Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination, March−June 2021, England

Powell, Annabel A; Power, Linda; Westrop, Samantha J.; McOwat, Kelsey; Campbell, Helen; Simmons, Ruth; Ramsay, Mary; Brown, Kevin E.; Ladhani, Shamez; Amirthalingam, Gayatri

doi:10.2807/1560-7917.es.2021.26.28.2100634

Cited by 58 publications

(68 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The large-scale US study also revealed that local and systemic reactions were less commonly reported by participants 65 years and older compared with those younger than 65 years, which is consistent with our findings. Regarding gender differences, no detailed information was available in the US study, but a UK study reported that reactogenicity was higher among women, consistent with the findings of our study [13].…”

supporting

confidence: 89%

Reactogenicity following two doses of the BNT162b2 mRNA COVID-19 vaccine: Real-world evidence from healthcare workers in Japan

Saita

Yan

Ito

et al. 2022

Journal of Infection and Chemotherapy

View full text Add to dashboard Cite

As the first authorized COVID-19 vaccine in Japan, the BNT162b2 mRNA COVID-19 vaccine is utilized for mass vaccination. Although efficacy has been proved, real-world evidence on reactogenicity in Japanese personnel is needed to prepare the public. Healthcare workers in a large academic hospital in Japan received two doses of the Pfizer-BioNTech vaccine from March 17 to May 19, 2021. Online questionnaires were distributed to registered recipients following each dose, from day 0 through day 8. Primary outcomes are the frequency of reactogenicity including local and systemic reactions. Length of absence from work was also analyzed. Most recipients self-reported reactogenicity after the first dose (97.3%; n=3,254; mean age [36.4]) and after the second dose (97.2%; n=3,165; mean age [36.5]). Systemic reactions following the second dose were substantially higher than the first dose, especially for fever (OR, 27.38; 95% CI, [22.00-34.06]; p<0.001), chills (OR, 16.49; 95% CI, [13.53-20.11]; p<0.001), joint pain (OR, 8.49; 95% CI, [7.21-9.99]; p<0.001), fatigue (OR, 7.18; 95% CI, [6.43-8.02]; p<0.001) and headache (OR, 5.43; 95% CI, [4.80-6.14]; p<0.001). Reactogenicity was more commonly seen in young, female groups. 19.3% of participants took days off from work after the second dose (2.2% after the first dose), with 4.7% absent for more than two days. Although most participants reported reactogenicity, severe cases were limited. This study provides real-world evidence for the general population and organizations to prepare for BNT162b2 mRNA COVID-19 vaccination in Japan and other countries in the region.

show abstract

supporting

confidence: 89%

Reactogenicity following two doses of the BNT162b2 mRNA COVID-19 vaccine: Real-world evidence from healthcare workers in Japan

Saita

Yan

Ito

et al. 2022

Journal of Infection and Chemotherapy

View full text Add to dashboard Cite

show abstract

“…In SOTR the combination of two vaccine strategies that offer complementary stimulation of different immune pathways may more effectively induce long-lasting B cell responses and potent T cell responses [27]. The heterologous vaccine schedules, however, might have some short-term disadvantages inducing greater systemic reactogenicity following the boost dose than their homologous counterparts, as shown by preliminary studies [28,29].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Humoral Response to mRNA COVID19 Vaccines in Kidney Transplant Recipients: A Longitudinal Study—The COViNEPH Project

et al. 2021

View full text Add to dashboard Cite

Background: The efficacy of SARS-CoV-2 vaccination among kidney transplant recipients (KTR) is low. The main goal of this study was to analyze factors that may influence the humoral response to vaccination. Methods: We analyzed the titer magnitude of IgG antibodies directed against spike (S)-SARS-CoV-2 antigen after the second dose of the mRNA vaccine in 142 infection naïve KTR (83 men, i.e., 58.4%) with a median age (IQR) of 54 (41–63), and 36 respective controls without chronic kidney disease. mRNA-1273 or BNT162b2 were applied in 26% and 74% of KTR, respectively. Results: S-specific immune response (seroconversion) was seen in 73 (51.41%) of KTR, and in all controls 36 (100%). Independent predictors of no response were elder age, shorter transplantation vintage, and a more than two-drug immunosuppressive protocol. In subgroup analyses, the seroconversion rate was highest among KTR without MMF/MPS treatment (70%), treated with no more than two immunosuppressants (69.2%), treated without corticosteroid (66.7%), younger patients aged <54 years (63.2%), and those vaccinated with the mRNA-1273 vaccine (62.16%). The independent predictors of higher S-antibody titer among responders were younger age, treatment with no more than two immunosuppressants, and the mRNA-1273 vaccination. Conclusions: Our study confirmed a low rate of seroconversion after vaccination with the mRNA vaccine in KTR. The major modifiable determinants of humoral response were the composition of the immunosuppressive protocol, as well as the type of vaccine. The latter could be taken into consideration when initial vaccination as well as booster vaccination is considered in KTR.

show abstract

“…Thus, in light of changing recommendations regarding use of Vaxzevria, several countries are now advising individuals previously primed with this vaccine to receive an alternative vaccine as their second dose, most commonly mRNA vaccines such as the BNT162b2 (BNT) COVID-19 vaccine (Comirnaty, Pfizer-BioNTech), administered in a heterologous prime-boost schedule (https://www.has-sante.fr/jcms/p_3260335/en/covid-19-quelle-strategie-vaccinale-pour-les-moins-de-55-ans-ayant-deja-recu-une-dose-d-astrazeneca, accessed on 9 April 2021). Although heterologous vaccine schedules induced greater systemic reactogenicity following the boost dose than their homologous counterparts [127,128], they may have advantages in form of stronger efficacy against multiple SARS-CoV-2 variants, including the worldwide arising Delta variant https://www.medrxiv.org/content/10.110 1/2021.07.13.21260417v1, accessed on 16 July 2021; https://www.medrxiv.org/content/10 .1101/2021.05.19.21257334v2 [129], accessed on 2 June 2021.…”

Section: How Does Severe Covid-19 Manifest In Children and Young?mentioning

confidence: 99%

“…The recognition of them should immediately lead to updated vaccine designs. Although they may have a stronger reactogenicity [127,128], heterologous vaccinations may be a stronger protection because they act complementary in stimulating the cellular and humoral immune response, and memory functions [129].…”

Section: What Are Strong and Measurable Correlations Between Protection And Disease?mentioning

confidence: 99%

Immune Responses against SARS-CoV-2—Questions and Experiences

et al. 2021

View full text Add to dashboard Cite

Understanding immune reactivity against SARS-CoV-2 is essential for coping with the COVID-19 pandemic. Herein, we discuss experiences and open questions about the complex immune responses to SARS-CoV-2. Some people react excellently without experiencing any clinical symptoms, they do not get sick, and they do not pass the virus on to anyone else (“sterilizing” immunity). Others produce antibodies and do not get COVID-19 but transmit the virus to others (“protective” immunity). Some people get sick but recover. A varying percentage develops respiratory failure, systemic symptoms, clotting disorders, cytokine storms, or multi-organ failure; they subsequently decease. Some develop long COVID, a new pathologic entity similar to fatigue syndrome or autoimmunity. In reality, COVID-19 is considered more of a systemic immune–vascular disease than a pulmonic disease, involving many tissues and the central nervous system. To fully comprehend the complex clinical manifestations, a profound understanding of the immune responses to SARS-CoV-2 is a good way to improve clinical management of COVID-19. Although neutralizing antibodies are an established approach to recognize an immune status, cellular immunity plays at least an equivalent or an even more important role. However, reliable methods to estimate the SARS-CoV-2-specific T cell capacity are not available for clinical routines. This deficit is important because an unknown percentage of people may exist with good memory T cell responsibility but a low number of or completely lacking peripheral antibodies against SARS-CoV-2. Apart from natural immune responses, vaccination against SARS-CoV-2 turned out to be very effective and much safer than naturally acquired immunity. Nevertheless, besides unwanted side effects of the currently available vector and mRNA preparations, concerns remain whether these vaccines will be strong enough to defeat the pandemic. Altogether, herein we discuss important questions, and try to give answers based on the current knowledge and preliminary data from our laboratories.

show abstract

Real-world data shows increased reactogenicity in adults after heterologous compared to homologous prime-boost COVID-19 vaccination, March−June 2021, England

Cited by 58 publications

References 8 publications

Reactogenicity following two doses of the BNT162b2 mRNA COVID-19 vaccine: Real-world evidence from healthcare workers in Japan

Reactogenicity following two doses of the BNT162b2 mRNA COVID-19 vaccine: Real-world evidence from healthcare workers in Japan

Predictors of Humoral Response to mRNA COVID19 Vaccines in Kidney Transplant Recipients: A Longitudinal Study—The COViNEPH Project

Immune Responses against SARS-CoV-2—Questions and Experiences

Contact Info

Product

Resources

About