Infectious Disease

Moderna bivalent COVID-19 booster outperforms original against variants, company says

November 14, 2022

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Moderna said Monday that data from a phase 2/3 trial showed that its bivalent COVID-19 booster shot triggers a higher antibody response against SARS-CoV-2 omicron subvariants than its original vaccine.

The booster, mRNA-1273.222, targets the BA.4 and BA.5 subvariants and is one of two boosters Moderna has been testing against its original vaccine. Both mRNA-1273.222 and the company’s other bivalent booster vaccine, mRNA-1273.214, which is aimed at the Wuhan strain of SARS-CoV-2 and the BA.1 subvariant, outperformed the original vaccine booster, according to a press release from Moderna.

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“We are pleased to see that both of our bivalent booster vaccine candidates offer superior protection against omicron BA.4/BA.5 variants compared to our original booster, which is given to encourage that COVID-19 remains a leading cause of hospitalization and death globally ,” Moderna CEO stephane Bancel, MSc, MBA, said in the release.

In 511 previously vaccinated and boosted study participants aged 19 to 89 years, Moderna reported that the mRNA-1273.222 booster elicited a superior neutralizing antibody response against the BA.4 and BA.5 subvariants when compared with a booster dose of the company’s original vaccine.

Study participants received Moderna’s original COVID-19 vaccine as a booster shot about 4 1/2 months after initial vaccination and the updated booster, mRNA-1273.222, about 9 1/2 months after initial vaccination. Although pre-booster titer levels were similar between the groups, the updated mRNA-1273.222 bivalent booster triggered a 15.1-fold increase in titer levels. Participants without a previous SARS-CoV-2 infection saw a 26.4-fold increase in titer levels and participants who had a previous infection saw a 9.8-fold increase in titer levels.

Moderna also reported that an exploratory analysis of 40 participants using research assays demonstrated “robust neutralizing activity” against BQ.1.1, though the response was about five-fold lower than the booster’s effects against BA.4 and BA.5.

Data published Oct. 6 in The New England Journal of Medicine also showed the mRNA-1273.214 booster triggered a stronger antibody response against BA.1, BA.4 and BA.5 than Moderna’s original shot.

“Responding quickly and effectively to emerging COVID-19 variants is one of the largest challenges facing the global community. This bivalent model provides a framework that may allow scientists to develop safe, effective and tailored vaccines more efficiently,” Rituparna Das, MDModerna’s vice president for clinical development of COVID-19 vaccines, said in a press release at the time.

Modern’s mRNA-1273.222 vaccine is authorized for use in people as young as age 6 years.

Nearly three-quarters of COVID-19 infections in the United States in the last week were BA.5, BQ.1.1 and BQ.1, according to CDC, but the percentage of people who have received a bivalent booster dose is just 10.1% .

Bancel noted the antibody response garnered by the new boosters against BQ.1.1 in assays and said the new data confirms “that updated vaccines have the potential to offer protection as the virus continues to evolve rapidly to escape our immunity.”

References:

  • Chalkias S, et al. N Engl J Med. 2022;doi:10.1056/NEJMoa2208343
  • Moderna’s BA.4/BA.5 targeting bivalent booster, mRNA-1273.222, meets primary endpoint of superiority against omicron variants compared to booster dose of mRNA-1273 in phase 2/3 clinical trial. Moderna’s BA.4/BA.5 targeting bivalent booster, mRNA-1273.222, meets primary endpoint of superiority against omicron variants compared to booster dose of mRNA-1273 in phase 2/3 clinical trial. Published Nov. 14. 2022. Accessed Nov. 14, 2022.
  • CDC. COVID Data Tracker: COVID-19 vaccinations in the United States. https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-booster-percent-pop5. Accessed Nov 14, 2022.
  • CDC. COVID Data Tracker: Variant proportions. https://covid.cdc.gov/covid-data-tracker/#variant-proportions. Accessed Nov 14, 2022.
  • Study shows Moderna’s omicron bivalent booster vaccine is safe and induces higher antibody responses than original COVID-19 vaccine. Study shows Moderna’s omicron bivalent booster vaccine is safe and induces higher antibody responses than original COVID-19 vaccine. Published Oct. 20, 2022. Accessed Nov 14, 2022.

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