Serendipitous COVID-19 Vaccine-Mix in Uttar Pradesh, India: Safety and Immunogenicity Assessment of a Heterologous Regime

Kant, R.; Dwivedi, G.; Zaman, K.; Sahay, R. R.; Sapkal, G.; Kaushal, H.; Nyayanit, D.; Yadav, P.; Deshpande, G.; Singh, R.; Chowdhary, S.; Gupta, N.; Kumar, S.; Abraham, P.; Panda, S.; Bhargava, B.

Immunization program against COVID-19 in India started with two vaccines; AstraZeneca ChAdOx1-nCov-19 (termed Covishield in India) and inactivated whole virion BBV152 (Covaxin); homologous prime-boost approach was followed. However, eighteen individuals, under the national program, inadvertently received Covishield as the first jab and Covaxin as the second. We compared the safety and immunogenicity profile of them against that of individuals receiving either Covishield or Covaxin (n=40 in each group). Lower and similar adverse events following immunization in all three groups underlined the safety of the combination vaccine-regime. Immunogenicity profile against Alpha, Beta and Delta variants in heterologous group was superior; IgG antibody and neutralising antibody response of the participants was also significantly higher compared to that in the homologous groups. The findings suggest that immunization with a combination of an adenovirus vector platform-based vaccine followed by an inactivated whole virus vaccine was not only safe but also elicited better immunogenicity.