Neutralization against BA.2.75.2, BQ.1.1, and XBB from mRNA Bivalent Booster

Davis-Gardner, Meredith E.; Lai, Lilin; Wali, Bushra; Samaha, Hady; Solis, D.; Lee, Matthew; Porter-Morrison, Andrea; Hentenaar, Ian; Yamamoto, Fumiko; Godbole, Sucheta; Liu, Yuan; Douek, Daniel C.; Lee, Frances Eun-Hyung; Rouphael, Nadine; Moreno, Alberto; Pinsky, Benjamin A.; Suthar, Mehul S.

doi:10.1056/nejmc2214293

Cited by 183 publications

(147 citation statements)

References 5 publications

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“…Covid-19 vaccination policies recommending the bivalent mRNA-booster vaccines as a fourth dose are mainly supported by studies on immunogenicity where some have shown higher induction of antibody levels against omicron subvariants including BA.4-5 compared with monovalent boosters. [4][5][6][7][8] Previous observational effectiveness studies of fourth dose monovalent vaccination, primarily on data from before BA.4-5 subvariant predominance, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] also lend some indirect support to these recommendations.…”

Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Andersson

Thiesson

Baum

et al. 2023

Preprint

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Background: Data on the comparative vaccine effectiveness (CVE) of the bivalent mRNA-booster vaccines containing the original SARS-CoV-2 and omicron BA.4-5 and BA.1 subvariants are limited. Methods: In a period of BA.4-5 subvariants predominance, we estimated the CVE of the bivalent Comirnaty (Pfizer-BioNTech) and Spikevax (Moderna) BA.4-5 and BA.1 mRNA-booster vaccines given as a fourth dose in Denmark, Finland, Norway, and Sweden. From 1 July 2022 to 12 December 2022, we conducted nationwide cohort analyses using target trial emulation to compare risks of Covid-19 hospitalization and death in four-dose (second booster) with three-dose (first booster) vaccinated and between four-dose vaccinated individuals. Results: Compared with having received three vaccine doses, receipt of a bivalent BA.4-5 booster as a fourth dose was associated with a country-combined CVE against Covid-19 hospitalization of 80.5% (95% confidence interval, 69.5% to 91.5%). The corresponding CVE for bivalent BA.1 boosters was 74.0% (68.6% to 79.4%). CVE against Covid-19 death was 77.8% (48.3% to 100%) and 80.1% (72.0% to 88.2%) for bivalent BA.4-5 and BA.1 boosters as a fourth dose, respectively. The CVE of bivalent BA.4-5 vs. BA.1 boosters were 32.3% (10.6% to 53.9%) for Covid-19 hospitalization and 12.3% (-36.1% to 60.7%) for death (the latter estimable in Denmark only). Conclusions: Vaccination with bivalent BA.4-5 or BA.1 mRNA-booster vaccines as a fourth dose was associated with increased protection against Covid-19 hospitalization and death during a period of BA.4-5 predominance. Bivalent BA.4-5 boosters conferred moderately greater vaccine effectiveness against Covid-19 hospitalization compared with bivalent BA.1 boosters.

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Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Andersson

Thiesson

Baum

et al. 2023

Preprint

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“…During 2022, the prototype Omicron variant has given rise to numerous subvariants, with many displaying even higher extents of immune escape 9,[14][15][16][17][18][19][20][21][22] , endangering the efficacy of vaccination efforts.…”

Section: Introductionmentioning

confidence: 99%

Extraordinary Evasion of Neutralizing Antibody Response by Omicron XBB.1.5, CH.1.1 and CA.3.1 Variants

Faraone

Evans

et al. 2023

Preprint

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Newly emerging Omicron subvariants continue to emerge around the world, presenting potential challenges to current vaccination strategies. This study investigates the extent of neutralizing antibody escape by new subvariants XBB.1.5, CH.1.1, and CA.3.1, as well as their impacts on spike protein biology. Our results demonstrated a nearly complete escape of these variants from neutralizing antibodies stimulated by three doses of mRNA vaccine, but neutralization was rescued by a bivalent booster. However, CH.1.1 and CA.3.1 variants were highly resistant to both monovalent and bivalent mRNA vaccinations. We also assessed neutralization by sera from individuals infected during the BA.4/5 wave of infection and observed similar trends of immune escape. In these cohorts, XBB.1.5 did not exhibit enhanced neutralization resistance over the recently dominant BQ.1.1 variant. Notably, the spike proteins of XBB.1.5, CH.1.1, and CA.3.1 all exhibited increased fusogenicity compared to BA.2, correlating with enhanced S processing. Overall, our results support the administration of new bivalent mRNA vaccines, especially in fighting against newly emerged Omicron subvariants, as well as the need for continued surveillance of Omicron subvariants.

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“…Third, all participants received monovalent COVID-19 vaccines for their third dose. Impaired neutralizing responses induced by the third monovalent COVID-19 vaccines have been reported against the current variants in circulation, such as BQ.1 and XBB [ 14 ].…”

mentioning

confidence: 99%

Humoral and cellular responses after COVID-19 booster vaccination in patients recently treated with anti-CD20 antibodies

et al. 2023

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Neutralization against BA.2.75.2, BQ.1.1, and XBB from mRNA Bivalent Booster

Cited by 183 publications

References 5 publications

Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries

Extraordinary Evasion of Neutralizing Antibody Response by Omicron XBB.1.5, CH.1.1 and CA.3.1 Variants

Humoral and cellular responses after COVID-19 booster vaccination in patients recently treated with anti-CD20 antibodies

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