.1016/j.jinf.2024.106346 
C. McLeod a, b, c, d, ⁎, 1 , M. Dymock a, e, 1, KL Flanagan f, g, h, M. Plebanski h, HS Marshall i, j, MJ Estcourt d, U. Wadia a, b, k, MC Tjiam a, CC Blyth a, b, c, l, K. Subbarao m, n, FL Mordant n, S. Nicholson o, p, N. Cain n, R. Brizuela n, SN Faust q, r, RB Thornton a, k, Z. Ellis a, A. Mckenzie s, JA Marsh a, c, TL Snelling d, PC Richmond a, c, k, t
a Wesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute of Australia, Nedlands, Australia 
b Infectious Diseases Department, Perth Children’s Hospital, Nedlands, Australia 
c Centre for Child Health Research, University of Western Australia, Crawley, Australia 
d Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Australia 
e School of Population and Global Health, University of Western Australia, Nedlands, Australia 
f Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Tasmania, Australia 
g School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia 
h School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University (RMIT), Melbourne, Australia 
i Women’s and Children’s Health Network, North Adelaide, Australia 
j Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Australia 
k Centre for Child Health Research, University of Western Australia, Crawley, Australia 
l Department of Microbiology, Pathwest Laboratory Medicine WA, QEII Medical Centre, Nedlands, Australia 
m WHO Collaborating Centre for Reference and Research on Influenza, University of Melbourne, Parkville, Victoria, Australia 
n Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia 
o Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia 
p Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia 
q National Institute of Health Research Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom 
r Faculty of Medicine and Institute for Life Sciences, University of Southampton, United Kingdom 
s The Kids Research Institute of Australia, Nedlands, Australia 
t General Paediatrics and Immunology Departments, Perth Children’s Hospital, Nedlands, Australia 

⁎Correspondence to: WCVID, Telethon Kids Institute, 15 Hospital Avenue, Nedlands 6010, Australia.WCVID, Telethon Kids Institute15 Hospital AvenueNedlands6010Australia
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Summary

Objectives

PICOBOO is a randomised, adaptive trial evaluating the immunogenicity, reactogenicity, and safety of COVID-19 booster strategies. Here, we present data for second boosters among individuals aged 18-<50 and 50-<70 years old primed with BNT162b2 until Day (D) 84.

Methods

Immunocompetent adults who had received two doses of BNT162b2 and any licensed COVID-19 booster at least three months prior were eligible. Participants were randomly allocated to BNT162b2, mRNA-1273 or NVX-CoV2373 1:1:1. The log10 concentration of anti-spike Ig Total was summarised as the geometric mean concentration (GMC). Reactogenicity and safety outcomes were captured.

Results

Between Mar 2022 and Aug 2023, 743 participants were recruited to the trial and had D28 samples available. Of these, 120 and 103 belonged to the 18-<50 y and 50-<70 y strata, respectively. The mean adjusted GMCs (95% credible intervals) peaked at D28; these were 41 262 (31 611, 51 105), 45 585 (34 194, 57 441) and 25 281 (20 021, 31 234) U/mL in the 18-<50 y stratum and 30 753 (25 071, 36 704), 35 132 (27 523, 42 239) and 17 322 (13 983, 20 641) U/mL in the 50-<70 y stratum following BNT162b2, mRNA-1273 and NVX-CoV2373, respectively. Limited neutralisation against Omicron subvariants was found following boosting with all vaccines. There were 4 possibly or probably-related adverse events in the 18-<50 y stratum and 5 events in the 50-<70 y stratum, and severe reactogenicity events were <10% and <11% in these strata, respectively.

Conclusions

Vaccines targeting Ancestral virus elicited boosted antibody responses to Ancestral virus but minimal neutralising antibody against Omicron variants.

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Highlights

•
All vaccines were immunogenic with more rapid waning found after mRNA vaccines.
•
Higher binding and neutralising antibodies were observed in younger participants.
•
Minimal neutralisation activity was found against Omicron BA.5 and XBB.1.5.
•
These data support boosting with vaccines targeting Omicron subvariants.

Le texte complet de cet article est disponible en PDF.

Keywords : COVID-19, Vaccination, Adaptive trial, Policy, Immunisation


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Vol 89 - N° 6

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