According to a new study, administering a different type of vaccination (heterologous) for the third or booster dose than the very first two doses results in greater vaccine performance than using the very same (homologous) inactivated SARS-CoV-2 vaccine for all 3 doses.
A new research study on Chiles nationwide COVID-19 vaccination program, being presented at this years European Congress of Clinical Microbiology & & Infectious Diseases (ECCMID 2022, Lisbon, April 23-26), and released in the journal The Lancet Global Health on April 23, 2022, reveals that offering a different type of vaccine (heterologous) for the 3rd or booster dose than was received for the very first 2 doses, causes much better vaccine performance than utilizing the exact same (homologous) suspended SARS-CoV-2 vaccine for all three dosages.
Dr. Rafael Araos of the Institute of Science and Innovation in Medicine, Clinica Alemana, Universidad del Desarrollo, Dr. Alejandro Jara and Dr. Eduardo A Undurraga of Pontificia Universidad Católica de Chile, and colleagues from the Chilean Ministry of Health contributed to the study.
The research study evaluated the efficiency of CoronaVac (Sinovac Biotech), AZD1222 (Oxford-AstraZeneca), or BNT162b2 (Pfizer-BioNTech) vaccine boosters in individuals who had finished a primary two-dose immunization schedule with CoronaVac, a suspended SARS-CoV-2 vaccine which accounts for about half the COVID-19 vaccine dosages delivered internationally, compared with no vaccination. The research study took a look at Chiles nationwide immunization program, where the two-dose Coronavac schedule was by far the most extensively used.
By European Society of Clinical Microbiology and Infectious Diseases
April 25, 2022
People administered vaccines from February 2, 2021, to the prespecified trial end date of November 10, 2021, were assessed; the group excluded individuals with a likely or verified SARS-CoV-2 infection (RT-PCR or antigen test) on or prior to February 2, 2021, and people who had actually received at least one dosage of any COVID-19 vaccine prior to February 2, 2021., and death).
An overall of 11,174,257 people were eligible for this study, among whom 4,127,546 finished a primary immunization schedule (two dosages) with CoronaVac and received a booster dosage during the study period. 1 921 340 (46 · 5% )participants received a heterologous AZD1222 booster, 2 019 260 (48 · 9% )got a heterologous BNT162b2 booster, and 186 946 (4 · 5%) received a homologous booster with CoronaVac.
The authors computed an adjusted vaccine efficiency (utilizing statistical modeling) in avoiding symptomatic COVID-19 of 79% for a two-dose schedule plus CoronaVac booster, 97% for a BNT162b2 booster, and 93% for an AZD1222 booster. The adjusted vaccine efficiency against COVID-19-related hospitalization, ICU admission, and death was 86%, 92%, and 87% for a CoronaVac booster, 96%, 96%, and 97% for a Pfizer-BioNTech booster, and 98%, 99% and 98% for an Astra Zeneca booster.
The authors explain that booster programs were initiated in numerous countries due to emerging evidence of waning resistance from two dose schedules. Boosters are likewise crucial since proof suggests that suspended vaccines like Coronavac provide lower security than the brand-new mRNA technology vaccines from Pfizer -BioNTech and Moderna. Delta was the primary circulating variant in Chile during the study duration.
They conclude: “Our results suggest that a 3rd dosage of Coronavac or utilizing a various booster vaccine such as Pfizer-BioNTech or Astra Zeneca vaccines in those that had actually formerly had 2 dosages of Coronavac provides a high level of security against COVID-19, including serious disease and death … However, receiving a different vaccine for the booster dosage leads to greater vaccine efficiency than a third dose of Coronavac for all outcomes, supplying extra support for a mix-and-match technique.”
The authors even more discuss that this is among the first research studies to examine the effectiveness of booster shots for suspended SARS-CoV-2 vaccines. A current research study in Brazil1 showed that homologous and heterologous booster vaccines (BNT162b2 and AZD1222) following a CoronoVac primary vaccination schedule were safe and immunogenic. A stage 1-2 research study in the USA2 with bnt162b2, ad26.cov2.s, and mrna-1273 boosters discovered that heterologous boosters where on average more immunogenic than homologous boosters.
The UKs Cov-Boost3 study (a stage 2 trial) revealed that various vaccines are immunogenic and safe when offered as boosters following a main two-dose schedule of AZD1222 and BNT162b2, with the highest antibody levels achieved by mRNA boosters.
And prior studies4 have taken a look at the immunogenicity of a heterologous two-dose regimen of ChAdOx1 followed by an mRNA vaccine, and found mix-and-match strategies were more immunogenic and used more security versus COVID-19 than two-dose homologous methods for that vaccine mix.
In Chile, the government has actually now encouraged that heterologous boosters need to be used as the very first choice; nevertheless, people can and have actually gotten a homologous booster as an option.
References:
” Effectiveness of heterologous and homologous booster doses for a suspended SARS-CoV-2 vaccine: a massive potential friend research study” by Alejandro Jara, PhD; Eduardo A Undurraga, PhD; José R Zubizarreta, PhD; Cecilia González, MD; Alejandra Pizarro, MD; Johanna Acevedo, MS; Katherinne Leo, BSE; Fabio Paredes, MSc; Tomás Bralic, MS; Verónica Vergara, MS; Marcelo Mosso, BSE; Francisco Leon, MBA; Ignacio Parot, MA; Paulina Leighton, BSE; Pamela Suárez, BSE; Juan Carlos Rios, PhD; Heriberto García-Escorza, MS and Rafael Araos, MD, 23 April 2022, The Lancet Global Health.DOI: 10.1016/ S2214-109X( 22 )00112-7.
” Heterologous versus homologous COVID-19 booster vaccination in previous receivers of two dosages of CoronaVac COVID-19 vaccine in Brazil (RHH-001): a phase 4, non-inferiority, single blind, randomised research study” by Sue Ann Costa Clemens, PhD; Lily Weckx, PhD; Ralf Clemens, PhD; Ana Verena Almeida Mendes, PhD; Alessandra Ramos Souza, PhD; Mariana B V Silveira, MD; Suzete Nascimento Farias da Guarda, PhD; Maristela Miyamoto de Nobrega, PhD; Maria Isabel de Moraes Pinto, PhD; Isabela G S Gonzalez, MD; Natalia Salvador, Nurse D; Marilia Miranda Franco, MD; Renata Navis de Avila Mendonça, MD; Isabelle Silva Queiroz Oliveira, MD; Bruno Solano de Freitas Souza, PhD; Mayara Fraga, Pharm D; Parvinder Aley, PhD; Sagida Bibi, PhD; Liberty Cantrell, MSc; Wanwisa Dejnirattisai, PhD; Xinxue Liu, PhD; Juthathip Mongkolsapaya, DPhil; Piyada Supasa, PhD; Gavin R Screaton, DPhil; Teresa Lambe, PhD and Merryn Voysey, DPhil, 21 January 2022, The Lancet.DOI: 10.1016/ S0140-6736( 22 )00094-0.
” Heterologous and homologous Covid-19 Booster Vaccinations” by Robert L. Atmar, M.D., Kirsten E. Lyke, M.D., Meagan E. Deming, M.D., Ph.D., Lisa A. Jackson, M.D., M.P.H., Angela R. Branche, M.D., Hana M. El Sahly, M.D., Christina A. Rostad, M.D., Judith M. Martin, M.D., Christine Johnston, M.D., M.P.H., Richard E. Rupp, M.D., Mark J. Mulligan, M.D., Rebecca C. Brady, M.D., Robert W. Frenck, Jr., M.D., Martín Bäcker, M.D., Angelica C. Kottkamp, M.D., Tara M. Babu, M.D., M.S.C.I., Kumaravel Rajakumar, M.D., Srilatha Edupuganti, M.D., M.P.H., David Dobrzynski, M.D., Rhea N. Coler, Ph.D., Christine M. Posavad, Ph.D., Janet I. Archer, M.Sc., Sonja Crandon, B.S.N., Seema U. Nayak, M.D., Daniel Szydlo, M.S., Jillian A. Zemanek, M.P.H., Clara P. Dominguez Islas, Ph.D, Elizabeth R. Brown, Sc.D., Mehul S. Suthar, Ph.D., M. Juliana McElrath, M.D., Ph.D., Adrian B. McDermott, Ph.D., Sarah E. OConnell, M.S., David C. Montefiori, Ph.D., Amanda Eaton, M.B.A., Kathleen M. Neuzil, M.D., David S. Stephens, M.D., Paul C. Roberts, Ph.D. and John H. Beigel, M.D. for the DMID 21-0012 Study Group, 17 March 2022, The New England Journal of Medicine.DOI: 10.1056/ NEJMoa2116414.
” Safety and immunogenicity of seven COVID-19 vaccines as a 3rd dose (booster) following two dosages of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomised, controlled, phase 2 trial” by Alasdair P S Munro, MRCPCH; Leila Janani, PhD; Victoria Cornelius, PhD; Parvinder K Aley, PhD; Gavin Babbage, MPhil; Prof David Baxter, PhD; Marcin Bula, FRCP; Katrina Cathie, MD; Prof Krishna Chatterjee, FRCP; Kate Dodd, MSc; Yvanne Enever, BSc [Hons]; Karishma Gokani, MBBS; Anna L Goodman, DPhil; Christopher A Green, DPhil; Linda Harndahl, PhD; John Haughney, FRCGP; Alexander Hicks, PhD; Agatha A van der Klaauw, PhD; Jonathan Kwok, MB BChir; Prof Teresa Lambe, PhD; Prof Vincenzo Libri, MD; Prof Martin J Llewelyn, PhD; Alastair C McGregor, FRCPath; Angela M Minassian, DPhil; Patrick Moore, MRCGP; Mehmood Mughal, MBBS; Yama F Mujadidi, MSc; Jennifer Murira, BM; Orod Osanlou, FRCP; Rostam Osanlou, MBChB; Daniel R Owens, MRCPCH; Mihaela Pacurar, MBBS; Adrian Palfreeman, FRCP; Daniel Pan, MRCP; Tommy Rampling, DPhil; Karen Regan, BSc; Stephen Saich, BACHELORS DEGREE; Jo Salkeld, BMBS; Prof Dinesh Saralaya, MD; Sunil Sharma, FRCPath; Ray Sheridan, MRCP; Ann Sturdy, MBBS; Prof Emma C Thomson, PhD; Shirley Todd, MSc; Prof Chris Twelves, MD; Prof Robert C Read, PhD; Sue Charlton, PhD; Bassam Hallis, PhD; Prof Mary Ramsay, FFPH; Prof Nick Andrews, PhD; Prof Jonathan S Nguyen-Van-Tam, DM; Prof Matthew D Snape, MD; Xinxue Liu, PhD and Prof Saul N Faust, PhD on behalf of theCOV-BOOST study hall, 2 December 2021, The Lancet.DOI: 10.1016/ S0140-6736( 21 )02717-3.
” Effectiveness of heterologous ChAdOx1 nCoV-19 and mRNA prime-boost vaccination against symptomatic Covid-19 infection in Sweden: An across the country cohort study” by Peter Nordström, Marcel Ballin and Anna Nordström, 18 October 2021, The Lancet Regional Health– Europe.DOI: 10.1016/ j.lanepe.2021.100249.
Boosters are also crucial since proof recommends that suspended vaccines like Coronavac use lower security than the new mRNA innovation vaccines from Pfizer -BioNTech and Moderna. The authors even more discuss that this is one of the very first studies to examine the efficiency of booster shots for suspended SARS-CoV-2 vaccines. A recent research study in Brazil1 revealed that homologous and heterologous booster vaccines (BNT162b2 and AZD1222) following a CoronoVac primary vaccination schedule were safe and immunogenic. A stage 1-2 research study in the USA2 with ad26.cov2.s, mrna-1273, and bnt162b2 boosters discovered that heterologous boosters where on average more immunogenic than homologous boosters.
; Karishma Gokani, MBBS; Anna L Goodman, DPhil; Christopher A Green, DPhil; Linda Harndahl, PhD; John Haughney, FRCGP; Alexander Hicks, PhD; Agatha A van der Klaauw, PhD; Jonathan Kwok, MB BChir; Prof Teresa Lambe, PhD; Prof Vincenzo Libri, MD; Prof Martin J Llewelyn, PhD; Alastair C McGregor, FRCPath; Angela M Minassian, DPhil; Patrick Moore, MRCGP; Mehmood Mughal, MBBS; Yama F Mujadidi, MSc; Jennifer Murira, BM; Orod Osanlou, FRCP; Rostam Osanlou, MBChB; Daniel R Owens, MRCPCH; Mihaela Pacurar, MBBS; Adrian Palfreeman, FRCP; Daniel Pan, MRCP; Tommy Rampling, DPhil; Karen Regan, BSc; Stephen Saich, BA; Jo Salkeld, BMBS; Prof Dinesh Saralaya, MD; Sunil Sharma, FRCPath; Ray Sheridan, MRCP; Ann Sturdy, MBBS; Prof Emma C Thomson, PhD; Shirley Todd, MSc; Prof Chris Twelves, MD; Prof Robert C Read, PhD; Sue Charlton, PhD; Bassam Hallis, PhD; Prof Mary Ramsay, FFPH; Prof Nick Andrews, PhD; Prof Jonathan S Nguyen-Van-Tam, DM; Prof Matthew D Snape, MD; Xinxue Liu, PhD and Prof Saul N Faust, PhD on behalf of theCOV-BOOST research study group, 2 December 2021, The Lancet.DOI: 10.1016/ S0140-6736( 21 )02717-3.
