No Immunological Interference or Safety Concerns When Adjuvanted Recombinant Zoster Vaccine Is Coadministered With a Coronavirus Disease 2019 mRNA-1273 Booster Vaccine in Adults Aged 50 Years and Older: A Randomized Trial.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
11 11 2023
Historique:
received: 12 03 2023
medline: 13 11 2023
pubmed: 19 6 2023
entrez: 19 6 2023
Statut: ppublish

Résumé

There is growing consensus that coronavirus disease 2019 booster vaccines may be coadministered with other age-appropriate vaccines. Adding to the limited available data supporting coadministration, especially with adjuvanted vaccines, could enhance vaccine coverage in adults. In this phase 3, randomized, open-label study, eligible adults aged ≥50 years were randomly assigned (1:1) to receive mRNA-1273 (50 µg) booster vaccination and a first dose of recombinant zoster vaccine (RZV1) 2 weeks apart (Seq group) or concomitantly (Coad group). The second RZV dose (RZV2) was administered 2 months post-RZV1 in both groups. Primary objectives were noninferiority of anti-glycoprotein E (gE) and anti-spike protein antibody responses in the Coad group compared to the Seq group. Safety and further immunogenicity assessments were secondary objectives. In total, 273 participants were randomized to the Seq group and 272 to the Coad group. Protocol-specified noninferiority criteria were met. The adjusted geometric mean concentration ratio (Seq/Coad) was 1.01 (95% confidence interval [CI], .89-1.13) for anti-gE antibodies 1 month post-RZV2, and 1.09 (95% CI, .90-1.32) for anti-spike antibodies 1 month post-mRNA-1273 booster. No clinically relevant differences were observed in overall frequency, intensity, or duration of adverse events between the 2 study groups. Most solicited adverse events were mild/moderate in intensity, each with median duration ≤2.5 days. Administration site pain and myalgia were the most frequently reported in both groups. Coadministration of mRNA-1273 booster vaccine with RZV in adults aged ≥50 years was immunologically noninferior to sequential administration and had a safety and reactogenicity profile consistent with both vaccines administered sequentially. Clinical Trials Registration. NCT05047770.

Sections du résumé

BACKGROUND
There is growing consensus that coronavirus disease 2019 booster vaccines may be coadministered with other age-appropriate vaccines. Adding to the limited available data supporting coadministration, especially with adjuvanted vaccines, could enhance vaccine coverage in adults.
METHODS
In this phase 3, randomized, open-label study, eligible adults aged ≥50 years were randomly assigned (1:1) to receive mRNA-1273 (50 µg) booster vaccination and a first dose of recombinant zoster vaccine (RZV1) 2 weeks apart (Seq group) or concomitantly (Coad group). The second RZV dose (RZV2) was administered 2 months post-RZV1 in both groups. Primary objectives were noninferiority of anti-glycoprotein E (gE) and anti-spike protein antibody responses in the Coad group compared to the Seq group. Safety and further immunogenicity assessments were secondary objectives.
RESULTS
In total, 273 participants were randomized to the Seq group and 272 to the Coad group. Protocol-specified noninferiority criteria were met. The adjusted geometric mean concentration ratio (Seq/Coad) was 1.01 (95% confidence interval [CI], .89-1.13) for anti-gE antibodies 1 month post-RZV2, and 1.09 (95% CI, .90-1.32) for anti-spike antibodies 1 month post-mRNA-1273 booster. No clinically relevant differences were observed in overall frequency, intensity, or duration of adverse events between the 2 study groups. Most solicited adverse events were mild/moderate in intensity, each with median duration ≤2.5 days. Administration site pain and myalgia were the most frequently reported in both groups.
CONCLUSIONS
Coadministration of mRNA-1273 booster vaccine with RZV in adults aged ≥50 years was immunologically noninferior to sequential administration and had a safety and reactogenicity profile consistent with both vaccines administered sequentially. Clinical Trials Registration. NCT05047770.

Identifiants

pubmed: 37335963
pii: 7202273
doi: 10.1093/cid/ciad361
pmc: PMC10640691
doi:

Substances chimiques

2019-nCoV Vaccine mRNA-1273 EPK39PL4R4
Adjuvants, Immunologic 0
Antibodies, Viral 0
COVID-19 Vaccines 0
Herpes Zoster Vaccine 0
Vaccines, Synthetic 0

Banques de données

ClinicalTrials.gov
['NCT05047770']

Types de publication

Clinical Trial, Phase III Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1238-1246

Informations de copyright

© GSK 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Déclaration de conflit d'intérêts

Potential conflicts of interest. A. N. is employed by GSK. A. K. is employed by GSK. P. P. is employed by GSK. J. D. is employed by GSK and holds shares in GSK. T. B. is employed by GSK and holds shares in GSK. A. M.-O. is employed by GSK and holds shares in GSK. B. L. is employed by Moderna and holds shares in Moderna. J. M. was employed by the GSK until May 2020 and is now employed by Moderna. J. M. also reports she holds shares in GSK and Moderna. K. A. is employed by Moderna and holds shares in Moderna. All authors declare no other financial and non-financial relationships and activities. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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Auteurs

Abdi Naficy (A)

Clinical Sciences, GSK, Rockville, Maryland, USA.

Adrienne Kuxhausen (A)

Biostatistics, GSK, Rockville, Maryland, USA.

Paola Pirrotta (P)

Safety Evaluation & Risk Management, GSK, Wavre, Belgium.

Brett Leav (B)

Infectious Disease Development, Moderna, Inc, Cambridge, Massachusetts, USA.

Jacqueline Miller (J)

Infectious Disease Development, Moderna, Inc, Cambridge, Massachusetts, USA.

Kate Anteyi (K)

Clinical Safety & Pharmacovigilance, Moderna, Inc, Cambridge, Massachusetts, USA.

Jasur Danier (J)

Clinical Sciences, GSK, Rockville, Maryland, USA.

Thomas Breuer (T)

Global Health, GSK, Tres Cantos, Spain.

Agnes Mwakingwe-Omari (A)

Clinical Sciences, GSK, Rockville, Maryland, USA.

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Classifications MeSH