Homologous and heterologous booster vaccination had an acceptable safety profile and were both immunogenic in adults who completed a primary COVID-19 vaccine regimen at least 12 weeks previously. These findings from the US DMID 21-0012 study appeared in NEJM.
Although the three corona vaccines are very effective, breakthrough infections do occur. Data is needed on the serial use of homologous boosters (use of the same type of vaccine as the primary vaccine) and heterologous boosters (use of a different type of vaccine).
Booster vaccination
In this open-label phase I/II study, 458 adults who had completed a COVID-19 vaccine regimen at least 12 weeks previously and who had not experienced SARS-CoV-2 infection were boosted with one of three vaccines: mRNA-1273 (Moderna), Ad26.COV2.S (Janssen) or BNT162b2 (Pfizer-BioNTech).
The reactogenicity on days 15 and 29 was similar to that reported in the primary series. After the homologous boosters, the neutralizing antibody titers increased 4- to 20-fold, while after the heterologous boosters, the titers increased 6 to 73-fold. Spike-specific T cell responses increased in all subgroups except the homologous Ad26.COV2 .S-enhanced subgroup.
CD8+ T cell levels were more durable in subjects who received the Ad26.COV2.S primed vaccines. A heterologous boost gave a significant increase in the spike-specific CD8 + T cells in subjects who had received an mRNA vaccine.
Conclusion
These preliminary results show that boosting with one of the three approved vaccines elicits a response in individuals who have previously received a primary vaccination. These data indicate that all of these vaccines generate an immune response as a booster regardless of the primary COVID-19 vaccine regimen.
Bron:
Atmar RL, Lyke KE, Deming ME, et al. Homologous and Heterologous Covid-19 Booster Vaccinations. N Engl J Med. 2022;386:1046-57.