A prefusion SARS-CoV-2 spike RNA vaccine is highly immunogenic and prevents lung infection in non-human primates

Vogel, Annette B.; Kanevsky, Isis; Che, Ye; Swanson, Kena A.; Muik, Alexander; Vormehr, Mathias; Kranz, Lena M.; Walzer, Kerstin C.; Hein, Stephanie; Güler, Alptekin; Loschko, Jakob; Maddur, Mohan S.; Tompkins, Kristin; Cole, Journey; Lui, Bonny G.; Ziegenhals, Thomas; Plaschke, Arianne; Eisel, David; Dany, Sarah C.; Fesser, Stephanie; Erbar, Stephanie; Bates, Ferdia; Schneider, Diana; Jesionek, Bernadette; Sänger, Bianca; Wallisch, Ann-Kathrin; Feuchter, Yvonne; Junginger, Hanna; Krumm, Stefanie A.; Heinen, André P.; Adams-Quack, Petra; Schlereth, Julia; Kröner, Christoph; Hall-Ursone, Shannan; Brasky, Kathleen; Griffor, Matthew C.; Han, Seungil; Lees, Joshua A.; Mashalidis, Ellene H.; Sahasrabudhe, Parag V.; Tan, Charles Y.; Pavliakova, Danka; Singh, Guy; Fontes-Garfias, Camila; Pride, Michael; Scully, Ingrid L.; Ciolino, Tara; Obregon, Jennifer; Gazi, Michal; Carrion, Ricardo; Alfson, Kendra J.; Kalina, Warren V.; Kaushal, Deepak; Shi, Pei-Yong; Klamp, Thorsten; Rosenbaum, Corinna; Kuhn, Andreas N.; Türeci, Özlem; Dormitzer, Philip R.; Jansen, Kathrin U.; Sahin, Ugur

To contain the coronavirus disease 2019 (COVID-19) pandemic, a safe and effective vaccine against the new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is urgently needed in quantities sufficient to immunise large populations. In this study, we report the design, preclinical development, immunogenicity and anti-viral protective effect in rhesus macaques of the BNT162b2 vaccine candidate. BNT162b2 contains an LNP-formulated nucleoside-modified mRNA that encodes the spike glycoprotein captured in its prefusion conformation. After expression of the BNT162b2 coding sequence in cells, approximately 20% of the spike molecules are in the one-RBD ‘up’, two-RBD ‘down’ state. Immunisation of mice with a single dose of BNT162b2 induced dose level-dependent increases in pseudovirus neutralisation titers. Prime-boost vaccination of rhesus macaques elicited authentic SARS-CoV-2 neutralising geometric mean titers 10.2 to 18.0 times that of a SARS-CoV-2 convalescent human serum panel. BNT162b2 generated strong TH1 type CD4+ and IFNγ+ CD8+ T-cell responses in mice and rhesus macaques. The BNT162b2 vaccine candidate fully protected the lungs of immunised rhesus macaques from infectious SARS-CoV-2 challenge. BNT162b2 is currently being evaluated in a global, pivotal Phase 2/3 trial (NCT04368728).