Immune Correlates Analysis of the mRNA-1273 COVID-19 Vaccine Efficacy Trial.
Journal
medRxiv : the preprint server for health sciences
Titre abrégé: medRxiv
Pays: United States
ID NLM: 101767986
Informations de publication
Date de publication:
15 Aug 2021
15 Aug 2021
Historique:
entrez:
17
8
2021
pubmed:
18
8
2021
medline:
18
8
2021
Statut:
epublish
Résumé
In the Coronavirus Efficacy (COVE) trial, estimated mRNA-1273 vaccine efficacy against coronavirus disease-19 (COVID-19) was 94%. SARS-CoV-2 antibody measurements were assessed as correlates of COVID-19 risk and as correlates of protection. Through case-cohort sampling, participants were selected for measurement of four serum antibody markers at Day 1 (first dose), Day 29 (second dose), and Day 57: IgG binding antibodies (bAbs) to Spike, bAbs to Spike receptor-binding domain (RBD), and 50% and 80% inhibitory dilution pseudovirus neutralizing antibody titers calibrated to the WHO International Standard (cID50 and cID80). Participants with no evidence of previous SARS-CoV-2 infection were included. Cox regression assessed in vaccine recipients the association of each Day 29 or 57 serologic marker with COVID-19 through 126 or 100 days of follow-up, respectively, adjusting for risk factors. Day 57 Spike IgG, RBD IgG, cID50, and cID80 neutralization levels were each inversely correlated with risk of COVID-19: hazard ratios 0.66 (95% CI 0.50, 0.88; p=0.005); 0.57 (0.40, 0.82; p=0.002); 0.42 (0.27, 0.65; p<0.001); 0.35 (0.20, 0.61; p<0.001) per 10-fold increase in marker level, respectively, multiplicity adjusted P-values 0.003-0.010. Results were similar for Day 29 markers (multiplicity adjusted P-values <0.001-0.003). For vaccine recipients with Day 57 reciprocal cID50 neutralization titers that were undetectable (<2.42), 100, or 1000, respectively, cumulative incidence of COVID-19 through 100 days post Day 57 was 0.030 (0.010, 0.093), 0.0056 (0.0039, 0.0080), and 0.0023 (0.0013, 0.0036). For vaccine recipients at these titer levels, respectively, vaccine efficacy was 50.8% (-51.2, 83.0%), 90.7% (86.7, 93.6%), and 96.1% (94.0, 97.8%). Causal mediation analysis estimated that the proportion of vaccine efficacy mediated through Day 29 cID50 titer was 68.5% (58.5, 78.4%). Binding and neutralizing antibodies correlated with COVID-19 risk and vaccine efficacy and likely have utility in predicting mRNA-1273 vaccine efficacy against COVID-19. COVE ClinicalTrials.gov number, NCT04470427.
Sections du résumé
BACKGROUND
BACKGROUND
In the Coronavirus Efficacy (COVE) trial, estimated mRNA-1273 vaccine efficacy against coronavirus disease-19 (COVID-19) was 94%. SARS-CoV-2 antibody measurements were assessed as correlates of COVID-19 risk and as correlates of protection.
METHODS
METHODS
Through case-cohort sampling, participants were selected for measurement of four serum antibody markers at Day 1 (first dose), Day 29 (second dose), and Day 57: IgG binding antibodies (bAbs) to Spike, bAbs to Spike receptor-binding domain (RBD), and 50% and 80% inhibitory dilution pseudovirus neutralizing antibody titers calibrated to the WHO International Standard (cID50 and cID80). Participants with no evidence of previous SARS-CoV-2 infection were included. Cox regression assessed in vaccine recipients the association of each Day 29 or 57 serologic marker with COVID-19 through 126 or 100 days of follow-up, respectively, adjusting for risk factors.
RESULTS
RESULTS
Day 57 Spike IgG, RBD IgG, cID50, and cID80 neutralization levels were each inversely correlated with risk of COVID-19: hazard ratios 0.66 (95% CI 0.50, 0.88; p=0.005); 0.57 (0.40, 0.82; p=0.002); 0.42 (0.27, 0.65; p<0.001); 0.35 (0.20, 0.61; p<0.001) per 10-fold increase in marker level, respectively, multiplicity adjusted P-values 0.003-0.010. Results were similar for Day 29 markers (multiplicity adjusted P-values <0.001-0.003). For vaccine recipients with Day 57 reciprocal cID50 neutralization titers that were undetectable (<2.42), 100, or 1000, respectively, cumulative incidence of COVID-19 through 100 days post Day 57 was 0.030 (0.010, 0.093), 0.0056 (0.0039, 0.0080), and 0.0023 (0.0013, 0.0036). For vaccine recipients at these titer levels, respectively, vaccine efficacy was 50.8% (-51.2, 83.0%), 90.7% (86.7, 93.6%), and 96.1% (94.0, 97.8%). Causal mediation analysis estimated that the proportion of vaccine efficacy mediated through Day 29 cID50 titer was 68.5% (58.5, 78.4%).
CONCLUSIONS
CONCLUSIONS
Binding and neutralizing antibodies correlated with COVID-19 risk and vaccine efficacy and likely have utility in predicting mRNA-1273 vaccine efficacy against COVID-19.
TRIAL REGISTRATION NUMBER
BACKGROUND
COVE ClinicalTrials.gov number, NCT04470427.
Identifiants
pubmed: 34401888
doi: 10.1101/2021.08.09.21261290
pmc: PMC8366808
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT04470427']
Types de publication
Preprint
Langues
eng
Subventions
Organisme : NIH HHS
ID : S10 OD028685
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI068614
Pays : United States
Commentaires et corrections
Type : UpdateIn
Références
Science. 2020 Mar 13;367(6483):1260-1263
pubmed: 32075877
Vaccine. 2007 May 10;25(19):3816-26
pubmed: 17368878
J Clin Microbiol. 2020 Oct 21;58(11):
pubmed: 32826322
Cell. 2021 Jun 24;184(13):3467-3473.e11
pubmed: 34133941
Stat Med. 1998 Apr 30;17(8):857-72
pubmed: 9595616
Proc Natl Acad Sci U S A. 2020 May 26;117(21):11727-11734
pubmed: 32376634
Nat Med. 2021 Jul;27(7):1205-1211
pubmed: 34002089
Ann Intern Med. 2017 Aug 15;167(4):268-274
pubmed: 28693043
JAMA. 2021 Apr 6;325(13):1318-1320
pubmed: 33635317
Clin Vaccine Immunol. 2010 Jul;17(7):1055-65
pubmed: 20463105
Clin Infect Dis. 2019 May 2;68(10):1713-1717
pubmed: 30202873
Vaccine. 2021 Jul 22;39(32):4423-4428
pubmed: 34210573
Lancet. 2020 Nov 14;396(10262):1595-1606
pubmed: 33065034
Nature. 2020 May;581(7807):215-220
pubmed: 32225176
JAMA. 2021 Jul 6;326(1):46-55
pubmed: 34081073
N Engl J Med. 2020 Nov 12;383(20):1920-1931
pubmed: 32663912
MMWR Morb Mortal Wkly Rep. 2021 Apr 02;70(13):495-500
pubmed: 33793460
Clin Infect Dis. 2012 Jun;54(11):1615-7
pubmed: 22437237
Cell Host Microbe. 2021 Apr 14;29(4):529-539.e3
pubmed: 33705729
Nature. 2021 Feb;590(7847):630-634
pubmed: 33276369
N Engl J Med. 2021 May 13;384(19):1866-1868
pubmed: 33761203
Lancet. 2021 Apr 10;397(10282):1347-1348
pubmed: 33770519
Nat Microbiol. 2020 Apr;5(4):562-569
pubmed: 32094589
N Engl J Med. 2021 Feb 4;384(5):403-416
pubmed: 33378609
Lancet. 2021 Mar 13;397(10278):1023-1034
pubmed: 33587887
Science. 2021 Sep 17;373(6561):eabj0299
pubmed: 34529476
Stat Med. 2012 Nov 10;31(25):2973-84
pubmed: 22711298
Science. 2020 Aug 14;369(6505):806-811
pubmed: 32434945
PLoS One. 2021 Oct 19;16(10):e0258858
pubmed: 34665829