Immunogenicity of NVX-CoV2373 heterologous boost against SARS-CoV-2 variants
Kirsten E. Lyke, Robert L. Atmar, Clara Domínguez Islas, Christine M. Posavad, Meagan E. Deming, Angela R Branche, Christine Johnston, Hana M. El Sahly, Srilatha Edupuganti, Mark J. Mulligan, Lisa A. Jackson, Richard Rupp, Christina A. Rostad, Rhea N. Coler, Martín Bäcker, Angelica C Kottkamp, Tara M Babu, David Dobrzynski, Judith M. Martin, Rebecca C. Brady, Robert W. Frenck, Kumaravel Rajakumar, Karen L. Kotloff, Nadine Rouphael, Daniel Szydlo, Rahul PaulChoudhury, Janet I. Archer, Sonja Crandon, Brian Ingersoll, Amanda Eaton, Elizabeth R. Brown, M. Juliana McElrath, Kathleen M. Neuzil, David S. Stephens, Diane J. Post, Bob C. Lin, Leonid Serebryannyy, John H. Beigel, David C. Montefiori, Paul C. Roberts, the DMID 21-0012 Study Group, Evan J. Anderson, Megan Berman, Kristen W. Cohen, Stephen De Rosa, Michelle Dickey, Jennifer Lee Dong, Madison Ellis, Ann R. Falsey, Andrew Fleming, Katharine Floyd, Stephanie L. Foster, Daniel S. Graciaa, A Kahn, Satoshi Kamidani, Wendy A. Keitel, Lilin Lai, Sasha E. Larsen, Marina Lee, Kelly E. Manning, Kathryn M. Moore, Vivian Mulholland, Gysella Muñiz, Seema Nayak, Asif Noor, Mit Patel, Laura Porterfield, Angie Price, Ian Shannon, Timothy R. Shope, Amber Stanford, Mehul S. Suthar, Anna Wald, Jennifer A. Whitaker
Abstract
As part of a multicenter study evaluating homologous and heterologous COVID-19 booster vaccines, we assessed the magnitude, breadth, and short-term durability of binding and pseudovirus-neutralizing antibody (PsVNA) responses following a single booster dose of NVX-CoV2373 in adults primed with either Ad26.COV2.S, mRNA-1273, or BNT162b2 vaccines. NVX-CoV2373 as a heterologous booster was immunogenic and associated with no safety concerns through Day 91. Fold-rises in PsVNA titers from baseline (Day 1) to Day 29 were highest for prototypic D614G variant and lowest for more recent Omicron sub-lineages BQ.1.1 and XBB.1. Peak humoral responses against all SARS-CoV-2 variants were lower in those primed with Ad26.COV2.S than with mRNA vaccines. Prior SARS CoV-2 infection was associated with substantially higher baseline PsVNA titers, which remained elevated relative to previously uninfected participants through Day 91. These data support the use of heterologous protein-based booster vaccines as an acceptable alternative to mRNA or adenoviral-based COVID-19 booster vaccines. This trial was conducted under ClinicalTrials.gov: NCT04889209.