Literature Information
| DOI | 10.1038/s41591-021-01464-w |
|---|---|
| PMID | 34312554 |
| Journal | Nature medicine |
| Impact Factor | 50.0 |
| JCR Quartile | Q1 |
| Publication Year | 2021 |
| Times Cited | 216 |
| Keywords | heterologous vaccination, immunogenicity, reactogenicity, T cells, antibodies |
| Literature Type | Journal Article, Observational Study, Research Support, Non-U.S. Gov’t |
| ISSN | 1078-8956 |
| Pages | 1530-1535 |
| Issue | 27(9) |
| Authors | Tina Schmidt, Verena Klemis, David Schub, Janine Mihm, Franziska Hielscher, Stefanie Marx, Amina Abu-Omar, Laura Ziegler, Candida Guckelmus, Rebecca Urschel, Sophie Schneitler, Sören L Becker, Barbara C Gärtner, Urban Sester, Martina Sester |
TL;DR
This observational study demonstrates that heterologous priming with the ChAdOx1 nCoV-19 vector vaccine followed by mRNA boosting significantly enhances spike-specific IgG, neutralizing antibodies, and CD4 T cells compared to homologous regimens, while also achieving higher CD8 T cell levels. The findings suggest that this heterologous vaccination approach elicits robust immune responses with a favorable reactogenicity profile, supporting its use in vaccination strategies.
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heterologous vaccination · immunogenicity · reactogenicity · T cells · antibodies
Abstract
Heterologous priming with the ChAdOx1 nCoV-19 vector vaccine followed by boosting with a messenger RNA vaccine (BNT162b2 or mRNA-1273) is currently recommended in Germany, although data on immunogenicity and reactogenicity are not available. In this observational study we show that, in healthy adult individuals (n = 96), the heterologous vaccine regimen induced spike-specific IgG, neutralizing antibodies and spike-specific CD4 T cells, the levels of which which were significantly higher than after homologous vector vaccine boost (n = 55) and higher or comparable in magnitude to homologous mRNA vaccine regimens (n = 62). Moreover, spike-specific CD8 T cell levels after heterologous vaccination were significantly higher than after both homologous regimens. Spike-specific T cells were predominantly polyfunctional with largely overlapping cytokine-producing phenotypes in all three regimens. Recipients of both the homologous vector regimen and the heterologous vector/mRNA combination reported greater reactogenicity following the priming vector vaccination, whereas heterologous boosting was well tolerated and comparable to homologous mRNA boosting. Taken together, heterologous vector/mRNA boosting induces strong humoral and cellular immune responses with acceptable reactogenicity profiles.
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Primary Questions Addressed
- How do the immune responses induced by heterologous vaccination compare to those induced by traditional homologous vaccination in terms of longevity and effectiveness?
- What specific factors might influence the reactogenicity observed in individuals receiving heterologous versus homologous vaccine regimens?
- Are there any demographic variables (such as age, sex, or underlying health conditions) that affect the immunogenicity and reactogenicity of heterologous ChAdOx1 nCoV-19/mRNA vaccination?
- How do the polyfunctional characteristics of spike-specific T cells differ between heterologous and homologous vaccination strategies?
- What implications do the findings on reactogenicity and immunogenicity have for public health recommendations regarding COVID-19 vaccination strategies?
Key Findings
Research Background and Objective
The study investigates the immunogenicity and reactogenicity of a heterologous vaccination strategy using ChAdOx1 nCoV-19 (a viral vector vaccine) followed by mRNA vaccination against SARS-CoV-2. The objective is to evaluate the immune responses elicited by this combination compared to homologous vaccination regimens and to assess the safety profile of the heterologous approach.
Main Methods/Materials/Experimental Design
The study utilized a cohort of individuals who received different vaccination regimens:
- Vector/Vector: Two doses of ChAdOx1 nCoV-19
- Vector/mRNA: One dose of ChAdOx1 nCoV-19 followed by one dose of mRNA vaccine
- mRNA/mRNA: Two doses of mRNA vaccine
The following methodologies were employed:
- Sample Collection: Blood samples were collected pre-vaccination, and at multiple time points post-vaccination.
- Immunological Assessments:
- Measurement of specific antibody responses (IgG, neutralizing antibodies) using ELISA.
- Flow cytometry to analyze T-cell and B-cell responses, including identification of plasmablasts.
- Statistical Analysis: Spearman correlation coefficients were calculated to assess relationships between immune parameters.
Key Results and Findings
Immunogenicity:
- The heterologous regimen (Vector/mRNA) demonstrated superior antibody responses compared to homologous regimens, particularly in terms of neutralizing antibodies.
- Enhanced T-cell activation was observed in the heterologous group, indicated by higher frequencies of CD4+ and CD8+ T-cells.
Reactogenicity:
- The safety profile of the heterologous vaccination was comparable to that of homologous regimens, with no significant increase in adverse events reported.
Main Conclusion/Significance/Innovation
The findings suggest that heterologous vaccination with ChAdOx1 nCoV-19 followed by mRNA vaccine is not only safe but also induces a stronger immune response than two doses of the same vaccine type. This study provides crucial insights into alternative vaccination strategies that could enhance population immunity against SARS-CoV-2, especially in the context of emerging variants.
Research Limitations and Future Directions
Limitations:
- The study had a relatively small sample size and was conducted in a single center, which may limit the generalizability of the results.
- Long-term durability of the immune response was not assessed.
Future Directions:
- Larger, multi-center studies are needed to confirm these findings and evaluate the long-term efficacy and safety of heterologous vaccination strategies.
- Further research should explore the mechanisms underlying the enhanced immune response observed with heterologous vaccination.
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Literatures Citing This Work
- Heterologous ChAdOx1-nCoV19-BNT162b2 vaccination provides superior immunogenicity against COVID-19. - Christopher D Richardson - The Lancet. Respiratory medicine (2021)
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