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Phase 3 Safety and Efficacy of AZD1222 (ChAdOx1 nCoV-19) Covid-19 Vaccine.


ABSTRACT:

Background

The safety and efficacy of the AZD1222 (ChAdOx1 nCoV-19) vaccine in a large, diverse population at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the United States, Chile, and Peru has not been known.

Methods

In this ongoing, double-blind, randomized, placebo-controlled, phase 3 clinical trial, we investigated the safety, vaccine efficacy, and immunogenicity of two doses of AZD1222 as compared with placebo in preventing the onset of symptomatic and severe coronavirus disease 2019 (Covid-19) 15 days or more after the second dose in adults, including older adults, in the United States, Chile, and Peru.

Results

A total of 32,451 participants underwent randomization, in a 2:1 ratio, to receive AZD1222 (21,635 participants) or placebo (10,816 participants). AZD1222 was safe, with low incidences of serious and medically attended adverse events and adverse events of special interest; the incidences were similar to those observed in the placebo group. Solicited local and systemic reactions were generally mild or moderate in both groups. Overall estimated vaccine efficacy was 74.0% (95% confidence interval [CI], 65.3 to 80.5; P<0.001) and estimated vaccine efficacy was 83.5% (95% CI, 54.2 to 94.1) in participants 65 years of age or older. High vaccine efficacy was consistent across a range of demographic subgroups. In the fully vaccinated analysis subgroup, no severe or critical symptomatic Covid-19 cases were observed among the 17,662 participants in the AZD1222 group; 8 cases were noted among the 8550 participants in the placebo group (<0.1%). The estimated vaccine efficacy for preventing SARS-CoV-2 infection (nucleocapsid antibody seroconversion) was 64.3% (95% CI, 56.1 to 71.0; P<0.001). SARS-CoV-2 spike protein binding and neutralizing antibodies increased after the first dose and increased further when measured 28 days after the second dose.

Conclusions

AZD1222 was safe and efficacious in preventing symptomatic and severe Covid-19 across diverse populations that included older adults. (Funded by AstraZeneca and others; ClinicalTrials.gov number, NCT04516746.).

SUBMITTER: Falsey AR 

PROVIDER: S-EPMC8522798 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Phase 3 Safety and Efficacy of AZD1222 (ChAdOx1 nCoV-19) Covid-19 Vaccine.

Falsey Ann R AR   Sobieszczyk Magdalena E ME   Hirsch Ian I   Sproule Stephanie S   Robb Merlin L ML   Corey Lawrence L   Neuzil Kathleen M KM   Hahn William W   Hunt Julie J   Mulligan Mark J MJ   McEvoy Charlene C   DeJesus Edwin E   Hassman Michael M   Little Susan J SJ   Pahud Barbara A BA   Durbin Anna A   Pickrell Paul P   Daar Eric S ES   Bush Larry L   Solis Joel J   Carr Quito Osuna QO   Oyedele Temitope T   Buchbinder Susan S   Cowden Jessica J   Vargas Sergio L SL   Guerreros Benavides Alfredo A   Call Robert R   Keefer Michael C MC   Kirkpatrick Beth D BD   Pullman John J   Tong Tina T   Brewinski Isaacs Margaret M   Benkeser David D   Janes Holly E HE   Nason Martha C MC   Green Justin A JA   Kelly Elizabeth J EJ   Maaske Jill J   Mueller Nancy N   Shoemaker Kathryn K   Takas Therese T   Marshall Richard P RP   Pangalos Menelas N MN   Villafana Tonya T   Gonzalez-Lopez Antonio A  

The New England journal of medicine 20210929 25


<h4>Background</h4>The safety and efficacy of the AZD1222 (ChAdOx1 nCoV-19) vaccine in a large, diverse population at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the United States, Chile, and Peru has not been known.<h4>Methods</h4>In this ongoing, double-blind, randomized, placebo-controlled, phase 3 clinical trial, we investigated the safety, vaccine efficacy, and immunogenicity of two doses of AZD1222 as compared with placebo in preventing the  ...[more]

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