What is the clinical evidence from this study?

Study design: Observational. Population: COVID-19 vaccination (n=40). Intervention: BA.4/5-containing bivalent mRNA vaccine vs. BA.5 neutralizing antibody titers. Primary outcome: Neutralizing antibody titer against XBB.1.5 compared to BA.5 at 1 month post-vaccination (2.8-fold lower, 95% CI 2.2-3.4, p=<0.001).

January 1, 2023Immune NetworkOpen Access

Low Neutralizing Activities to the Omicron Subvariants BN.1 and XBB.1.5 of Sera From the Individuals Vaccinated With a BA.4/5-Containing Bivalent mRNA Vaccine

Q: What are the key findings of this study?

One month after BA.4/5-containing bivalent vaccination, neutralizing antibody titers against the XBB.1.5 subvariant were 2.8-fold lower compared to those against the BA.5 subvariant.

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Key result

One month after BA.4/5-containing bivalent vaccination, neutralizing antibody titers against the XBB.1.5 subvariant were 2.8-fold lower compared to those against the BA.5 subvariant.

Why the study?

The continuous emergence of SARS-CoV-2 variants has provided insights for updating COVID-19 vaccines, prompting examination of neutralizing activity induced by a BA.4/5-containing bivalent mRNA vaccine against Omicron subvariants BN.1 and XBB.1.5.

Does a BA.4/5-containing bivalent mRNA vaccine booster improve neutralizing antibody titers against Omicron subvariants BN.1 and XBB.1.5 in previously vaccinated individuals?

Population

40 individuals vaccinated with a BA.4/5-containing bivalent vaccine after a monovalent booster

Design

Prospective observational cohort study

Authors

ENEliel NhamInternational Vaccine Institute JKJineui KimInternational Vaccine Institute JLJungmin LeeInternational Vaccine Institute

Discussion

Member takes

Implication

BA.4/5 bivalent boosters were associated with lower nAb titers against BN.1/XBB.1.5; leaves open whether variant-updated vaccines are needed.

Study Design

Type

Observational (n=40)

Multicenter

Structured PICO

Does a BA.4/5-containing bivalent mRNA vaccine booster improve neutralizing antibody titers against Omicron subvariants BN.1 and XBB.1.5 in previously vaccinated individuals?

Population

40 adults (median age 36, 80% female) who had completed a primary series and monovalent booster and were planning to receive a BA.4/5-containing bivalent mRNA booster, followed for 3 months.

Intervention

BA.4/5-containing bivalent mRNA vaccine booster

Comparator

Pre-vaccination baseline

Outcome

Neutralizing antibody (nAb) titers against ancestral SARS-CoV-2 and Omicron subvariants BA.5, BN.1, and XBB.1.5 at one month and three months after a bivalent boostersurrogate

Main Result

Effect estimate: 2.8-fold lower (95% CI 2.2-3.4)

Absolute Event Rate: 227.2% vs 626.9%

p-value: p=<0.001

A BA.4/5-containing bivalent mRNA vaccine boosts neutralizing antibodies against Omicron subvariants, but the response to BN.1 and XBB.1.5 is lower compared to ancestral and BA.5 strains, suggesting a need for updated vaccines.

Limitations

Small sample size and study population consisted mainly of young women
Duration for the observation of neutralizing antibody activities is limited to three months after the bivalent vaccination
Lack of sequencing data to confirm that participants infected during the Omicron predominant period were actually infected with the Omicron variant
Absence of a self-reported COVID-19 history and anti-N IgG negativity does not guarantee infection-naïve status due to potential antibody waning
Did not investigate the T cell response, which is a crucial immune component in preventing severe disease

Cite This Study

Nham et al. (2023) conducted an observational in COVID-19 vaccination (n=40). BA.4/5-containing bivalent mRNA vaccine vs. BA.5 neutralizing antibody titers was evaluated on Neutralizing antibody titer against XBB.1.5 compared to BA.5 at 1 month post-vaccination (2.8-fold lower, 95% CI 2.2-3.4, p=<0.001). One month after BA.4/5-containing bivalent vaccination, neutralizing antibody titers against the XBB.1.5 subvariant were 2.8-fold lower compared to those against the BA.5 subvariant.

synapsesocial.com/papers/6a962c1f804be5fdf4bad15e https://doi.org/10.4110/in.2023.23.e43

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Implication

BA.4/5 bivalent boosters were associated with lower nAb titers against BN.1/XBB.1.5; leaves open whether variant-updated vaccines are needed.

Low Neutralizing Activities to the Omicron Subvariants BN.1 and XBB.1.5 of Sera From the Individuals Vaccinated With a BA.4/5-Containing Bivalent mRNA Vaccine

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Low Neutralizing Activities to the Omicron Subvariants BN.1 and XBB.1.5 of Sera From the Individuals Vaccinated With a BA.4/5-Containing Bivalent mRNA Vaccine

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider