Immune response and safety of heterologous ChAdOx1-nCoV-19/mRNA-1273 vaccination compared with homologous ChAdOx1-nCoV-19 or homologous mRNA-1273 vaccination

Sheng, Wang‐Huei; Chang, Shih‐Ying; Lin, Pin‐Hung; Hsieh, Ming‐Ju; Chang, Hao-Hsiang; Cheng, Chien-Yu; Yang, Hung‐Chih; Pan, Ching‐Fu; Ieong, Si‐Man; Chao, Tai‐Ling; Chen, Cheng-Pin; Cheng, Shu‐Hsing; Chang, Shan-Chwen

doi:10.1016/j.jfma.2022.02.020

Cited by 23 publications

(22 citation statements)

References 16 publications

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“…Our findings were consistent with studies performed on the healthy population, where lower humoral response was reported in inactivated vaccine when compared to adenovirus-vectored or mRNA vaccine [17,18]. The other studies also found that heterologous adenovirus-vectored/mRNA vaccination was more immunogenic than homologous adenovirus-vectored vaccination [19,20]. Vaccine type remains to be a strong independent predictor of humoral immune response in AIRD patients, even when it is adjusted for other potential confounders, including baseline characteristics and immunosuppressive load.…”

Section: Discussionsupporting

confidence: 92%

Comparison of Immunogenicity and Safety of Inactivated, Adenovirus-Vectored, and Heterologous Adenovirus-Vectored/mRNA Vaccines in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Prospective Cohort Study

et al. 2022

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Background: Impaired immune responses to COVID-19 vaccines have been observed in autoimmune rheumatic disease patients. Determining the most effective and safe vaccine regimen is critically needed in such a population. We aim to compare the immunogenicity and safety of three COVID-19 vaccine regimens in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Methods: SLE and RA patients aged 18–65 years who received inactivated (CoronaVac or COVILO), adenovirus-vectored (AZD1222), or heterogeneous (AZD1222/BNT162b2) vaccines were enrolled. Humoral and cellular immune responses were assessed at day 28 after the second vaccination. This was performed using the serum binding antibody level against the receptor-binding domain of the SARS-CoV-2 spike protein (anti-RBD Ig) and IFNy-ELISpot assay (ELISpot), respectively. Reactogenicity was reviewed on day 7 following each vaccination. Disease activity was assessed before and on day 28 after the second vaccination. Results: The cohort consisted of 94 patients (64 SLE and 30 RA). Inactivated, AZD1222, and AZD1222/BNT162b2 vaccines were administered to 23, 43, and 28 patients, respectively. Anti-RBD titers were lowest in the inactivated vaccine group (2.84 AU/mL; 95% CI 0.96–8.44), followed by AZD1222 (233.7 AU/mL; 95% CI 99.0–505.5), and AZD1222/BNT162b2 (688.6 AU/mL; 95% CI 271–1745), p < 0.0001. After adjusting for relevant factors, the inactivated vaccine was associated with the lowest humoral response, while adenovirus-vectored/mRNA vaccine was the highest. The proportion of positive ELISpot test was also lowest in the inactivated vaccine group (27%), followed by the adenovirus-vectored vaccine (67%), and the adenovirus-vectored/mRNA vaccine (73%) (p = 0.03). All types of vaccine were well-tolerated. There was no flare of autoimmune disease post-vaccination. Conclusion: Adenovirus-vectored and adenovirus-vectored/mRNA vaccines elicited a stronger humoral and cellular immune response than inactivated vaccines, suggesting that they may be more suitable in SLE and RA patients receiving immunosuppressive therapy.

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Section: Discussionsupporting

confidence: 92%

Comparison of Immunogenicity and Safety of Inactivated, Adenovirus-Vectored, and Heterologous Adenovirus-Vectored/mRNA Vaccines in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Prospective Cohort Study

et al. 2022

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“…Our findings were consistent with studies performed on healthy population where lower humoral response was reported in inactivated vaccine when compared to adenovirus-vectored or mRNA vaccine (17, 18). Heterologous adenovirus-vectored /mRNA vaccination was also more immunogenic than homologous adenovirus-vectored vaccination and comparable to homologous mRNA vaccination (19, 20). Vaccine type remains to be a strong independent predictor of humoral immune response in AIRD patients, even adjusted for other potential confounders including baseline characteristics and immunosuppressive load.…”

Section: Discussionmentioning

confidence: 94%

Comparison of immunogenicity and safety of inactivated, adenovirus-vectored and heterologous adenovirus-vectored/mRNA vaccines in patients with systemic lupus erythematosus and rheumatoid arthritis: a prospective cohort study

Assawasaksakul

Lertussavavivat

Sathitratanacheewin

et al. 2022

Preprint

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BackgroundImpaired immune response to COVID-19 vaccines have been observed in autoimmune rheumatic disease patients. Determining the most effective and safe vaccine regimen is critically needed in such a population. We aim to compare the immunogenicity and safety of three COVID-19 vaccine regimens in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).MethodsSLE and RA patients aged 18-65 years who received inactivated (CoronaVac or COVILO), adenovirus-vectored (AZD1222), or heterogeneous (AZD1222/BNT162b2) vaccines were enrolled. Humoral and cellular immune responses were assessed at day 28 after the second vaccination. This was performed using the serum binding antibody level against receptor-binding domain of the SARS-CoV-2 spike protein (anti-RBD Ig) and IFNy-ELISpot assay (ELISpot) respectively. Reactogenicity was reviewed on day 7 following each vaccination. Disease activity was assessed before and on day 28 after the second vaccination.ResultsThe cohort consisted of 94 patients (64 SLE and 30 RA). Inactivated, AZD1222, and AZD1222/BNT162b2 vaccines were administered to 23, 43, and 28 patients, respectively. Anti-RBD titers were lowest in the inactivated vaccine group (2.84 AU/mL; 95% CI 0.96-8.44), followed by AZD1222 (233.7 AU/mL; 95% CI 99.0 - 505.5) and AZD1222/BNT162b2 (688.6 AU/mL; 95% CI 271 - 1745), p 0<0.0001. After adjusting for relevant factors, the inactivated vaccine was associated with the lowest humoral response, while adenovirus-vectored/mRNA vaccine was the highest. The proportion of positive ELISpot test was also lowest in the inactivated vaccine group (27%), followed by the adenovirus-vectored vaccine (67%), and adenovirus-vectored/mRNA vaccine (73%)(p = 0.03). All types of vaccine were well-tolerated. There was no flare of autoimmune disease post-vaccination.ConclusionAdenovirus-vectored and adenovirus-vectored/mRNA vaccines elicited a stronger humoral and cellular immune response than inactivated vaccines, suggesting that they may be more suitable in SLE and RA patients receiving immunosuppressive therapy.

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“…We have previously addressed the immune responses and safety of heterologous ChAdOx1-nCoV-19/mRNA-1273 vaccination with prime-boost intervals of 4 and 8 weeks, compared with homologous ChAdOx1 vaccination and homologous mRNA-1273 vaccination separately. 10 The SARS-CoV-2 anti-spike IgG titers and neutralization antibody titers against SARS-CoV-2 variants, as well as T-cell responses to heterologous vaccinations with either 4- or 8-week intervals, were significantly higher than that of homologous ChAdOx1 vaccination and comparable to homologous mRNA-1273 vaccination. Heterologous prime-boost ChAdOx1/mRNA-1273 vaccination with an 8-week interval had significantly higher mean neutralizing antibody titers than the 4-week interval of heterologous ChAdOx1/mRNA-1273 vaccination at day 28 after the booster dose.…”

Section: Introductionmentioning

confidence: 89%

“…Enrollment criteria and test schedules were the same as those of our previous study. 10 The serum SARS-CoV-2 anti-spike IgG titers and neutralizing antibody titers were determined as described in our previous report. 10 The primary outcome was the analysis of serum SARS-CoV-2 anti-spike IgG titers and neutralizing antibody titers against B.1.1.7 (alpha) and the B.1.617.2 (delta) SARS-CoV-2 variants at day 28 after the booster.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Serological response and safety of heterologous ChAdOx1-nCoV-19/mRNA-1273 prime-boost vaccination with a twelve-week interval

Sheng

Chang²,

Hsieh³

et al. 2023

Journal of the Formosan Medical Association

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Immune response and safety of heterologous ChAdOx1-nCoV-19/mRNA-1273 vaccination compared with homologous ChAdOx1-nCoV-19 or homologous mRNA-1273 vaccination

Cited by 23 publications

References 16 publications

Comparison of Immunogenicity and Safety of Inactivated, Adenovirus-Vectored, and Heterologous Adenovirus-Vectored/mRNA Vaccines in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Prospective Cohort Study

Comparison of Immunogenicity and Safety of Inactivated, Adenovirus-Vectored, and Heterologous Adenovirus-Vectored/mRNA Vaccines in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Prospective Cohort Study

Comparison of immunogenicity and safety of inactivated, adenovirus-vectored and heterologous adenovirus-vectored/mRNA vaccines in patients with systemic lupus erythematosus and rheumatoid arthritis: a prospective cohort study

Serological response and safety of heterologous ChAdOx1-nCoV-19/mRNA-1273 prime-boost vaccination with a twelve-week interval

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