Article
作者: Savergave, Laxman ; Karmalkar, Abhishek ; Singh, Ajay ; Lahoti, Manoj ; Borthakur, Swapnav ; Bulle, Ajay ; Saraf, Amit ; Giri, Krishna ; Agarwal, Praveen ; Vikhe, Vikram ; Rao, A. Venkateshwar ; Kumar, Durgesh ; Kaviraj, Swarnendu ; Baranwal, Ekta ; Jain, Manish Kumar ; Siddiqui, Md. Sabah ; Das, Manoja Kumar ; Shukla, Dhaiwat ; Shende, Prakash ; Barge, Vijaykumar ; Krishnan, Jayashri ; Raghuwanshi, Arjun ; Supe, Pravin Dinkar ; Pophale, Himanshu ; Yadav, Anjali ; Kulkarni, Ruta ; Deshpande, Shrikant ; Bhardwaj, Pankaj ; Gurjar, Rohan ; Kulkarni, Aishwarya ; Virkar, Rashmi ; Deshmukh, Bhaskar ; Shinde, Ravindra Baban ; Tummuru, V. Reddy ; Singh, Sanjay
Abstract:Here we conducted a multicenter open-label, randomized phase 2 and 3 study to assess the safety and immunogenicity of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-specific (BA.1/B.1.1.529), monovalent, thermostable, self-amplifying mRNA vaccine, GEMCOVAC-OM, when administered intradermally as a booster in healthy adults who had received two doses of BBV152 or ChAdOx1 nCoV-19. GEMCOVAC-OM was well tolerated with no related serious adverse events in both phase 2 and phase 3. In phase 2, the safety and immunogenicity of GEMCOVAC-OM was compared with our prototype mRNA vaccine GEMCOVAC-19 (D614G variant-specific) in 140 participants. At day 29 after vaccination, there was a significant rise in anti-spike (BA.1) IgG antibodies with GEMCOVAC-OM (P < 0.0001) and GEMCOVAC-19 (P < 0.0001). However, the IgG titers (primary endpoint) and seroconversion were higher with GEMCOVAC-OM (P < 0.0001). In phase 3, GEMCOVAC-OM was compared with ChAdOx1 nCoV-19 in 3,140 participants (safety cohort), which included an immunogenicity cohort of 420 participants. At day 29, neutralizing antibody titers against the BA.1 variant of SARS-CoV-2 were significantly higher than baseline in the GEMCOVAC-OM arm (P < 0.0001), but not in the ChAdOx1 nCoV-19 arm (P = 0.1490). GEMCOVAC-OM was noninferior (primary endpoint) and superior to ChAdOx1 nCoV-19 in terms of neutralizing antibody titers and seroconversion rate (lower bound 95% confidence interval of least square geometric mean ratio >1 and difference in seroconversion >0% for superiority). At day 29, anti-spike IgG antibodies and seroconversion (secondary endpoints) were significantly higher with GEMCOVAC-OM (P < 0.0001). These results demonstrate that GEMCOVAC-OM is safe and boosts immune responses against the B.1.1.529 variant. Clinical Trial Registry India identifier: CTRI/2022/10/046475.