Immunogenicity and safety of homologous and heterologous ChAdOx1-S and mRNA-1273 vaccinations in healthy adults in Taiwan

Chun-Min Kang; Nan-Yao Lee; Chih-Hsueh Lin; Yuan-Shan Hsu; Yu-Chang Chang; Ming-Yi Chung; Ya-Fan Lee; Wen-Pin Tseng; Jhong-Lin Wu; Shey-Ying Chen; Min-Chi Lu; Wen-Chien Ko; Ping-Ing Lee; Po-Ren Hsueh

doi:10.1016/j.jcv.2022.105156

Immunogenicity and safety of homologous and heterologous ChAdOx1-S and mRNA-1273 vaccinations in healthy adults in Taiwan

J Clin Virol. 2022 Jun:150-151:105156. doi: 10.1016/j.jcv.2022.105156. Epub 2022 Apr 6.

Authors

Chun-Min Kang¹, Nan-Yao Lee², Chih-Hsueh Lin³, Yuan-Shan Hsu⁴, Yu-Chang Chang⁵, Ming-Yi Chung⁶, Ya-Fan Lee⁶, Wen-Pin Tseng⁷, Jhong-Lin Wu⁷, Shey-Ying Chen⁸, Min-Chi Lu⁹, Wen-Chien Ko¹⁰, Ping-Ing Lee¹¹, Po-Ren Hsueh¹²

Affiliations

¹ Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan,; Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
² Department of Medicine, College of Medicine, National Cheng Kung University; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
³ Division of family medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
⁴ Nursing Department, China Medical University Hospital, China Medical University, Taichung, Taiwan.
⁵ Department of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
⁶ Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
⁷ Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
⁸ Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Center for Quality Management, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan,. Electronic address: erdrcsy@gmail.com.
⁹ Department of Microbiology and Immunology, School of Medicine, China Medical University, Taichung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan. Electronic address: luminchi@hotmail.com.
¹⁰ Department of Medicine, College of Medicine, National Cheng Kung University; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: winston3415@gmail.com.
¹¹ Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: pinging@ntu.edu.tw.
¹² Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan,; Department of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan,; Ph.D Program for Aging, School of Medicine, China Medical University, Taichung, Taiwan. Electronic address: hsporen@ntu.edu.tw.

Abstract

Background: In Taiwan, the vaccination program started in March 2021, with ChAdOx1-S being the first available WHO-approved COVID-19 vaccine, followed by Moderna vaccine. This study aimed to investigate the immunogenicity and safety of homologous and heterologous prime-boost regimens with ChAdOx1-S and mRNA-1273.

Methods: From March to November 2021, homologous or heterologous regimens with ChAdOx1-S and mRNA-1273 vaccination (ChAdOx1-S/ChAdOx1-S, mRNA-1273/mRNA-1273, ChAdOx1-S/mRNA-1273) were given to 945 healthy participants. Serum samples were collected at designated time points. The anti-RBD/S1 antibody titers and neutralizing ability were measured by three different immunoassays: Elecsys® Anti-SARS-CoV-2 S (Roche Diagnostics, Mannheim, Germany), AdviseDx SARS-CoV-2 IgG II (Abbott Diagnostics Division, Sligo, Ireland), and cPass™ SARS-CoV-2 Neutralization Antibody Detection Kit (GenScript, New Jersey, USA).

Results: We found that heterologous vaccination with ChAdOx1-S/mRNA-1273 had an acceptable safety profile and induced higher total anti-RBD/S1 antibody production (p < 0.0001), yet lower anti-RBD/S1 IgG titer (p < 0.0001) and neutralizing ability (p = 0.0101) than mRNA-1273/mRNA-1273 group. Both regimens showed higher antibody titers and superior neutralizing abilities than ChAdOx1-S/ChAdOx1-S. An age-dependent antibody response to ChAdOx1-S/mRNA-1273 was shown after both the priming and the booster doses. Younger age was associated with higher antibody production and neutralizing ability.

Conclusions: Heterologous ChAdOx1-S/mRNA-1273 vaccination regimen is generally safe and induces a robust humoral immune response that is non-inferior to that of mRNA-1273/mRNA-1273.

Keywords: COVID-19 vaccines; Homologous and heterologous prime-boost regimens; Immunogenicity; Safety.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

2019-nCoV Vaccine mRNA-1273* / adverse effects
2019-nCoV Vaccine mRNA-1273* / immunology
Adult
Antibodies, Viral
COVID-19* / prevention & control
ChAdOx1 nCoV-19* / adverse effects
ChAdOx1 nCoV-19* / immunology
Humans
Immunogenicity, Vaccine*
Immunoglobulin G
SARS-CoV-2
Taiwan
Vaccination

Substances

Antibodies, Viral
Immunoglobulin G
ChAdOx1 nCoV-19
2019-nCoV Vaccine mRNA-1273