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. 2023 Dec 31;19(1):2153532.
doi: 10.1080/21645515.2022.2153532. Epub 2023 Jan 11.

Emerging heterologous mRNA-based booster strategies within the COVID-19 vaccine landscape

Rituparna Das  1 , Randall N Hyer  2 , Paul Burton  1 , Jacqueline M Miller  1 , Barbara J Kuter  1
Affiliations

Emerging heterologous mRNA-based booster strategies within the COVID-19 vaccine landscape

Rituparna Das et al. Hum Vaccin Immunother. .

Abstract

Messenger RNA (mRNA)-based vaccine platforms used for the development of mRNA-1273 and BNT162b2 have provided a robust adaptable approach to offer protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, as variants of concern (VoCs), such as omicron and associated sub-variants, emerge, boosting strategies must also adapt to keep pace with the changing landscape. Heterologous vaccination regimens involving the administration of booster vaccines different than the primary vaccination series offer a practical, effective, and safe approach to continue to reduce the global burden of coronavirus disease 2019 (COVID-19). To understand the immunogenicity, effectiveness, and safety of heterologous mRNA-based vaccination strategies, relevant clinical and real-world observational studies were identified and summarized. Overall, heterologous boosting strategies with mRNA-based vaccines that are currently available and those in development will play an important global role in protecting individuals from COVID-19 caused by emerging VoCs.

Keywords: COVID-19; SARS-CoV-2; heterologous booster; mRNA-1273 vaccine.

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Conflict of interest statement

RD, PB, and JMM are employees of Moderna, Inc., and hold stock/stock options. BJK is a consultant for Moderna, Inc., RNH was an employee of Moderna, Inc., at the time of writing the manuscript and held stock/stock options at the company.

Figures

Figure 1.
Figure 1.
Immunogenicity outcomes by priming vaccine series and booster from five COVID-19 clinical trials including prime-boosting 2-dose regimens in: a) Com-COV2, b) ARNCOMBI, and c) SWITCH; and prime boosting 3-dose regimens in: d) NIH DMID and e) COV-BOOST. Response to booster is shown as bars.
Figure 2.
Figure 2.
Solicited local reactions within 0 to 7 days of injection in four clinical trials evaluating heterologous vaccine regimens. a) Com-COV2, b) ARNCOMBI, c) SWITCH, and d) NIH DMID.
Figure 3.
Figure 3.
Solicited systemic reactions within 0 to 7 days of injection in four clinical trials evaluating heterologous vaccine regimens. a) Com-COV2, b) ARNCOMBI, c) SWITCH, and d) NIH DMID. Vaccine dosing regimens are as described per Figure 2.
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