Safety and Immunogenicity of Two RNA-Based Covid-19 Vaccine Candidates.
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Viral
/ blood
BNT162 Vaccine
COVID-19
/ immunology
COVID-19 Vaccines
/ adverse effects
Female
Humans
Injections, Intramuscular
/ adverse effects
Male
Middle Aged
Neutralization Tests
SARS-CoV-2
/ immunology
Single-Blind Method
Spike Glycoprotein, Coronavirus
Young Adult
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
17 12 2020
17 12 2020
Historique:
pubmed:
15
10
2020
medline:
29
12
2020
entrez:
14
10
2020
Statut:
ppublish
Résumé
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the resulting disease, coronavirus disease 2019 (Covid-19), have spread to millions of persons worldwide. Multiple vaccine candidates are under development, but no vaccine is currently available. Interim safety and immunogenicity data about the vaccine candidate BNT162b1 in younger adults have been reported previously from trials in Germany and the United States. In an ongoing, placebo-controlled, observer-blinded, dose-escalation, phase 1 trial conducted in the United States, we randomly assigned healthy adults 18 to 55 years of age and those 65 to 85 years of age to receive either placebo or one of two lipid nanoparticle-formulated, nucleoside-modified RNA vaccine candidates: BNT162b1, which encodes a secreted trimerized SARS-CoV-2 receptor-binding domain; or BNT162b2, which encodes a membrane-anchored SARS-CoV-2 full-length spike, stabilized in the prefusion conformation. The primary outcome was safety (e.g., local and systemic reactions and adverse events); immunogenicity was a secondary outcome. Trial groups were defined according to vaccine candidate, age of the participants, and vaccine dose level (10 μg, 20 μg, 30 μg, and 100 μg). In all groups but one, participants received two doses, with a 21-day interval between doses; in one group (100 μg of BNT162b1), participants received one dose. A total of 195 participants underwent randomization. In each of 13 groups of 15 participants, 12 participants received vaccine and 3 received placebo. BNT162b2 was associated with a lower incidence and severity of systemic reactions than BNT162b1, particularly in older adults. In both younger and older adults, the two vaccine candidates elicited similar dose-dependent SARS-CoV-2-neutralizing geometric mean titers, which were similar to or higher than the geometric mean titer of a panel of SARS-CoV-2 convalescent serum samples. The safety and immunogenicity data from this U.S. phase 1 trial of two vaccine candidates in younger and older adults, added to earlier interim safety and immunogenicity data regarding BNT162b1 in younger adults from trials in Germany and the United States, support the selection of BNT162b2 for advancement to a pivotal phase 2-3 safety and efficacy evaluation. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.).
Sections du résumé
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the resulting disease, coronavirus disease 2019 (Covid-19), have spread to millions of persons worldwide. Multiple vaccine candidates are under development, but no vaccine is currently available. Interim safety and immunogenicity data about the vaccine candidate BNT162b1 in younger adults have been reported previously from trials in Germany and the United States.
METHODS
In an ongoing, placebo-controlled, observer-blinded, dose-escalation, phase 1 trial conducted in the United States, we randomly assigned healthy adults 18 to 55 years of age and those 65 to 85 years of age to receive either placebo or one of two lipid nanoparticle-formulated, nucleoside-modified RNA vaccine candidates: BNT162b1, which encodes a secreted trimerized SARS-CoV-2 receptor-binding domain; or BNT162b2, which encodes a membrane-anchored SARS-CoV-2 full-length spike, stabilized in the prefusion conformation. The primary outcome was safety (e.g., local and systemic reactions and adverse events); immunogenicity was a secondary outcome. Trial groups were defined according to vaccine candidate, age of the participants, and vaccine dose level (10 μg, 20 μg, 30 μg, and 100 μg). In all groups but one, participants received two doses, with a 21-day interval between doses; in one group (100 μg of BNT162b1), participants received one dose.
RESULTS
A total of 195 participants underwent randomization. In each of 13 groups of 15 participants, 12 participants received vaccine and 3 received placebo. BNT162b2 was associated with a lower incidence and severity of systemic reactions than BNT162b1, particularly in older adults. In both younger and older adults, the two vaccine candidates elicited similar dose-dependent SARS-CoV-2-neutralizing geometric mean titers, which were similar to or higher than the geometric mean titer of a panel of SARS-CoV-2 convalescent serum samples.
CONCLUSIONS
The safety and immunogenicity data from this U.S. phase 1 trial of two vaccine candidates in younger and older adults, added to earlier interim safety and immunogenicity data regarding BNT162b1 in younger adults from trials in Germany and the United States, support the selection of BNT162b2 for advancement to a pivotal phase 2-3 safety and efficacy evaluation. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.).
Identifiants
pubmed: 33053279
doi: 10.1056/NEJMoa2027906
pmc: PMC7583697
doi:
Substances chimiques
Antibodies, Viral
0
COVID-19 Vaccines
0
Spike Glycoprotein, Coronavirus
0
spike protein, SARS-CoV-2
0
BNT162 Vaccine
N38TVC63NU
Banques de données
ClinicalTrials.gov
['NCT04368728']
Types de publication
Clinical Trial, Phase I
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2439-2450Commentaires et corrections
Type : UpdateOf
Type : CommentIn
Informations de copyright
Copyright © 2020 Massachusetts Medical Society.
Références
Science. 2020 Mar 13;367(6483):1260-1263
pubmed: 32075877
N Engl J Med. 2020 Nov 12;383(20):1920-1931
pubmed: 32663912
Vaccine. 2019 May 31;37(25):3326-3334
pubmed: 31079849
Nature. 2020 Oct;586(7830):589-593
pubmed: 32785213
Biochem Biophys Res Commun. 2004 Nov 12;324(2):773-81
pubmed: 15474494
Vaccine. 2013 Jun 26;31(30):3051-8
pubmed: 23701746
Virology. 2016 Jan 15;488:169-78
pubmed: 26650692
MMWR Morb Mortal Wkly Rep. 2020 Jun 19;69(24):759-765
pubmed: 32555134
N Engl J Med. 2017 Jan 26;376(4):330-341
pubmed: 25830322
Proc Natl Acad Sci U S A. 2017 Aug 29;114(35):E7348-E7357
pubmed: 28807998
Mol Ther. 2008 Nov;16(11):1833-40
pubmed: 18797453
Nature. 2020 Oct;586(7830):594-599
pubmed: 32998157
JAMA. 2015 Mar 24-31;313(12):1249-55
pubmed: 25742465
Vaccine. 2010 May 7;28(21):3627-31
pubmed: 20362616
Annu Rev Immunol. 1997;15:235-70
pubmed: 9143688
J Control Release. 2015 Nov 10;217:345-51
pubmed: 26264835
Nat Commun. 2020 Aug 13;11(1):4059
pubmed: 32792628
J Immunol. 2004 Aug 1;173(3):1663-70
pubmed: 15265895
Cell Host Microbe. 2020 May 13;27(5):841-848.e3
pubmed: 32289263
Lancet. 2009 Jun 6;373(9679):1949-57
pubmed: 19493565
J Mol Biol. 2004 Apr 2;337(4):905-15
pubmed: 15033360