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Real-world data on immune responses following heterologous prime-boost COVID-19 vaccination schedule with Pfizer and AstraZeneca vaccines in England.
J Infect. 2022 05; 84(5):692-700.JI

Abstract

BACKGROUND

There are limited data on immune responses to heterologous COVID-19 immunisation schedules, especially following an extended ≥12-week interval between doses.

METHODS

SARS-CoV-2 infection-naïve and previously-infected adults receiving ChAd-BNT (ChAdOx1 nCoV-19, AstraZeneca followed by BNT162b2, Pfizer-BioNTech) or BNT-ChAd as part of the UK national immunisation programme provided blood samples at 30 days and 12 weeks after their second dose. Geometric mean concentrations (GMC) of anti-SARS-CoV-2 spike (S-antibody) and nucleoprotein (N-antibody) IgG antibodies and geometric mean ratios (GMR) were compared with a contemporaneous cohort receiving homologous ChAd-ChAd or BNT-BNT.

RESULTS

During March-October 2021, 75,827 individuals were identified as having received heterologous vaccination, 9,489 invited to participate, 1,836 responded (19.3%) and 656 were eligible. In previously-uninfected adults, S-antibody GMC at 30 days post-second dose were lowest for ChAd-ChAd (862 [95% CI, 694 - 1069]) and significantly higher for ChAd-BNT (6233 [5522-7035]; GMR 6.29; [5.04-7.85]; p<0.001), BNT-ChAd (4776 [4066-5610]; GMR 4.55 [3.56-5.81]; p<0.001) and BNT-BNT (5377 [4596-6289]; GMR 5.66 [4.49-7.15]; p<0.001). By 12 weeks after dose two, S-antibody GMC had declined in all groups and remained significantly lower for ChAd-ChAd compared to ChAd-BNT (GMR 5.12 [3.79-6.92]; p<0.001), BNT-ChAd (GMR 4.1 [2.96-5.69]; p<0.001) and BNT-BNT (GMR 6.06 [4.32-8.50]; p<0.001). Previously infected adults had higher S-antibody GMC compared to infection-naïve adults at all time-points and with all vaccine schedules.

CONCLUSIONS

These real-world findings demonstrate heterologous schedules with adenoviral-vector and mRNA vaccines are highly immunogenic and may be recommended after a serious adverse reaction to one vaccine product, or to increase programmatic flexibility where vaccine supplies are constrained.

Authors+Show Affiliations

Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK. Electronic address: samantha.westrop@phe.gov.uk.Statistics, Modelling and Economics Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Virus Reference Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK; Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.Immunisation Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

35131335

Citation

Westrop, Samantha J., et al. "Real-world Data On Immune Responses Following Heterologous Prime-boost COVID-19 Vaccination Schedule With Pfizer and AstraZeneca Vaccines in England." The Journal of Infection, vol. 84, no. 5, 2022, pp. 692-700.
Westrop SJ, Whitaker HJ, Powell AA, et al. Real-world data on immune responses following heterologous prime-boost COVID-19 vaccination schedule with Pfizer and AstraZeneca vaccines in England. J Infect. 2022;84(5):692-700.
Westrop, S. J., Whitaker, H. J., Powell, A. A., Power, L., Whillock, C., Campbell, H., Simmons, R., Warrener, L., Ramsay, M. E., Ladhani, S. N., Brown, K. E., & Amirthalingam, G. (2022). Real-world data on immune responses following heterologous prime-boost COVID-19 vaccination schedule with Pfizer and AstraZeneca vaccines in England. The Journal of Infection, 84(5), 692-700. https://doi.org/10.1016/j.jinf.2022.01.038
Westrop SJ, et al. Real-world Data On Immune Responses Following Heterologous Prime-boost COVID-19 Vaccination Schedule With Pfizer and AstraZeneca Vaccines in England. J Infect. 2022;84(5):692-700. PubMed PMID: 35131335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Real-world data on immune responses following heterologous prime-boost COVID-19 vaccination schedule with Pfizer and AstraZeneca vaccines in England. AU - Westrop,Samantha J, AU - Whitaker,Heather J, AU - Powell,Annabel A, AU - Power,Linda, AU - Whillock,Corinne, AU - Campbell,Helen, AU - Simmons,Ruth, AU - Warrener,Lenesha, AU - Ramsay,Mary E, AU - Ladhani,Shamez N, AU - Brown,Kevin E, AU - Amirthalingam,Gayatri, Y1 - 2022/02/04/ PY - 2022/01/25/received PY - 2022/01/27/accepted PY - 2022/2/9/pubmed PY - 2022/5/11/medline PY - 2022/2/8/entrez SP - 692 EP - 700 JF - The Journal of infection JO - J Infect VL - 84 IS - 5 N2 - BACKGROUND: There are limited data on immune responses to heterologous COVID-19 immunisation schedules, especially following an extended ≥12-week interval between doses. METHODS: SARS-CoV-2 infection-naïve and previously-infected adults receiving ChAd-BNT (ChAdOx1 nCoV-19, AstraZeneca followed by BNT162b2, Pfizer-BioNTech) or BNT-ChAd as part of the UK national immunisation programme provided blood samples at 30 days and 12 weeks after their second dose. Geometric mean concentrations (GMC) of anti-SARS-CoV-2 spike (S-antibody) and nucleoprotein (N-antibody) IgG antibodies and geometric mean ratios (GMR) were compared with a contemporaneous cohort receiving homologous ChAd-ChAd or BNT-BNT. RESULTS: During March-October 2021, 75,827 individuals were identified as having received heterologous vaccination, 9,489 invited to participate, 1,836 responded (19.3%) and 656 were eligible. In previously-uninfected adults, S-antibody GMC at 30 days post-second dose were lowest for ChAd-ChAd (862 [95% CI, 694 - 1069]) and significantly higher for ChAd-BNT (6233 [5522-7035]; GMR 6.29; [5.04-7.85]; p<0.001), BNT-ChAd (4776 [4066-5610]; GMR 4.55 [3.56-5.81]; p<0.001) and BNT-BNT (5377 [4596-6289]; GMR 5.66 [4.49-7.15]; p<0.001). By 12 weeks after dose two, S-antibody GMC had declined in all groups and remained significantly lower for ChAd-ChAd compared to ChAd-BNT (GMR 5.12 [3.79-6.92]; p<0.001), BNT-ChAd (GMR 4.1 [2.96-5.69]; p<0.001) and BNT-BNT (GMR 6.06 [4.32-8.50]; p<0.001). Previously infected adults had higher S-antibody GMC compared to infection-naïve adults at all time-points and with all vaccine schedules. CONCLUSIONS: These real-world findings demonstrate heterologous schedules with adenoviral-vector and mRNA vaccines are highly immunogenic and may be recommended after a serious adverse reaction to one vaccine product, or to increase programmatic flexibility where vaccine supplies are constrained. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/35131335/Real_world_data_on_immune_responses_following_heterologous_prime_boost_COVID_19_vaccination_schedule_with_Pfizer_and_AstraZeneca_vaccines_in_England_ DB - PRIME DP - Unbound Medicine ER -