A major British study on mixing COVID-19 vaccines has found that people had a better immune response when they received a first dose of the AstraZeneca or Pfizer-BioNTech vaccines followed by the Moderna vaccine nine weeks later, the results showed on Monday.
“We found a really good immune response across the board ... in fact, higher than the threshold set by two doses of the Oxford-AstraZeneca vaccine,” said Matthew Snape, the University of Oxford professor behind the trial dubbed Com-COV2.
The findings supporting flexible dosing offer some hope to poor and middle-income countries that might need to combine different brands between the first and second doses if supplies run low or become unstable.
“I think the data from this study will be especially interesting and valuable to low and middle-income countries, where they’re still rolling out the first two doses of vaccines,” Snape said.
“We’re showing ... you don’t have to stick rigidly to receiving the same vaccine for a second dose ... and that if the program will be delivered more quickly by using multiple vaccines, then it is okay to do so,” Snape added.
If the AstraZeneca vaccine is followed by a Moderna or Novavax vaccine, higher antibodies and T-cell responses were induced versus two doses of AstraZeneca, Oxford researchers said.
The study of 1,070 volunteers also found that a dose of the Pfizer-BioNTech vaccine followed by a Moderna vaccine is better than two doses of the Pfizer-BioNTech vaccine.
Pfizer-BioNTech followed by Novavax induced higher antibodies than two doses of AstraZeneca, although two doses of AstraZeneca induced lower antibody and T-cell responses than two doses of Pfizer-BioNTech.
No safety concerns were raised, an Oxford study published in the Lancet medical journal said.
Many countries have been deploying a mix-and-match approach well before robust data were available, as nations were faced with soaring infection numbers, low supplies and slow vaccination rollouts.
Longevity of protection offered by vaccines has been under scrutiny, with booster doses being considered as cases surge. New variants of SARS-CoV-2, including Delta and Omicron, have increased the pressure to speed up vaccination campaigns.
Blood samples from participants were tested against the Wild-Type, Beta and Delta variants, researchers of the Com-COV2 study said, adding that vaccines’ efficacy against the variants had waned, but this was consistent across mixed courses.
Deploying vaccines from different technology platforms — such as Pfizer and Moderna’s mRNA, AstraZeneca’s viral vector and Novavax’s protein-based shot — and within the same schedule is new.
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