Immunogenicity and reactogenicity of heterologous COVID-19 vaccination in pregnant women
Issued Date
2023-01-01
Resource Type
ISSN
21645515
eISSN
2164554X
Scopus ID
2-s2.0-85165210487
Pubmed ID
37439770
Journal Title
Human Vaccines and Immunotherapeutics
Rights Holder(s)
SCOPUS
Bibliographic Citation
Human Vaccines and Immunotherapeutics (2023)
Suggested Citation
Chayachinda C., Watananirun K., Phatihattakorn C., Anuwutnavin S., Niyomnaitham S., Phongsamart W., Lapphra K., Wittawatmongkol O., Rungmaitree S., Jansarikit L., Boonnak K., Wongprompitak P., Senawong S., Upadhya A., Toh Z.Q., Licciardi P.V., Chokephaibulkit K. Immunogenicity and reactogenicity of heterologous COVID-19 vaccination in pregnant women. Human Vaccines and Immunotherapeutics (2023). doi:10.1080/21645515.2023.2228670 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/88118
Title
Immunogenicity and reactogenicity of heterologous COVID-19 vaccination in pregnant women
Author's Affiliation
Other Contributor(s)
Abstract
This open-labeled non-inferiority trial evaluated immunogenicity and reactogenicity of heterologous and homologous COVID-19 vaccination schedules in pregnant Thai women. 18–45-year-old pregnant women with no history of COVID-19 infection or vaccination and a gestational age of ≥12 weeks were randomized 1:1:1 into three two-dose primary series scheduled 4 weeks apart: BNT162b2-BNT162b2 (Group 1), ChAdOx1-BNT162b2 (Group 2), and CoronaVac-BNT162b2 (Group 3). Serum antibody responses, maternal and cord blood antibody levels at delivery, and adverse events (AEs) following vaccination until delivery were assessed. The 124 enrolled participants had a median age of 31 (interquartile range [IQR] 26.0–35.5) years and gestational age of 23.5 (IQR 18.0–30.0) weeks. No significant difference in anti-receptor binding domain (RBD) IgG were observed across arms at 2 weeks after the second dose. Neutralizing antibody geometric mean titers against the ancestral Wuhan strain were highest in Group 3 (258.22, 95% CI [187.53, 355.56]), followed by Groups 1 (187.47, 95% CI [135.15, 260.03]) and 2 (166.63, 95% CI [124.60, 222.84]). Cord blood anti-RBD IgG was correlated with, and equal to or higher than, maternal levels at delivery (r = 0.719, P <.001) and inversely correlated with elapsed time after the second vaccination (r = −0.366, P <.001). No significant difference in cord blood antibody levels between groups were observed. Local and systemic AEs were mild-to-moderate and more frequent in Group 2. Heterologous schedules of CoronaVac-BNT162b2 or ChAdOx1-BNT162b2 induced immunogenicity on-par with BNT162b2-BNT162b2 and may be considered as alternative schedules for primary series in pregnant women in mRNA-limited vaccine settings.