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Immunogenicity of Extended mRNA SARS-CoV-2 Vaccine Dosing Intervals

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To identify the key insights or developments described in this article
1 Credit CME

Standard dosing intervals for BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines are 21 and 28 days, respectively.1 Data suggest improved effectiveness of ChAdOx1 adenoviral2 and other nonreplicating vaccines3 with increased dosing intervals, but little data exist for mRNA vaccines. This study investigated the immunogenicity of extended mRNA vaccine dosing intervals.

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Article Information

Corresponding Author: Brian Grunau, MD, MHSc, British Columbia Resuscitation Research Collaborative, 1190 Hornby St, Fourth Floor, Vancouver, BC V6Z 2K5, Canada (brian.grunau@ubc.ca).

Accepted for Publication: November 18, 2021.

Published Online: December 3, 2021. doi:10.1001/jama.2021.21921

Author Contributions: Drs Grunau and Lavoie had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Grunau, Goldfarb, Asamoah-Boaheng, Kirkham, Demers, Lavoie.

Acquisition, analysis, or interpretation of data: Grunau, Asamoah-Boaheng, Golding, Kirkham, Demers, Lavoie.

Drafting of the manuscript: Grunau, Asamoah-Boaheng, Lavoie.

Critical revision of the manuscript for important intellectual content: Goldfarb, Asamoah-Boaheng, Golding, Kirkham, Demers, Lavoie.

Statistical analysis: Asamoah-Boaheng, Lavoie.

Obtained funding: Grunau, Goldfarb, Kirkham, Demers, Lavoie.

Administrative, technical, or material support: Goldfarb, Golding, Kirkham, Demers.

Supervision: Grunau, Goldfarb, Kirkham, Lavoie.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by funding from the government of Canada, through the COVID-19 Immunity Task Force.

Role of the Funder/Sponsor: The government of Canada had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Mohammad Ehsanul Karim, PhD (School of Population and Public Health, University of British Columba), for providing statistical expertise; Paul N. Levett, PhD, and Martin Petric, PhD (British Columbia Centre for Disease Control), for performing live virus neutralization testing; Richard Armour, MSc (British Columbia Emergency Health Services), for assisting with participant enrollment; and Vilte Barakauskas, PhD (British Columbia Children’s and Women’s Hospital), for managing specimens. No compensation was received for their contributions to this work.

References
1.
Centers for Disease Control and Prevention (CDC). COVID-19. Accessed August 11, 2021. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html
2.
Voysey  M , Costa Clemens  SA , Madhi  SA ,  et al; Oxford COVID Vaccine Trial Group.  Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials.   Lancet. 2021;397(10277):881-891. doi:10.1016/S0140-6736(21)00432-3 PubMedGoogle ScholarCrossref
3.
Wahl  M , Hermodsson  S , Iwarson  S .  Hepatitis B vaccination with short dose intervals—a possible alternative for post-exposure prophylaxis?   Infection. 1988;16(4):229-232. doi:10.1007/BF01650758 PubMedGoogle ScholarCrossref
4.
Romero-Brufau  S , Chopra  A , Ryu  AJ ,  et al.  Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study.   BMJ. 2021;373(May):n1087. doi:10.1136/bmj.n1087 PubMedGoogle Scholar
5.
Moghadas  SM , Vilches  TN , Zhang  K ,  et al.  Evaluation of COVID-19 vaccination strategies with a delayed second dose.   PLoS Biol. 2021;19(4):e3001211. doi:10.1371/journal.pbio.3001211PubMedGoogle Scholar
6.
Khoury  DS , Cromer  D , Reynaldi  A ,  et al.  Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection.   Nat Med. 2021;27(7):1205-1211. doi:10.1038/s41591-021-01377-8 PubMedGoogle ScholarCrossref
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