Clinical and Experimental Vaccine Research

The Korean Vaccine Society (대한백신학회)
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Impact of the COVID-19 vaccine booster strategy on vaccine protection: a pilot study of a military hospital in Taiwan

  • Yu-Li Wang (Department of Emergent Room, Armed Force Hualien General Hospital) ;
  • Shu-Tsai Cheng (Institute of Biomedical Engineering, National Tsing Hua University) ;
  • Ching-Fen Shen (Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University) ;
  • Shu-Wei Huang (Department of Orthopedics, Taipei Municipal Wanfang Hospital, Taipei Medical University) ;
  • Chao-Min Cheng (Institute of Biomedical Engineering, National Tsing Hua University)
  • Received : 2023.08.25
  • Accepted : 2023.09.12
  • Published : 2023.10.31
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Abstract

Purpose: The global fight against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to widespread vaccination efforts, yet the optimal dosing schedule for SARS-CoV-2 vaccines remains a subject of ongoing research. This study aims to investigate the effectiveness of administering two booster doses as the third and fourth doses at different intervals to enhance vaccine protection. Materials and Methods: This study was conducted at a military regional hospital operated by the Ministry of National Defense in Taiwan. A cohort of vaccinated individuals was selected, and their vaccine potency was assessed at various time intervals following their initial vaccine administration. The study participants received booster doses as the third and fourth doses, with differing time intervals between them. The study monitored neutralizing antibody titers and other relevant parameters to assess vaccine efficacy. Results: Our findings revealed that the potency of the SARS-CoV-2 vaccine exhibited a significant decline 80 days after the initial vaccine administration. However, a longer interval of 175 days between booster injections resulted in significantly higher neutralizing antibody titers. The individuals who received the extended interval boosters exhibited a more robust immune response, suggesting that a vaccine schedule with a 175-day interval between injections may provide superior protection against SARS-CoV-2. Conclusion: This study underscores the importance of optimizing vaccine booster dosing schedules to maximize protection against SARS-CoV-2. The results indicate that a longer interval of 175 days between the third and fourth doses of the vaccine can significantly enhance the neutralizing antibody response, potentially offering improved protection against the virus. These findings have important implications for vaccine distribution and administration strategies in the ongoing battle against the SARS-CoV-2 pandemic. Further research and largescale trials are needed to confirm and extend these findings for broader public health implications.

Keywords

Acknowledgement

This study was partially supported by Taiwan's National Tsing Hua University (112F7MBBE1).

References

  1. Gross S, Jahn C, Cushman S, Bar C, Thum T. SARS-CoV-2 receptor ACE2-dependent implications on the cardiovascular system: from basic science to clinical implications. J Mol Cell Cardiol 2020;144:47-53.
  2. Chitsike L, Duerksen-Hughes P. Keep out! SARS-CoV-2 entry inhibitors: their role and utility as COVID-19 therapeutics. Virol J 2021;18:154.
  3. Gui M, Song W, Zhou H, et al. Cryo-electron microscopy structures of the SARS-CoV spike glycoprotein reveal a prerequisite conformational state for receptor binding. Cell Res 2017;27:119-29.
  4. Yuan M, Wu NC, Zhu X, et al. A highly conserved cryptic epitope in the receptor binding domains of SARS-CoV-2 and SARS-CoV. Science 2020;368:630-3.
  5. Trougakos IP, Terpos E, Alexopoulos H, et al. Adverse effects of COVID-19 mRNA vaccines: the spike hypothesis. Trends Mol Med 2022;28:542-54.
  6. Lippi G, Lavie CJ, Henry BM, Sanchis-Gomar F. Do genetic polymorphisms in angiotensin converting enzyme 2 (ACE2) gene play a role in coronavirus disease 2019 (COVID-19)? Clin Chem Lab Med 2020;58:1415-22.
  7. Wang Q, Zhang Y, Wu L, et al. Structural and functional basis of SARS-CoV-2 entry by using human ACE2. Cell 2020;181:894-904.
  8. Ke Z, Oton J, Qu K, et al. Structures and distributions of SARS-CoV-2 spike proteins on intact virions. Nature 2020;588:498-502.
  9. Ismail AM, Elfiky AA. SARS-CoV-2 spike behavior in situ: a Cryo-EM images for a better understanding of the COVID-19 pandemic. Signal Transduct Target Ther 2020;5:252.
  10. Ma J, Su D, Sun Y, et al. Cryo-EM structure of S-Trimer, a subunit vaccine candidate for COVID-19. J Virol 2021;95:e00194-21.
  11. Yadav T, Srivastava N, Mishra G, et al. Recombinant vaccines for COVID-19. Hum Vaccin Immunother 2020;16:2905-12.
  12. Wrapp D, Wang N, Corbett KS, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science 2020;367:1260-3.
  13. Dai L, Gao GF. Viral targets for vaccines against COVID-19. Nat Rev Immunol 2021;21:73-82.
  14. Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell 2020;181:281-92.
  15. Pack SM, Peters PJ. SARS-CoV-2-specific vaccine candidates; the contribution of structural vaccinology. Vaccines (Basel) 2022;10:236.
  16. Forthal DN. Functions of antibodies. Microbiol spectr 2014;2:1-17.
  17. Lu LL, Suscovich TJ, Fortune SM, Alter G. Beyond binding: antibody effector functions in infectious diseases. Nat Rev Immunol 2018;18:46-61.
  18. Vivaldi G, Jolliffe DA, Faustini S, et al. Correlation between postvaccination anti-spike antibody titers and protection against breakthrough severe acute respiratory syndrome coronavirus 2 infection: a population-based longitudinal study. J Infect Dis 2022;226:1903-8.
  19. Goldblatt D, Fiore-Gartland A, Johnson M, et al. Towards a population-based threshold of protection for COVID-19 vaccines. Vaccine 2022;40:306-15.
  20. Post N, Eddy D, Huntley C, et al. Antibody response to SARS-CoV-2 infection in humans: a systematic review. PLoS One 2020;15:e0244126.
  21. Earle KA, Ambrosino DM, Fiore-Gartland A, et al. Evidence for antibody as a protective correlate for COVID-19 vaccines. Vaccine 2021;39:4423-8.
  22. Gilbert PB, Montefiori DC, McDermott AB, et al. Immune correlates analysis of the mRNA-1273 COVID-19 vaccine efficacy clinical trial. Science 2022;375:43-50.
  23. Gilboa M, Regev-Yochay G, Mandelboim M, et al. Durability of immune response after COVID-19 booster vaccination and association with COVID-19 Omicron infection. JAMA Netw Open 2022;5:e2231778.
  24. Barouch DH. COVID-19 vaccines: immunity, variants, boosters. N Engl J Med 2022;387:1011-20.
  25. Magen O, Waxman JG, Makov-Assif M, et al. Fourth dose of BNT162b2 mRNA COVID-19 vaccine in a nationwide setting. N Engl J Med 2022;386:1603-14.
  26. Hart JD, Chokephaibulkit K, Mayxay M, Ong-Lim AL, Saketa ST, Russell FM. COVID-19 vaccine boosters in the Asia-Pacific region in the context of Omicron. Lancet Reg Health West Pac 2022;20:100404.
  27. Shen CJ, Lin YP, Hu SY, et al. Pilot study for immunogenicity of SARS-CoV-2 vaccine with seasonal influenza and pertussis vaccines in pregnant women. Vaccines (Basel) 2023;11:119.
  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. Kolesov DE, Sinegubova MV, Dayanova LK, Dolzhikova IV, Vorobiev II, Orlova NA. Fast and accurate surrogate virus neutralization test based on antibody-mediated blocking of the interaction of ACE2 and SARS-CoV-2 spike protein RBD. Diagnostics (Basel) 2022;12:393.
  30. Kim D, Lee YJ. Vaccination strategies and transmission of COVID-19: evidence across advanced countries. J Health Econ 2022;82:102589.
  31. Chenchula S, Karunakaran P, Sharma S, Chavan M. Current evidence on efficacy of COVID-19 booster dose vaccination against the Omicron variant: a systematic review. J Med Virol 2022;94:2969-76.
  32. Wang L, Kainulainen MH, Jiang N, et al. Differential neutralization and inhibition of SARS-CoV-2 variants by antibodies elicited by COVID-19 mRNA vaccines. Nat Commun 2022;13:4350.
  33. Burckhardt RM, Dennehy JJ, Poon LL, Saif LJ, Enquist LW. Are COVID-19 vaccine boosters needed?: the science behind boosters. J Virol 2022;96:e0197321.
  34. Atmar RL, Lyke KE, Deming ME, et al. Heterologous SARS-CoV-2 booster vaccinations: preliminary report. medRxiv [Preprint] 2021 Oct 15. https://doi.org/10.1101/2021.10.10.21264827
  35. Burki TK. Fourth dose of COVID-19 vaccines in Israel. Lancet Respir Med 2022;10:e19.
  36. Granwehr BP. In adults who had not had COVID-19, Novavax vaccine had 90% efficacy at ≥7 d after the second dose. Ann Intern Med 2022;175:JC52.
  37. Stuart AS, Shaw RH, Liu X, et al. Immunogenicity, safety, and reactogenicity of heterologous COVID-19 primary vaccination incorporating mRNA, viral-vector, and protein-adjuvant vaccines in the UK (Com-COV2): a single-blind, randomised, phase 2, non-inferiority trial. Lancet 2022;399:36-49.
  38. Montastruc JL, Biron P, Sommet A. NVX-Cov2373 Novavax COVID-19 vaccine: a further analysis of its efficacy using multiple modes of expression. Fundam Clin Pharmacol 2022;36:1125-7.
  39. Esposito M, Cocimano G, Vanaria F, Sessa F, Salerno M. Death from COVID-19 in a fully vaccinated subject: a complete autopsy report. Vaccines (Basel) 2023;11:142.