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“Mixed” doses induces high concentrations of antibodies against the SARS-CoV2 – says new study

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Pfizer followed by AstraZeneca vaccine or Oxford-AstraZeneca followed by Pfizer/BioNTech vaccine, both ways covid vaccine generates high concentrations of antibodies against Coronavirus.

A new research paper from researchers running the University of Oxford-led Com-COV study published today has revealed that mixing the AstraZeneca and Pfizer coronavirus doses induces an effective immune response against COVID-19.

The study published on the Lancet pre-print server, scientists reported that both “mixed” schedules (Pfizer-BioNTech followed by Oxford-AstraZeneca, and Oxford-AstraZeneca followed by Pfizer-BioNTech) generated high concentrations of antibodies against the SARS-CoV2 spike IgG protein when doses were administered four weeks apart.

The results of the study suggest there could be more flexibility and overlap in vaccination schedules involving the Oxford-AstraZeneca and Pfizer-BioNTech vaccines moving forward.

Professor Matthew Snape, Associate Professor in Paediatrics and Vaccinology at the University of Oxford, and Chief Investigator on the trial, said:

The Com-COV study has evaluated ‘mix and match’ combinations of the Oxford and Pfizer vaccines to see to what extent these vaccines can be used interchangeably, potentially allowing flexibility in the UK and global vaccine roll-out.

The results show that when given at a four-week interval both mixed schedules induce an immune response that is above the threshold set by the standard schedule of the Oxford/AstraZeneca vaccine.

The investigators would like to thank the participants that made this important study possible.

Vaccinating with AstraZeneca vaccine first and the Pfizer-BioNTech second induced higher antibodies and T-cell responses than Pfizer-BioNTech/Oxford-AstraZeneca, and both of these induced higher antibodies than the licensed, and highly effective “standard” two-dose Oxford-AstraZeneca schedule.

The highest antibody response was seen after the two-dose Pfizer-BioNTech schedule, and the highest T cell response was observed from Oxford-AstraZeneca followed by Pfizer jab.

The T cell response is an integral and essential part of the host immune response to to virus infection.

Professor Matthew Snape said:

These results are an invaluable guide to the use of mixed dose schedules, however the interval of four weeks studied here is shorter than the eight to 12-week schedule most commonly used for the Oxford-AstraZeneca vaccine. This longer interval is known to result in a better immune response, and the results for a 12-week interval will be available shortly.

Deputy Chief Medical Officer Professor Jonathan Van-Tam said:

Today’s data are a vital step forward, showing a mixed schedule gives people protective immunity against COVID-19 after four weeks.

Equally, they offer supportive evidence that the standard (non-mixed) JCVI recommendations for COVID-19 vaccination all produce highly satisfactory immune responses, for both main vaccines in use. Given the UK’s stable supply position there is no reason to change vaccine schedules at this moment in time.

The results for the 12-week interval, which are yet to come, will have an instrumental role to play in decisions on the future of the UK’s vaccination programme.

Our non-mixed (homologous) vaccination programme has already saved tens of thousands of lives across the UK but we now know mixing doses could provide us with even greater flexibility for a booster programme, while also supporting countries who have further to go with their vaccine rollouts and who may be experiencing supply difficulties.

Professor Andrew Ustianowski, NIHR Clinical Lead for the COVID-19 Vaccination Programme and Joint National Infection Specialty Lead, added:

We know that the Oxford-AstraZeneca two-dose schedule is highly effective and has helped to save many lives.

The fact we now know it works well, in terms of immune responses, when combined with the Pfizer vaccine provides researchers with the valuable knowledge that these vaccines could be used flexibly for those yet to be vaccinated in the UK and globally.

It would have been impossible to discover these results without the willingness and efforts of research participants across the country. Yet again they have worked alongside researchers to help find an end to the spread of COVID-19.

In May, researchers reported preliminary Com-COV data revealing more frequent mild to moderate reactions in mixed schedules compared to standard schedules, however, these were short-lived in duration.

Photo by SeongJoon Cho/Bloomberg via Getty Images

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