Immune correlates analysis of the PREVENT-19 COVID-19 vaccine efficacy clinical trial

• DOI: 10.1038/s41467-022-35768-3
• Publication Date: 2023-01-19T17:04:49Z
• Authors: Youyi Fong; Yunda Huang; David Benkeser; Lindsay N. Carpp; Germán Áñez; Wayne Woo; Alice McGarry; Lisa M. Dunkle; Iksung Cho; Christopher R. Ho...; Karen Martins; Lakshmi Jayashankar; Flora Castellino; Christos J. Petro...; Andrew Leith; Deanne Haugaard; Bill Webb; Yiwen Lu; Chenchen Yu; Bhavesh Borate; Lars W. P. van de...; Nima S. Hejazi; April K. Randhawa; Michele P. Andrasik; James G. Kublin; Julia Hutter; Maryam Keshtkar-J...; Tatiana H. Beresnev; Lawrence Corey; Kathleen M. Neuzil; Dean Follmann; Julie A. Ake; Cynthia L. Gay; Karen L. Kotloff; Richard A. Koup; Ruben O. Donis; Peter B. Gilbert
• Keywords: 0303 health sciences; COVID-19 Vaccines; SARS-CoV-2; Science; Q; COVID-19; Vaccine Efficacy; Antibodies, Viral; Antibodies, Neutralizing; Article; 03 medical and health sciences; Clinical Trials, Phase III as Topic; Immunoglobulin G; Humans

AbstractIn the PREVENT-19 phase 3 trial of the NVX-CoV2373 vaccine (NCT04611802), anti-spike binding IgG concentration (spike IgG), anti-RBD binding IgG concentration (RBD IgG), and pseudovirus 50% neutralizing antibody titer (nAb ID50) measured two weeks post-dose two are assessed as correlates of risk and as correlates of protection against COVID-19. Analyses are conducted in the U.S. cohort of baseline SARS-CoV-2 negative per-protocol participants using a case-cohort design that measures the markers from all 12 vaccine recipient breakthrough COVID-19 cases starting 7 days post antibody measurement and from 639 vaccine recipient non-cases. All markers are inversely associated with COVID-19 risk and directly associated with vaccine efficacy. In vaccine recipients with nAb ID50 titers of 50, 100, and 7230 international units (IU50)/ml, vaccine efficacy estimates are 75.7% (49.8%, 93.2%), 81.7% (66.3%, 93.2%), and 96.8% (88.3%, 99.3%). The results support potential cross-vaccine platform applications of these markers for guiding decisions about vaccine approval and use.