1/Pleased to share our work, systematically comparing the three US FDA EUA vaccines with regards humoral and cellular immunogenicity, and effectiveness in >40M individuals from public health reports.
@GaihaLab, @BalazsLab, @MGHPathology @CAPRISAOfficial
academic.oup.com/jid/advance-ar…
@GaihaLab, @BalazsLab, @MGHPathology @CAPRISAOfficial
academic.oup.com/jid/advance-ar…
2/ We compared the immunogenicity and effectiveness of moderna (mRNA1273), Pfizer (BNT162b2) and J&J (Ad26.COV2.S) vaccines. Crucially, we have control groups with and without prior infection in the immunogenicity studies, standardized assays, multiple different assays etc.
3/ We find a significant hierarchy where Moderna > Pfizer >>>J&J by binding antibodies (spike or RBD, by multiple assays), neutralization of wildtype or variants (incl. delta), and CD4+ T-cells. 
4/ None of the vaccines appear to induce robust spike-specific effector CD8+ T-cell responses (<50% for each vaccine).
5/ In a meta-analysis of data from >45M people in Iceland, South Korea and three US states/districts: breakththrough infection, hospitalization and deaths are highest for Ad26.COV2.S (J&J), then BNT162b2 (Pfizer) and then mRNA1273 (Moderna).
6/Implications?
6.1/ J&J is not really a ‘one shot’ vaccine; its immunogenicity and effectiveness is low and benefits from 2nd dose (regardless of type). Substantial relevance for developing countries relying on single dose J&J.
6.1/ J&J is not really a ‘one shot’ vaccine; its immunogenicity and effectiveness is low and benefits from 2nd dose (regardless of type). Substantial relevance for developing countries relying on single dose J&J.
Also be careful of comparing studies of neutralization: eg the Victoria strain used previously by some is much easier to neutralize (we show this in the paper too).
This has important implications for global vaccine programs and vaccine equity, where the J&J advantages (single dose and higher storage temperatures) have to be balanced with the lower immunogenicity and effectiveness against important outcomes like hospitalizations death.
6.2/ We will need better vaccines to induce CD8+ responses; by implication we don’t yet know what role CD8+ responses may be playing in protection. Maybe next gen variant cocktail and T-cell will offer enhanced variant protection.
6.3/Prediction: vaccine-mediated protection from #OmicronVariant will follow the same pattern. So… vaccinate with the best vaccine accessible, boosted if possible BUT MASSIVE work on enhancing access AND #masking, #distancing, testing scale-up etc. alongside vaccination.
Very grateful to so many esp VIC and ReToCh study participants, and many co-authors (incl @wilfredo_nk @TylerEMiller @GaihaGaurav @BalazsLab) who persisted despite comments from people discomforted by following the data.
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