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Master of Public Health

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

AUTHORS

Fong Y , Huang Y , Benkeser D , Carpp LN , Áñez G , Woo W , McGarry A , Dunkle LM , Cho I , Houchens CR , Martins K , Jayashankar L , Castellino F , Petropoulos CJ , Leith A , Haugaard D , Webb B , Lu Y , Yu C , Borate B , van der Laan LWP , Hejazi NS , Randhawa AK , Andrasik MP , Kublin JG , Hutter J , Keshtkar-Jahromi M , Beresnev TH , Corey L , Neuzil KM , Follmann D , Ake JA , Gay CL , Kotloff KL , Koup RA , Donis RO , Gilbert PB , , , , . Nature communications. 2023 1 19; 14(1). 331

ABSTRACT

In 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.

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