Safety and immunogenicity of heterologous and homologous inactivated and adenoviral-vectored COVID-19 vaccine regimens in healthy adults: a prospective cohort study

Wanlapakorn, Nasamon; Suntronwong, Nungruthai; Phowatthanasathian, Harit; Yorsaeng, Ritthideach; Vichaiwattana, Preeyaporn; Thongmee, Thanunrat; Auphimai, Chompoonut; Srimuan, Donchida; Thatsanatorn, Thaksaporn; Assawakosri, Suvichada; Kanokudom, Sitthichai; Poovorawan, Yong

doi:10.1080/21645515.2022.2029111

Cited by 55 publications

(63 citation statements)

References 35 publications

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“…Regarding the reactogenicity of the heterologous regimen, we did not record the adverse events following homologous and heterologous vaccination in this cohort. Nevertheless, our previous prospective cohort study showed that the heterologous CoronaVac/AZD1222 regimen resulted in a higher percentage of local and systemic adverse events compared to the homologous group after the second dose vaccination which is in agreement with the initial reactogenicity data in the Com-COV trial [3] , [8] .…”

Section: Discussionsupporting

confidence: 84%

“…The adenoviral-vectored vaccine (AZD1222) was administered two doses at 10 weeks apart. Preliminary studies have found the two-dose CoronaVac regimen induced a lower, but acceptable, immune response compared to the two-dose AZD1222 regimen with a shorter interval between two doses [8] . A 10-week interval for AZD1222 vaccine was established based on recommendations of the Thailand FDA and efficacy studies identifying that a waiting period of <6 weeks resulted in lower immune stimulation than a period of 10 weeks [9] .…”

Section: Introductionmentioning

confidence: 99%

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Immunogenicity of heterologous inactivated and adenoviral-vectored COVID-19 vaccine: Real-world data

Wanlapakorn

Suntronwong

Phowatthanasathian

et al. 2022

Vaccine

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Immunogenicity of heterologous inactivated and adenoviral-vectored COVID-19 vaccine: Real-world data

Wanlapakorn

Suntronwong

Phowatthanasathian

et al. 2022

Vaccine

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“…The mean anti-RBD titer of inactivated vaccine recipients was also lower than AZD1222, and AZD1222/BNT162b2 by 82 and 242 fold. 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).…”

Section: Discussionsupporting

confidence: 93%

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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“…The mean anti-RBD titer of inactivated vaccine recipients was also lower than AZD1222 and AZD1222/BNT162b2 by 82 and 242 fold, respectively. 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].…”

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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Safety and immunogenicity of heterologous and homologous inactivated and adenoviral-vectored COVID-19 vaccine regimens in healthy adults: a prospective cohort study

Cited by 55 publications

References 35 publications

Immunogenicity of heterologous inactivated and adenoviral-vectored COVID-19 vaccine: Real-world data

Immunogenicity of heterologous inactivated and adenoviral-vectored COVID-19 vaccine: Real-world data

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

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