Zhe Zhang, Shipo Wu, Yawei Liu, Kailiang Li, Pengfei Fan, Xiaohong Song, Yudong Wang, Zhenghao Zhao, Xianwei Zhang, Jin Shang, Jinlong Zhang, Jinghan Xu, Yao Li, Yaohui Li, Jipeng Zhang, Kefan Fu, Busen Wang, Meng Hao, Guanying Zhang, Pengwei Long, Ziyu Qiu, Tao Zhu, Shuling Liu, Yue Zhang, Fangze Shao, Peng Lv, Yilong Yang, Xiaofan Zhao, Yufa Sun, Lihua Hou, and Wei Chen
The SARS-CoV-2 Omicron variant has become the dominant SARS-CoV-2 variant around the world and exhibits immune escape to current COVID-19 vaccines to some extent due to its numerous spike mutations. Here, we evaluated the immune responses to booster vaccination with intramuscular adenovirus-vectored vaccine (Ad5-nCoV), aerosolized Ad5-nCoV, a recombinant protein subunit vaccine (ZF2001) or homologous inactivated vaccine (CoronaVac) in those who received two doses of inactivated COVID-19 vaccines 6 months prior. We found that the Ad5-nCoV booster induced potent neutralizing activity against the wild-type virus and Omicron variant, while aerosolized Ad5-nCoV generated the greatest neutralizing antibody responses against the Omicron variant at day 28 after booster vaccination, at 14.1-fold that of CoronaVac, 5.6-fold that of ZF2001 and 2.0-fold that of intramuscular Ad5-nCoV. Similarly, the aerosolized Ad5-nCoV booster produced the greatest IFNγ T-cell response at day 14 after booster vaccination. The IFNγ T-cell response to aerosolized Ad5-nCoV was 12.8-fold for CoronaVac, 16.5-fold for ZF2001, and 5.0-fold for intramuscular Ad5-nCoV. Aerosolized Ad5-nCoV booster also produced the greatest spike-specific B cell response. Our findings suggest that inactivated vaccine recipients should consider adenovirus-vectored vaccine boosters in China and that aerosolized Ad5-nCoV may provide a more efficient alternative in response to the spread of the Omicron variant.