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Toback S, Marchese AM, Warren B, Ayman S, Zarkovic S, ElTantawy I, Mallory RM, Rousculp M, Almarzooqi F, Piechowski-Jozwiak B, Bonilla MF, Bakkour AE, Hussein SE, Al Kaabi N. Safety and immunogenicity of the NVX-CoV2373 vaccine as a booster in adults previously vaccinated with the BBIBP-CorV vaccine. Vaccine 2024; 42:1777-1784. [PMID: 38365482 DOI: 10.1016/j.vaccine.2024.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/01/2024] [Accepted: 02/10/2024] [Indexed: 02/18/2024]
Abstract
This phase 3 observer-blind, randomized, controlled study was conducted in adults ≥18 years of age to assess the safety and immunogenicity of NVX-CoV2373 as a heterologous booster compared to BBIBP-CorV when utilized as a homologous booster. Approximately 1000 participants were randomly assigned in a 1:1 ratio to receive a single dose of NVX-CoV2373 or BBIBP-CorV after prior vaccination with 2 or 3 doses of BBIBP-CorV. Solicited adverse events (AEs) were collected for 7 days after vaccination. Unsolicited AEs were collected for 28 days following the booster dose and serious adverse and adverse events of special interest (AESI) were collected throughout the study. Anti-spike IgG and neutralizing antibodies against SARS-CoV-2 were measured at baseline, day 14, day 28, and day 180. The study achieved its primary non-inferiority endpoint and also demonstrated statistically higher neutralization responses when NVX-CoV2373 was utilized as a heterologous booster compared with BBIBP-CorV as a homologous booster. Both vaccines had an acceptably low reactogenicity profile, and no new safety concerns were found. Heterologous boosting with NVX-CoV2373 was a highly immunogenic and safe vaccine regimen in those previously vaccinated with BBIBP-CorV.
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Affiliation(s)
- Seth Toback
- Novavax Inc., 700 Quince Orchard Rd, Gaithersburg, MD 20878, United States.
| | - Anthony M Marchese
- Novavax Inc., 700 Quince Orchard Rd, Gaithersburg, MD 20878, United States.
| | - Brandy Warren
- Novavax Inc., 700 Quince Orchard Rd, Gaithersburg, MD 20878, United States.
| | - Sondos Ayman
- Insights Research Organization & Solutions (IROS), Building of Masdar M13 T Limited, SE 45_05, Plot C16, Khalifa City, Abu Dhabi, United Arab Emirates.
| | - Senka Zarkovic
- Insights Research Organization & Solutions (IROS), Building of Masdar M13 T Limited, SE 45_05, Plot C16, Khalifa City, Abu Dhabi, United Arab Emirates.
| | - Islam ElTantawy
- Insights Research Organization & Solutions (IROS), Building of Masdar M13 T Limited, SE 45_05, Plot C16, Khalifa City, Abu Dhabi, United Arab Emirates.
| | - Raburn M Mallory
- Novavax Inc., 700 Quince Orchard Rd, Gaithersburg, MD 20878, United States.
| | - Matthew Rousculp
- Novavax Inc., 700 Quince Orchard Rd, Gaithersburg, MD 20878, United States.
| | - Fahed Almarzooqi
- G42 Healthcare, 3(rd) Floor, 1B Building, Mohamed bin Zayed University of Artificial Intelligence, Masdar City, Abu Dhabi, United Arab Emirates.
| | - Bartlomiej Piechowski-Jozwiak
- Cleveland Clinic Abu Dhabi, 59 Hamouda Bin Ali Al Dhaheri St - Al Maryah Island - Abu Dhabi Global Market Square, Abu Dhabi, United Arab Emirates.
| | - Maria-Fernanda Bonilla
- Cleveland Clinic Abu Dhabi, 59 Hamouda Bin Ali Al Dhaheri St - Al Maryah Island - Abu Dhabi Global Market Square, Abu Dhabi, United Arab Emirates.
| | - Agyad Ebrahim Bakkour
- Sheikh Khalifa Medical City, SEHA, Al Karamah St - Al Manhal - Al Tibbiya, Abu Dhabi, United Arab Emirates.
| | - Salah Eldin Hussein
- Sheikh Khalifa Medical City, SEHA, Al Karamah St - Al Manhal - Al Tibbiya, Abu Dhabi, United Arab Emirates.
| | - Nawal Al Kaabi
- Sheikh Khalifa Medical City, SEHA, Al Karamah St - Al Manhal - Al Tibbiya, Abu Dhabi, United Arab Emirates; College of Medicine and Health Sciences, Khalifa University, Shakhbout Bin Sultan St - Hadbat Al Za'faranah - Zone 1, Abu Dhabi, United Arab Emirates
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Al Kaabi N, Zhang Y, Xia S, Yang Y, Al Qahtani MM, Abdulrazzaq N, Al Nusair M, Hassany M, Jawad JS, Abdalla J, Hussein SE, Al Mazrouei SK, Al Karam M, Li X, Yang X, Wang W, Lai B, Chen W, Huang S, Wang Q, Yang T, Liu Y, Ma R, Hussain ZM, Khan T, Saifuddin Fasihuddin M, You W, Xie Z, Zhao Y, Jiang Z, Zhao G, Zhang Y, Mahmoud S, ElTantawy I, Xiao P, Koshy A, Zaher WA, Wang H, Duan K, Pan A, Yang X. Effect of 2 Inactivated SARS-CoV-2 Vaccines on Symptomatic COVID-19 Infection in Adults: A Randomized Clinical Trial. JAMA 2021; 326:35-45. [PMID: 34037666 PMCID: PMC8156175 DOI: 10.1001/jama.2021.8565] [Citation(s) in RCA: 504] [Impact Index Per Article: 168.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Although effective vaccines against COVID-19 have been developed, additional vaccines are still needed. OBJECTIVE To evaluate the efficacy and adverse events of 2 inactivated COVID-19 vaccines. DESIGN, SETTING, AND PARTICIPANTS Prespecified interim analysis of an ongoing randomized, double-blind, phase 3 trial in the United Arab Emirates and Bahrain among adults 18 years and older without known history of COVID-19. Study enrollment began on July 16, 2020. Data sets used for the interim analysis of efficacy and adverse events were locked on December 20, 2020, and December 31, 2020, respectively. INTERVENTIONS Participants were randomized to receive 1 of 2 inactivated vaccines developed from SARS-CoV-2 WIV04 (5 µg/dose; n = 13 459) and HB02 (4 µg/dose; n = 13 465) strains or an aluminum hydroxide (alum)-only control (n = 13 458); they received 2 intramuscular injections 21 days apart. MAIN OUTCOMES AND MEASURES The primary outcome was efficacy against laboratory-confirmed symptomatic COVID-19 14 days following a second vaccine dose among participants who had no virologic evidence of SARS-CoV-2 infection at randomization. The secondary outcome was efficacy against severe COVID-19. Incidence of adverse events and reactions was collected among participants who received at least 1 dose. RESULTS Among 40 382 participants randomized to receive at least 1 dose of the 2 vaccines or alum-only control (mean age, 36.1 years; 32 261 [84.4%] men), 38 206 (94.6%) who received 2 doses, contributed at least 1 follow-up measure after day 14 following the second dose, and had negative reverse transcriptase-polymerase chain reaction test results at enrollment were included in the primary efficacy analysis. During a median (range) follow-up duration of 77 (1-121) days, symptomatic COVID-19 was identified in 26 participants in the WIV04 group (12.1 [95% CI, 8.3-17.8] per 1000 person-years), 21 in the HB02 group (9.8 [95% CI, 6.4-15.0] per 1000 person-years), and 95 in the alum-only group (44.7 [95% CI, 36.6-54.6] per 1000 person-years), resulting in a vaccine efficacy, compared with alum-only, of 72.8% (95% CI, 58.1%-82.4%) for WIV04 and 78.1% (95% CI, 64.8%-86.3%) for HB02 (P < .001 for both). Two severe cases of COVID-19 occurred in the alum-only group and none occurred in the vaccine groups. Adverse reactions 7 days after each injection occurred in 41.7% to 46.5% of participants in the 3 groups; serious adverse events were rare and similar in the 3 groups (WIV04: 64 [0.5%]; HB02: 59 [0.4%]; alum-only: 78 [0.6%]). CONCLUSIONS AND RELEVANCE In this prespecified interim analysis of a randomized clinical trial, treatment of adults with either of 2 inactivated SARS-CoV-2 vaccines significantly reduced the risk of symptomatic COVID-19, and serious adverse events were rare. Data collection for final analysis is pending. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04510207; Chinese Clinical Trial Registry: ChiCTR2000034780.
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Affiliation(s)
- Nawal Al Kaabi
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Yuntao Zhang
- China National Biotec Group Company Limited, Beijing, China
| | - Shengli Xia
- Henan Province Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Yunkai Yang
- China National Biotec Group Company Limited, Beijing, China
| | - Manaf M. Al Qahtani
- Bahrain Defence Force Royal Medical Services, Military Hospital, Kingdom of Bahrain
| | | | | | | | | | - Jehad Abdalla
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Salah Eldin Hussein
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Shamma K. Al Mazrouei
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Maysoon Al Karam
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Xinguo Li
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co, Ltd, Wuhan, Hubei, China
| | - Xuqin Yang
- China National Biotec Group Company Limited, Beijing, China
| | - Wei Wang
- Beijing Institute of Biological Products Co, Ltd, Beijing, China
| | - Bonan Lai
- China National Biotec Group Company Limited, Beijing, China
| | - Wei Chen
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co, Ltd, Wuhan, Hubei, China
| | - Shihe Huang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co, Ltd, Wuhan, Hubei, China
| | - Qian Wang
- China National Biotec Group Company Limited, Beijing, China
| | - Tian Yang
- China National Biotec Group Company Limited, Beijing, China
| | - Yang Liu
- China National Biotec Group Company Limited, Beijing, China
| | - Rui Ma
- Beijing Institute of Biological Products Co, Ltd, Beijing, China
| | - Zaidoon M. Hussain
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Tehmina Khan
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | | | - Wangyang You
- Henan Province Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Zhiqiang Xie
- Henan Province Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Yuxiu Zhao
- Beijing Institute of Biological Products Co, Ltd, Beijing, China
| | - Zhiwei Jiang
- Beijing Key-Tech Statistical Consulting Co, Ltd, Beijing, China
| | - Guoqing Zhao
- Beijing Key-Tech Statistical Consulting Co, Ltd, Beijing, China
| | - Yanbo Zhang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | | | | | - Peng Xiao
- G42 Healthcare, Abu Dhabi, United Arab Emirates
| | - Ashish Koshy
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | | | - Hui Wang
- Beijing Institute of Biological Products Co, Ltd, Beijing, China
| | - Kai Duan
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co, Ltd, Wuhan, Hubei, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoming Yang
- China National Biotec Group Company Limited, Beijing, China
- National Engineering Technology Research Center for Combined Vaccines, Wuhan Institute of Biological Products Co, Ltd, Wuhan, Hubei, China
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