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Additional administration of BNT162b2 after two doses of CoronaVac improves neutralization of SARS-CoV-2 omicron mutants

Additional administration of BNT162b2 after two doses of CoronaVac improves neutralization of SARS-CoV-2 omicron mutants

 


In the process of developing a vaccine, new vaccines are expected to stimulate the immune response at both cellular and serological levels in order to achieve regulatory level of efficacy. Therefore, the detection and quantification of neutralizing antibodies is one of the basic steps in this procedure. In a pandemic situation, some anomalous measures are needed to improve defense, such as a combination of different vaccines with different immunological mechanisms, in which case follow-up of the immune response is important. is. In this scenario, data showed that after a complete vaccination protocol with the CoronaVac inactivated virus vaccine, BNT162b2 mRNA vaccine booster doses could enhance antibody neutralization capacity against SARS-CoV-2 omicron variants.

The improvement in neutralization described here can be explained by the fact that betacoronaviruses, including the SARS-CoV-2 mutant, share a storage site for peplomers. Because the BNT162b2 vaccine uses spiked mRNA from the original Wuhan SARS-CoV-2 isolate, this conserved region allows recognition of Omicron variants by the induced antibody, regardless of the number of accumulated mutations. Will be.11 11.. In addition, our findings are consistent with recent studies that also evaluated antibody neutralization patterns with similar vaccination protocols. Works by Kon et al. Among the various vaccine combinations, the use of BNT162b2 after CoronaVac has been shown to show higher immunogenicity against SARS-CoV-2 containing the Omicron mutant.12, This is reinforced by the data tested on more samples. Similarly, a study conducted by Cheng et al. He emphasized that the combination of the BNT162b2 booster dose and the CoronaVac2 dose scheme achieved 80% of seroconversion (24 out of 30).13Close to 76.6% observed in our assay (30 of 23).

It is worth noting that our data is supported by some of the findings recently published by Geurtsvan Kessel et al.Analysis of BNT162b2 booster dose effects in other vaccination schemes, both in serological and cell-mediated immune responses14.. In this study, the author evaluated four different immunization schemes. Two used adenoviral vector technology and two used an mRNA platform (including the BNT162b2 original scheme). They observed that, depending on the vaccine used, neutralizing antibodies against Omicron variants were significantly lower or absent when compared to VOCs such as beta and delta. However, as our data show, boost immunization with BNT162b2 restored neutralizing titers against Omicron in all schemes tested. It is interesting to emphasize that the cellular response to T cell-mediated omicrons was maintained in all vaccination protocols tested, and the greatest effect of this mutant on immune response is predominantly in antibodies. It shows that it is in the sum ability14..

From a clinical point of view, a recent article showed in a Brazilian cohort that administration of BNT162b2 after CoronaVac provides better protection against infection when compared to the original protocol of CoronaVac. The two-dose scheme of CoronaVac showed 34.7% efficacy against new infections when compared to unvaccinated individuals, and this protection was shown to diminish over time. However, administration of the BNT162b2 booster played a role in increasing protection against infection to 82.6%. The same pattern was observed for the progression of COVID-19 disease, demonstrating that booster immunization reduces the likelihood of serious outcomes, especially in the risk group.15.. This is another study from the clinical field, but an analysis of this booster after the original vaccination scheme for BNT162b2 showed a 90% reduction in mortality.16 16.. Explaining our results explain the improvement in protection caused by the BNT162b2 booster in terms of serological response, these studies all complement our observations and the impact of this immunization approach on different branches of the immune system. indicate.

As a limitation of our study, the neutralization analysis was performed randomly and different individuals were used at each time point. Performing these analyzes using samples from the same patient as follow-up, despite presenting heterogeneity in the study and representing more realistic images of the actual situation without selection bias, is serological. Response durability that may bring several different insights. It is also well known that the immunological aspects stimulated by vaccination are not limited to serological responses, but that cell-mediated immunity associated with clinical data is required to determine the efficacy of the vaccine. increase. Nonetheless, the data presented here are enhanced by the work of Geurtsvan Kessel et al.14It emphasizes the need for continuous monitoring of neutralizing antibody volumes, especially given the potential for new mutants to emerge in the future.

Therefore, our data show that for Omicron variants, the neutralizing titers induced by primary vaccination with CoronaVac decreased over time, 43.1-fold lower when compared to the use of a booster immune dose with BNT162b2. Is shown. Therefore, this enhanced neutralization after booster immunization can be clinically reflected in higher protection and lower risk of disease progression.

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2/ https://www.nature.com/articles/s43856-022-00141-4

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