Vaccine Information: Pfizer-BioNTech Covid-19 Vaccine, Bivalent (Page 11 of 14)

14.7 Immunogenicity of Pfizer-BioNTech COVID-19 Vaccine Booster Dose Following Pfizer-BioNTech COVID-19 Vaccine Primary Series in Participants 5 Through 11 Years of Age

In Study 3, immunogenicity of a booster dose administered at 7 to 9 months after the second primary series dose was evaluated in 67 study participants 5 through 11 years of age who had no serological or virological evidence of past SARS-CoV-2 infection up to 1 month after the booster dose. Using a microneutralization assay against the reference strain of SARS-CoV-2 (USA_WA1/2020), the NT50 GMT at 1 month after the booster dose (2720.9 [95% CI: 2280.1, 3247.0]) was increased compared to before the booster dose (271.0 [95% CI: 229.1, 320.6]). Using a non-validated fluorescence focus reduction neutralization test assay against the Omicron variant of SARS-CoV-2 (B.1.1.529), the NT50 GMT at 1 month after the booster dose among a subset of 17 study participants (614.4 [95% CI: 410.7, 919.2]) was increased compared to the NT50 GMT at 1 month after dose 2 among a subset of 29 study participants (27.6 [95% CI: 22.1, 34.5]).

14.8 Immunogenicity of the Pfizer-BioNTech COVID-19 Vaccine Booster Dose Following Primary Vaccination with Another Authorized or Approved COVID-19 Vaccine

Effectiveness of a Pfizer-BioNTech COVID-19 Vaccine booster dose (30 mcg modRNA) in individuals who completed primary vaccination with another authorized or approved COVID-19 Vaccine (heterologous booster dose) is inferred from immunogenicity data supporting effectiveness of a Pfizer-BioNTech COVID-19 Vaccine booster dose administered following completion of Pfizer-BioNTech COVID-19 Vaccine primary series and from immunogenicity data from an independent NIH study Phase 1/2 open-label clinical trial (NCT04889209) conducted in the United States that evaluated a heterologous booster dose of the Pfizer-BioNTech COVID-19 Vaccine. In this study, participants who had completed primary vaccination with a Moderna COVID-19 Vaccine 2-dose series (N=151), a Janssen COVID-19 Vaccine single dose (N=156), or a Pfizer-BioNTech COVID-19 Vaccine 2-dose series (N=151) at least 12 weeks prior to enrollment and who reported no history of SARS-CoV-2 infection were randomized 1:1:1 to receive a booster dose of 1 of 3 vaccines: Moderna COVID-19 Vaccine, Janssen COVID-19 Vaccine, or Pfizer-BioNTech COVID-19 Vaccine (30 mcg modRNA). Neutralizing antibody titers, as measured by a pseudovirus neutralization assay using a lentivirus expressing the SARS-CoV-2 Spike protein with D614G mutation, were assessed on Day 1 prior to administration of the booster dose and on Day 15 after the booster dose. A booster response to the Pfizer-BioNTech COVID-19 Vaccine was demonstrated regardless of the vaccine used for primary vaccination.

14.9 Immunogenicity of Pfizer-BioNTech COVID-19 Vaccine, Bivalent (Original and Omicron BA.4/BA.5) Administered as a Booster (Fourth Dose) in Individuals 6 Months Through 4 Years of Age

In Study 6, a subset of 60 participants 6 months through 4 years of age received a booster dose (fourth dose) of Pfizer-BioNTech COVID-19 Vaccine, Bivalent (3 mcg modRNA) after receiving 3 prior doses of Pfizer-BioNTech COVID-19 Vaccine (3 mcg modRNA). Neutralizing antibody levels following the fourth dose are presented in Table 37. Data from a subset of participants 6 months through 4 years of age in Study 3 who received 3 doses of Pfizer-BioNTech COVID-19 Vaccine (3 mcg modRNA) are included as a reference. There were no formal statistical comparisons of the immune response between subsets from the two studies.

Table 37: Study 6 – Geometric Mean Titers – Participants With or Without Evidence of Infection * – 6 Months Through 4 Years of Age – Evaluable Immunogenicity Population
Abbreviations: GMT = geometric mean titer; LLOQ = lower limit of quantitation; N-binding = SARS-CoV-2 nucleoprotein-binding; NAAT = nucleic acid amplification test.NT50 = 50% neutralizing titer; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.
*
Included all participants regardless of SARS-CoV-2 infection status prior to or after vaccination.
Protocol-specified timing for blood sample collection.
n = Number of participants with valid and determinate assay results for the specified assay at the given sampling time point.
§
GMTs and 2-sided 95% CIs were calculated by exponentiating the mean logarithm of the titers and the corresponding CIs (based on the Student t distribution). Assay results below the LLOQ were set to 0.5 × LLOQ.
SARS-CoV-2 NT50 were determined using a validated 384-well assay platform (original strain [USA-WA1/2020, isolated in January 2020] and Omicron B.1.1.529 subvariant BA.4/BA.5).

SARS-CoV-2 Neutralization Assay

Age Group

Sampling Time Point

Study 6

Pfizer-BioNTech COVID‑19 Vaccine, Bivalent (Original/Omicron BA.4/BA.5)

3 mcg modRNA

Dose 4 and

1 Month After Dose 4

Study 3

Pfizer-BioNTech COVID‑19 Vaccine

3 mcg modRNA

Dose 3 and

1 Month After Dose 3

n

GMT § (95% CI § )

n

GMT § (95% CI) §

Omicron BA.4/BA.5 — NT50 (titer)

6 through 23 months

Pre-

vaccination

21

243.9

(115.3, 516.1)

23

96.0

(55.3, 166.8)

1 month

23

2011.4

(1141.3, 3544.9)

23

625.6

(365.7, 1070.5)

2 through 4 years

Pre-

vaccination

33

165.6

(88.3, 310.5)

31

56.1

(38.0, 82.7)

1 month

35

1514.9

(882.2, 2601.5)

31

595.0

(370.5, 955.6)

Reference strain — NT50 (titer)

6 through 23 months

Pre-vaccination

22

2491.2

(1432.0, 4333.8)

22

981.6

(503.5, 1913.7)

1 month

23

8737.2

(5959.6, 12809.5)

23

9221.7

(6734.0, 12628.3)

2 through 4 years

Pre-vaccination

35

2802.7

(1795.7, 4374.3)

31

657.9

(421.5, 1026.9)

1 month

35

10448.3

(7685.1, 14205.1)

30

8933.3

(6388.0, 12492.9)

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