Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination
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 COVI...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1010835/full |
| _version_ | 1811242795284824064 |
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| author | Somruedee Chatsiricharoenkul Somruedee Chatsiricharoenkul Suvimol Niyomnaitham Suvimol Niyomnaitham Harry Joshua Posen Zheng Quan Toh Zheng Quan Toh Paul V. Licciardi Paul V. Licciardi Patimaporn Wongprompitak Thaneeya Duangchinda Thaneeya Duangchinda Pattarakul Pakchotanon Pattarakul Pakchotanon Warangkana Chantima Warangkana Chantima Kulkanya Chokephaibulkit Kulkanya Chokephaibulkit |
| author_facet | Somruedee Chatsiricharoenkul Somruedee Chatsiricharoenkul Suvimol Niyomnaitham Suvimol Niyomnaitham Harry Joshua Posen Zheng Quan Toh Zheng Quan Toh Paul V. Licciardi Paul V. Licciardi Patimaporn Wongprompitak Thaneeya Duangchinda Thaneeya Duangchinda Pattarakul Pakchotanon Pattarakul Pakchotanon Warangkana Chantima Warangkana Chantima Kulkanya Chokephaibulkit Kulkanya Chokephaibulkit |
| author_sort | Somruedee Chatsiricharoenkul |
| collection | DOAJ |
| description | 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 anti-receptor 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. |
| first_indexed | 2024-04-12T13:56:21Z |
| format | Article |
| id | doaj.art-dd67c2858b414869924fe40db6f740a2 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-12T13:56:21Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-dd67c2858b414869924fe40db6f740a22022-12-22T03:30:21ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.10108351010835Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccinationSomruedee Chatsiricharoenkul0Somruedee Chatsiricharoenkul1Suvimol Niyomnaitham2Suvimol Niyomnaitham3Harry Joshua Posen4Zheng Quan Toh5Zheng Quan Toh6Paul V. Licciardi7Paul V. Licciardi8Patimaporn Wongprompitak9Thaneeya Duangchinda10Thaneeya Duangchinda11Pattarakul Pakchotanon12Pattarakul Pakchotanon13Warangkana Chantima14Warangkana Chantima15Kulkanya Chokephaibulkit16Kulkanya Chokephaibulkit17Siriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Infectious Diseases, Hospital for Sick Children, Toronto, ON, CanadaInfection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, AustraliaDepartment of Pediatrics, The University of Melbourne, Parkville, VIC, AustraliaInfection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, AustraliaDepartment of Pediatrics, The University of Melbourne, Parkville, VIC, AustraliaDepartment of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandMolecular Biology of Dengue and Flaviviruses Research Team, National Center for Genetic Engineering and Biotechnology, National Science and Development Agency, Pathum Thani, ThailandDivision of Dengue Hemorrhagic Fever Research Team, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandMolecular Biology of Dengue and Flaviviruses Research Team, National Center for Genetic Engineering and Biotechnology, National Science and Development Agency, Pathum Thani, ThailandDivision of Dengue Hemorrhagic Fever Research Team, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Dengue Hemorrhagic Fever Research Team, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand0Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandThere 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 anti-receptor 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.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1010835/fullCOVID vaccinefractional dose vaccinationheterologous regimenintradermal vaccinevaccine immunogenicityvaccine safety |
| spellingShingle | Somruedee Chatsiricharoenkul Somruedee Chatsiricharoenkul Suvimol Niyomnaitham Suvimol Niyomnaitham Harry Joshua Posen Zheng Quan Toh Zheng Quan Toh Paul V. Licciardi Paul V. Licciardi Patimaporn Wongprompitak Thaneeya Duangchinda Thaneeya Duangchinda Pattarakul Pakchotanon Pattarakul Pakchotanon Warangkana Chantima Warangkana Chantima Kulkanya Chokephaibulkit Kulkanya Chokephaibulkit Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination Frontiers in Immunology COVID vaccine fractional dose vaccination heterologous regimen intradermal vaccine vaccine immunogenicity vaccine safety |
| title | Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination |
| title_full | Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination |
| title_fullStr | Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination |
| title_full_unstemmed | Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination |
| title_short | Safety and immunogenicity of intradermal administration of fractional dose CoronaVac®, ChAdOx1 nCoV-19 and BNT162b2 as primary series vaccination |
| title_sort | safety and immunogenicity of intradermal administration of fractional dose coronavac r chadox1 ncov 19 and bnt162b2 as primary series vaccination |
| topic | COVID vaccine fractional dose vaccination heterologous regimen intradermal vaccine vaccine immunogenicity vaccine safety |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1010835/full |
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