Efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 lineages circulating in Brazil

Sue Ann Costa Clemens, Pedro M. Folegatti, Katherine R. W. Emary, Lily Yin Weckx, Jeremy Ratcliff, Sagida Bibi, Ana Verena Almeida Mendes, Eveline Pipolo Milan, Ana Pittella, Alexandre V. Schwarzbold, Eduardo Sprinz, Parvinder K. Aley, David Bonsall, Christophe Fraser, Michelle Fuskova, Sarah C. Gilbert, Daniel Jenkin, Sarah Kelly, Simon Kerridge, Teresa Lambe, Natalie G. Marchevsky, Yama F. Mujadidi, Emma Plested, Maheshi N. Ramasamy, Peter Simmonds, Tanya Golubchik, Merryn Voysey () and Andrew J. Pollard ()
Additional contact information
Sue Ann Costa Clemens: University of Oxford
Pedro M. Folegatti: University of Oxford
Katherine R. W. Emary: University of Oxford
Lily Yin Weckx: Universidade Federal de São Paulo
Jeremy Ratcliff: University of Oxford
Sagida Bibi: University of Oxford
Ana Verena Almeida Mendes: Escola Bahiana de Medicina e Saúde Pública, Brazil and ID’OR
Eveline Pipolo Milan: Universidade Federal do Rio Grande do Norte - UFRN
Ana Pittella: Hospital Quinta D’Or
Alexandre V. Schwarzbold: Universidade Federal de Santa Maria
Eduardo Sprinz: Infectious Diseases Service, Hospital de Clinicas de Porto Alegre
Parvinder K. Aley: University of Oxford
David Bonsall: University of Oxford
Christophe Fraser: University of Oxford
Michelle Fuskova: University of Oxford
Sarah C. Gilbert: University of Oxford
Daniel Jenkin: University of Oxford
Sarah Kelly: University of Oxford
Simon Kerridge: University of Oxford
Teresa Lambe: University of Oxford
Natalie G. Marchevsky: University of Oxford
Yama F. Mujadidi: University of Oxford
Emma Plested: University of Oxford
Maheshi N. Ramasamy: University of Oxford
Peter Simmonds: University of Oxford
Tanya Golubchik: University of Oxford
Merryn Voysey: University of Oxford
Andrew J. Pollard: University of Oxford

Nature Communications, 2021, vol. 12, issue 1, 1-10

Abstract: Abstract Several COVID-19 vaccines have shown good efficacy in clinical trials, but there remains uncertainty about the efficacy of vaccines against different variants. Here, we investigate the efficacy of ChAdOx1 nCoV-19 (AZD1222) against symptomatic COVID-19 in a post-hoc exploratory analysis of a Phase 3 randomised trial in Brazil (trial registration ISRCTN89951424). Nose and throat swabs were tested by PCR in symptomatic participants. Sequencing and genotyping of swabs were performed to determine the lineages of SARS-CoV-2 circulating during the study. Protection against any symptomatic COVID-19 caused by the Zeta (P.2) variant was assessed in 153 cases with vaccine efficacy (VE) of 69% (95% CI 55, 78). 49 cases of B.1.1.28 occurred and VE was 73% (46, 86). The Gamma (P.1) variant arose later in the trial and fewer cases (N = 18) were available for analysis. VE was 64% (−2, 87). ChAdOx1 nCoV-19 provided 95% protection (95% CI 61%, 99%) against hospitalisation due to COVID-19. In summary, we report that ChAdOx1 nCoV-19 protects against emerging variants in Brazil despite the presence of the spike protein mutation E484K.

Date: 2021
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DOI: 10.1038/s41467-021-25982-w

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