tetano
Editor, Senior Moderator
Expert Rev Vaccines
. 2021 Aug 20.
doi: 10.1080/14760584.2021.1971522. Online ahead of print.
To mix or not to mix? A rapid systematic review of heterologous prime-boost covid-19 vaccination
Nan-Chang Chiu[SUP] 1 2 [/SUP], Hsin Chi[SUP] 1 2 [/SUP], Yu-Kang Tu[SUP] 3 [/SUP], Ya-Ning Huang[SUP] 1 [/SUP], Yu-Lin Tai[SUP] 4 [/SUP], Shun-Long Weng[SUP] 4 [/SUP], Lung Chang[SUP] 2 5 [/SUP], Daniel Tsung-Ning Huang[SUP] 1 2 [/SUP], Fu-Yuan Huang[SUP] 1 [/SUP], Chien-Yu Lin[SUP] 2 4 [/SUP]
Affiliations
Abstract
Introduction: : Coronavirus disease 2019 (COVID-19) has had an enormous impact worldwide, and vaccination is believed to be the method that will control the pandemic. Several types of vaccines developed using different platforms have been authorized for emergency use, but vaccine administration has varied based on the country, vaccine supply, safety concerns, and emerging variants. Heterologous prime-boost vaccination with different vaccines is emerging as an interesting option, but the immunogenicity and reactogenicity of heterologous vaccination remain largely unclear.
Methods: : Electronic databases including PubMed, Embase, medRxiv, Research Square, and SSRN were searched to investigate the immunogenicity and reactogenicity associated with heterologous vaccination.
Results: : As of 30 June 2021, four trials including 2,116 participants were identified. Heterologous administration of BNT162b2 (BNT) in ChAdOx1 (ChAd)-primed participants (ChAd/BNT) showed noninferior immunogenicity to homologous BNT administration (both prime and booster were BNT vaccines, BNT/BNT) with tolerable reactogenicity and higher T cell responses. Compared with single-dose ChAdOX1 vaccination (ChAd) and homologous ChAdOX1 vaccination (ChAd/ChAd), heterologous ChAd/BNT was found to elicit higher immunogenicity (ChAd/BNT vs. ChAd, antibody titer ratio: 36.4-138; ChAd/BNT vs. ChAd/ChAd, antibody titer ratio: 9.2).
Conclusion: Our systematic review found robust immunogenicity and tolerable reactogenicity of heterologous administration of a BNT162b2 boost in ChAdOx1-primed participants. An additional benefit of stronger T cellular immunity was also observed. Heterologous vaccination is a reasonable and feasible strategy to combat COVID-19. Further studies are warranted to confirm the benefits and identify the optimal combinations, doses, and intervals.
Keywords: BNT162b2; COVID-19; ChAdOx1; SARS-CoV-2; boost; heterologous; mRNA; vaccination.
. 2021 Aug 20.
doi: 10.1080/14760584.2021.1971522. Online ahead of print.
To mix or not to mix? A rapid systematic review of heterologous prime-boost covid-19 vaccination
Nan-Chang Chiu[SUP] 1 2 [/SUP], Hsin Chi[SUP] 1 2 [/SUP], Yu-Kang Tu[SUP] 3 [/SUP], Ya-Ning Huang[SUP] 1 [/SUP], Yu-Lin Tai[SUP] 4 [/SUP], Shun-Long Weng[SUP] 4 [/SUP], Lung Chang[SUP] 2 5 [/SUP], Daniel Tsung-Ning Huang[SUP] 1 2 [/SUP], Fu-Yuan Huang[SUP] 1 [/SUP], Chien-Yu Lin[SUP] 2 4 [/SUP]
Affiliations
- PMID: 34415818
- DOI: 10.1080/14760584.2021.1971522
Abstract
Introduction: : Coronavirus disease 2019 (COVID-19) has had an enormous impact worldwide, and vaccination is believed to be the method that will control the pandemic. Several types of vaccines developed using different platforms have been authorized for emergency use, but vaccine administration has varied based on the country, vaccine supply, safety concerns, and emerging variants. Heterologous prime-boost vaccination with different vaccines is emerging as an interesting option, but the immunogenicity and reactogenicity of heterologous vaccination remain largely unclear.
Methods: : Electronic databases including PubMed, Embase, medRxiv, Research Square, and SSRN were searched to investigate the immunogenicity and reactogenicity associated with heterologous vaccination.
Results: : As of 30 June 2021, four trials including 2,116 participants were identified. Heterologous administration of BNT162b2 (BNT) in ChAdOx1 (ChAd)-primed participants (ChAd/BNT) showed noninferior immunogenicity to homologous BNT administration (both prime and booster were BNT vaccines, BNT/BNT) with tolerable reactogenicity and higher T cell responses. Compared with single-dose ChAdOX1 vaccination (ChAd) and homologous ChAdOX1 vaccination (ChAd/ChAd), heterologous ChAd/BNT was found to elicit higher immunogenicity (ChAd/BNT vs. ChAd, antibody titer ratio: 36.4-138; ChAd/BNT vs. ChAd/ChAd, antibody titer ratio: 9.2).
Conclusion: Our systematic review found robust immunogenicity and tolerable reactogenicity of heterologous administration of a BNT162b2 boost in ChAdOx1-primed participants. An additional benefit of stronger T cellular immunity was also observed. Heterologous vaccination is a reasonable and feasible strategy to combat COVID-19. Further studies are warranted to confirm the benefits and identify the optimal combinations, doses, and intervals.
Keywords: BNT162b2; COVID-19; ChAdOx1; SARS-CoV-2; boost; heterologous; mRNA; vaccination.