TY - JOUR

T1 - Protection against SARS-CoV-2 transmission by a parenteral prime—Intranasal boost vaccine strategy

AU - Christensen, Dennis

AU - Polacek, Charlotta

AU - Sheward, Daniel J.

AU - Hanke, Leo

AU - Moliner-morro, Ainhoa

AU - Mcinerney, Gerald

AU - Murrell, Ben

AU - Hartmann, Katrine Top

AU - Jensen, Henrik Elvang

AU - Jungersen, Gregers

AU - Illigen, Kristin

AU - Isling, Louise Krag

AU - Jensen, Rune Fledelius

AU - Hansen, Julia Sid

AU - Rosenkrands, Ida

AU - Fernandez-antunez, Carlota

AU - Ramirez, Santseharay

AU - Follmann, Frank

AU - Bukh, Jens

AU - Pedersen, Gabriel Kristian

PY - 2022

Y1 - 2022

N2 - BackgroundLicensed vaccines against SARS-CoV-2 effectively protect against severe disease, but display incomplete protection against virus transmission. Mucosal vaccines providing immune responses in the upper airways are one strategy to protect against transmission.MethodsWe administered Spike HexaPro trimer formulated in a cationic liposomal adjuvant as a parenteral (subcutaneous – s.c.) prime - intranasal boost regimen to elicit airway mucosal immune responses and evaluated this in a Syrian hamster model of virus transmission.FindingsParenteral prime - intranasal boost elicited high-magnitude serum neutralizing antibody responses and IgA responses in the upper respiratory tract. The vaccine strategy protected against virus in the lower airways and lung pathology, but virus could still be detected in the upper airways. Despite this, the parenteral prime - intranasal booster vaccine effectively protected against onward SARS-CoV-2 transmission.InterpretationThis study suggests that parenteral-prime mucosal boost is an effective strategy for protecting against SARS-CoV-2 infection and highlights that protection against virus transmission may be obtained despite incomplete clearance of virus from the upper respiratory tract. It should be noted that protection against onward transmission was not compared to standard parenteral prime-boost, which should be a focus for future studies.FundingThis work was primarily supported by the European Union Horizon 2020 research and innovation program under grant agreement no. 101003653.

AB - BackgroundLicensed vaccines against SARS-CoV-2 effectively protect against severe disease, but display incomplete protection against virus transmission. Mucosal vaccines providing immune responses in the upper airways are one strategy to protect against transmission.MethodsWe administered Spike HexaPro trimer formulated in a cationic liposomal adjuvant as a parenteral (subcutaneous – s.c.) prime - intranasal boost regimen to elicit airway mucosal immune responses and evaluated this in a Syrian hamster model of virus transmission.FindingsParenteral prime - intranasal boost elicited high-magnitude serum neutralizing antibody responses and IgA responses in the upper respiratory tract. The vaccine strategy protected against virus in the lower airways and lung pathology, but virus could still be detected in the upper airways. Despite this, the parenteral prime - intranasal booster vaccine effectively protected against onward SARS-CoV-2 transmission.InterpretationThis study suggests that parenteral-prime mucosal boost is an effective strategy for protecting against SARS-CoV-2 infection and highlights that protection against virus transmission may be obtained despite incomplete clearance of virus from the upper respiratory tract. It should be noted that protection against onward transmission was not compared to standard parenteral prime-boost, which should be a focus for future studies.FundingThis work was primarily supported by the European Union Horizon 2020 research and innovation program under grant agreement no. 101003653.

U2 - 10.1016/j.ebiom.2022.104248

DO - 10.1016/j.ebiom.2022.104248

M3 - Journal article

C2 - 36088218

VL - 84

JO - EBioMedicine

JF - EBioMedicine

SN - 2352-3964

M1 - 104248

ER -