Your browser doesn't support javascript.
Immunogenicity and reactogenicity of heterologous immunization schedules with COVID-19 vaccines: a systematic review and network meta-analysis.
Li, Pei; Wang, Weiwei; Tao, Yiming; Tan, Xiaoyu; Li, Yujing; Mao, Yinjun; Gao, Le; Feng, Lei; Zhan, Siyan; Sun, Feng.
  • Li P; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
  • Wang W; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
  • Tao Y; National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
  • Tan X; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
  • Li Y; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
  • Mao Y; Peking University Aerospace School of Clinical Medicine, Beijing 100049, China.
  • Gao L; Department of Pharmacy, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China.
  • Feng L; Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
  • Zhan S; National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
  • Sun F; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Chin Med J (Engl) ; 136(1): 24-33, 2023 Jan 05.
Article in English | MEDLINE | ID: covidwho-2222795
ABSTRACT

BACKGROUND:

Data on the immunogenicity and safety of heterologous immunization schedules are inconsistent. This study aimed to evaluate the immunogenicity and safety of homologous and heterologous immunization schedules.

METHODS:

Multiple databases with relevant studies were searched with an end date of October 31, 2021, and a website including a series of Coronavirus disease 2019 studies was examined for studies before March 31, 2022. Randomized controlled trials (RCTs) that compared different heterologous and homologous regimens among adults that reported immunogenicity and safety outcomes were reviewed. Primary outcomes included neutralizing antibodies against the original strain and serious adverse events (SAEs). A network meta-analysis (NMA) was conducted using a random-effects model.

RESULTS:

In all, 11 RCTs were included in the systematic review, and nine were ultimately included in the NMA. Among participants who received two doses of CoronaVac, another dose of mRNA or a non-replicating viral vector vaccine resulted in a significantly higher level of neutralizing antibody than a third CoronaVac 600 sino unit (SU); a dose of BNT162b2 induced the highest geometric mean ratio (GMR) of 15.24, 95% confidence interval [CI] 9.53-24.39. Following one dose of BNT162b2 vaccination, a dose of mRNA-1273 generated a significantly higher level of neutralizing antibody than BNT162b2 alone (GMR = 1.32; 95% CI 1.06-1.64), NVX-CoV2373 (GMR = 1.60; 95% CI 1.16-2.21), or ChAdOx1 (GMR = 1.80; 95% CI 1.25-2.59). Following one dose of ChAdOx1, a dose of mRNA-1273 was also more effective for improving antibody levels than ChAdOx1 (GMR = 11.09; 95% CI 8.36-14.71) or NVX-CoV2373 (GMR = 2.87; 95% CI 1.08-3.91). No significant difference in the risk for SAEs was found in any comparisons.

CONCLUSIONS:

Relative to vaccination with two doses of CoronaVac, a dose of BNT162b2 as a booster substantially enhances immunogenicity reactions and has a relatively acceptable risk for SAEs relative to other vaccines. For primary vaccination, schedules including mRNA vaccines induce a greater immune response. However, the comparatively higher risk for local and systemic adverse events introduced by mRNA vaccines should be noted. REGISTRATION PROSPERO; https//www.crd.york.ac.uk/PROSPERO/ ; No. CRD42021278149.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Vaccines / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Vaccines Limits: Adult / Humans Language: English Journal: Chin Med J (Engl) Year: 2023 Document Type: Article Affiliation country: CM9.0000000000002567

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Vaccines / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Vaccines Limits: Adult / Humans Language: English Journal: Chin Med J (Engl) Year: 2023 Document Type: Article Affiliation country: CM9.0000000000002567