4.5 Article

Safety and immunogenicity of heterologous and homologous inactivated and adenoviral-vectored COVID-19 vaccine regimens in healthy adults: a prospective cohort study

Journal

HUMAN VACCINES & IMMUNOTHERAPEUTICS
Volume 18, Issue 1, Pages -

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/21645515.2022.2029111

Keywords

Heterologous; homologous; inactivated; COVID-19; vaccine; viral vectored; adults

Funding

  1. National Research Council of Thailand (NRCT)
  2. Health Systems Research Institute (HSRI)
  3. Center of Excellence in Clinical Virology of Chulalongkorn University
  4. King Chulalongkorn Memorial Hospital

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This study assessed the reactogenicity and immunogenicity of heterologous regimens for COVID-19 vaccines in healthy Thai adults. The adverse events were mild and well tolerated overall. Heterologous regimens showed higher antibody responses and neutralizing activities. Spike-specific IgA response was detected only in the heterologous group. The interferon gamma response was detected in both heterologous groups after two-dose vaccination.
In light of intermittent supply shortages of individual vaccines and evidence of rare but serious adverse events after vaccination, heterologous regimens for COVID-19 vaccines have gained significant interest. This study aims to assess the reactogenicity and immunogenicity of the heterologous adenoviral vector (ChAdOx1-S, AstraZeneca; hereafter referred to as AZ) and the inactivated vaccine regimen (CoronaVac; hereafter referred to as CV) in healthy Thai adults immunized between June and September 2021. Our study showed that adverse events following homologous CV-CV and AZ-AZ, and heterologous CV-AZ and AZ-CV combinations, were mild and well tolerated overall. Receptor-binding domain (RBD)-specific antibody responses and neutralizing activities against wild-type and variants of concern after two-dose vaccination were higher in the heterologous CV-AZ and homologous AZ-AZ groups compared to the CV-CV and AZ-CV groups. Conversely, the spike-specific IgA response was detected only in the CV-AZ group after two doses of vaccination. The total interferon gamma response was detected in both the CV-AZ and AZ-CV groups after the two-dose vaccination. Given the shorter completion time of two doses, heterologous CoronaVac followed by ChAdOx1-S can be considered as an alternative regimen to homologous efficacy-proven ChAdOx1-S in countries with circulating variants. Additional studies on the efficacy and durability of immune responses induced by heterologous vaccine regimens are warranted.

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