Optimising SARS-CoV-2 vaccination schedules

Belda-Iniesta, Cristóbal

doi:10.1016/s0140-6736(21)01729-3

Cited by 3 publications

(6 citation statements)

References 9 publications

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“…One approach currently under investigation is the use of heterologous vaccination schedules. 11 The Com-COV trial conducted by Liu et al 12 presented first results of a heterologous vaccination regimen combining ChAdOx1 nCoV-19 vaccine and BNT162b2, showing ChA-dOx1/BNT162b2 to be non-inferior in immunological response compared to double-dose ChAdOx1 and therefore supporting previously published data from Borobia et al 13 Another approach to improve the serological response in immunocompromised patients, especially in those with haemato-oncological malignancies, is the application of a booster vaccination. Recently, Shroff et al 14 showed that a third dose of BNT162b2 was safe in patients with solid tumours and led to a significant increase in spike receptor binding-domain-specific (S/RBD) antibody titres.…”

Section: Introductionsupporting

confidence: 60%

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Efficacy and safety of heterologous booster vaccination with Ad26.COV2.S after BNT162b2 mRNA COVID‐19 vaccine in haemato‐oncological patients with no antibody response

et al. 2021

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Summary Patients with haemato‐oncological malignancies are one of the high‐risk groups for a severe course in case of COVID‐19 infections. Furthermore, vaccination results in significantly lower response rates in haematological malignancies and lower antibody levels in patients with solid cancer. We investigated efficacy and safety of a heterologous booster vaccination with Ad26.COV2.S DNA vector vaccine in haemato‐oncological patients without antibody response after double‐dose BNT162b2 messenger (m‐)RNA COVID‐19 vaccine. A total of 32 haemato‐oncological non‐responders to double‐dose BNT162b2 received a heterologous booster vaccination with Ad26.COV2.S. Blood samples were assessed directly before the vaccination (T0) and four weeks after (T1). Safety assessment was performed using a standardised questionnaire. The overall response rate was 31%, with a mean (SD) antibody titre of 693·79 (1 096·99) binding activity units (BAU)/ml. Patients with chronic lymphocytic leukaemia or lymphoma showed a significantly lower response rate (P = 0·048). Adverse events were reported in 29·6% of patients, of which 7·1% were graded as severe, including grade III and IV events following the Common Terminology Criteria of Adverse Events (CTCAE). The heterologous booster vaccination with Ad26.COV2.S led to a serological response in nine out of 29 patients without response after double‐dose BNT162b2. Furthermore, the vaccination was safe in our cohort, leading to mainly mild local and systemic reactions. Overall, this vaccination regimen should be further evaluated to increase the response rate in the highly vulnerable population of haemato‐oncological patients.

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Section: Introductionsupporting

confidence: 60%

“…Therefore, further strategies to improve protection against COVID‐19 are urgently needed for the high‐risk group of haemato‐oncological patients. One approach currently under investigation is the use of heterologous vaccination schedules 11 . The Com‐COV trial conducted by Liu et al 12 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of heterologous booster vaccination with Ad26.COV2.S after BNT162b2 mRNA COVID‐19 vaccine in haemato‐oncological patients with no antibody response

et al. 2021

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“… 18 19 20 21 22 23 24 25 Although no severe adverse events were found related to immunisation, these studies were not statistically powered to identify risks of the rare or serious adverse events of special interest to the covid-19 vaccines. 19 26 27 28 Additionally, one observational study from Sweden 29 and another from Spain, 30 examining the effectiveness of heterologous primary vaccination schedules for covid-19, each reported rates of three different safety outcomes. A primary schedule was defined as including one priming vaccine dose and one booster dose.…”

Section: Introductionmentioning

confidence: 99%

“…As such, analyses that adequately assess the safety of heterologous vaccine schedules for covid-19 are needed to inform the public, clinicians, and regulatory authorities. 27 28 31 …”

Section: Introductionmentioning

confidence: 99%

“…Some of these studies reported similar reactogenicity profiles for both heterologous primary and booster vaccine schedules,13141516 whereas other studies suggested a tolerable short term increase in reactogenicity 1819202122232425. Although no severe adverse events were found related to immunisation, these studies were not statistically powered to identify risks of the rare or serious adverse events of special interest to the covid-19 vaccines 19262728. Additionally, one observational study from Sweden29 and another from Spain,30 examining the effectiveness of heterologous primary vaccination schedules for covid-19, each reported rates of three different safety outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Safety of heterologous primary and booster schedules with ChAdOx1-S and BNT162b2 or mRNA-1273 vaccines: nationwide cohort study

Andersson

Thiesson

Laursen

et al. 2022

BMJ

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Objective To assess the risk of adverse events associated with heterologous primary (two dose) and booster (three dose) vaccine schedules for covid-19 with Oxford-AstraZeneca’s ChAdOx1-S priming followed by mRNA vaccines (Pfizer-BioNTech’s BNT162b2 or Moderna’s mRNA-1273) as compared with homologous mRNA vaccine schedules for covid-19. Design Nationwide cohort study. Setting Denmark, 1 January 2021 to 26 March 2022. Participants Adults aged 18-65 years who received a heterologous vaccine schedule of priming with ChAdOx1-S and one or two mRNA booster doses (with either the BNT162b2 or mRNA-1273 vaccine) were compared with adults who received a homologous BNT162b2 or mRNA-1273 vaccine schedule (ie, two dose v two dose, and three dose v three dose schedule). Main outcome measures The incidence of hospital contacts for a range of adverse cardiovascular and haemostatic events within 28 days after the second or third vaccine dose, comparing heterologous versus homologous vaccine schedules. Secondary outcomes included additional prioritised adverse events of special interest. Poisson regression was used to estimate incidence rate ratios with adjustment for selected covariates. Results Individuals who had had a heterologous primary vaccine (n=137 495) or a homologous vaccine (n=2 688 142) were identified, in addition to those who had had a heterologous booster (n=129 770) or a homologous booster (n=2 197 213). Adjusted incidence rate ratios of adverse cardiovascular and haemostatic events within 28 days for the heterologous primary and booster vaccine schedules in comparison with the homologous mRNA vaccine schedules were 1.22 (95% confidence interval 0.79 to 1.91) and 1.00 (0.58 to 1.72) for ischaemic cardiac events, 0.74 (0.40 to 1.34) and 0.72 (0.37 to 1.42) for cerebrovascular events, 1.12 (0.13 to 9.58) and 4.74 (0.94 to 24.01) for arterial thromboembolisms, 0.79 (0.45 to 1.38) and 1.09 (0.60 to 1.98) for venous thromboembolisms, 0.84 (0.18 to 3.96) and 1.04 (0.60 to 4.55) for myocarditis or pericarditis, 0.97 (0.45 to 2.10) and 0.89 (0.21 to 3.77) for thrombocytopenia and coagulative disorders, and 1.39 (1.01 to 1.91) and 1.02 (0.70 to 1.47) for other bleeding events, respectively. No associations with any of the outcomes were found when restricting to serious adverse events defined as stay in hospital for more than 24 h. Conclusion Heterologous primary and booster covid-19 vaccine schedules of ChAdOx1-S priming and mRNA booster doses as both second and third doses were not associated with increased risk of serious adverse events compared with homologous mRNA vaccine schedules. These results are reassuring but given the rarity of some of the adverse events, associations cannot be excluded.

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Efficacy and safety of tixagevimab/cilgavimab as passive immunisation against COVID-19 infections in patients with hematological malignancies

Reimann,

Petzer,

Mündlein

et al. 2024

Ann Hematol

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Optimising SARS-CoV-2 vaccination schedules

Cited by 3 publications

References 9 publications

Efficacy and safety of heterologous booster vaccination with Ad26.COV2.S after BNT162b2 mRNA COVID‐19 vaccine in haemato‐oncological patients with no antibody response

Efficacy and safety of heterologous booster vaccination with Ad26.COV2.S after BNT162b2 mRNA COVID‐19 vaccine in haemato‐oncological patients with no antibody response

Safety of heterologous primary and booster schedules with ChAdOx1-S and BNT162b2 or mRNA-1273 vaccines: nationwide cohort study

Efficacy and safety of tixagevimab/cilgavimab as passive immunisation against COVID-19 infections in patients with hematological malignancies

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