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Vaccines (Basel) . The Effects of Heterologous Immunization with Prime-Boost COVID-19 Vaccination against SARS-CoV-2

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  • Vaccines (Basel) . The Effects of Heterologous Immunization with Prime-Boost COVID-19 Vaccination against SARS-CoV-2


    Vaccines (Basel)


    . 2021 Oct 11;9(10):1163.
    doi: 10.3390/vaccines9101163.
    The Effects of Heterologous Immunization with Prime-Boost COVID-19 Vaccination against SARS-CoV-2


    Tzu-Chuan Ho 1 , Yi-Ming Arthur Chen 2 3 , ****-Pin Chan 4 , Chin-Chuan Chang 5 6 7 8 , Kuo-Pin Chuang 9 , Che-Hsin Lee 10 , Cheng-Hui Yuan 11 , Yu-Chang Tyan 1 6 9 12 13 14 15 16 , Ming-Hui Yang 17 18



    Affiliations

    Abstract

    Coronavirus Disease 2019 (COVID-19) pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become the global challenge. Reaching global herd immunity will help end the COVID-19 pandemic. However, vaccine shortage and vaccine hesitancy are the obstacles to achieve global herd immunity against SARS-CoV-2. The current homologous vaccine regimen is experimentally switching to heterologous vaccination at several study sites. However, the reactogenicity of heterologous ChAdOx1-S and mRNA vaccination against SARS-CoV-2 is still unclear. We have conducted a systematic review to summarize the current findings on the safety and immunogenicity of this heterologous vaccination and elucidate their implications against SARS-CoV-2. This systematic review was conducted by the guidelines of PRISMA. Articles were searched from PubMed and other sources (MedRixv and Google scholar) starting from 1 January to 5 September 2021. The search term was heterologous ChAdOx1-S and BNT162b2 or mRNA-1273 vaccination. Our review found that participants with ChAdOx1/BNT162b2, ChAdOx1-S/mRNA-1273 or BNT162b2/ChAdOx1-S did not have the serious adverse events seen with homologous vaccination. Participants with the heterologous regimen (ChAdOx1/BNT162b2, ChAdOx1-S/mRNA-1273 or BNT162b2/ChAdOx1-S), compared with those with two doses of ChAdOx1-S, have shown a more robust immune responses against SARS-CoV-2, such as higher levels of responsive antibodies or increased numbers of spike-specific T-cells. Nevertheless, these immune responses were slightly diminished in the recipients of BNT162b2/ChAdOx1-S. Also, the safety study of heterologous ChAdOx1-S/mRNA vaccination was based on small populations. Further studies to enclose diverse categories, such as race/ethnicity or geography, may be necessary. Overall, the heterologous immunization with ChAdOX1-S and the mRNA vaccine may improve the vaccine shortage related slow pace of reaching herd immunity, especially using the heterologous immunization with ChAdOx1-S/BNT162b2.

    Keywords: COVID-19; SARS-CoV-2; T-cell response; heterologous; vaccine safety.

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