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Homologous and Heterologous Covid-19 Booster Vaccinations.
Atmar, Robert L; Lyke, Kirsten E; Deming, Meagan E; Jackson, Lisa A; Branche, Angela R; El Sahly, Hana M; Rostad, Christina A; Martin, Judith M; Johnston, Christine; Rupp, Richard E; Mulligan, Mark J; Brady, Rebecca C; Frenck, Robert W; Bäcker, Martín; Kottkamp, Angelica C; Babu, Tara M; Rajakumar, Kumaravel; Edupuganti, Srilatha; Dobrzynski, David; Coler, Rhea N; Posavad, Christine M; Archer, Janet I; Crandon, Sonja; Nayak, Seema U; Szydlo, Daniel; Zemanek, Jillian A; Dominguez Islas, Clara P; Brown, Elizabeth R; Suthar, Mehul S; McElrath, M Juliana; McDermott, Adrian B; O'Connell, Sarah E; Montefiori, David C; Eaton, Amanda; Neuzil, Kathleen M; Stephens, David S; Roberts, Paul C; Beigel, John H.
  • Atmar RL; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Lyke KE; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Deming ME; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Jackson LA; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Branche AR; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • El Sahly HM; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Rostad CA; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Martin JM; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Johnston C; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Rupp RE; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Mulligan MJ; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Brady RC; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Frenck RW; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Bäcker M; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Kottkamp AC; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Babu TM; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Rajakumar K; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Edupuganti S; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Dobrzynski D; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Coler RN; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Posavad CM; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Archer JI; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Crandon S; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Nayak SU; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Szydlo D; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Zemanek JA; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Dominguez Islas CP; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Brown ER; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Suthar MS; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • McElrath MJ; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • McDermott AB; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • O'Connell SE; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Montefiori DC; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Eaton A; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Neuzil KM; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Stephens DS; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Roberts PC; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
  • Beigel JH; From the Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston (R.L.A., H.M.E.S.), and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston (R.E.R.); the Center for Vaccine Development and Global Health, University of Mary
N Engl J Med ; 386(11): 1046-1057, 2022 03 17.
Article in English | MEDLINE | ID: covidwho-1655751
ABSTRACT

BACKGROUND:

Although the three vaccines against coronavirus disease 2019 (Covid-19) that have received emergency use authorization in the United States are highly effective, breakthrough infections are occurring. Data are needed on the serial use of homologous boosters (same as the primary vaccine) and heterologous boosters (different from the primary vaccine) in fully vaccinated recipients.

METHODS:

In this phase 1-2, open-label clinical trial conducted at 10 sites in the United States, adults who had completed a Covid-19 vaccine regimen at least 12 weeks earlier and had no reported history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection received a booster injection with one of three vaccines mRNA-1273 (Moderna) at a dose of 100 µg, Ad26.COV2.S (Johnson & Johnson-Janssen) at a dose of 5×1010 virus particles, or BNT162b2 (Pfizer-BioNTech) at a dose of 30 µg. The primary end points were safety, reactogenicity, and humoral immunogenicity on trial days 15 and 29.

RESULTS:

Of the 458 participants who were enrolled in the trial, 154 received mRNA-1273, 150 received Ad26.COV2.S, and 153 received BNT162b2 as booster vaccines; 1 participant did not receive the assigned vaccine. Reactogenicity was similar to that reported for the primary series. More than half the recipients reported having injection-site pain, malaise, headache, or myalgia. For all combinations, antibody neutralizing titers against a SARS-CoV-2 D614G pseudovirus increased by a factor of 4 to 73, and binding titers increased by a factor of 5 to 55. Homologous boosters increased neutralizing antibody titers by a factor of 4 to 20, whereas heterologous boosters increased titers by a factor of 6 to 73. Spike-specific T-cell responses increased in all but the homologous Ad26.COV2.S-boosted subgroup. CD8+ T-cell levels were more durable in the Ad26.COV2.S-primed recipients, and heterologous boosting with the Ad26.COV2.S vaccine substantially increased spike-specific CD8+ T cells in the mRNA vaccine recipients.

CONCLUSIONS:

Homologous and heterologous booster vaccines had an acceptable safety profile and were immunogenic in adults who had completed a primary Covid-19 vaccine regimen at least 12 weeks earlier. (Funded by the National Institute of Allergy and Infectious Diseases; DMID 21-0012 ClinicalTrials.gov number, NCT04889209.).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antibodies, Neutralizing / Immunogenicity, Vaccine / COVID-19 Vaccines / BNT162 Vaccine / 2019-nCoV Vaccine mRNA-1273 / Ad26COVS1 / Antibodies, Viral Type of study: Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: N Engl J Med Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antibodies, Neutralizing / Immunogenicity, Vaccine / COVID-19 Vaccines / BNT162 Vaccine / 2019-nCoV Vaccine mRNA-1273 / Ad26COVS1 / Antibodies, Viral Type of study: Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: N Engl J Med Year: 2022 Document Type: Article