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A meta-analysis on the immunogenicity of homologous versus heterologous immunization regimens against SARS-CoV-2 Beta, Delta, and Omicron BA.1 VoCs in healthy adults
Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation, Huazhong University of Science and Technology, Wuhan, China.
Department of Mathematica and Statistics, Fourah Bay College, University of Sierra Leone, Sierra Leone.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.ORCID iD: 0000-0001-6089-8906
Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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2025 (English)In: Journal of Microbiology and Biotechnology, ISSN 1017-7825, E-ISSN 1738-8872, Vol. 35, article id e2411059Article in journal (Refereed) Published
Abstract [en]

Since the outbreak of the COVID-19 pandemic, SARS-CoV-2 has not stopped evolving, leading to the emergence of variants of concern (VoCs) involved in significant immune escape. Here, we compared the immunogenicity of different prime-boost vaccination regimens against SARS-CoV-2 wildtype (WT) and its Beta, Delta, and Omicron BA.1 VoCs. We used 5 databases to retrieve publications and random-effect models to estimate pooled neutralization titers. We included 11 randomized controlled trials (RCTs) and 16 non-RCTs, 10 prime-boost vaccination regimens, and 4598 subjects. We found neutralization activity against SARS-CoV-2 decreased with virus evolution. The heterologous immunization was more effective. The increase in neutralization titers against SARS-CoV-2 WT and Beta, Delta, and Omicron BA.1 VoCs after heterologous immunization was 1.41(95%CI:0.82–2.01), 0.90(95%CI:0.39–1.41), 1.23 (95%CI: 0.81–1.65), and 1.32 (95%CI: 0.99–1.65), respectively. Furthermore, the booster dose of viral vector vaccine did not show a higher increase in neutralization titers against SARS-CoV-2 WT(MD=0.48; 95%CI:−1.12-1.09), Beta (MD=0.20; 95%CI:−0.26-0.67), Delta (MD=0.35; 95%CI:−0.09-0.79), and Omicron BA.1 (MD=0.38; 95%CI:−0.14-0.89) VoCs. The combination of inactivated-recombinant protein vaccines showed a higher increase in neutralization titers (Beta: MD=1.88 and Delta: MD=1.70) than other combinations of vaccines. However, only a combination of mRNA-viral vector vaccines showed a higher increase in neutralization titers (MD:1.52; 95%CI:0.34-2.70) against Omicron BA.1 VoC. Interestingly, the viral vector-mRNA immunization regimen appears better compared to mRNA-viral vector regimen, especially against Beta and Delta VoCs. Overall, the type of combination followed by the order of administration of COVID-19 vaccines could be a potential vaccine strategy against the occurrence of SARS-CoV-2 variants.

Place, publisher, year, edition, pages
Korean Society for Microbiology and Biotechnology , 2025. Vol. 35, article id e2411059
Keywords [en]
COVID-19 vaccines, heterologous booster, homologous booster, immunogenicity, neutralization titers, SARS-CoV-2 VoCs
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-238237DOI: 10.4014/jmb.2411.11059ISI: 001460039500004PubMedID: 40147926Scopus ID: 2-s2.0-105002360682OAI: oai:DiVA.org:umu-238237DiVA, id: diva2:1955241
Available from: 2025-04-29 Created: 2025-04-29 Last updated: 2025-04-29Bibliographically approved

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Ullah, Nadeem

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