Abstract
The COVID-19 pandemic is changing rapidly and requires different strategies to maintain immunization. In Korea, different COVID-19 vaccines are recommended and available for various populations, including healthcare workers (HCWs) at high risk of SARS-CoV-2 infection. We plan to evaluate the adverse events (AEs) and immunogenicity of the BNT162b2 and ChAdOx1 vaccines in HCWs at a single center. This cohort study included HCWs fully vaccinated with either BNT162b2 or ChAdOx1. Blood samples were taken eight weeks after the second vaccination with both COVID-19 vaccines and six months after the second vaccination from participants with the BNT162b2 vaccine. The primary endpoint for immunogenicity was the serum neutralizing antibody responses eight weeks after vaccination. The secondary endpoint was the incidence of various AEs within 28 days of each vaccination. Between 16 March and 23 June 2021, 115 participants were enrolled (65 in the ChAdOx1 group and 50 in the BNT162b2 group). Significantly higher surrogate virus neutralization test (sVNT) inhibition was observed in participants vaccinated with two doses of BNT162b2 (mean (SD) 91.4 (9.68)%) than in those vaccinated with ChAdOx1 (mean (SD) 73.3 (22.57)%). The effectiveness of the BNT162b2 vaccine was maintained across all age and gender categories. At six months after the second dose, serum antibody levels declined significantly in the BNT162b2 group. The main adverse events, including fever, myalgia, fatigue, and headache, were significantly higher in the ChAdOx1 group after the first dose, whereas, after the second dose, those AEs were significantly higher in the BNT162b2 group (p < 0.05). Two doses of either the ChAdOx1 or the BNT162b2 COVID-19 vaccine resulted in very high seropositivity among the HCWs at our center. The quality of the antibody response, measured by sVNT inhibition, was significantly better with the BNT162b2 vaccine than with the ChAdOx1 vaccine. There was no significant association between neutralizing antibody response and AE after each vaccination in our cohort.
Highlights
Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2), which initially emerged inChina in late 2019 [1]
This study included a total of 115 healthcare workers (HCWs), with 65 participants in the ChAdOx1 group and 50 participants in the BNT162b2 group
P value < 0.05 when comparing frequencies of adverse events between ChAdOx1 and BNT162b2 groups. This cohort study demonstrated a significantly higher humoral immunogenicity of the SARS-CoV-2 BNT162b2 messenger RNA (mRNA) vaccine compared with the ChAdOx1 vector vaccine in healthy healthcare workers
Summary
Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2), which initially emerged inChina in late 2019 [1]. As of July 2021, there have been more than 180 million confirmed 4.0/). Cases with 3.93 million deaths worldwide [2], and 157,723 confirmed cases with 2021 deaths reported in Korea [3]. Several vaccines against COVID-19 have been approved globally, and some are currently ongoing in human trials. One is a messenger RNA (mRNA)-based vaccine (BNT162b2) developed by Pfizer/BioNTech. This lipid nanoparticle-formulated, nucleoside-modified RNA vaccine encodes a prefusion-stabilized, membrane-anchored SARS-CoV-2 full-length spike protein [4]. The other is a genetically modified organism (virus vector) vaccine (ChAdOx1), developed by both the University of Oxford and AstraZeneca, which consists of the replication-deficient chimpanzee adenoviral vector ChAdOx1, containing the SARS-CoV-2 structural surface glycoprotein antigen (spike protein; nCoV-19) gene [5].
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