METHODS: Participants were randomized to BNT162b2 (Comirnaty, 30 µg) or messenger RNA (mRNA)-1273 (Spikevax, 100 µg). The primary end point was the rate of two-fold antibody titer increase 14 days after vaccination, targeting the receptor binding domain (RBD) region of wild-type SARS-CoV-2. The secondary end points included changes in neutralizing activity against wild-type and 25 variants. Safety was assessed by monitoring solicited adverse events (AEs) for 7 days.
RESULTS: A total of 269 participants (mean age 81 years, mRNA-1273 n = 135/BNT162b2 n = 134) were included. Two-fold anti-RBD immunoglobulin (Ig) G titer increase was achieved by 101 of 129 (78%) and 116 of 133 (87%) subjects in the BNT162b2 and the mRNA-1273 group, respectively (P = 0.054). A second booster of mRNA-1273 provided higher anti-RBD IgG geometric mean titer: 21.326 IU/mL (95% confidence interval: 18.235-24.940) vs BNT162b2: 15.181 IU/mL (95% confidence interval: 13.172-17.497). A higher neutralizing activity was noted for the mRNA-1273 group. The most frequent AE was pain at the injection site (51% in mRNA-1273 and 48% in BNT162b2). Participants in the mRNA-1273 group had less vaccine-related AEs (30% vs 39%).
CONCLUSIONS: A second booster of either BNT162b2 or mRNA-1273 provided substantial IgG increase. Full-dose mRNA-1273 provided higher IgG levels and neutralizing capacity against SARS-CoV-2, with similar safety profile for subjects of advanced age.
METHODS: In this prospective cohort study, 268 healthcare professionals and medical students in Malaysia were followed up for 24 weeks following homologous (messenger ribonucleic acid [mRNA]-mRNA [mR-mR], viral vector-viral vector [VV-VV], inactivated virus-inactivated virus [IV-IV]) and heterologous (inactivated virus-mRNA [IV-mR], viral vector-mRNA [VV-mR]) booster vaccines. Of them, 190 recipients underwent a longitudinal immunogenicity study. Anti-spike (anti-S) immunoglobulin G (IgG) and anti-receptor-binding domain (anti-RBD) responses were assessed by the ADVIA Centaur severe acute respiratory syndrome coronavirus 2 chemiluminescent immunoassay followed by a surrogate virus neutralization test using the Omicron variant across all boosters.
RESULTS: Compared to homologous boosters, heterologous regimens, particularly the IV-mR booster, elicited significantly higher and sustained anti-S IgG and anti-RBD antibody (P < 0.0001) responses. Over 24 weeks, the heterologous IV-mR booster group had 100% seropositivity for anti-S IgG and anti-RBD antibodies; conversely, in the homologous (IV-IV) booster group, the seropositivity of anti-S IgG and anti-RBD antibodies decreased to 15.63% and 18.75%, respectively. Omicron virus-neutralizing was observed to be as high as 95.92% (IV-mR) and 83.87% (VV-mR) at week 24 after the heterologous booster, while virus neutralization was found to be as low as 9.38% in the IV-IV homologous booster. Age, gender, and ethnicity were not found to be confounding factors for antibody kinetics following a booster vaccine.
CONCLUSION: In conclusion, heterologous booster vaccines induced a superior prolonged humoral immune response against coronavirus disease 2019 infection.