Comparison of the reactogenicity and immunogenicity of a reduced and standard booster dose of the mRNA COVID-19 vaccine in healthy adults after two doses of inactivated vaccine

Kanokudom, Sitthichai; Assawakosri, Suvichada; Suntronwong, Nungruthai; Chansaenroj, Jira; Auphimai, Chompoonut; Nilyanimit, Pornjarim; Vichaiwattana, Preeyaporn; Thongmee, Thanunrat; Yorsaeng, Ritthideach; Duangchinda, Thaneeya; Chantima, Warangkana; Pakchotanon, Pattarakul; Srimuan, Donchida; Thatsanatorn, Thaksaporn; Klinfueng, Sirapa; Mongkolsapaya, Juthathip; Sudhinaraset, Natthinee; Wanlapakorn, Nasamon; Honsawek, Sittisak; Poovorawan, Yong

doi:10.1101/2022.03.01.22271735

Cited by 4 publications

(9 citation statements)

References 18 publications

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“…Recently, we reported the results of a third dose booster study in healthy adults previously primed with two doses of CoronaVac. Our finding showed that a third heterologous dose elicited a robust immune response against the Omicron variant (Assawakosri et al, 2022b, Kanokudom et al, 2022b). Moreover, a booster with BNT162b2 in CoronaVac-primed individuals improved vaccine effectiveness (VE) to 92.7% for protection against COVID-19 infection in Brazil (Cerqueira-Silva et al, 2022b).…”

Section: Introductionmentioning

confidence: 50%

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Immunogenicity and durability against Omicron BA.1, BA.2 and BA.4/5 variants at 3 to 4 months after a heterologous COVID-19 booster vaccine in healthy adults with a two-doses CoronaVac vaccination

Assawakosri

Kanokudom

Suntronwong³

et al. 2022

Preprint

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Objectives: Several countries have authorized a booster vaccine campaign to combat the spread of COVID-19. Data on persistence of booster vaccine-induced immunity against new Omicron subvariants are still limited. Therefore, our study aimed to determine the serological immune response of COVID-19 booster after CoronaVac-priming. Methods: A total of 187 CoronaVac-primed participants were enrolled and received an inactivated (BBIBP), viral vector (AZD1222) or mRNA vaccine (full-/half-dose BNT162B2, full-/half-dose mRNA-1273) as a booster dose. The persistence of humoral immunity both binding and neutralizing antibodies against wild-type and Omicron was determined on day 90-120 after booster. Results: A waning of total RBD immunoglobulin (Ig) levels, anti-RBD IgG, and neutralizing antibodies against Omicron BA.1, BA.2, and BA.4/5 variants was observed 90-120 days after booster vaccination. Participants who received mRNA-1273 had the highest persistence of the immunogenicity response, followed by BNT162b2, AZD1222, and BBIBP-CorV. The responses between full and half doses of mRNA-1273 were comparable. The percentage reduction of binding antibody ranged from 50% to 75% among all booster vaccine. Conclusions: The antibody response substantially waned after 90-120 days post-booster dose. The heterologous mRNA and the viral vector booster demonstrated higher detectable rate of humoral immune responses against the Omicron variant compared to the inactivated BBIBP booster. Nevertheless, an additional fourth dose is recommended to maintain immune response against infection.

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Section: Introductionmentioning

confidence: 50%

“…The study protocol was described in our previous studies (Assawakosri et al, 2022b, Kanokudom et al, 2022b). Briefly, this study was a prospective cohort study of heterologous third-dose vaccination.…”

Section: Methodsmentioning

confidence: 99%

Immunogenicity and durability against Omicron BA.1, BA.2 and BA.4/5 variants at 3 to 4 months after a heterologous COVID-19 booster vaccine in healthy adults with a two-doses CoronaVac vaccination

Assawakosri

Kanokudom

Suntronwong³

et al. 2022

Preprint

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“…A fractional low dose of BNT162b as a booster dose has been studied in Thailand among adults who received a primary series of the CoronaVac vaccine [28]. The study was conducted among 222 healthy adults with a median age of 39.1 years who received twodose CoronaVac for 6 months.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Clinical Trial of a Fractional Low Dose of BNT162b2 Booster in Adults Following AZD1222

et al. 2022

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In the era of globally predominant omicron strains, a COVID-19 booster vaccine is needed. Our study aimed to evaluate the immunogenicity of a half-dose BNT162b2 booster after AZD1222 in healthy adults. A randomized trial of volunteers aged 18–69 years who received two-dose AZD1222 was conducted. The participants were randomized to receive the BNT162b2 vaccine intramuscularly—half (15 µg) vs. standard dose (30 µg). The immunogenicity was evaluated by a surrogate virus neutralization test (sVNT) against omicron variants and anti-spike-receptor-binding-domain IgG (anti-S-RBD IgG). From November–December 2021, 100 adults with a median age of 59.3 years (IQR 33.4–65.5) were enrolled. A booster dose was given at median of 98 days (IQR 92–128) after AZD1222. At day 14, the geometric means (GMs) of anti-S-RBD IgG in half- vs. standard-dose group were 2329.8 vs. 2574.7 BAU/mL, with a geometric mean ratio (GMR) of 0.90 (0.77–1.06). The GMs of sVNT against the omicron variant in the half- and standard-dose groups were 74.4% inhibition (95% CI 68.8–80.5) and 67.3% inhibition (57.9–78.1), respectively, with GMR of 0.95 (0.69–1.30). At day 90, the sVNT indicated 22.3% inhibition (95% CI 14.9–33.4) and 20.4% inhibition (13.1–32.0), respectively, with GMR of 1.09 (0.60–1.98). The fractional low-dose BNT162b2 mRNA booster vaccine provided non-inferior immunogenicity responses. During a shortage of vaccine supply, a fractional low dose should be considered for a booster vaccination program.

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“…The enrolled participants self-reported reactogenicity using an electronic or paper questionnaire, starting on the day of vaccination and for 7 subsequent days (days 0-7). Local, systemic and adverse events (AE) were classified as mild, moderate and severe, as previously described (Kanokudom et al, 2022a).…”

Section: Safety Assessmentsmentioning

confidence: 99%

The fourth dose of mRNA COVID-19 vaccine following 12 different three-dose regimens: Safety and immunogenicity to Omicron BA.4/BA.5

Kanokudom

Chansaenroj²,

Suntronwong³

et al. 2023

Preprint

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Objective:To investigate the reactogenicity and immunogenicity of the fourth dose using mRNA vaccines after different three-dose regimens and to compare the 30 μg BNT162b2 and 50 μg mRNA-1273 vaccines.Methods:This prospective cohort study was conducted between June and October 2022. The self-recorded reactogenicity was evaluated on the subsequent 7 days after a fourth dose. Binding and neutralizing activity of antibodies against the Omicron BA.4/5 variants were determined.Results:Overall, 292 healthy adults were enrolled and received BNT162b2 or mRNA-1273. Reactogenicity was mild to moderate and well-tolerated after a few days. Sixty-five individuals were excluded. Thus, 227 eligible individuals received a fourth booster dose of BNT162b2 (n=109) and mRNA-1273 (n=118). Most participants, regardless the type of previous three dose regimens, elicited a significantly high level of binding antibodies and neutralizing activity against the Omicron BA.4/5 28 days after a fourth dose. The neutralizing activity against the Omicron BA.4/5 between the BNT162b2 (82.8%) and mRNA-1273 (84.2%) groups was comparable with a median ratio of 1.02.Conclusion:This study found that the BNT162b2 and mRNA-1273 vaccines can be used as a fourth booster dose for individuals who were previously immunized with any prior mix and match three dose COVID-19 vaccine.

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Comparison of the reactogenicity and immunogenicity of a reduced and standard booster dose of the mRNA COVID-19 vaccine in healthy adults after two doses of inactivated vaccine

Cited by 4 publications

References 18 publications

Immunogenicity and durability against Omicron BA.1, BA.2 and BA.4/5 variants at 3 to 4 months after a heterologous COVID-19 booster vaccine in healthy adults with a two-doses CoronaVac vaccination

Immunogenicity and durability against Omicron BA.1, BA.2 and BA.4/5 variants at 3 to 4 months after a heterologous COVID-19 booster vaccine in healthy adults with a two-doses CoronaVac vaccination

A Randomized Clinical Trial of a Fractional Low Dose of BNT162b2 Booster in Adults Following AZD1222

The fourth dose of mRNA COVID-19 vaccine following 12 different three-dose regimens: Safety and immunogenicity to Omicron BA.4/BA.5

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