You're using an outdated browser. Please upgrade to a modern browser for the best experience.
Submitted Successfully!
Thank you for your contribution! You can also upload a video entry or images related to this topic. For video creation, please contact our Academic Video Service.
Version Summary Created by Modification Content Size Created at Operation
1 Yu-Chang Tyan + 1588 word(s) 1588 2021-10-19 09:04:47 |
2 h Camila Xu + 1914 word(s) 3502 2021-12-07 07:47:21 | |
3 h Camila Xu + 1914 word(s) 3502 2021-12-07 07:47:49 |

Video Upload Options

We provide professional Academic Video Service to translate complex research into visually appealing presentations. Would you like to try it?
No, upload directly Yes
Cite
If you have any further questions, please contact Encyclopedia Editorial Office.
Tyan, Y. Prime-Boost COVID-19 Vaccination against SARS-CoV-2. Encyclopedia. Available online: https://encyclopedia.pub/entry/16778 (accessed on 19 December 2025).
Tyan Y. Prime-Boost COVID-19 Vaccination against SARS-CoV-2. Encyclopedia. Available at: https://encyclopedia.pub/entry/16778. Accessed December 19, 2025.
Tyan, Yu-Chang. "Prime-Boost COVID-19 Vaccination against SARS-CoV-2" Encyclopedia, https://encyclopedia.pub/entry/16778 (accessed December 19, 2025).
Tyan, Y. (2021, December 06). Prime-Boost COVID-19 Vaccination against SARS-CoV-2. In Encyclopedia. https://encyclopedia.pub/entry/16778
Tyan, Yu-Chang. "Prime-Boost COVID-19 Vaccination against SARS-CoV-2." Encyclopedia. Web. 06 December, 2021.
Prime-Boost COVID-19 Vaccination against SARS-CoV-2
Edit
This entry is adapted from the peer-reviewed paper 10.3390/vaccines9101163

The types of these vaccines include two recombinant adenovirus vaccines (ChAdOx1-S and Ad26.COV2-S), one heterologous recombinant adenovirus vaccine (Gam-COVID-Vac), two mRNA vaccines (BNT162b2 and mRNA-1273), two inactivated virus vaccines (BBIBP-CorV and CoronaVac), and one recombinant protein vaccine (NVX-CoV2373).

SARS-CoV-2 COVID-19 heterologous vaccine safety T-cell response

1. Introduction

According to Table 1, for full immunization with most vaccines (excluded from Ad26.COV2-S and Gam-COVID-VaC), people need to be inoculated with two doses of the same vaccines (i.e., homologous vaccination, homologous vaccine regimen, or homologous prime-boost schedules) with an interval of 14 days to three months. As of 26 September 2021, only 32.86% of the world was fully immunized with the COVID-19 vaccine [1]. Vaccine shortage delays the schedule for the second dose of homologous vaccination and postpones the achievement of global herd immunity.
Table 1. List of valid vaccines for COVID-19.
Vaccine Name Developer Country Manufacturer Vaccine Type Storage Temperature/Shelf Life Number of Doses Interval between Doses Vaccine Efficacy/Age (y) Serious Adverse Event Reference
ChAdOx1-S (AZD1222) UK AstraZeneca, SK Bioscience, and Serum Institute of India Recombinant adenovirus vector 2–8 °C/6 months 2 Day 28–84 63%/≥18 Cerebral venous sinus thrombosis (CSVT) and other venous thrombosis with thrombocytopenia syndrome [2][3][4][5]
Ad26.COV2-S USA and Europe Janssen Pharmaceutical and Johnson & Johnson Recombinant adenovirus vector 2–8 °C/4.5 months
−20 °C/2 years		 1 Day 0 66.9%/≥18 Cerebral venous sinus thrombosis (CSVT) and other venous vthrombosis with thrombocytopenia syndrome [3][4][5][6]
BNT162b2 USA and
Germany		 Pfizer and BioNTech mRNA −70 °C/6 months 2 Day 21 92%/≥16 Anaphylaxis and myocarditis [3][5][7][8]
mRNA-1273 USA and
Europe		 Moderna Biotech mRNA 2–8 °C/1 month
−20 °C/6 months		 2 Day 28 94.1%/≥18 Myocarditis, anaphylaxis, and other serious allergic reactions [3][5][8][9][10]
BBIBP-CorV (BIBP vaccine or Sinopharm COVID-19 vaccine) China Beijing Institute of Biological Products and Sinopharm Inactivated virus 2–8 °C/2 years 2 Day 14 78.1%/18–59 No adverse reports ** [3][5]
CoronaVac China Sinovac Inactivated virus 2–8 °C/2 years 2 Day 14 50.7%/18–59 51.1%/≥60 No adverse reports ** [3][5][11][12]
NVX-CoV2373 USA Novavax Recombinant protein 2–8 °C/not reported 2 Day 21 89.7%/≥18 * Myocarditis [13]
Gam-COVID-Vac (Sputnik V) Russia Gamaleya Research Institute of Epidemiology and Microbiology Heterologous recombinant adenovirus vector 2–8 °C for dry form or −18.5 °C for liquid form/not reported 1st dose rAd5; 2nd dose rAd6 Day 21 91.6%/≥18 No adverse reports ** [14][15]
* The vaccine efficacy was based on combination of vaccination with one or two dose. ** Accorded to WHO website.
Since the vaccination is voluntary, the rate of full immunization also depends on population acceptance [16]. Accompanied with the increased numbers of vaccinated people, more uncommon serious adverse events are found in the immunization with ChAdOx1-S, Ad26.COV2-S, BNT162b2, mRNA-1273, or NVX-CoV2373 (Table 1). As of the beginning of March 2021, the life-threatening cerebral or other venous sinus thrombosis related to homologous ChAdOx1-S vaccination (ChAdOx1-S/ChAdOx1-S) have frequently occurred, especially in young women [17][18][19]. Those uncommon serious adverse events may trigger the decline of COVID-19 vaccination, including those people who had received the first dose of ChAdOx1-S. These events have enhance the forming of vaccine hesitancy, which is a behavior of a delayed acceptance or refusal of vaccination despite the vaccination services which are available [16][20]. Subsequently, vaccine hesitancy may become one of the key factors to delay the completion of global herd immunity.
The status of vaccine shortage and vaccine hesitancy can affect the timing of global herd immunity. The use of heterologous vaccines may be beneficial for earlier reduction of the COVID-19 pandemic. Since the vaccine shortage and vaccine hesitancy slow the rate of herd immunity, the current vaccine regimen has been switched to heterologous vaccination from homologous vaccination [21][22]. Several studies have been reported for the safety and immunogenicity of heterologous ChAdOx1-S and mRNA vaccination (heterologous combing with first dose/second dose of ChAdOx1-S/mRNA and mRNA vaccine/ChAdOx1-S) [23][24][25][26][27][28][29][30][31]. However, the implication of heterologous ChAdOx1-S and mRNA vaccination against COVID-19 is still unclear. The safety and immunogenicity for each vaccine regmien are crtical factors to combat COVID-19. Hence, we conduct a systematic review to summarize the current findings on the safety and immuno-genicity of this heterologous vaccination and elucidate their implications against COVID-19.

2. Safety and Immunogenicity

The safety of heterologous ChAdOx1-S and mRNA vaccination was reported in five clinical studies [25][26][27][28][29][30] and one prospective study [32]. Two clinical studies had separately enrolled the participants for heterologous ChAdOx1-S/BNT162b2 vaccination from Spain (n = 451) [27] and Germany (n = 26) [28]. Two clinical studies utilized the same participants from the UK to separately evaluate the vaccine safety within seven and 28 days after the boost (n = 110) [24][29]. Another one was estimated the vaccine effectiveness (VE) of heterologous vaccine (ChAdOx1 with mRNA vaccine as the second dose) from Denmark [30]. The interval for heterologous vaccination of ChAdOx1-S/BNT162b2 was 8–12 weeks for the study in Spain [27], eight weeks for that in Germany [28], four weeks for that in the United Kingdom [25][29], and 82 days in Denmark [30]. For the prospective study, the individuals were screened who received the ChAdOx1-S/BNT162b2 with the 10–12-week vaccine interval (n = 104). Although the intervals were dissimilar, these studies all reported no serious adverse events regarding heterologous ChAdOx1-S/BNT162b2 vaccination after one [32], seven [26][27], 28 days [29], or more than one day [28].
The two clinical studies from the United Kingdom also enrolled the participants for heterologous BNT162b2/ChAdOx1-S vaccination with the four-week interval. All participants with heterologous BNT162b2/ChAdOx1-S vaccination did not present vaccine-related serious adverse events within seven [26] and 28 days [29] after boost (n = 114). The occurrence of serious adverse events was not related to the vaccination order of BNT162b2 and ChAdOx1-S.
A clinical study in Sweden further reported no serious adverse events in the participants with the heterologous ChAdOx1-S/mRNA-1273 vaccination on day 7 to day 10 after the boost [26]. This was also found in the individuals with heterologous ChAdOx1-S/mRNA-1273 or ChAdOx1-S/BNT162b2 vaccination within seven days after the boost (n = 96). Regardless of interventions or intervals of heterologous ChAdOx1-S and mRNA vaccination, there were no serious adverse events regarding this heterologous vaccine regimen. However, the serious adverse events are still listed in the safety concerns of ChAdOx1-S and mRNA vaccine as very rare, which have been only observed in one per 100,000 to 250,000 ChAdOx1-S vaccinated people [33] and 2.5 to 24 per 10,000,000 mRNA vaccinated people [6][7][8]. Current studies in the safety of heterologous ChAdOx1-S and mRNA vaccination were based only on small populations. More clinical studies are needed to evaluate the safety of heterologous vaccination.
The immunogenicity of heterologous ChAdOx1-S and mRNA vaccination is important for COVID-19 protection. Current studies have evaluated the immunogenicity of heterologous ChAdOx1-S and mRNA vaccination via detecting the level of SARS-CoV-2-specific IgG, the ability of neutralization antibody against wild type or variant SARS-CoV-2 or Spike-specific T-cell immune response (Table 2). These five studies reported the levels of SARS-CoV-2-specific IgG between homologous and heterologous vaccine groups [25][28][29][30][31][32]. Four of those studies independently showed that the level of SARS-CoV-2-Spike-specific IgG was significantly higher (in people who received ChAdOx1-S, then the boost of BNT162b2 or mRNA-1273) than that in people having homologous ChAdOx1-S/ChAdOx1-S vaccination regardless of the inoculating intervals [25][29][30][31][32][33]. Moreover, this IgG level of the heterologous vaccination groups was similar to or higher than that of the homologous vaccination with BNT162b2/BNT162b2 [28][29][32] or mRNA 1273/mRNA 1273 [31]. A similar observation was found on the level of SARS-CoV-2- receptor-binding domain-specific IgG [25][32]. One clinical study further showed that the heterologous ChAdOx1-S/BNT162b2 vaccination could induce a higher level of SARS-CoV-2-Spike-specific IgG in comparison to the heterologous BNT162b2/ChAdOx1-S vaccination [29].
Table 2. Studies of heterologous ChAdOx1-S with mRNA vaccination.
Reference Country Design Interval between Doses Intervention
(1st/2nd Dose)		 Results
Johan N. et al., 2021 [25] Sweden An open, multicenter phase IV study 9–12 weeks Homologous vaccine group:
ChAdOx1-S/ChAdOx1-S (n = 37, 28- to 62-year-old)
Heterologous vaccine group:
ChAdOx1-S/mRNA-1273 (n = 51, 23- to 59-year-old)		 S-specific and RBD-specific IgG geometric mean titers
At the day of the 2nd dose inoculation, the similar titer of S-specific and RBD-specific IgG between two groups
  • At D7 to D10 after 2nd dose inoculation, S-specific and RBD-specific IgG titers in the ChAdOx1-S/mRNA-1273 were separately 115-fold and 125-fold of that on the day of the 2nd dose inoculation, and that was 5-fold in the ChAdOx1-S/ChAdOx1-S
  • At D30 after 2nd dose inoculation, S-specific and RBD-specific IgG titers in two groups were the same with that on D7 to D10 time point.
Neutralization antibody against wild type SARS-CoV-2
  • At the day of 2nd dose inoculation, the titer of ID50 was similar between two groups
  • At D7 to D10 after 2nd dose inoculation, the titer of ID50 in the ChAdOx1-S/mRNA-1273 was 20-fold of that on the day of 2nd dose inoculation and it was 2-fold in the ChAdOx1-S/ChAdOx1-S
  • At D30 after 2nd dose inoculation, the titer of ID50 in two groups was 1.6 to 1.7-fold of that on D7 to D10 time point, but it was not significant
Neutralization antibody against B.1.351, Beta variant SARS-CoV-2
  • At the D7 to D10 after 2nd dose inoculation, the ChAdOx1-S/mRNA-1273 had induced the antibodies that could neutralize the B.1.351, Beta variant SARS-CoV-2, but the ChAdOx1-S/ChAdOx1-S could not induce potent antibodies against this variant
Adverse events (on the D7 to D10 after 2nd dose inoculation)
  • No serious adverse events were reported in two groups
  • The incidence of systemic adverse events such as fever, headache, chills and injection site pain, was frequently found in the ChAdOx1-S/mRNA-1273 than that in the ChAdOx1-S/ChAdOx1-S
  • The grade of adverse events was not statistically significant different between two groups
Robert, H.S. et al., 2021 [23][24][26] UK A single-blind, randomized, multicenter
phase II study		 4 weeks Homologous vaccine group
(50- to 69-year-old):
ChAdOx1-S/ChAdOx1-S (n = 115); BNT162b2/BNT 162b2 (n = 110)
Heterologous vaccine group
(50- to 69-year-old):
ChAdOx1-S/BNT162b2 (n = 110); BNT162b2/ChAdOx1-S (n = 114)		 Adverse events
  • No serious adverse events reported in all groups within 7 days after inoculation
  • The systemic adverse events were more frequently found in the heterologous vaccine groups than that in their homologous vaccine groups within 2 days after inoculation
Alberto, M.B. et al., 2021 [24][27] Spain An open-label, randomized, controlled multicenter
phase II study		 8–12 weeks Without homologous vaccine group, only 1 dose of ChAdOx1-S (n = 226, 18- to 60-year-old):
Heterologous vaccine group (18- to 60-year-old):
ChAdOx1-S/BNT162b2 (n = 451)		 S-specific and RBD-specific IgG geometric mean titers
  • At the day of 2nd dose inoculation, the similar titer of S-specific and RBD-specific IgG between two groups
  • The titer of S-specific and RBD-specific IgG in the 1st dose of ChAdOx1-S on the day of 2nd dose inoculation, which was similar to that on D7 and D14 after inoculation
  • At D7 and D14 after 2nd dose inoculation, both S-specific and RBD-specific IgG titers in the ChAdOx1-S/BNT162b2 were significantly higher than that in the 1st dose of ChAdOx1-S
Neutralization antibody against pseudovirus-SARS-CoV-2
  • At the day of 2nd dose inoculation, PVNT50 was similar between two groups
  • At D14 after 2nd dose inoculation, PVNT50 in the ChAdOx1-S/BNT162b2 were 45-fold of that in the 1st dose of ChAdOx1-S
S-specific T cell immune response
  • At the day of 2nd dose inoculation, production of IFN-γ was similar between two groups
  • At the D14 after 2nd dose inoculation, production of IFN-γ in the ChAdOx1-S/BNT162b2 was significantly higher than in the 1st dose of ChAdOx1-S
Adverse events
  • No serious adverse events were reported in heterologous vaccine group
  • Incidence of systematic adverse events were more than others in ChAdOx1-S/BNT162b2 within D7 after 2nd dose of inoculation
  • There was no data regarding the difference in the incidence of adverse events between the two group
Tina S. et al., 2021 [31] Germany Observation study 9–12 weeks:
ChAdOx1-S/ChAdOx1-S; ChAdOx1-S/BNT162b2 or mRNA-1273
3–6 weeks:
BNT162b2/BNT162b2 or mRNA-1273/mRNA-1273		 Homologous vaccine group:
ChAdOx1-S/ChAdOx1-S (n = 55, 36- to 61-year-old); BNT162b2/BNT162b2 or mRNA-1273/mRNA-1273 (n = 62, 29- to 52-year-old)
Heterologous vaccine group:
ChAdOx1-S/BNT162b2 or mRNA-1273 (n = 96, 30- to 59-year-old)		 S-specific IgG geometric mean titers:
  • At the D14 after 2nd dose inoculation, the titer of S-specific IgG was similar between ChAdOx1-S/BNT162b2 or mRNA-1273 and 2 dose of BNT162b2 or mRNA-1273, that was significantly higher than that in the ChAdOx1-S/ChAdOx1-S
Neutralization antibody against SARS-CoV-2 by surrogate virus neutralization test
  • At the D14 after 2nd dose inoculation, the percentage inhibition of neutralization antibody was similar between ChAdOx1-S/BNT162b2 or mRNA-1273 and 2nd dose of BNT162b2 or mRNA-1273, that was significantly higher than that in the ChAdOx1-S/ChAdOx1-S
S-specific T cell immune response:
  • At the D14 after 2nd dose inoculation, percentage of CD69+ IFN-γ+ CD4+ T cells was similar between ChAdOx1-S/BNT162b2 or mRNA-1273 and 2nd dose of BNT162b2 or mRNA-1273, that was significantly higher than that in the ChAdOx1-S/ChAdOx1-S
  • The percentage of CD69+ IFN-γ+ CD8+ T cells was significantly higher than that in both ChAdOx1-S/ChAdOx1-S and 2nd dose of BNT162b2 or mRNA-1273
Adverse events (within D7 after 2nd inoculation):
  • No serious adverse events were reported in heterologous vaccine group
  • The incidence of adverse events in the ChAdOx1-S/BNT162b2 or mRNA-1273 was similar to that in the 2 doses of BNT162b2 or mRNA-1273, but more than that in the 2 doses of ChAdOx1-S
  • The incidence of adverse events in the ChAdOx1-S/BNT162b2 was similar to that in the ChAdOx1-S prime
Rüdiger G. et al., 2021 [28] Germany Clinical study 8 weeks Homologous vaccine group:
BNT162b2/BNT162b2 (n = NR, 25-to 55-year-old)
Heterologous vaccine group:
ChAdOx1-S/BNT162-b2 (n = 26, 25- to 46- year-old)		 S-specific IgG titer:
  • At the D14–19 after 2nd dose inoculation, this titer in the ChAdOx1-S/BNT162b2 were separately significantly higher than that at the day of 2nd dose inoculation and that in the 2 doses of BNT162b2 at D13–15 after 2nd dose inoculation
Neutralization antibody against pseudovirus-wild type-SARS-CoV-2
  • At the D14–19 after 2nd dose inoculation, the PVNT50 in the ChAdOx1-S/BNT162b2 were separately significantly higher than that at the day of 2nd dose inoculation and that in the 2 doses of BNT162b2 at D13–15 after 2nd dose inoculation
Neutralization antibody against pseudovirus-variant-SARS-CoV-2
  • PVNT50 against alpha- and beta-SARS-CoV-2 in in the ChAdOx1-S/BNT162b2 at D14–19 after 2nd dose inoculation, was separately higher than that in the 2 doses of BNT162b2 at D13–15 after 2nd dose inoculation, but the PVNT50 against delta-SARS-CoV was similar between two groups
S-specific T cell immune response:
  • A significantly high percentage of S-specific IFN-γ+CD4 or CD8 T cells the ChAdOx1-S/BNT162b2 at the D6–11 and D14–19 after 2nd dose inoculation in comparison to that at D2 before 1st dose inoculation
  • There was no data regarding the difference on S-specific T cell immune response between two groups
Adverse events (lasting than D1 after boost):
  • No serious adverse events were reported in heterologous vaccine group
  • There is no data regarding the difference in the incidence of adverse events between the two groups
Xin Xue L. et. al., 2021 [29] UK A single blinded, randomized, multicenter, phase II, non-inferiority study 4 weeks Homologous vaccine group (50- to 69-year-old):
ChAdOx1-S/ChAdOx1-S (n = 112); BNT162b2/BNT162b2 (n = 110)
Heterologous vaccine group (50- to 69-year-old):
ChAdOx1-S/BNT162b2 (n = 110); BNT162b2/ChAdOx1-S (n = 114)		 S-specific IgG geometric mean titers:
  • At D28 after 2nd dose inoculation, there was a similar titer between the ChAdOx1-S/BNT162b2 and BNT162b2/BNT162b2, but that in ChAdOx1-S/BNT162b2 were significantly higher than that in ChAdOx1-S/ChAdOx1-S and BNT162b2/ChAdOx1-S
Neutralization antibody against pseudovirus-wild type-SARS-CoV-2:
  • At D28 after 2nd dose inoculation, there was a similar PVNT50 between the ChAdOx1-S/BNT162b2 and BNT162b2/BNT162b2, but that in ChAdOx1-S/BNT162b2 were significantly higher than that in ChAdOx1-S/ChAdOx1-S and BNT162b2/ChAdOx1-S
S-specific T cell immune response:
  • At D28 after 2nd dose inoculation, the number of IFN-γ+T cell per 106 PBMC in ChAdOx1-S/BNT162b2 was more than that in ChAdOx1-S/BNT162b2, BNT162b2/BNT162b2 and BNT162b2/ChAdOx1-S
Adverse events:
  • Within D28 after 2nd dose inoculation, the incidence of systemic adverse events was increased in heterologous vaccine group as compared to their homologous vaccine group, but no significant difference between those vaccine schedules
  • Within D28 after 2nd dose inoculation, there were four serious adverse events across all groups, but not related to vaccine immunization
David H. et al., 2021 [32] Germany Prospective study 3 weeks:
BNT162b2/BNT162b2
10–12 weeks: ChAdOx1-S/ChAdOx1-S, ChAdOx1-S/BNT162b2		 Homologous vaccine group:
ChAdOx1-S/ChAdOx1-S (n = 38, 33- to 59-year-old); BNT162b2/BNT162b2 (n = 174, 29- to 43-year-old)
Heterologous vaccine group:
ChAdOx1-S/BNT162-b2 (n = 104, 29- to 51-year-old)		 S1-specific and RBD-specific IgG signal-to cutoff- ratio:
  • At D21–28 after 2nd dose inoculation, the ratio of S1-specific IgG in the ChAdOx1-S/BNT162b2 was more than that in all homologous vaccine groups, but no significant difference
  • At D21–28 after 2nd dose inoculation, the ratio of RBD-specific IgG in ChAdOx1-S/BNT162b2 was similar to that in BNT162b2/BNT162b2 and slightly more than that in the ChAdOx1-S/ChAdOx1-S
Index of S1-specific IgG avidity:
  • At D21–28 after 2nd dose inoculation, the index of S1-specific IgG avidity in the ChAdOx1-S/BNT162b2 was significantly higher than that in all homologous vaccine groups
Neutralization antibody against pseudovirus-variant-SARS-CoV-2
  • At D21–28 after 2nd dose inoculation, PVNT50 against alpha- and beta- SARS-CoV-2 in the ChAdOx1-S/BNT162b2 was significantly higher than that in all homologous vaccine groups
S1-specific T cell immune response:
  • At the D21–28 after 2nd inoculation, the production of IFN-γ in the ChAdOx1-S/BNT162b2 was significantly higher than that in in all homologous vaccine groups
Adverse events (within 24 h after 2nd dose inoculation):
  • No serious adverse events were reported across all groups
  • The incidence of systemic adverse event in the ChAdOx1-S/BNT162b2 was slightly more than in ChAdOx1-S/ChAdOx1-S and less than that in BNT162b2/BNT162b2 and ChAdOx1-S prime
Gram M.A. et al. [30] Denmark Clinical study 82 days Heterologous vaccine group:
ChAdOx1-S/BNT162b2 (n = 88,050)
ChAdOx1-S/mRNA-1273 (n = 44,501)
Median age of 45 and 46 years at the first and second dose
  • A reduction in the risk of SARS-CoV-2 infection when combining the ChAdOx1 and an mRNA vaccine.
  • The vaccine effectiveness (VE) against SARS-CoV-2 infection when combining the ChAdOx1 and an mRNA vaccine was 88%.
  • The VE of ChAdOx1/mRNA is similar to the two doses of the BNT162b2 mRNA vaccine.
  • No COVID-19 related hospitalizations were observed after the second dose.
  • No COVID-19 related deaths were observed after neither the first dose ChAdOx1 nor the ChAdOx1/mRNA vaccine schedule.
S, spike protein; RBD, receptor-binding domain; ID50, 50% inhibitory dilution; PVNT50, 50% of pseudovirus neutralization titer; NR, not reported; S1, S1 domain of spike protein.
Four studies reviewed as following, have shown the efficacy of neutralization antibody against wild type SARS-CoV-2 between homologous and heterologous vaccine groups [25][28][29][31]. The 50% of pseudovirus neutralization titer (PVNT50) in the heterologous ChAdOx1-S/BNT162b2 vaccinated people was significantly higher than that in the homologous ChAdOx1-S/ChAdOx1-S vaccinated people and was equal or similar to that in the homologous BNT162b2/BNT162b2 vaccinated people regardless of the inoculating intervals [28][29]. One clinical study showed that the percentage of inhibition of surrogate virus neutralization antibody in the groups of heterologous ChAdOx1-S/BNT162b2 or mRNA1273 vaccination was significantly higher than that in the homologous ChAdOx1-S/ChAdOx1-S vaccination [31]. Another study that utilized the real virus neutralization test found similar results between the groups of the heterologous ChAdOx1-S/mRNA1273 vaccination and the homologous ChAdOx1-S/ChAdOx1-S vaccination [25]. In addition, the efficacy of neutralization antibody against wild type SARS-CoV-2 in the heterologous ChAdOx1-S/BNT162b2 vaccination group was better than that of the heterologous BNT162b2/ChAdOx1-S vaccination group [29].
The efficacy of neutralization antibody against variant SARS-CoV-2 between homologous and heterologous vaccine groups which was detected in three studies [25][28][32]. The heterologous vaccination of ChAdOx1-S/BNT162b2 or ChAdOx1-S/mRNA-1273 produced a better neutralization capacity against alpha- or beta- SARS-CoV-2 when compared with that of the homologous vaccination of ChAdOx1-S/ChAdOx1-S or BNT162b2/BNT162b2 [25][28][32].
There were three studies which showed the Spike-specific T-cell immune response between the heterologous vaccine group and the homologous vaccine group [29][31][32]. This was detected by the production of IFN-γ or the level of IFN-γ+ T-cell in PBMC after Spike stimulation. The production of IFN-γ was significantly higher in the heterologous ChAdOx1-S/BNT162b2 vaccination than that in the homologous ChAdOx1-S/ChAdOx1-S [32]. Although the level of IFN-γ+ T-cell in PBMC was not significantly higher in the heterologous ChAdOx1-S/BNT162b2 group [29], the other study showed that the level of antigen-specific T-cells (CD69+ IFN-γ+ CD8+ T-cell) was significantly higher in the heterologous ChAdOx1-S/BNT162b2 or mRNA-1273 group [33]. Overall, the heterologous ChAdOx1-S and mRNA vaccination could induce a robust immune response against COVID-19 in comparison with the homologous ChAdOx1-S/ChAdOx1-S.

References

  1. Our World in Data. Coronavirus (COVID-19) Vaccinations. Available online: https://ourworldindata.org/covid-vaccinations?country=OWID_WRL (accessed on 27 September 2021).
  2. MacIntyre, C.R.; Veness, B.; Berger, D.; Hamad, N.; Bari, N. Thrombosis with Thrombocytopenia Syndrome (TTS) following AstraZeneca ChAdOx1 nCoV-19 (AZD1222) COVID-19 vaccination—A risk-benefit analysis for people <60 years in Australia. Vaccine 2021, 39, 4784–4787.
  3. World Health Organization. Strategic Advisory Group of Experts on Immunization (SAGE). 2021. Available online: https://www.who.int/groups/strategic-advisory-group-of-experts-on-immunization/covid-19-materials (accessed on 10 August 2021).
  4. Long, B.; Bridwell, R.; Gottlieb, M. Thrombosis with thrombocytopenia syndrome associated with COVID-19 vaccines. Am. J. Emerg. Med. 2021, 49, 58–61.
  5. World Health Organization. Coronavirus Disease (COVID-19)-COVID-19 Vaccine EUL Issued. Available online: https://extranet.who.int/pqweb/vaccines/covid-19-vaccines (accessed on 14 August 2021).
  6. Schmidt, T.; Klemis, V.; Schub, D.; Mihm, J.; Hielscher, F.; Marx, S.; Abu-Omar, A.; Ziegler, L.; Guckelmus, C.; Urschel, R.; et al. Immunogenicity and reactogenicity of heterologous ChAdOx1 nCoV-19/mRNA vaccination. Nat. Med. 2021, 27, 1530–1535.
  7. Shimabukuro, T. Allergic reactions including anaphylaxis after receipt of the first dose of Pfizer-BioNTech COVID-19 vaccine—United States, December 14–23, 2020. Am. J. Transplant. 2021, 21, 1332–1337.
  8. Shay, D.K.; Shimabukuro, T.T.; DeStefano, F. Myocarditis Occurring After Immunization with mRNA-Based COVID-19 Vaccines. JAMA Cardiol. 2021, in press.
  9. American Centers for Disease Control and Prevention. Safety Monitoring of the Janssen (Johnson & Johnson) COVID-19 Vaccine—United States, March–April 2021. Available online: https://www.cdc.gov/mmwr/volumes/70/wr/mm7018e2.htm (accessed on 14 August 2021).
  10. McMahon, D.E.; Amerson, E.; Rosenbach, M.; Lipoff, J.B.; Moustafa, D.; Tyagi, A.; Desai, S.R.; French, L.E.; Lim, H.W.; Thiers, B.H.; et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. J. Am. Acad. Dermatol. 2021, 85, 46–55.
  11. Tanriover, M.D.; Doğanay, H.L.; Akova, M.; Güner, H.R.; Azap, A.; Akhan, S.; Aksu, K. Efficacy and safety of an inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac): Interim results of a double-blind, randomised, placebo-controlled, phase 3 trial in Turkey. Lancet 2021, 398, 213–222.
  12. Palacios, R.; Batista, A.P.; Albuquerque, C.S.N.; Patiño, E.G.; Santos, J.D.P.; Tilli Reis Pessoa Conde, M.; de Oliveira Piorelli, R.; Pereira Júnior, L.C.; Raboni, S.M.; Ramos, F.; et al. Efficacy and Safety of a COVID-19 Inactivated Vaccine in Healthcare Professionals in Brazil: The PROFISCOV Study 2021. Available online: https://ssrn.com/abstract=3822780 (accessed on 15 August 2021).
  13. Heath, P.T.; Galiza, E.P.; Baxter, D.N.; Boffito, M.; Browne, D.; Burns, F.; Chadwick, D.R.; Clark, R.; Cosgrove, C.; Galloway, J.; et al. Safety and Efficacy of NVX-CoV2373 Covid-19 Vaccine. N. Engl. J. Med. 2021, 385, 1172–1183.
  14. Logunov, D.Y.; Dolzhikova, I.V.; Shcheblyakov, D.V.; Tukhvatulin, A.I.; Zubkova, O.V.; Dzharullaeva, A.S.; Kovyrshina, A.V.; Lubenets, N.L.; Grousova, D.M.; Erokhova, A.S.; et al. Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: An interim analysis of a randomised controlled phase 3 trial in Russia. Lancet 2021, 397, 671–681.
  15. Santos, A.; Gaspar, P.; de Souza, H. Refrigeration of COVID-19 Vaccines: Ideal Storage Characteristics, Energy Efficiency and Environmental Impacts of Various Vaccine Options. Energies 2021, 14, 1849.
  16. Gallè, F.; Sabella, E.; Roma, P.; De Giglio, O.; Caggiano, G.; Tafuri, S.; Da Molin, G.; Ferracuti, S.; Montagna, M.; Liguori, G.; et al. Knowledge and Acceptance of COVID-19 Vaccination among Undergraduate Students from Central and Southern Italy. Vaccines 2021, 9, 638.
  17. MacDonald, N.E.; SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine 2015, 33, 4161–4164.
  18. Greinacher, A.; Thiele, T.; Warkentin, T.E.; Weisser, K.; Kyrle, P.A.; Eichinger, S. Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination. N. Engl. J. Med. 2021, 384, 2092–2101.
  19. Schultz, N.H.; Sørvoll, I.H.; Michelsen, A.E.; Munthe, L.A.; Lund-Johansen, F.; Ahlen, M.T.; Wiedmann, M.; Aomodt, A.H.; Skottor, T.H.; Tjonnfjord, G.E.; et al. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N. Engl. J. Med. 2021, 384, 2124–2130.
  20. Pottegård, A.; Lund, L.C.; Karlstad, Ø.; Dahl, J.; Andersen, M.; Hallas, J.; Hviid, A. Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: Population based cohort study. BMJ 2021, 373, n1114.
  21. European Centre for Disease Prevention and Control. Overview of EU/EEA Country Recommendations on COVID-19 Vaccination with Vaxzevria, and a Scoping Review of Evidence to Guide Decision-Making. Available online: https://www.ecdc.europa (accessed on 21 August 2021).
  22. Government of Canada. Archived 12: NACI Rapid Response: Interchangeability of Authorized COVID-19 Vaccines. Available online: https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci.html (accessed on 19 August 2021).
  23. Ledford, H. Could mixing COVID vaccines boost immune response? Nature 2021, 590, 375–376.
  24. Callaway, E. Mix-and-match COVID vaccines trigger potent immune response. Nature 2021, 593, 491.
  25. Normark, J.; Vikström, L.; Gwon, Y.-D.; Persson, I.-L.; Edin, A.; Björsell, T.; Dernstedt, A.; Christ, W.; Tevell, S.; Evander, M.; et al. Heterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination. N. Engl. J. Med. 2021, 385, 1049–1051.
  26. Shaw, R.H.; Stuart, A.; Greenland, M.; Liu, X.; Van-Tam, J.S.N.; Snape, M.D. Heterologous prime-boost COVID-19 vaccination: Initial reactogenicity data. Lancet 2021, 397, 2043–2046.
  27. Borobia, A.M.; Carcas, A.J.; Pérez-Olmeda, M.; Castaño, L.; Bertran, M.J.; García-Pérez, J.; Campins, M.; Portolés, A.; González-Pérez, M.; Morales, M.T.G.; et al. Immunogenicity and reactogenicity of BNT162b2 booster in ChAdOx1-S-primed participants (CombiVacS): A multicentre, open-label, randomised, controlled, phase 2 trial. Lancet 2021, 398, 121–130.
  28. Gross, R.; Zanoni, M.; Seidel, A.; Conzelmann, C.; Gilg, A.; Krnavek, D.; Mueller, J.A. Heterologous ChAdOx1 nCoV-19 and BNT162b2 prime-boost vaccination elicits potent neutralizing antibody responses and T-cell reactivity. medRxiv 2021.
  29. Liu, X.; Shaw, R.H.; Stuart, A.S.V.; Greenland, M.; Aley, P.K.; Andrews, N.J.; Cameron, J.C.; Charlton, S.; Clutterbuck, E.A.; Collins, A.M.; et al. Safety and immunogenicity of heterologous versus homologous prime-boost schedules with an adenoviral vectored and mRNA COVID-19 vaccine (Com-COV): A single-blind, randomised, non-inferiority trial. Lancet 2021, 398, 856–869.
  30. Gram, M.A.; Emborg, H.D.; Moustsen-Helms, I.R.; Nielsen, J.; Sørensen, A.K.B.; Valentiner-Branth, P.; Nielsen, K. Vaccine effectiveness when combining the ChAdOx1 vaccine as the first dose with an mRNA COVID-19 vaccine as the second dose. medRxiv 2021.
  31. Shimabukuro, T. Allergic reactions including anaphylaxis after receipt of the first dose of Moderna COVID-19 vaccine—United States, December 21, 2020–January 10, 2021. Am. J. Transplant. 2021, 21, 1326–1331.
  32. Hillus, D.; Schwarz, T.; Tober-Lau, P.; Hastor, H.; Thibeault, C.; Kasper, S.; COVIM/EICOV Study Group. Safety, reactogenicity, and immunogenicity of homologous and heterologous prime-boost immunisation with ChAdOx1 nCoV-19 and BNT162b2: A prospective cohort study. Lancet Respir Med. 2021, in press.
  33. Rizk, J.G.; Gupta, A.; Sardar, P.; Henry, B.M.; Lewin, J.C.; Lippi, G.; Lavie, C.J. Clinical Characteristics and Pharmacological Management of COVID-19 Vaccine-Induced Immune Thrombotic Thrombocytopenia with Cerebral Venous Sinus Thrombosis: A Review. JAMA Cardiol. 2021, in press.
More
© Text is available under the terms and conditions of the Creative Commons Attribution (CC BY) license; additional terms may apply. By using this site, you agree to the Terms and Conditions and Privacy Policy.
Upload a video for this entry
Information
Subjects: Virology
Contributor MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register : Yu-Chang Tyan
View Times: 959
Entry Collection: COVID-19
Revisions: 3 times (View History)
Update Date: 07 Dec 2021
Table of Contents
    Notice
    You are not a member of the advisory board for this topic. If you want to update advisory board member profile, please contact office@encyclopedia.pub.
    OK
    Confirm
    Only members of the Encyclopedia advisory board for this topic are allowed to note entries. Would you like to become an advisory board member of the Encyclopedia?
    Yes
    No
    ${ textCharacter }/${ maxCharacter }
    Submit
    Cancel
    There is no comment~
    ${ textCharacter }/${ maxCharacter }
    Submit
    Cancel
    ${ selectedItem.replyTextCharacter }/${ selectedItem.replyMaxCharacter }
    Submit
    Cancel
    Confirm
    Are you sure to Delete?
    Yes No
    Academic Video Service
    Feedback