Homologous and Heterologous Covid-19 Booster Vaccinations

作者：Robert L. Atmar, Kirsten E. Lyke, Meagan E. Deming, Lisa A. Jackson, Angela R Branche, Hana M. El Sahly, Christina A. Rostad, Judith M. Martin, Christine Johnston, Richard Rupp, Mark J. Mulligan, Rebecca C. Brady, Robert W. Frenck, Martín Bäcker, Angelica C Kottkamp, Tara M. Babu, Kumaravel Rajakumar, Srilatha Edupuganti, David Dobrzynski, Rhea N. Coler, Christine M. Posavad, Janet I. Archer, Sonja Crandon, Seema Nayak, Daniel Szydlo, Jillian A. Zemanek, Clara P. Domínguez Islas, Elizabeth R. Brown, Mehul S. Suthar, M. Juliana McElrath, Adrian B. McDermott, Sarah O’Connell, David C. Montefiori, Amanda Eaton, Kathleen M. Neuzil, David S. Stephens, Paul C. Roberts, John H. Beigel · 发表于：New England Journal of Medicine · 年份：2022 · DOI：10.1056/nejmoa2116414 · 被引用次数：619 · 研究领域：SARS-CoV-2 and COVID-19 Research、Vaccine Coverage and Hesitancy、Animal Virus Infections Studies

BACKGROUND: Although the three vaccines against coronavirus disease 2019 (Covid-19) that have received emergency use authorization in the United States are highly effective, breakthrough infections are occurring. Data are needed on the serial use of homologous boosters (same as the primary vaccine) and heterologous boosters (different from the primary vaccine) in fully vaccinated recipients. METHODS: virus particles, or BNT162b2 (Pfizer-BioNTech) at a dose of 30 μg. The primary end points were safety, reactogenicity, and humoral immunogenicity on trial days 15 and 29. RESULTS: Of the 458 participants who were enrolled in the trial, 154 received mRNA-1273, 150 received Ad26.COV2.S, and 153 received BNT162b2 as booster vaccines; 1 participant did not receive the assigned vaccine. Reactogenicity was similar to that reported for the primary series. More than half the recipients reported having injection-site pain, malaise, headache, or myalgia. For all combinations, antibody neutralizing titers against a SARS-CoV-2 D614G pseudovirus increased by a factor of 4 to 73, and binding titers increased by a factor of 5 to 55. Homologous boosters increased neutralizing antibody titers by a factor of 4 to 20, whereas heterologous boosters increased titers by a factor of 6 to 73. Spike-specific T-cell responses increased in all but the homologous Ad26.COV2.S-boosted subgroup. CD8+ T-cell levels were more durable in the Ad26.COV2.S-primed recipients, and heterologous boosting with the Ad26.C...