Heterologous COVID-19 vaccination strategy


Regarding the use of heterologous vaccination regimens for COVID-19 vaccines, results of the heterologous ChAdOx1 nCoV-19 and mRNA1273 vaccination study, published 14 July 2021 in the New England Journal of Medicine, indicate that neutralizing antibody levels and T-cell-mediated immune response were higher when the first dose of a ChAdOx1S-based [recombinant] vaccine was followed by a second dose of mRNA vaccine, such as Pfizer-BioNTech's BNT162b2 or Moderna's mRNA-1273, administered between 9 and 12 weeks later, compared with two doses of ChAdOx1-S [recombinant] vaccines.  Moreover, the immune response proved to be similar to that obtained with two doses of mRNA vaccines, and superior to the response obtained from a first dose of mRNA vaccine followed by a dose of a ChAdOx1-S-based [recombinant] vaccine.

The study noted that, with administration of the ChAdOx1-S [recombinant] vaccine, followed by one dose of an mRNA vaccine, reactogenicity was higher but acceptable, compared to two doses of ChAdOx1-S [recombinant] vaccine, with more frequent reports of fever, headache, chills, and muscle aches. 

Source: Heterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination. The New England Journal of Medicine. Available at: https://www.nejm.org/doi/full/10.1056/NEJMc2110716.

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