Published in The Lancet’s eBioMedicine, 76 healthy adults from Melbourne, aged 18 to 64 who were previously vaccinated with licensed SARS-CoV-2 vaccines, were randomised to receive a fourth dose of a novel protein vaccine, mRNA vaccine or placebo. Both vaccines demonstrated strong boosting capabilities in a highly immune population and a remarkable breadth of immune response, including against omicron sub-variants. In addition, no safety signals were observed with either candidate.
The two vaccine candidates, created by researchers at the Peter Doherty Institute for Infection and Immunity (Doherty Institute) and the Monash Institute of Pharmaceutical Sciences (MIPS), are distinct from most existing vaccines that are in use around the globe because they focus the immune response on the tip of the SARS-CoV-2 spike protein, called the receptor binding domain (RBD). The RBD enables the virus to enter and infect cells in the body and elicits over 90 per cent of neutralising antibodies (antibodies that can block the virus) following SARS-CoV-2 infection.
The two candidates are:
- RBD protein vaccine – uses an engineered part of the virus protein, rather than genetic material or another virus, to elicit an immune response.
- RBD mRNA vaccine – represents the virus genetic sequence of mRNA that codes for the tip of the spike, which leads to production of the RBD protein in the recipient.
University of Melbourne Professor Terry Nolan, Head of the Vaccine and Immunisation Research Group at the Doherty Institute, which led the Phase 1 first-in-human trial, said the team was exceptionally pleased by the results.
“Post-market studies of omicron-directed, whole spike bivalent mRNA booster vaccines have shown modest increases in immune responses to omicron variants compared to ancestral vaccine boosts,” said Professor Nolan.
“Because our two vaccines focus the immune response on the receptor binding domain, they avoid unhelpful immune responses against other parts of the spike protein and could therefore provide a more efficient approach for boosting immunity to the virus, presenting a strong case to proceed to Phase 2 clinical trials.”
Professor Colin Pouton of MIPS, who led the development of the RBD mRNA vaccine, said the mRNA vaccine showed a strong immune response, even at the lowest dose tested.
“So far, both preclinical and clinical studies have shown our RBD mRNA vaccine to provide a strong boost at low doses, suggesting the very real potential to develop a multivalent vaccine, on an annual basis and to protect against emerging new variants of COVID-19, which are believed to be the root cause behind the ongoing ‘waves’ we are still experiencing,” said Professor Pouton.
“New strategies are still needed to improve efficacy of COVID-19 variant vaccines and to reduce death rates, particularly among older and vulnerable patients. In the case of our mRNA vaccine, we’ve also seen early potential to address the issue of immune imprinting, which will also need to be a critical feature for a next-generation vaccine.”
The team is now exploring options for progressing these vaccines to Phase 2 trials, which will require additional funding and industry support.
The Doherty Institute and MIPS would like to thank their funders and other supporting organisations including the University of Melbourne, The Royal Melbourne Hospital, CSIRO, Seqirus and IDT Australia.
Journal
EBioMedicine
Method of Research
Randomized controlled/clinical trial
Subject of Research
People
Article Title
nterim results from a phase I randomized, placebo-controlled trial of novel SARS-CoV-2 beta variant receptor-binding domain recombinant protein and mRNA vaccines as a 4th dose booster
Article Publication Date
27-Nov-2023
COI Statement
The vaccines evaluated in this Phase I study were the result of independent University of Melbourne and Monash University research and development, with funding provided by the Australian Government's Medical Research Future Fund (MRFF), the National Health and Medical Research Council (NHMRC), the Victorian Government (mRNA Victoria) and philanthropic funders. The MF59 for the protein-RBD candidate was donated by CSL Seqirus. One author (S.R.) is an employee of CSL Seqirus and he also has an adjunct (honorary) appointment to the University of Melbourne. G.D., N.G., D.P., D.I.G. are named inventors on 2 provisional patents for the RBD-Fc dimer vaccine in this study. T.M.N. has been a DSMB member for vaccine studies conducted by Moderna, Clover, Novavax, CSL Seqirus, and SK Bioscience Korea, and has received payment for advisory roles on vaccines from AstraZeneca, Moderna, MSD, Sanofi, CSL, and Pfizer. G.D. received salary support from philanthropic funds from IFM Investors Pty Ltd. S.L. received consulting fees from several companies related to HIV research, and honoraria from MSD and Gilead. H.McQ. received consulting fees from Ena Respiratory Pty Ltd. K.S. was a member of a DSMB for a vaccine study in Thailand. H.alW. received consulting and research funding from CSL Seqirus. D.I.G. received research support from CSL.