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Heterologous prime-boost with the mRNA-1273 vaccine among CoronaVac-vaccinated healthcare workers in Indonesia

  • 투고 : 2021.11.23
  • 심사 : 2022.04.29
  • 발행 : 2022.05.31

초록

Purpose: This study was performed to investigate humoral immune response and adverse events upon the heterologous prime-boost with a single dose of the mRNA-1273 vaccine among fully CoronaVac-vaccinated, infection-naïve healthcare workers in Indonesia. Materials and Methods: One hundred twenty-five eligible healthcare workers were recruited from one hospital for this prospective cohort study. Blood collection was conducted twice, i.e., on 7 days before and 28 days after the booster vaccination. The titer of anti-SARS-CoV-2 receptor-binding domain (RBD) antibodies was quantified accordingly. The post-vaccination adverse event was recorded for both CoronaVac and mRNA-1273 vaccinations. Any breakthrough infection was monitored during the follow-up period. Wilcoxon matched-pairs signed rank test was used to test differences between groups. Results: A significant increase was observed in the titer of anti-SARS-CoV-2 RBD antibodies upon receiving the mRNA-1273 booster (geometric mean titers of 65.57 and 47,445 U/mL in pre-and post-booster, respectively), supporting the argument to use heterologous prime-boost vaccination to improve the protection against COVID-19 in a high-risk population. The mRNA1273 vaccine, however, caused a higher frequency of adverse events than the CoronaVac vaccine. Nonetheless, the adverse events were considered minor medical events and temporary as all subjects were not hospitalized and fully recovered. Of note, no breakthrough infection was observed during the follow-up to 12 weeks post-booster. Conclusion: The heterologous prime-boost vaccination of healthcare workers with a single dose of the mRNA-1273 vaccine generated a significant elevation in humoral immune response towards RBD of SARS-CoV-2 and was associated with a higher frequency, but minor and transient, adverse events.

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참고문헌

  1. Zhang Y, Zeng G, Pan H, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18-59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect Dis 2021;21:181-92.
  2. Cucunawangsih C, Wijaya RS, Lugito NP, Suriapranata I. Antibody response to the inactivated SARS-CoV-2 vaccine among healthcare workers, Indonesia. Int J Infect Dis 2021;113:15-7.
  3. Barnes CO, Jette CA, Abernathy ME, et al. SARS-CoV-2 neutralizing antibody structures inform therapeutic strategies. Nature 2020;588:682-7.
  4. Pan H, Wu Q, Zeng G, et al. Immunogenicity and safety of a third dose, and immune persistence of CoronaVac vaccine in healthy adults aged 18-59 years: interim results from a double-blind, randomized, placebo-controlled phase 2 clinical trial. MedRxiv [Preprint] 2021 Jul 23 [Epub]. https://doi.org/10.1101/2021.07.23.21261026.
  5. Mallapaty S. China's COVID vaccines have been crucial: now immunity is waning. Nature 2021;598:398-9.
  6. Lu S. Heterologous prime-boost vaccination. Curr Opin Immunol 2009;21:346-51.
  7. He Q, Mao Q, Zhang J, et al. COVID-19 vaccines: current understanding on immunogenicity, safety, and further considerations. Front Immunol 2021;12:669339.
  8. Chiu NC, Chi H, Tu YK, et al. To mix or not to mix?: a rapid systematic review of heterologous prime-boost covid-19 vaccination. Expert Rev Vaccines 2021;20:1211-20.
  9. Zhang J, He Q, An C, et al. Boosting with heterologous vaccines effectively improves protective immune responses of the inactivated SARS-CoV-2 vaccine. Emerg Microbes Infect 2021;10:1598-608.
  10. Mlcochova P, Kemp SA, Dhar MS, et al. SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion. Nature 2021;599:114-9.
  11. Callaway E. The mutation that helps Delta spread like wildfire. Nature 2021;596:472-3.
  12. Dyer O. COVID-19: Indonesia becomes Asia's new pandemic epicentre as Delta variant spreads. BMJ 2021;374:n1815.
  13. Saifuddin A, Koesnoe S, Kurniati N, Sirait S, Arisanty R, Yunihastuti E. COVID arm after Moderna booster in healthcare worker: a case report. Acta Med Indones 2021;53:326-30.
  14. Jackson LA, Anderson EJ, Rouphael NG, et al. An mRNA vaccine against SARS-CoV-2: preliminary report. N Engl J Med 2020;383:1920-31.
  15. Atmar RL, Lyke KE, Deming ME, et al. Heterologous SARS-CoV-2 booster vaccinations: preliminary report. medRxiv [Preprint] 2021 Oct 15 [Epub]. https://doi.org/10.1101/2021.10.10.21264827.
  16. Tang P, Hasan MR, Chemaitelly H, et al. BNT162b2 and mRNA-1273 COVID-19 vaccine effectiveness against the SARS-CoV-2 Delta variant in Qatar. Nat Med 2021;27:2136-43.
  17. Food and Drug Administration. Guidance for industry: toxicity grading scale for healthy adult and adolescent volunteers enrolled in preventive vaccine clinical trials. Rockville (MD): Food and Drug Administration; 2007.
  18. Breivik H, Borchgrevink PC, Allen SM, et al. Assessment of pain. Br J Anaesth 2008;101:17-24.
  19. Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021;384:403-16.
  20. Jochum S, Kirste I, Hortsch S, et al. Clinical utility of Elecsys anti-SARS-CoV-2 S assay in COVID-19 vaccination: an exploratory analysis of the mRNA-1273 phase 1 trial. Front Immunol 2022;12:798117.
  21. Jo J, Sanjaya A, Pinontoan R, Aruan M, Wahyuni RM, Viktaria V. Assessment on anti-SARS-CoV-2 receptor-binding domain antibodies among CoronaVac-vaccinated Indonesian adults. Clin Exp Vaccine Res 2022;11:116-20.
  22. Herve C, Laupeze B, Del Giudice G, Didierlaurent AM, Tavares Da Silva F. The how's and what's of vaccine reactogenicity. NPJ Vaccines 2019;4:39.
  23. Jara A, Undurraga EA, Gonzalez C, et al. Effectiveness of an inactivated SARS-CoV-2 vaccine in Chile. N Engl J Med 2021;385:875-84.
  24. Saure D, O'Ryan M, Torres JP, Zuniga M, Santelices E, Basso LJ. Dynamic IgG seropositivity after rollout of CoronaVac and BNT162b2 COVID-19 vaccines in Chile: a sentinel surveillance study. Lancet Infect Dis 2022;22:56-63.
  25. Li M, Yang J, Wang L, et al. A booster dose is immunogenic and will be needed for older adults who have completed two doses vaccination with CoronaVac: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. MedRxiv [Preprint] 2021 Aug 3 [Epub]. https://doi.org/10.1101/2021.08.03.21261544.
  26. Wanlapakorn N, Suntronwong N, Phowatthanasathian H, et al. Immunogenicity of heterologous inactivated and adenoviral-vectored COVID-19 vaccine: real-world data. Vaccine 2022 Apr 18 [Epub]. https://doi.org/10.1016/j.vaccine.2022.04.043.
  27. Yorsaeng R, Vichaiwattana P, Klinfueng S, et al. Immune response elicited from heterologous SARS-CoV-2 vaccination: Sinovac (CoronaVac) followed by AstraZeneca (Vaxzevria). medRxiv [Preprint] 2021 Sep 1 [Epub]. https://doi.org/10.1101/2021.09.01.21262955.
  28. Tan CW, Chia WN, Qin X, et al. A SARS-CoV-2 surrogate virus neutralization test based on antibody-mediated blockage of ACE2-spike protein-protein interaction. Nat Biotechnol 2020;38:1073-8.
  29. Swadling L, Diniz MO, Schmidt NM, et al. Pre-existing polymerase-specific T cells expand in abortive seronegative SARS-CoV-2. Nature 2022;601:110-7.
  30. Kang YM, Lim J, Choe KW, et al. Reactogenicity after the first and second doses of BNT162b2 mRNA coronavirus disease vaccine: a single-center study. Clin Exp Vaccine Res 2021;10:282-9.
  31. Chia PY, Ong SW, Chiew CJ, et al. Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study. Clin Microbiol Infect 2022;28:612.