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. 2023 Jan 21;13(1):1222.
doi: 10.1038/s41598-023-27698-x.

Novavax NVX-COV2373 triggers neutralization of Omicron sub-lineages

Jinal N Bhiman  1   2 , Simone I Richardson  1   2 , Bronwen E Lambson  1   2 , Prudence Kgagudi  1   2 , Nonkululeko Mzindle  1   2 , Haajira Kaldine  1   2 , Carol Crowther  1   2 , Glenda Gray  3 , Linda-Gail Bekker  4   5 ; Novavax trial clinical lead author group; Vivek Shinde  6 , Chijioke Bennett  6 , Gregory M Glenn  6 , Shabir A Madhi  7 , Penny L Moore  8   9   10   11
Collaborators, Affiliations

Novavax NVX-COV2373 triggers neutralization of Omicron sub-lineages

Jinal N Bhiman et al. Sci Rep. .

Abstract

The SARS-CoV-2 Omicron (B.1.1.529) Variant of Concern (VOC) and its sub-lineages (including BA.2, BA.4, BA.5, BA.2.12.1) contain spike mutations that confer high level resistance to neutralizing antibodies induced by vaccination with ancestral spike or infection with previously circulating variants. The NVX-CoV2373 vaccine, a protein nanoparticle vaccine containing the ancestral spike sequence, has value in countries with constrained cold-chain requirements. Here we report neutralizing titers following two or three doses of NVX-CoV2373. We show that after two doses, Omicron sub-lineages BA.1 and BA.4/BA.5 were resistant to neutralization by 72% (21/29) and 59% (17/29) of samples respectively. However, after a third dose of NVX-CoV2373, we observed high titers against Omicron BA.1 (GMT: 1,197) and BA.4/BA.5 (GMT: 582), with responses similar in magnitude to those triggered by three doses of an mRNA vaccine. These data are of particular relevance as BA.4/BA.5 is dominating in multiple locations, and highlight the potential utility of the NVX-CoV2373 vaccine as a booster in resource-limited environments.

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Conflict of interest statement

Dr. Shinde reports being employed by and owning shares in Novavax; Dr. Q. Bhorat, receiving grant support from Wits Health Consortium, Regeneron Pharmaceuticals, GSK, Avillion, Sanofi, Novo Nordisk, and Novavax; Dr. Fouche, receiving grant support from BioNTech; Dr Bennet reports being employed by Novavax; Dr. Glenn, being employed by and owning stock in Novavax and owning stock in RA Capital; and Dr. Madhi, receiving grant support, paid to his institution, from Pfizer and GSK. All remaining authors have not reported any conflicts of interest.

Figures

Figure 1
Figure 1
Neutralization of SARS-CoV-2 variants by NVX-CoV2373 vaccinee plasma. Neutralization of ancestral D164G, Beta, Omicron BA.1 and Omicron BA.4/BA.5 pseudoviruses by NVX-CoV2373 vaccinee plasma following 2 (grey) or 3 (teal) doses. Samples were collected 14 days after the second dose and 1 month after the third dose. Geometric mean titers (GMT) for each virus are shown above the individual points, and percent of specimens where no neutralization was observed (red) is indicated in the pie charts. Number of vaccinee specimens tested are indicated and p values were calculated using the Mann–Whitney t-test for non-parametric data with p < 0,001 for D614G, Beta, Omicron BA.1 and Omicron BA.4/BA.5. Samples were used at a starting dilution of 1 in 20 (limit of detection) with a seven threefold dilutions to create a titration series.
Figure 2
Figure 2
Neutralization of Omicron BA.1 and BA.4/BA.5 by boosted vaccinee plasma. Neutralization of Omicron BA.1 and BA.4/BA.5 by vaccinee plasma following 2 doses of the AD26.COV2S or 3 doses of the BNT162b2 or NVX-CoV2373 vaccines. Number of doses, number of samples and date of sample collection after boost for each group are indicated. Geometric mean titers (GMT) for each virus are shown above the individual points, P values were calculated using two-way ANOVA with p < 0.001 for AD26CoV2.S versus NXV-CoV2373 and p = 0.0011 for NVX-CoV2373 BA.1 versus BA.4/BA.5). Samples were used at a starting dilution of 1 in 20 (limit of detection) with a seven threefold dilutions to create a titration series.
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