Covid-19 booster vaccines: What we know and who’s doing what

Mahase, Elisabeth

doi:10.1136/bmj.n2082

Cited by 51 publications

(27 citation statements)

References 5 publications

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“…However, although the calls to offer booster doses to the public are becoming frequent, some researchers remain conservative about booster vaccinations [ 10 ]. In addition, several governments are waiting for more data before making a final decision on whether to recommend a booster dose [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity and Safety of Homologous and Heterologous Prime–Boost Immunization with COVID-19 Vaccine: Systematic Review and Meta-Analysis

Cheng

Peng

et al. 2022

Vaccines

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A prime–boost strategy of COVID-19 vaccines brings hope to limit the spread of SARS-CoV-2, while the immunogenicity of the vaccines is waning over time. Whether a booster dose of vaccine is needed has become a widely controversial issue. However, no published meta-analysis has focused on the issue. Therefore, this study assessed the immunogenicity and safety of the different combinations of prime–boost vaccinations. Electronic databases including PubMed, the Cochrane Library, Embase, medRxiv, Wanfang and CNKI were used to retrieve the original studies. A total of 28 studies, 9 combinations of prime–boost vaccinations and 5870 subjects were included in the meta-analysis, and random effect models were used to estimate pooled immunogenicity and safety. The immunity against COVID-19 after the prime vaccination waned over time, especially in the populations primed with inactivated vaccines, in which the seropositive rate of antibodies was only 28% (95% CI: 17–40%). Booster vaccination could significantly increase the antibody responses, and heterologous immunization was more effective than homologous immunization (neutralization titers: 1.65 vs. 1.27; anti-RBD IgG: 1.85 vs. 1.15); in particular, the combination of inactivated–mRNA vaccines had the highest antibody responses (neutralization titers: MRAW = 3.64, 95% CI: 3.54–3.74; anti-RBD IgG: 3.73, 95% CI: 3.59–3.87). Moreover, compared with the initial two doses of vaccines, a booster dose did not induce additional or severe adverse events. The administration of the booster dose effectively recalled specific immune responses to SARS-CoV-2 and increased antibody levels, especially in heterologous immunization. Considering the long-term immunogenicity and vaccine equity, we suggest that now, only individuals primed with inactivated vaccines require a booster dose.

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Section: Introductionmentioning

confidence: 99%

Immunogenicity and Safety of Homologous and Heterologous Prime–Boost Immunization with COVID-19 Vaccine: Systematic Review and Meta-Analysis

Cheng

Peng

et al. 2022

Vaccines

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“…With vaccine efficacy for Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) waning over time [1,2] and reduced for emerging variants [3,4], many countries are accelerating their COVID-19 booster programmes [5]. However, vaccine availability does not necessarily translate to vaccine acceptance [6], with the World Health Organization (WHO) recognising vaccine hesitancy as a global health threat [7].…”

Section: Introductionmentioning

confidence: 99%

Positive Attribute Framing Increases COVID-19 Booster Vaccine Intention for Unfamiliar Vaccines

Barnes

Colagiuri

2022

Vaccines

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Positive framing has been proposed as an intervention to increase COVID-19 vaccination intentions. However, available research has examined fictitious or unfamiliar treatments. This pre-registered study (aspredicted#78369) compared the effect of standard negatively framed EU patient information leaflets (PILs), with new positively framed PILs, on booster intentions (measured pre- and post-intervention) for AstraZeneca, Pfizer, and Moderna COVID-19 vaccines. A representative sample of 1222 UK-based adults was randomised to one of six groups in a factorial design with framing (Positive vs. Negative) and vaccine familiarity (same (as previous), familiar, unfamiliar) as factors. The benefit of positive framing was hypothesised to be strongest for the least familiar vaccine (Moderna). Framing was moderated by familiarity, where only the unfamiliar vaccine showed a benefit of positive relative to negative Framing. Framing and familiarity also interacted with baseline Intention with the effect of framing on the unfamiliar vaccine especially pronounced at low baseline Intent. Conversely, standard negative framing appeared to increase intentions for familiar vaccines at low baseline intent. Findings provide important evidence that positive framing could improve vaccine uptake globally when switches or new developments require individuals to receive less familiar vaccines. Positive framing of familiar vaccines, however, should be treated with caution until better understood.

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“…While in the immunocompetent population a third dose of SARS-CoV-2 vaccines has been authorized and rolled out over the past months, since their antibody titers tend to diminish with time [ 33 ], in immunosuppressed patients, who in multiple studies showed minimal response to two doses of SARS-CoV-2 vaccines (i.e., they never achieved a good humoral response), a third or even a fourth dose should be made mandatory given that it can increase their antibody titers up to those of immunocompetent individuals. This renders making the administration of a third or even a fourth dose an immediate priority for these non-responders, multiple recently published reports supporting this concept.…”

Section: Solid Organ Transplant Recipientsmentioning

confidence: 99%

Immunosuppressed non-responders to two doses of mRNA SARS-CoV-2 vaccines achieve an immune response comparable to those of immunocompetent individuals after a third dose

Margioris

2022

Hormones

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The SARS-CoV-2 vaccines trigger the production of neutralizing antibodies to the SARS-CoV-2 spike (S) protein and induce a T cell-mediated immune response. However, the antibody titers that confer protection against the SARS-CoV-2 virus are currently not well-established. While immunocompetent individuals achieve a high level of immune response after SARS-CoV-2 vaccination, it now appears that a high proportion of immunosuppressed or immunocompromised, patients exhibit low or no response to two doses of the vaccines. Most non-responders are on treatment with either glucocorticoids, mycophenolate-mofetil (MMF), the anti-CD20 monoclonal antibody rituximab, calcineurin inhibitors like cyclosporine and tacrolimus, rapamycin (mTOR) signaling cascade inhibitors (i.e., sirolimus and everolimus), azathioprine, or methotrexate given for a variety of diseases including autoimmune disorders, hematological malignancies, and solid cancers, while recipients of solid organ transplants also fall within this category. Recently, several published reports have suggested that a third dose of these vaccines induces an elevated antibody response against the SARS-CoV-2 S protein.

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Covid-19 booster vaccines: What we know and who’s doing what

Cited by 51 publications

References 5 publications

Immunogenicity and Safety of Homologous and Heterologous Prime–Boost Immunization with COVID-19 Vaccine: Systematic Review and Meta-Analysis

Immunogenicity and Safety of Homologous and Heterologous Prime–Boost Immunization with COVID-19 Vaccine: Systematic Review and Meta-Analysis

Positive Attribute Framing Increases COVID-19 Booster Vaccine Intention for Unfamiliar Vaccines

Immunosuppressed non-responders to two doses of mRNA SARS-CoV-2 vaccines achieve an immune response comparable to those of immunocompetent individuals after a third dose

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