ABSTRACT

Introduction

Coronavirus disease 2019 (COVID-19) has had an enormous impact worldwide, and vaccination is believed to be the method that will control the pandemic. Several types of vaccines developed using different platforms have been authorized, but the immunogenicity and reactogenicity of heterologous prime–boost vaccination with different vaccines remain largely unclear.

Areas covered

Electronic databases including PubMed, Embase, medRxiv, Research Square, and SSRN were searched to investigate the immunogenicity and reactogenicity associated with heterologous vaccination.

As of 30 June 2021, four trials including 1,862 participants were identified. Heterologous administration of BNT162b2 (BNT) in ChAdOx1 (ChAd)-primed participants (ChAd/BNT) showed noninferior immunogenicity to homologous BNT administration (both prime and booster were BNT vaccines, BNT/BNT) with tolerable reactogenicity and higher T cell responses. Compared with homologous ChAdOX1 vaccination (ChAd/ChAd), heterologous ChAd/BNT was found to elicit higher immunogenicity (ChAd/BNT vs. ChAd/ChAd, antibody titer ratio: 9.2).

Expert opinion

Our systematic review found robust immunogenicity and tolerable reactogenicity of heterologous administration of a BNT162b2 boost in ChAdOx1-primed participants. An additional benefit of stronger T cellular immunity was also observed. Heterologous vaccination is a reasonable and feasible strategy to combat COVID-19. Further studies are warranted to confirm the benefits and identify the optimal combinations, doses, and intervals.

中文翻译：

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混合还是不混合？异源初免-加强covid-19疫苗接种的快速系统评价

 抽象的

 介绍

2019 年冠状病毒病 (COVID-19) 在全球范围内产生了巨大影响，疫苗接种被认为是控制这一流行病的方法。使用不同平台开发的几种类型的疫苗已获得批准，但不同疫苗的异源初免-加强疫苗接种的免疫原性和反应原性仍不清楚。

 覆盖领域

检索了包括 PubMed、Embase、medRxiv、Research Square 和 SSRN 在内的电子数据库，以研究与异源疫苗接种相关的免疫原性和反应原性。

截至 2021 年 6 月 30 日，已确定四项试验，共有 1,862 名参与者。在 ChAdOx1 (ChAd) 引发的参与者 (ChAd/BNT) 中异源施用 BNT162b2 (BNT) 表现出不劣于同源 BNT 施用（初免和加强均为 BNT 疫苗，BNT/BNT）的免疫原性，具有可耐受的反应原性和更高的 T 细胞反应。与同源ChAdOX1疫苗接种(ChAd/ChAd)相比，异源ChAd/BNT被发现能引起更高的免疫原性(ChAd/BNT vs. ChAd/ChAd，抗体效价比：9.2)。

 专家意见

我们的系统评价发现，在 ChAdOx1 引发的参与者中异源施用 BNT162b2 增强剂具有强大的免疫原性和可耐受的反应原性。还观察到更强的 T 细胞免疫的另一个好处。异源疫苗接种是对抗COVID-19合理可行的策略。需要进一步的研究来确认其益处并确定最佳组合、剂量和间隔。