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Daniel Park Profile picture
@Daniel_E_Park
Sep 2 • 7 tweets • 3 min read Twitter logo Read on Twitter
Recently released immunogenicity results from a Phase 3 RCT of the original Novavax vaccine when used as a booster. Good safety profile and excellent immune responses regardless of prior vaccine platform, even against Omicron BA.1 and BA.5
sciencedirect.com/science/articl…
Immune responses suggest booster shots provide protection that exceed the 87% efficacy based on correlates of protection established in a previous study
nature.com/articles/s4146…
The findings also suggest that the Novavax booster is especially beneficial for those who had homologous (i.e. same platform) mRNA schedules previously: "NVX-CoV2373-induced IgG seroconversion may be higher when given after a homologous primary and booster mRNA regimen"
As a reminder, heterologous boosting in general has been previously shown to increase the breadth and durability of the immune response, both with AZ and NVX.


There are interesting nuggets in the supplement. E.g. Not significant, but interesting that Ab titers were higher at baseline (pre-boost) for the NVX primary group for all strains. This lines up with animal models showing better durability with novavax
nature.com/articles/s4146…
Image
The study also reported good lot consistency. This is important for FDA authorization. Image
This study adds to the evidence base for expanding authorization to allow heterologous boosting w/ Novavax.
Although IMO the ComCOV3 results should have put that to rest already (89% reduction in breakthrough infections w/ NVX het boosting compared w/ BNT)
journalofinfection.com/article/S0163-…

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More from @Daniel_E_Park

Daniel Park Profile picture
Aug 8
Helpful results to inform the strategy behind annual COVID-19 vaccines. Good durability and efficacy (>80%) against hospitalization over 10 months with AstraZeneca (ChAdOx1).

https://t.co/9hFKVLiEBosciencedirect.com/science/articl…
Image
Comparatively, mRNA efficacy vs hospitalization wanes ~50%-80% by the fourth month after vaccination:

https://t.co/hntIoJhpbx
And significant waning vs. infection:
https://t.co/w6bsK0lSIibmj.com/content/379/bm…
cdc.gov/mmwr/volumes/7…
nature.com/articles/s4146…
Some of this may be confounded by emerging variants (with mRNA being more specific to only the target variant), since other studies show longer efficacy.
jamanetwork.com/journals/jamao…
Read 5 tweets
Daniel Park Profile picture
Jul 31
RCT of Covovax / Novavax COVID vaccine in children 2-11y and 12-17y. Excellent immune responses across variants that had higher titers than adults. Also very low rate of side effects, with no myocarditis reported.
jamanetwork.com/journals/jamap…
This figure shows excellent antibody responses in both adolescents and children through at least 6 months. Many vaccine platforms have differential responses by age, but the adjuvant (Matrix-M) may be helping responses across the age spectrum. Image
Case in point: There were also excellent responses in older ages in this comparative effectiveness study from Korea - showing the breadth and robustness of the immune responses with the adjuvanted NVX platform.
medrxiv.org/content/10.110…
Read 4 tweets
Daniel Park Profile picture
Jun 1
This WaPo article serves as a reminder that having multiple vax platforms is important. mRNA vaccines are great, but newer doesn't necessarily equal better. Cuba achieved broad coverage and strong protection with a protein vaccine (similar tech to Novavax)
washingtonpost.com/opinions/2023/…
Although the vaccine took a bit longer to develop, by the end of Sep 2021, they achieved >80% coverage. A remarkable achievement. Image
Let's see what impact this had on infections. During the initial parts of the Delta wave (mid-2021) Cuba was faring worse than the US, but by Sep we see a sharp decline. Omicron was barely a blip, and they have near-zero transmission ever since. Image
Read 8 tweets
Daniel Park Profile picture
May 16
Important study of Novavax (ancestral & BA.1) and Moderna boosters in primates. All have effective long-term immune responses and lower viral replication, but only NVX had significantly lower viral loads in upper airways, which could limit transmission. science.org/doi/10.1126/sc…
Panel E shows some of the mRNA-1273 boosted NHPs with similar upper airway viral loads to controls, whereas the viral loads are much lower (or non-detectable) after Novavax boost, with significance shown using AUCs in panel F. Image
A key note is that the viral challenge was 3-months post-boost, indicating strong protection during periods of waning immunity. There is also some interesting data on IgG class switching, VOCs, and also notably lung pathology was comparably milder among NVX boosted macaques.
Read 4 tweets
Daniel Park Profile picture
May 15
Preprint of NVX-CoV2373 immunogenicity outcomes by age and HIV status. Very high seroconversion rates (i.e. protection) in all groups (98.3% for younger and 94.3% for older adults), regardless of age and HIV status.
medrxiv.org/content/10.110…
This is important in context of immunosenescence and higher risk of severe disease in older adults, which is well characterized for all vaccines, including mRNA.

ncbi.nlm.nih.gov/pmc/articles/P…
nature.com/articles/s4358…
Adjuvanted vaccines (as used with Novavax) often help with the response in older adults. More direct studies needed but initial estimates suggest comparable (or perhaps improved) efficacy in older individuals using adjuvanted NVX vs mRNA
Read 4 tweets
Daniel Park Profile picture
May 5
I’ve been asked for a list of Novavax studies. Apologies for the long thread but compiling some selected studies into a narrative here, hope this is helpful:
1) Original RCT shows >99% efficacy against severe disease and >90% vs. infection: nejm.org/doi/full/10.10…
2) Nvx generates a broad immune response (likely thanks to the adjuvant): jci.org/articles/view/…
(Side note: The adjuvant also provides great immunologic properties for their flu vax and the malaria vax which is being rolled out)
thelancet.com/journals/lanin…
thelancet.com/journals/lanin…
3) The immune response likely includes a diverse immune response beyond markers typically measured (anamnestic responses, memory B cells, Fc effector functions, and T cell responses): nature.com/articles/s4146…
Read 10 tweets

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