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      Neutralizing response elicited by homologous and heterologous prime booster vaccination against ancestral SARS-CoV-2 B.1, P.1, C.37 and B.1.617.2 variants

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          Abstract

          Heterologous Covid-19 vaccination strategies arose due to interruption of vaccination programs plus delay and shortage of vaccine supplies. We analysed neutralizing response against ancestral SARS-CoV-2 B.1 and P.1, C.37 and B.1.67.2 variants elicited by 16 homologous and heterologous protocols combining Gam-COVID-Vac, ChAdOx1-S, Ad5-nCorV, BBIBP-CorV and mRNA-1273 vaccines. Homologous mRNA-1273 and heterologous schemes of a non-replicative viral vector/inactivated virus-based vaccine combined with mRNA-1273 induced significantly broader and greater neutralizing antibody-response. Moreover, serum from participants vaccinated with combinations of ChAdOx1-S/Ad5-nCorV and BBIBP-CorV/non-replicative viral vector-based vaccines showed higher or equivalent neutralizing response compared to homologous protocols, pointing them as good alternative platforms. BBIBP-CorV used as second dose exhibited significantly lower neutralizing response compared to other protocols, demonstrating that it should not be recommended as second dose. The information provided herein is valuable to redesign vaccination strategies, especially for low-income countries that still struggle with low percentages of immunized populations and vaccine supply shortage.

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          Efficacy of the ChAdOx1 nCoV-19 Covid-19 Vaccine against the B.1.351 Variant

          Abstract Background Assessment of the safety and efficacy of vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in different populations is essential, as is investigation of the efficacy of the vaccines against emerging SARS-CoV-2 variants of concern, including the B.1.351 (501Y.V2) variant first identified in South Africa. Methods We conducted a multicenter, double-blind, randomized, controlled trial to assess the safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) in people not infected with the human immunodeficiency virus (HIV) in South Africa. Participants 18 to less than 65 years of age were assigned in a 1:1 ratio to receive two doses of vaccine containing 5×1010 viral particles or placebo (0.9% sodium chloride solution) 21 to 35 days apart. Serum samples obtained from 25 participants after the second dose were tested by pseudovirus and live-virus neutralization assays against the original D614G virus and the B.1.351 variant. The primary end points were safety and efficacy of the vaccine against laboratory-confirmed symptomatic coronavirus 2019 illness (Covid-19) more than 14 days after the second dose. Results Between June 24 and November 9, 2020, we enrolled 2026 HIV-negative adults (median age, 30 years); 1010 and 1011 participants received at least one dose of placebo or vaccine, respectively. Both the pseudovirus and the live-virus neutralization assays showed greater resistance to the B.1.351 variant in serum samples obtained from vaccine recipients than in samples from placebo recipients. In the primary end-point analysis, mild-to-moderate Covid-19 developed in 23 of 717 placebo recipients (3.2%) and in 19 of 750 vaccine recipients (2.5%), for an efficacy of 21.9% (95% confidence interval [CI], −49.9 to 59.8). Among the 42 participants with Covid-19, 39 cases (92.9%) were caused by the B.1.351 variant; vaccine efficacy against this variant, analyzed as a secondary end point, was 10.4% (95% CI, −76.8 to 54.8). The incidence of serious adverse events was balanced between the vaccine and placebo groups. Conclusions A two-dose regimen of the ChAdOx1 nCoV-19 vaccine did not show protection against mild-to-moderate Covid-19 due to the B.1.351 variant. (Funded by the Bill and Melinda Gates Foundation and others; ClinicalTrials.gov number, NCT04444674; Pan African Clinical Trials Registry number, PACTR202006922165132).
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            Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants

            Assessing COVID-19 vaccine performance against the rapidly spreading SARS-CoV-2 Omicron variant is critical to inform public health guidance.
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              Immune responses against SARS-CoV-2 variants after heterologous and homologous ChAdOx1 nCoV-19/BNT162b2 vaccination

              Currently approved viral vector-based and mRNA-based vaccine approaches against coronavirus disease 2019 (COVID-19) consider only homologous prime-boost vaccination. After reports of thromboembolic events, several European governments recommended using AstraZeneca’s ChAdOx1-nCov-19 (ChAd) only in individuals older than 60 years, leaving millions of already ChAd-primed individuals with the decision to receive either a second shot of ChAd or a heterologous boost with mRNA-based vaccines. However, such combinations have not been tested so far. We used Hannover Medical School’s COVID-19 Contact Study cohort of healthcare professionals to monitor ChAd-primed immune responses before and 3 weeks after booster with ChAd ( n  = 32) or BioNTech/Pfizer’s BNT162b2 ( n  = 55). Although both vaccines boosted prime-induced immunity, BNT162b2 induced significantly higher frequencies of spike-specific CD4 + and CD8 + T cells and, in particular, high titers of neutralizing antibodies against the B.1.1.7, B.1.351 and P.1 variants of concern of severe acute respiratory syndrome coronavirus 2. In a study of healthcare professionals previously vaccinated with ChAdOx-1 nCoV-19, booster vaccination with BNT162b2 elicited more neutralizing antibodies with greater breadth, as well as higher frequencies of virus-specific T cells, than ChAdOx-1 nCoV-19.
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                Author and article information

                Journal
                Vaccine
                Vaccine
                Vaccine
                Elsevier Ltd.
                0264-410X
                1873-2518
                20 October 2022
                20 October 2022
                Affiliations
                [a ]Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
                [b ]Centro de Investigación y Desarrollo en Inmunología y Enfermedades Infecciosas, Universidad Católica de Córdoba, Córdoba, Argentina
                [c ]Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba, Argentina
                [d ]Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
                Author notes
                [* ]Corresponding author at: Address: Caseros 1576. Barrio Alberdi. CP: 5000, Córdoba, Argentina.
                Article
                S0264-410X(22)01283-X
                10.1016/j.vaccine.2022.10.021
                9581801
                aa13262e-2ef9-47bf-9525-3e643f1488d2
                © 2022 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 19 May 2022
                : 26 September 2022
                : 7 October 2022
                Categories
                Short Communication

                Infectious disease & Microbiology
                covid-19,heterologous vaccination,vaccine,shortage,neutralizing antibodies,variants of concern

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