{"doi":"10.4269/ajtmh.22-0256","title":"Antibody Responses and Reactogenicity of a Heterologous, Full-Dose Messenger RNA-1273 Booster in Heavily SARS-CoV-2–Exposed CoronaVac-Vaccinated Health-Care Workers in Indonesia: A Real-World Observational Study","abstract":"<jats:title>ABSTRACT.</jats:title>\n<jats:p>Real-world data on heterologous boosting with messenger RNA (mRNA)-1273 (Moderna) after inactivated COVID-19 vaccination are limited. We report mRNA-1273 boosting in heavily SARS-CoV-2–exposed Indonesian health-care workers who received a two-dose CoronaVac 6 months prior. Between August and November 2021, we measured SARS-CoV-2 spike-specific IgG binding antibody (Bab) titers in all 304 participants, and neutralizing antibody titers in a random subset of 71 participants, on stored paired serum samples taken before and 28 days after a full-dose (100-μg) mRNA-1273 booster. At the time of the mRNA-1273 boost, 107 participants (35.2%) were not previously infected (naive vaccinated), 42 (13.8%) were infected before CoronaVac (infected vaccinated), and 155 (51.0%) were infected after CoronaVac (mostly during the Delta wave; vaccinated infected). At time of the mRNA-1273 boost, neutralizing antibodies could still be detected in 83% of participants (59 of 71) overall, 60% of naive-vaccinated participants (15 of 25), 95.7% of vaccinated-infected participants (22 of 23), and 95.7% of infected vaccinated participants (22 of 23). After the mRNA-1273 boost, 100% of participants (71 of 71) had neutralizing antibody activity, with increases in median Bab and neutralizing antibody serum titers of 9.3- and 27.0-fold overall, 89.1- and 2,803.4-fold in naive-vaccinated participants, 15.9- and 19.9-fold in infected-vaccinated participants, and 2.2- and 18.4-fold in vaccinated-infected participants. In the multivariable analysis, Bab titers after the mRNA-1273 boost were greatest in individuals who had a previous virus breakthrough post-CoronaVac, and when a longer time period (&gt; 4 months) had elapsed since the most recent prior “spike antigen exposure” (either second CoronaVac or virus breakthrough). Overall, adverse reactions were mild and short-lived. In conclusion, a full-dose mRNA-1273 booster after CoronaVac was well tolerated and immunogenic after 28 days, including in those with very low antibody levels.</jats:p>","journal":"The American Journal of Tropical Medicine and Hygiene","year":2023,"id":640392,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1664316,"name":"Dwi Utomo","orcid":null,"position":1,"is_corresponding":false},{"id":1664318,"name":"Suwarti","orcid":null,"position":2,"is_corresponding":false},{"id":1664319,"name":"Erni J. Nelwan","orcid":null,"position":3,"is_corresponding":false},{"id":1335873,"name":"Henry Surendra","orcid":"0000-0002-6029-0623","position":4,"is_corresponding":false},{"id":1664321,"name":"Cindy Natasha","orcid":null,"position":5,"is_corresponding":false},{"id":1664323,"name":"Fransiska","orcid":null,"position":6,"is_corresponding":false},{"id":1664324,"name":"Deborah Theresia","orcid":null,"position":7,"is_corresponding":false},{"id":1664325,"name":"Adella Faiqa Ranitria","orcid":null,"position":8,"is_corresponding":false},{"id":1250997,"name":"Decy Subekti","orcid":"0000-0003-3109-7194","position":9,"is_corresponding":false},{"id":1664326,"name":"Nunung Nuraeni","orcid":null,"position":10,"is_corresponding":false},{"id":1664327,"name":"Winahyu Handayani","orcid":null,"position":11,"is_corresponding":false},{"id":1664328,"name":"Mutia Rahardjani","orcid":null,"position":12,"is_corresponding":false},{"id":881036,"name":"J. Kevin Baird","orcid":"0000-0002-2170-300X","position":13,"is_corresponding":false},{"id":75918,"name":"Susanna Dunachie","orcid":"0000-0001-5665-6293","position":14,"is_corresponding":false},{"id":411367,"name":"Anuraj H. Shankar","orcid":"0000-0001-7268-6708","position":15,"is_corresponding":false},{"id":36830,"name":"Raph L. Hamers","orcid":"0000-0002-5007-7896","position":16,"is_corresponding":false},{"id":1572439,"name":"Robert Sinto","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Antibody Responses and Reactogenicity of a Heterologous, Full-Dose Messenger RNA-1273 Booster in Heavily SARS-CoV-2–Exposed CoronaVac-Vaccinated Health-Care Workers in Indonesia: A Real-World Observational Study","abstract":"<jats:title>ABSTRACT.</jats:title>\n<jats:p>Real-world data on heterologous boosting with messenger RNA (mRNA)-1273 (Moderna) after inactivated COVID-19 vaccination are limited. We report mRNA-1273 boosting in heavily SARS-CoV-2–exposed Indonesian health-care workers who received a two-dose CoronaVac 6 months prior. Between August and November 2021, we measured SARS-CoV-2 spike-specific IgG binding antibody (Bab) titers in all 304 participants, and neutralizing antibody titers in a random subset of 71 participants, on stored paired serum samples taken before and 28 days after a full-dose (100-μg) mRNA-1273 booster. At the time of the mRNA-1273 boost, 107 participants (35.2%) were not previously infected (naive vaccinated), 42 (13.8%) were infected before CoronaVac (infected vaccinated), and 155 (51.0%) were infected after CoronaVac (mostly during the Delta wave; vaccinated infected). At time of the mRNA-1273 boost, neutralizing antibodies could still be detected in 83% of participants (59 of 71) overall, 60% of naive-vaccinated participants (15 of 25), 95.7% of vaccinated-infected participants (22 of 23), and 95.7% of infected vaccinated participants (22 of 23). After the mRNA-1273 boost, 100% of participants (71 of 71) had neutralizing antibody activity, with increases in median Bab and neutralizing antibody serum titers of 9.3- and 27.0-fold overall, 89.1- and 2,803.4-fold in naive-vaccinated participants, 15.9- and 19.9-fold in infected-vaccinated participants, and 2.2- and 18.4-fold in vaccinated-infected participants. In the multivariable analysis, Bab titers after the mRNA-1273 boost were greatest in individuals who had a previous virus breakthrough post-CoronaVac, and when a longer time period (&gt; 4 months) had elapsed since the most recent prior “spike antigen exposure” (either second CoronaVac or virus breakthrough). Overall, adverse reactions were mild and short-lived. In conclusion, a full-dose mRNA-1273 booster after CoronaVac was well tolerated and immunogenic after 28 days, including in those with very low antibody levels.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36450232","pmcid":"PMC9833072","openalex_id":null,"authors":[],"funders":[{"funder_name":"National Institute for Health Research (NIHR)","grant_id":"NIHR300791","title":null},{"funder_name":"Medical Research Council","grant_id":"MR/X009297/1","title":null}],"total_grants":2,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://www.ajtmh.org/downloadpdf/journals/tpmd/108/1/article-p115.pdf","host_type":"publisher"},{"url":"https://www.ajtmh.org/view/journals/tpmd/108/1/article-p115.xml","host_type":"publisher"},{"url":"https://www.ajtmh.org/downloadpdf/journals/tpmd/108/1/article-p115.xml","host_type":"publisher"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9833072","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC9833072","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC9833072?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":[],"mesh_terms":["Humans","Immunoglobulin G","RNA, Messenger","Vaccines, Inactivated","Antibodies, Viral","Antibody Formation","Indonesia","Antibodies, Neutralizing","COVID-19","SARS-CoV-2","COVID-19 Vaccines","2019-nCoV Vaccine mRNA-1273"],"keywords":[],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-07T11:16:51.631335Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}