New Data on Heterologous COVID-19 Vaccine Combinations

Switching to a different COVID-19 vaccine after a first dose of the Sputnik V C1, ChAdOx1-S, or BBIBP-CorV vaccines can greatly increase immune response while maintaining safety, according to a study published in Cell Reports Medicine. The results provide information for mixing vaccine types in both primary vaccination and vaccine booster schedules, which is particularly important for middle- and lower-income countries to strengthen vaccine programs, the authors wrote.

In the study, administering a messenger RNA (mRNA) vaccine dose between 34 and 80 days after a first dose with an inactivated virus or nonreplicating adenovirus vaccine boosted serum antibodies and neutralizing titers the most. Although the approach also increased vaccine-related adverse events, none were serious.

The study enrolled 1314 individuals in Argentina divided into 3 groups to receive their first vaccine dose: 669 received Sputnik V C1 (Gamaleya Institute), a nonreplicating adenovirus vaccine; 448 received ChAdOx1-S (Oxford-AstraZeneca), also an adenovirus vaccine; and 197 received BBIBP-CorV (Sinopharm), an inactivated virus vaccine. The 3 first-dose cohorts were further divided into 15 groups that received as a second dose either the same vaccine or 1 of 5 different vaccines.

Before the second dose, levels of SARS-CoV-2 antispike IgG antibodies and neutralizing antibody titers were similar among all study groups. In all 3 cohorts, antibody levels and neutralizing titers were lowest 14 and 21 days after a second dose of BBIBP-CorV and highest after a second dose of the mRNA vaccine mRNA-1273 (Moderna).

Combining the first dose with mRNA-1273 was superior to 2 doses of the same vaccine in all 3 cohorts, as was combining Sputnik V C1 with a first dose of ChAdOx1-S or BBIBP-CorV. Adding Sputnik V C2, ChAdOx1-S, or Ad5-nCoV (CanSino), an adenovirus vaccine, equaled or bettered the immune response following 2 doses of Sputnik V C1, as did adding Ad5nCoV in the ChAdOx1-S cohort.

Injection site pain was the most common local reaction, while headache and fever were the most common systemic reactions. No serious adverse events occurred in any study group.

https://jamanetwork.com/journals/jama/fullarticle/2796271?guestAccessKey=b4514c48-b5f7-4e2e-be08-0a14b27a6a53&utm_source=fbpage&utm_medium=social_jama&utm_term=7608313362&utm_campaign=article_alert&linkId=181218292&fbclid=IwAR0rXPXlFeBX5YMSTNZUk_8ID2abaFHt2559i2ILkLuzWyCg0Zd3Gp1CoAM

Créditos: Comité científico Covid