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. 2023 Mar 2;388(9):857-859.
doi: 10.1056/NEJMc2215509. Epub 2023 Jan 25.

Immunogenicity of a Fourth Homologous Dose of NVX-CoV2373

Katia Alves  1 , Joyce S Plested  1 , Shirley Galbiati  1 , Gordon Chau  1 , Shane Cloney-Clark  1 , Mingzhu Zhu  1 , Raj Kalkeri  1 , Nita Patel  1 , Kathy Smith  1 , Alex Marcheschi  1 , Susan Pfeiffer  1 , Heather McFall  1 , Gale Smith  1 , Gregory M Glenn  1 , Filip Dubovsky  1 , Raburn M Mallory  1 ; Novavax 2019nCoV-101 Study Group
Affiliations

Immunogenicity of a Fourth Homologous Dose of NVX-CoV2373

Katia Alves et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. Immunogenicity of the NVX-CoV2373 Vaccine against Ancestral and Variant Strains of SARS-CoV-2 According to Dose, as Assessed by Anti-rS IgG and Neutralization Titers.
Immune response was assessed as previously described before and after each dose of NVX-CoV2373, with the use of a validated anti–recombinant spike protein (rS) IgG assay for the ancestral strain and the BA.1 and BA.5 variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Panel A) and with the use of serum neutralizing antibodies in validated pseudovirus neutralization assays for the ancestral strain and BA.1 and BA.4 or BA.5 variants (Panel B). Antigenic cartography maps were constructed with the use of cartography software (http://acmacs-web.antigenic-cartography.org). Anti-rS IgG and neutralizing titers that were obtained after two, three, and four doses were input into the software to construct an antigenic map for SARS-CoV-2. SARS-CoV-2 antigens are indicated by colored circles, and serum samples by small squares. Each grid square represents one antigenic unit, which is equal to a change in titer by a factor of 2. The antigenic distances from the ancestral vaccine strain (green) to the omicron variants (BA.1 [red] and BA.4 or BA.5 [pink]) were calculated after two, three, and four doses of vaccine, followed by conversion of antigenic distances to factor differences, as previously described. Red arrows indicate the antigenic distance from the ancestral strain to the BA.5 variant (Panel A) or to the BA.4 or BA.5 variant (Panel B), and dashed circles represent the overall decrease in antigenic distances. Data on anti-rS IgG were not available for the BA.1 variant for 3 of the 34 participants. CI denotes confidence interval, GMT geometric mean titer, and ID50 50% inhibitory dilution.
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References

    1. Mallory RM, Formica N, Pfeiffer S, et al. Safety and immunogenicity following a homologous booster dose of a SARS-CoV-2 recombinant spike protein vaccine (NVX-CoV2373): a secondary analysis of a randomised, placebo-controlled, phase 2 trial. Lancet Infect Dis 2022;22:1565-1576. - PMC - PubMed
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