Inactivated SARS-CoV-2 vaccine (Vero cell) (Beijing Bio-Institute)

The adaptive immune response plays a crucial role in resolution of viral infections; however, there is limited data on the T cell response to SARS-CoV-2 vaccines such as BBIBP-CorV, Gam-COVID-Vac, and especially for the heterologous combination Gam-COVID-Vac/mRNA-1273 scheme. Furthermore, emerging variants may compromise the adaptive immune response established in the population.

To evaluate the T cell immune response induced by the BBIBP-CorV, Gam-COVID-Vac and Gam-COVID-Vac/mRNA-1273, against the ancestral wild type (WT) virus and the Gamma and Omicron variants.

Serum levels of IgG antibodies were assessed by CMIA (Abbott Diagnostics, Abbott Park, Illinois). T cell responses against WT virus, Gamma and Omicron were evaluated through an activation-induced marker assay. Sixty individuals, evenly distributed across the BBIBP-CorV, Gam-COVID-Vac, and Gam-COVID-Vac/mRNA-1273 groups, were included.

The median age of participants was 48 years (IQR: 34-56), with 58.3 % (n = 35) being female. Seventeen (28.3 %) individuals had a prior confirmed COVID-19 infection. Gam-COVID-Vac/mRNA-1273 scheme elicited significantly higher humoral responses (p < 0.001). However, the three vaccination platforms showed consistent T cell responses across the three stimuli tested. Particularly, all three schemes induced stronger CD8⁺ responses against the WT virus. In addition, more responders to WT were observed in the BBIBP-CorV and Gam-COVID-Vac groups, while the Gam-COVID-Vac/mRNA-1273 group showed a greater proportion of responders to Omicron.

This study provides new data on effective humoral and cellular immune responses against the ancestral WT virus as well as the Gamma and Omicron variants. Moreover, memory CD4⁺ and CD8⁺ T cell responses remain protective, and the heterologous scheme may elicit stronger T cell responses against emerging variants.

Authorized COVID-19 vaccines require boosters for continued protection; however, the lack of cross-platform compatible boosters creates practical challenges to keeping populations protected.

This Phase 3, multicenter, international, randomized, active-controlled trial compared UB-612 as a third-dose heterologous booster to BNT162b2, ChAdOx1-S, or BBIBP-CorV homologous boosters in healthy subjects aged ≥16 years. Participants were randomly assigned 1:1 to receive a single intramuscular injection of UB-612 or an active comparator matching the primary dose, and were stratified for age, sex, N-protein seropositivity, and time since the last dose of their primary series COVID-19 vaccination. The primary objective was to show non-inferiority of neutralizing antibody geometric mean titer (GMT) against live SARS-CoV-2 Wuhan strain after boosting with UB-612 or each of the licensed platform vaccines. Secondary and exploratory objectives covered short and long-term antibody responses. The safety analysis addressed subject and investigator reported adverse events. The study was registered on ClinicalTrials.gov, NCT05293665, and completed on September 12, 2023.

Between March 22 and September 9, 2022, 469 subjects received UB-612 as a heterologous booster, and 467 received BNT162b2 (n = 204), ChAdOx1-S (n = 95), or BBIBP-CorV (n = 168) as homologous boosters. Over 90% of all subjects were positive for N-protein antibody at baseline. When compared to the respective homologous booster response, UB-612 stimulated Wuhan and Omicron BA.5 neutralizing antibody responses that were non-inferior, thus meeting all primary and secondary immunogenicity endpoints of the study. Importantly, UB-612 demonstrated superiority in neutralizing antibody GMT and seroresponse rates compared to ChAdOx1-S and BBIBP-CorV. UB-612 was also effective in stimulating neutralizing antibodies against a more recent Omicron XBB1.5 strain. Long-term immunity analysis through 6- and 12-month follow-ups favored UB-612 over ChAdOx1-S and BBIBP-CorV and supported comparable immunity to BNT162b2. All vaccines were well tolerated and had similar safety profiles.

In a pivotal Phase 3 study, UB-612 demonstrated the potential for broad use as a cross-platform heterologous booster, restoring protective immunity in adults previously vaccinated with mRNA, adenovirus-vectored, or inactivated virus-based COVID-19 vaccines.

The study was co-funded by the Coalition for Epidemic Preparedness Innovations (CEPI) and Vaxxinity.