Safety and immunogenicity of INO-4800 DNA vaccine against SARS-CoV-2: A preliminary report of an open-label, Phase 1 clinical trial
Pablo Tebas, ShuPing Yang, Jean Boyer, Emma L. Reuschel, Ami Patel, Aaron Christensen-Quick, Viviane M. Andrade, Matthew P. Morrow, Kimberly A. Kraynyak, Joseph Agnes, Mansi Purwar, Albert J. Sylvester, Jan M. Pawlicki, Elisabeth Gillespie, Igor Maricic, Faraz I. Zaidi, Kevin Y. Kim, Yaya Dia, Drew Frase, Patrick Pezzoli, Katherine Schultheis, Trevor R.F. Smith, Stephanie Ramos, Trevor McMullan, Karen R. Buttigieg, Miles W. Carroll, John Ervin, Malissa Diehl, Elliott Blackwood, Mammen P. Mammen, Jessica Lee, Michael Dallas, Ami Shah Brown, Jacqueline E. Shea, J. Joseph Kim, David B. Weiner, Kate E. Broderick, Laurent Humeau
Abstract
Background: A vaccine against SARS-CoV-2 is of high urgency. Here the safety and immunogenicity induced by a DNA vaccine (INO-4800) targeting the full length spike antigen of SARS-CoV-2 are described. Methods: INO-4800 was evaluated in two groups of 20 participants, receiving either 1.0 mg or 2.0 mg of vaccine intradermally followed by CELLECTRA EP at 0 and 4 weeks. Thirty-nine subjects completed both doses; one subject in the 2.0 mg group discontinued trial participation prior to receiving the second dose. Clinical-Trials.gov identifier: NCT04336410. Findings: The median age was 34.5, 55% (22/40) were men and 82.5% (33/40) white. Through week 8, only 6 related Grade 1 adverse events in 5 subjects were observed. None of these increased in frequency with the second administration. No serious adverse events were reported. All 38 subjects evaluable for immunogenicity had cellular and/or humoral immune responses following the second dose of INO-4800. By week 6, 95% (36/38) of the participants seroconverted based on their responses by generating binding (ELISA) and/or neutralizing antibodies (PRNT IC 50 ), with responder geometric mean binding antibody titers of 655.5 [95% CI (255.6, 1681.0)] and 994.2 [95% CI (395.3, 2500.3)] in the 1.0 mg and 2.0 mg groups, respectively. For neutralizing antibody, 78% (14/18) and 84% (16/19) generated a response with corresponding geometric mean titers of 102.3 [95% CI (37.4, 280.3)] and 63.5 [95% CI (39.6, 101.8)], in the respective groups. By week 8, 74% (14/ 19) and 100% (19/19) of subjects generated T cell responses by IFN- ELISpot assay with the median SFU per 10 6 PBMC of 46 [95% CI (21.1, 142.2)] and 71 [95% CI (32.2, 194.4)] in the 1.0 mg and 2.0 mg groups, respectively. Flow cytometry demonstrated a T cell response, dominated by CD8 + T cells co-producing IFN- and TNF-a, without increase in IL-4. Interpretation: INO-4800 demonstrated excellent safety and tolerability and was immunogenic in 100% (38/ 38) of the vaccinated subjects by eliciting either or both humoral or cellular immune responses.