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Correlates of protection against symptomatic and asymptomatic SARS-CoV-2 infection.
Feng, Shuo; Phillips, Daniel J; White, Thomas; Sayal, Homesh; Aley, Parvinder K; Bibi, Sagida; Dold, Christina; Fuskova, Michelle; Gilbert, Sarah C; Hirsch, Ian; Humphries, Holly E; Jepson, Brett; Kelly, Elizabeth J; Plested, Emma; Shoemaker, Kathryn; Thomas, Kelly M; Vekemans, Johan; Villafana, Tonya L; Lambe, Teresa; Pollard, Andrew J; Voysey, Merryn.
  • Feng S; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
  • Phillips DJ; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
  • White T; Late-stage development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
  • Sayal H; Late-stage development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
  • Aley PK; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
  • Bibi S; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
  • Dold C; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
  • Fuskova M; The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  • Gilbert SC; The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  • Hirsch I; Late-stage development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
  • Humphries HE; National Infection Service, Public Health England, Salisbury, UK.
  • Jepson B; Late-stage development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA.
  • Kelly EJ; Cytel Inc., Cambridge, MA, USA.
  • Plested E; Microbial Sciences, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA.
  • Shoemaker K; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
  • Thomas KM; Late-stage development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA.
  • Vekemans J; National Infection Service, Public Health England, Salisbury, UK.
  • Villafana TL; Late-stage development Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
  • Lambe T; Late-stage development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA.
  • Pollard AJ; The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  • Voysey M; Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK.
Nat Med ; 27(11): 2032-2040, 2021 11.
Article in English | MEDLINE | ID: covidwho-1526097
Preprint
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ABSTRACT
The global supply of COVID-19 vaccines remains limited. An understanding of the immune response that is predictive of protection could facilitate rapid licensure of new vaccines. Data from a randomized efficacy trial of the ChAdOx1 nCoV-19 (AZD1222) vaccine in the United Kingdom was analyzed to determine the antibody levels associated with protection against SARS-CoV-2. Binding and neutralizing antibodies at 28 days after the second dose were measured in infected and noninfected vaccine recipients. Higher levels of all immune markers were correlated with a reduced risk of symptomatic infection. A vaccine efficacy of 80% against symptomatic infection with majority Alpha (B.1.1.7) variant of SARS-CoV-2 was achieved with 264 (95% CI 108, 806) binding antibody units (BAU)/ml and 506 (95% CI 135, not computed (beyond data range) (NC)) BAU/ml for anti-spike and anti-RBD antibodies, and 26 (95% CI NC, NC) international unit (IU)/ml and 247 (95% CI 101, NC) normalized neutralization titers (NF50) for pseudovirus and live-virus neutralization, respectively. Immune markers were not correlated with asymptomatic infections at the 5% significance level. These data can be used to bridge to new populations using validated assays, and allow extrapolation of efficacy estimates to new COVID-19 vaccines.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunity, Humoral / COVID-19 Vaccines / SARS-CoV-2 / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Nat Med Journal subject: Molecular Biology / Medicine Year: 2021 Document Type: Article Affiliation country: S41591-021-01540-1

Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunity, Humoral / COVID-19 Vaccines / SARS-CoV-2 / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Incidence study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Nat Med Journal subject: Molecular Biology / Medicine Year: 2021 Document Type: Article Affiliation country: S41591-021-01540-1