mRNA-1273诱导青少年SARS-CoV-2免疫反应的安全性和持久性:TeenCOVE 2/3期试验结果。

IF 9.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
EClinicalMedicine Pub Date : 2024-07-18 eCollection Date: 2024-08-01 DOI:10.1016/j.eclinm.2024.102720
Amparo L Figueroa, Kashif Ali, Gary Berman, Honghong Zhou, Weiping Deng, Wenqin Xu, Stephanie Lussier, Bethany Girard, Frank J Dutko, Karen Slobod, Anne Yeakey, Frances Priddy, Jacqueline M Miller, Rituparna Das
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引用次数: 0

摘要

背景:在青少年中,疫苗接种诱导的免疫反应的纵向变化仍未得到充分描述。我们介绍了接种过疫苗的青少年接种 2 剂 mRNA-1273 100 μg 主要系列疫苗后的长期安全性、免疫原性和 COVID-19 发生率,以及接种单剂 mRNA-1273 50 μg 后的免疫原性:TeenCOVE (NCT04649151) 第 1 部分将青少年(12-17 岁)随机分为 2 剂 mRNA-1273 100 μg(n = 2490)或安慰剂(n = 1243),每剂间隔 28 天。随后,安慰剂接受者(n = 91)可接受开放标签 mRNA-1273。主要目标包括 12 个月内的预设不良事件;次要目标是 12 个月内的 COVID-19 发生率以及针对 SARS-CoV-2(祖先/变种)的中和抗体和尖峰结合抗体(nAbs/bAbs)(研究期限:2020 年 12 月至 2022 年 1 月)。在第 2 部分中,未接种过疫苗的青少年(n = 52)最多接种 2 次 mRNA-1273 50 μg;中期分析包括 SARS-CoV-2 基础抗体阳性参与者(血清学/生理学证据表明曾感染)注射后第 1 天(D28)的 nAbs:在SARS-CoV-2-baseline阴性的青少年(369人)中,mRNA-1273在注射2后的第28天(1868 [1759-1985])、6个月(625 [583-670])和12个月(550 [490-618])与基线(几何平均浓度[GMC] = 11; 95% CI, 11-12)相比,诱导了强有力的nAb反应。对 alpha/beta/delta/gamma 变体也观察到了类似的 bAb 反应;在 SARS-CoV-2 基线阳性的青少年中,nAb/bAb 反应也类似。两剂 mRNA-1273 100μg 主要系列的耐受性普遍良好;一例非严重、中度、可能的急性心肌炎病例在症状出现 8 天后痊愈。对 SARS-CoV-2 基线阳性的青少年单剂量使用 mRNA-1273 50 μg,诱导的抗 SARS-CoV-2 祖先的 D28 nAb GMCs 比对年轻成人双剂量使用 mRNA-1273 100 μg 高(几何平均比 = 4.322 [3.274-5.707]):mRNA-1273在青少年中的总体风险-效益情况仍然良好,可对SARS-CoV-2(祖先/变种)产生持续12个月的免疫反应。在未接种疫苗的青少年中单次注射 50μg mRNA-1273 可引起针对 SARS-CoV-2 的强大免疫反应:本项目全部或部分由美国卫生与公众服务部、美国战略准备与反应管理局、美国生物医学高级研究与发展局的联邦基金资助,合同号为 75A50120C00034。本报告中的调查结果和结论仅代表作者的观点,并不一定代表美国卫生与公众服务部或其组成部分的观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Safety and durability of mRNA-1273-induced SARS-CoV-2 immune responses in adolescents: results from the phase 2/3 TeenCOVE trial.

Background: Longitudinal changes in vaccination-induced immune response remain inadequately characterized in adolescents. We present long-term safety, immunogenicity, and COVID-19 incidence following a 2-dose mRNA-1273 100-μg primary series, and immunogenicity following a single dose of mRNA-1273 50 μg in vaccine-naïve adolescents.

Methods: TeenCOVE (NCT04649151) Part 1 randomized adolescents (12-17 years) to 2-dose mRNA-1273 100 μg (n = 2490) or placebo (n = 1243) 28 days apart. Subsequently, placebo recipients (n = 91) could receive open-label mRNA-1273. Primary objectives included prespecified adverse events through 12 months; secondary objectives were COVID-19 incidence and neutralizing and spike-binding antibodies (nAbs/bAbs) against SARS-CoV-2 (ancestral/variants) through 12 months (study period: December 2020-January 2022). In Part 2, vaccine-naïve adolescents (n = 52) received up to 2 doses of mRNA-1273 50 μg; interim analysis included Day 28 (D28) nAbs post-injection 1 in SARS-CoV-2-baseline-positive participants (serologic/virologic evidence of prior infection).

Findings: In SARS-CoV-2-baseline-negative adolescents (N = 369), mRNA-1273 induced robust nAb responses versus baseline (geometric mean concentration [GMC] = 11; 95% CI, 11-12) at D28 (1868 [1759-1985]), 6 months (625 [583-670]) and 12 months (550 [490-618]) post-injection 2. Similar bAb responses were observed to alpha/beta/delta/gamma variants; nAb/bAb responses were similar in SARS-CoV-2-baseline-positive adolescents. The 2-dose mRNA-1273 100-μg primary series was generally well-tolerated; one case of nonserious, moderate, probable acute myocarditis resolved by 8 days from symptom onset. A single dose of mRNA-1273 50 μg in SARS-CoV-2-baseline-positive adolescents induced higher D28 nAb GMCs against ancestral SARS-CoV-2 than 2-dose mRNA-1273 100 μg in young adults (geometric mean ratio = 4.322 [3.274-5.707]).

Interpretation: The overall risk-benefit profile of mRNA-1273 remains favorable in adolescents, with durable 12-month immune responses against SARS-CoV-2 (ancestral/variants). A single mRNA-1273 50-μg injection in vaccine-naïve adolescents elicited robust immune responses against SARS-CoV-2.

Funding: This project has been funded in whole or in part with federal funds by the Department of Health and Human Services, United States; Administration for Strategic Preparedness and Response, United States; Biomedical Advanced Research and Development Authority, United States, under Contract No. 75A50120C00034. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Department of Health and Human Services or its components.

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来源期刊
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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