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. 2022 Mar 23;10(4):491.
doi: 10.3390/vaccines10040491.

Evaluation of Two-Month Antibody Levels after Heterologous ChAdOx1-S/BNT162b2 Vaccination Compared to Homologous ChAdOx1-S or BNT162b2 Vaccination

Simone Barocci  1 , Chiara Orlandi  2 , Aurora Diotallevi  2 , Gloria Buffi  2 , Marcello Ceccarelli  1 , Daniela Vandini  1 , Eugenio Carlotti  3 , Luca Galluzzi  2 , Marco Bruno Luigi Rocchi  2 , Mauro Magnani  2 , Anna Casabianca  2
Affiliations

Evaluation of Two-Month Antibody Levels after Heterologous ChAdOx1-S/BNT162b2 Vaccination Compared to Homologous ChAdOx1-S or BNT162b2 Vaccination

Simone Barocci et al. Vaccines (Basel). .

Abstract

We evaluated the post-vaccination humoral response of three real-world cohorts. Vaccinated subjects primed with ChAdOx1-S and boosted with BNT162b2 mRNA vaccine were compared to homologous dosing (BNT162b2/BNT162b2 and ChAdOx1-S/ChAdOx1-S). Serum samples were collected two months after vaccination from a total of 1248 subjects. The results showed that the heterologous vaccine schedule induced a significantly higher humoral response followed by homologous BNT162b2/BNT162b2 and ChAdOx1-S/ChAdOx1-S vaccines (p < 0.0001). Moreover, analyzing factors (i.e., vaccine schedule, sex, age, BMI, smoking, diabetes, cardiovascular diseases, respiratory tract diseases, COVID-19 diagnosis, vaccine side effects) influencing the IgG anti-S response, we found that only the type of vaccine affected the antibody titer (p < 0.0001). Only mild vaccine reactions resolved within few days (40% of subjects) and no severe side effects for either homologous groups or the heterologous group were reported. Our data support the use of heterologous vaccination as an effective and safe alternative to increase humoral immunity against COVID-19.

Keywords: COVID-19; IgG anti-S response; SARS-CoV-2; anti-S antibodies; heterologous vaccination.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Heterologous ChAdOx1-S nCoV-19/BNT162b2 prime-boost vaccination enhances antibody titers. Comparison of anti-trimeric spike protein IgG antibodies to SARS-CoV-2 among three different groups of vaccinated subjects. ChAd/ChAd denotes an Oxford-AstraZeneca ChAdOx1-S nCoV-19 vaccine for prime and second doses. BNT/BNT denotes a Pfizer-BioNTech BNT162b2 vaccine for prime and second doses. ChAd/BNT denotes a ChAdOx1-S nCoV-19 vaccine for the prime dose and a BNT162b2 vaccine for the second dose. The serum samples were analyzed approximately two months after the second dose. Box-whisker plot displaying the 90/10 percentile at the whiskers, the 75/25 percentiles at the boxes, and the median in the center line. **** p < 0.0001, *** p < 0.001, Kruskal Wallis test with Dunn´s multiple comparisons post-test.
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