Immunogenicity of bivalent versus monovalent mRNA booster vaccination among adult paramedics in Canada who had received three prior mRNA wild-type doses

Michael Asamoah-Boaheng; David M. Goldfarb; Iryna Kayda; Justin Yap; Tracy Kirkham; Mohammad Ehsanul Karim; Paul Demers; Jeffrey M. Copp; Brian Grunau

doi:10.1099/acmi.0.000791.v3

Immunogenicity of bivalent versus monovalent mRNA booster vaccination among adult paramedics in Canada who had received three prior mRNA wild-type doses

Michael Asamoah-Boaheng^1,2,3,4, David M. Goldfarb^3,5, Iryna Kayda³, Justin Yap^4,6, Tracy Kirkham^7,8, Mohammad Ehsanul Karim^2,9, Paul Demers^7,8, Jeffrey M. Copp¹⁰ and Brian Grunau^1,2,3,4
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Affiliations: ¹ Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada ² Centre for Advancing Health Outcomes, St. Pauls Hospital, Vancouver, British Columbia, Canada ³ Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada ⁴ British Columbia Resuscitation Research Collaborative, Vancouver, British Columbia, Canada ⁵ Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada ⁶ Faculty of Science, University of British Columbia, Vancouver, British Columbia, Canada ⁷ Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada ⁸ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada ⁹ School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada ¹⁰ British Columbia Emergency Health Services, British Columbia, Canada
*Correspondence: Michael Asamoah-Boaheng, [email protected]
Published: 13 January 2025 https://doi.org/10.1099/acmi.0.000791.v3

Abstract

Introduction. Comparative immunogenicity from different mRNA booster vaccines (directed at WT, BA.1 or BA.4/5 antigens) remains unclear.

Methods. We included blood samples from adult paramedics who received three mRNA WT-directed vaccines plus a fourth dose of the following: (1) WT monovalent, (2) Moderna BA.1-WT bivalent or (3) Pfizer BA.4/5 WT bivalent vaccine. The primary outcome was angiotensin-converting enzyme 2 (ACE2) inhibition to BA.4/5 antigen. We used optimal pair matching (using age, sex-at-birth, preceding SARS-CoV-2 infection and fourth vaccine-to-blood collection interval) to create balanced groups to individually compare each vaccine type to each other vaccine (overall, within subgroups defined by SARS-CoV-2 infection and after combining BA.1 and BA.4/5 cases). We compared outcomes with the Wilcoxon matched-pairs signed rank test.

Results. Overall, 158 paramedics (mean age 45 years) were included. ACE2 inhibition was higher for BA.1 compared to WT (P=0.002); however, no difference was detected between BA.4/5 vs. WT or BA.1 vs. BA.4/5. Among cases with preceding SARS-CoV-2, there were no detected between-group differences. Among cases without preceding SARS-CoV-2, the only detected difference was BA.1>WT (P=0.003). BA.1 and BA.4/5 cases combined had higher ACE2 inhibition than WT (P=0.003).

Conclusion. Omicron-directed vaccines appear to improve Omicron-specific immunogenicity; however, this appears limited to SARS-CoV-2-naive individuals.

Received: 26/01/2024
Accepted: 16/12/2024
Published Online: 13/01/2025

Keyword(s): BA.4/5 Omicron subvariant , bivalent mRNA vaccines , immunogenicity , mRNA COVID-19 vaccines and SARS-CoV-2 Omicron infection

Funding

This study was supported by the:

Michael Smith Health Research BC
- Principle Award Recipient: MichaelAsamoah-Boaheng
Government of Canada
- Principle Award Recipient: NotApplicable

This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.

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References

Andrews N, Stowe J, Kirsebom F, Toffa S, Rickeard T et al. Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant. N Engl J Med 2022; 386:1532–1546 [View Article] [PubMed]
[Google Scholar]
Chemaitelly H, Ayoub HH, AlMukdad S, Coyle P, Tang P et al. Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar. Nat Commun 2022; 13:3082 [View Article] [PubMed]
[Google Scholar]
Tseng HF, Ackerson BK, Bruxvoort KJ, Sy LS, Tubert JE et al. Effectiveness of mRNA-1273 vaccination against SARS-CoV-2 omicron subvariants BA.1, BA.2, BA.2.12.1, BA.4, and BA.5. Nat Commun 2023; 14:189 [View Article] [PubMed]
[Google Scholar]
Ferdinands JM, Rao S, Dixon BE, Mitchell PK, DeSilva MB et al. Waning 2-dose and 3-dose effectiveness of mRNA vaccines against COVID-19–associated emergency department and urgent care encounters and hospitalizations among adults during periods of Delta and Omicron variant predominance — VISION Network, 10 states, August 2021–January 2022.. MMWR Morb Mortal Wkly Rep 2022; 71:255–263 [View Article]
[Google Scholar]
Link-Gelles R, Levy ME, Gaglani M, Irving SA, Stockwell M et al. Effectiveness of 2, 3, and 4 COVID-19 mRNA vaccine doses among immunocompetent adults during periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 sublineages predominated — VISION Network, 10 states, December 2021–June 2022. MMWR Morb Mortal Wkly Rep 2021; 71:931–939 [View Article]
[Google Scholar]
Tartof SY, Slezak JM, Puzniak L, Hong V, Xie F et al. Durability of BNT162b2 vaccine against hospital and emergency department admissions due to the omicron and delta variants in a large health system in the USA: a test-negative case–control study. Lancet Respir Med 2022; 10:689–699 [View Article]
[Google Scholar]
Offit PA. Bivalent COVID-19 vaccines - a cautionary tale. N Engl J Med 2023; 388:481–483 [View Article] [PubMed]
[Google Scholar]
Pfizer Pfizer and BioNTech announce Omicron-adapted COVID-19 vaccine candidates demonstrate high immune response against Omicron; 2022 https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce-omicron-adapted-covid-19 accessed 16 May 2023
CORSIP Canada COVID-19 occupational risk, seroprevalence and immunity among paramedics in canada; 2023 https://omc.ohri.ca/CORSIP/pages/About.aspx accessed 20 April 2023
Grunau B, Tom J, Asamoah-Boaheng M, O’Brien SF, Drews SJ et al. Sensitivity of the Elecsys nucleocapsid assay for the detection of preceding SARS-CoV-2 infections. Open Forum Infect Dis 2022; 9:fac349 [View Article] [PubMed]
[Google Scholar]
SAS Institute Inc SAS/STAT® 14.2 User’s Guide The PSMATCH Procedure. Cary, NC: SAS Institute Inc; 2016 https://support.sas.com/documentation/onlinedoc/stat/142/psmatch.pdf
Greifer N. Matching methods; 2023 https://cran.r-project.org/web/packages/MatchIt/vignettes/matching-methods.html#optimal-pair-matching-method-optimal accessed 20 June 2023
Andersson NW, Thiesson EM, Baum U, Pihlström N, Starrfelt J et al. Comparative effectiveness of the bivalent BA.4-5 and BA.1 mRNA-booster vaccines in the Nordic countries. Infect Dis 20231–25 [View Article]
[Google Scholar]
Grunau B, Prusinkiewicz M, Asamoah-Boaheng M, Golding L, Lavoie PM et al. Correlation of SARS-CoV-2 viral neutralizing antibody titers with anti-spike antibodies and ACE-2 inhibition among vaccinated individuals. Microbiol Spectr 2022; 10:e0131522 [View Article] [PubMed]
[Google Scholar]

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Immunogenicity of bivalent versus monovalent mRNA booster vaccination among adult paramedics in Canada who had received three prior mRNA wild-type doses

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Immunogenicity of bivalent versus monovalent mRNA booster vaccination among adult paramedics in Canada who had received three prior mRNA wild-type doses

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