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Safety and immunogenicity of intradermal administration of fractional dose CoronaVac (R), ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination
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Document Title
Safety and immunogenicity of intradermal administration of fractional dose CoronaVac (R), ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination
Author
Chatsiricharoenkul S, Niyomnaitham S, Posen HJ, Toh ZQ, Licciardi PV, Wongprompitak P, Duangchinda T, Pakchotanon P, Chantima W, Chokephaibulkit K
Name from Authors Collection
Affiliations
Mahidol University; Mahidol University; University of Toronto; University Toronto Affiliates; Hospital for Sick Children (SickKids); Murdoch Children's Research Institute; University of Melbourne; Mahidol University; National Science & Technology Development Agency - Thailand; National Center Genetic Engineering & Biotechnology (BIOTEC); Mahidol University; Mahidol University; Mahidol University
Type
Article
Source Title
FRONTIERS IN IMMUNOLOGY
Year
2022
Volume
13
Open Access
Green Published, gold, Green Submitted
Publisher
FRONTIERS MEDIA SA
DOI
10.3389/fimmu.2022.1010835
Format
Abstract
There is a limited supply of COVID-19 vaccines, with less than 20% of eligible populations in low-income countries having received one dose. Intradermal delivery of fractional dose vaccines is one way to improve global vaccine access, but no studies have reported data on intradermal delivery of COVID-19 primary series vaccination. We conducted a pilot study to examine the safety and immunogenicity of three intradermal primary series regimens - heterologous regimen of CoronaVac and ChAdOx1 (CoronaVac-ChAdOx1), homologous regimen of ChAdOx1 (ChAdOx1-ChAdOx1), and homologous regimen of BNT162b2 (BNT162b2-BNT162b2). Each dose was 1/5th or 1/6th of the standard dose. Two additional exploratory arms of intradermal vaccination for the second dose following an intramuscular first dose of ChAdOx1 and BNT162b2 were included. Intradermal vaccination was found to be immunogenic and safe. The antibody responses generated by the intradermal primary series were highest in the BNT162b2 arms. The antireceptor binding domain (anti-RBD) IgG concentration following fractional dose intradermal vaccination was similar to that of standard dose intramuscular vaccination of the same regimen for all study arms except for BNT162b2. The BNT162b2 intradermal series generated a lower antibody concentration than the reference intramuscular series, despite generating the highest antibody concentration of all three intradermal primary series regimens. Neutralizing antibody responses against the SARS-CoV-2 ancestral strain were consistent with what was observed for anti-RBD IgG, with lower titers for SARS-CoV-2 variants. Neutralizing titers were lowest against the omicron variant, being undetectable in about a quarter of study participants. T-cell responses against spike- and nucleocapsid-membrane-open reading frame proteins were also detected following intradermal vaccination. Adverse effects following intradermal vaccination were generally comparable with post-intramuscular vaccination effects. Taken together, our data suggest that intradermal vaccination using 1/5th or 1/6th of standard COVID-19 intramuscular vaccination dosing were immunogenic with tendency of lower systemic adverse reactions than intramuscular vaccination. Our findings have implications in settings where COVID-19 vaccines are in shortage.
Funding Sponsor
Health Systems Research Institute, Thailand; [64-209]
License
CC BY
Rights
Authors
Publication Source
WOS