Efficacy and Safety of the RBD-Dimer–Based Covid-19 Vaccine ZF2001 in Adults

Autor: Lianpan, Dai, Lidong, Gao, Lifeng, Tao, Sri R, Hadinegoro, Musabaev, Erkin, Zhifang, Ying, Peng, He, Rodman T, Girsang, Hugo, Vergara, Javed, Akram, Hindra I, Satari, Tanwir, Khaliq, Ume, Sughra, Ana P, Celi, Fangjun, Li, Yan, Li, Zhiwei, Jiang, Dilbar, Dalimova, Jaloliddin, Tuychiev, Shahlo, Turdikulova, Aamer, Ikram, Nancy, Flores Lastra, Fan, Ding, Mahendra, Suhardono, Eddy, Fadlyana, Jinghua, Yan, Zhongyu, Hu, Changgui, Li, Ibrokhim Y, Abdurakhmonov, George F, Gao, Zoraida, Vidal Perez
Rok vydání: 2022
Předmět:
Zdroj: New England Journal of Medicine. 386:2097-2111
ISSN: 1533-4406
0028-4793
DOI: 10.1056/nejmoa2202261
Popis: The ZF2001 vaccine, which contains a dimeric form of the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 and aluminum hydroxide as an adjuvant, was shown to be safe, with an acceptable side-effect profile, and immunogenic in adults in phase 1 and 2 clinical trials.We conducted a randomized, double-blind, placebo-controlled, phase 3 trial to investigate the efficacy and confirm the safety of ZF2001. The trial was performed at 31 clinical centers across Uzbekistan, Indonesia, Pakistan, and Ecuador; an additional center in China was included in the safety analysis only. Adult participants (≥18 years of age) were randomly assigned in a 1:1 ratio to receive a total of three 25-μg doses (30 days apart) of ZF2001 or placebo. The primary end point was the occurrence of symptomatic coronavirus disease 2019 (Covid-19), as confirmed on polymerase-chain-reaction assay, at least 7 days after receipt of the third dose. A key secondary efficacy end point was the occurrence of severe-to-critical Covid-19 (including Covid-19-related death) at least 7 days after receipt of the third dose.Between December 12, 2020, and December 15, 2021, a total of 28,873 participants received at least one dose of ZF2001 or placebo and were included in the safety analysis; 25,193 participants who had completed the three-dose regimen, for whom there were approximately 6 months of follow-up data, were included in the updated primary efficacy analysis that was conducted at the second data cutoff date of December 15, 2021. In the updated analysis, primary end-point cases were reported in 158 of 12,625 participants in the ZF2001 group and in 580 of 12,568 participants in the placebo group, for a vaccine efficacy of 75.7% (95% confidence interval [CI], 71.0 to 79.8). Severe-to-critical Covid-19 occurred in 6 participants in the ZF2001 group and in 43 in the placebo group, for a vaccine efficacy of 87.6% (95% CI, 70.6 to 95.7); Covid-19-related death occurred in 2 and 12 participants, respectively, for a vaccine efficacy of 86.5% (95% CI, 38.9 to 98.5). The incidence of adverse events and serious adverse events was balanced in the two groups, and there were no vaccine-related deaths. Most adverse reactions (98.5%) were of grade 1 or 2.In a large cohort of adults, the ZF2001 vaccine was shown to be safe and effective against symptomatic and severe-to-critical Covid-19 for at least 6 months after full vaccination. (Funded by the National Science and Technology Major Project and others; ClinicalTrials.gov number, NCT04646590.).
Databáze: OpenAIRE
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