交差接種(ChAdOx1 nCoV-19/mRNA-1273)の免疫反応

//Special note//---
 Today, I have had a plan to share the contents of the other article. However, the important articles which needs to urgently communalize are published from Nature medicine and The New England Journal of Medicine. Therefore, I change the original plan. I introduce a part of contents about SARS-CoV-2 important reports exclusively today.
 
//Background//---
 Several European counties have recommended heterologous messenger RNA (mRNA) boost strategies for persons younger than 60/65 years old who have already received one dose of ChAdOx1 nCoV-19 due to risk of thrombotic event(2,3). To date, data on the safety and immunogenicity of these regimens are limited.
 Johan Normark, M.D., Ph.D., Linnea Vikström, B.Sc. et al. evaluate the neutralization ability of heterologous vaccination (ChAdOx1 nCoV-19/mRNA-1273) through the comparison for homogenous vaccination(ChAdOx1 nCoV-19)(1). I want to share this correspondence with the global important readers.
 
//Condition(1)//---
*Ongoing clinical study: (EudraCT number, 2021 - 000683 – 30)
*Participant: 88 health care workers.
*They received one dose of ChAdOx1 nCoV-19 vaccine 9 to 12 weeks earlier.
*37 participants chose a homologous boost with ChAdOx1 nCoV-19 (AstraZeneca)
*51 participants chose a heterologous boost with mRNA-1273 (Moderna)
*The median age: 46 years--homologous
*The median age: 40 years--heterologous
 
//Result(1)(See Supplemental figure 1)//---
(Neutralization ability)
*Homologous booster dose: ChAdOx1 nCoV-19/ ChAdOx1 nCoV-19
After 7-10 days: 100 / After 1 month: 100
*Heterologous booster dose: ChAdOx1 nCoV-19/mRNA-1273
After 7-10 days: 1000 / After 1 month: 1000 *Increasing in 7-10 days after boost.
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(Against B.1.351 vs Original Swedish isolate)
 Decreasing rate is almost same between heterologous and homologous groups, so the neutralization ability against B.1.351 is higher in heterologous group, and the neutralization ability of some persons in homologous group is below detection limit.
 
//Systemic events(1)//---
*Some systemic event(#) of heterologous vaccination group is higher than homologous group.
(#): Fever(35%), Headache(=40%),, Fatigue(=40%), Chills(40%), Muscle pain(30%), Joint pain(20%)
*In 88 participant cohort, severe adverse event was not confirmed.
 
//Discussion//---
 Neutralization ability against B.1.351 is similar between mRNA-1273/mRNA-1273 homologous boosting and ChAdOx1 nCoV-19/mRNA-1273, according to Ref.(4) Figure.1D. (*We need to carefully evaluate absolute value.) Therefore, heterologous vaccination ChAdOx1 nCoV-19/mRNA-1273 is expected to have similar epidemiological efficacy of mRNA boosting vaccination case. Therefore, it may have social value to vaccinate the persons who have receive one dose of ChAdOx1 nCoV-19, but we need to carefully evaluate adverse event.
 
//Support(1)//---
Supported by grants from Vetenskapsrådet (2020-06235, to Dr. Forsell, and 2020-05782, to Dr. Klingström), SciLife Laboratories (VC-2020-0015, to Dr. Forsell), Region Västerbotten and Umeå University (RV-938855, to Dr. Ahlm), and the Center for Innovative Medicine (CIMED) (20200141, to Dr. Klingström). Dr. Normark is a Wallenberg Center for Molecular Medicine Associated Researcher.
 
(Reference)
(1)
Johan Normark, M.D., Ph.D., Linnea Vikström, B.Sc., Yong-Dae Gwon, Ph.D., Ida-Lisa Persson, B.Sc. Alicia Edin, M.D., Ph.D., Tove Björsell, M.Sc., Andy Dernstedt, M.Sc., Wanda Christ, M.Sc., Staffan Tevell, M.D., Ph.D., Magnus Evander, Ph.D., Jonas Klingström, Ph.D., Clas Ahlm, M.D., Ph.D., Mattias Forsell, Ph.D.
Heterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination
The New England Journal of Medicine July 14, 2021
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Affiliation
Umeå University, Umeå, Sweden
Karolinska Institutet, Stockholm, Sweden
Region Värmland, Karlstad, Sweden
Umeå University, Umeå, Sweden
Karolinska Institutet, Stockholm, Sweden
Umeå University, Umeå, Sweden
(2)
Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger  S. 
Thrombotic  thrombocytopenia  after  ChAdOx1 nCov-19 vaccination.
N Engl J Med 2021; 384: 2092-101.
(3)
European Centre for Disease Prevention and Control. Overview of EU/EEA country recommendations on COVID-19 vaccination with Vaxzevria, and a scoping review of evidence to guide decision-making.
May 18, 2021
(https://www . ecdc . europa . eu/  en/  publications - data/  overview - eueea - country - recommendations - covid - 19 - vaccination - vaxzevria - and - scoping).
(4)
Kai Wu, Ph.D., Anne P. Werner, B.S., Matthew Koch, B.S. Angela Choi, Ph.D. Elisabeth Narayanan, Ph.D. Guillaume B.E. Stewart-Jones, Ph.D. Tonya Colpitts, Ph.D. Hamilton Bennett, M.S. Seyhan Boyoglu-Barnum, Ph.D. Wei Shi, Ph.D. Juan I. Moliva, Ph.D. Nancy J. Sullivan, Ph.D. Barney S. Graham, M.D. Andrea Carfi, Ph.D. Kizzmekia S. Corbett, Ph.D. Robert A. Seder, M.D. Darin K. Edwards, Ph.D.
Serum Neutralizing Activity Elicited by mRNA-1273 Vaccine
The New England Journal of Medicine  2021; 384:1468-1470