Association Between SARS-CoV-2 Viral Load and COVID-19 Vaccination in 4 Phase 3 Trials

Holly Janes; Leigh H Fisher; Jia Jin Kee; Lalitha Parameswaran; Paul A Goepfert; Ann R Falsey; James Ludwig; Craig A Magaret; Peter B Gilbert; James G Kublin; Nadine Rouphael; Magdalena E Sobieszczyk; Hana M El Sahly; Lindsey R Baden; Beatriz Grinsztejn; Stephen R Walsh; Glenda E Gray; Karen L Kotloff; Cynthia L Gay; Alexander L Greninger; Milagritos D Tapia; E Adrianne Hammershaimb; Frances H Priddy; Justin A Green; Frank Struyf; Lisa Dunkle; Kathleen M Neuzil; Lawrence Corey; Yunda Huang

doi:10.1093/infdis/jiae400

Association Between SARS-CoV-2 Viral Load and COVID-19 Vaccination in 4 Phase 3 Trials

J Infect Dis. 2024 Sep 3:jiae400. doi: 10.1093/infdis/jiae400. Online ahead of print.

Authors

Holly Janes¹, Leigh H Fisher¹, Jia Jin Kee¹, Lalitha Parameswaran², Paul A Goepfert³, Ann R Falsey⁴, James Ludwig¹, Craig A Magaret¹, Peter B Gilbert¹, James G Kublin¹, Nadine Rouphael⁵, Magdalena E Sobieszczyk⁶, Hana M El Sahly⁷, Lindsey R Baden⁸, Beatriz Grinsztejn⁹, Stephen R Walsh⁸, Glenda E Gray¹⁰, Karen L Kotloff¹¹, Cynthia L Gay¹², Alexander L Greninger¹³, Milagritos D Tapia¹¹, E Adrianne Hammershaimb¹¹, Frances H Priddy¹⁴, Justin A Green¹⁵, Frank Struyf¹⁶, Lisa Dunkle¹⁷, Kathleen M Neuzil¹⁸, Lawrence Corey¹, Yunda Huang¹

Affiliations

¹ Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
² New York University Langone Vaccine Center, New York University Grossman School of Medicine, New York, New York, USA.
³ Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁴ Infectious Disease Division, University of Rochester, Rochester, New York, USA.
⁵ Hope Clinic, Emory University, Atlanta, Georgia, USA.
⁶ Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
⁷ Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA.
⁸ Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁹ Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
¹⁰ South African Medical Research Council, Cape Town, South Africa.
¹¹ Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
¹² Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
¹³ Department of Medicine, Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, Washington, USA.
¹⁴ Moderna, Inc, Cambridge, Massachusetts, USA.
¹⁵ Vaccines and Immune Therapies, BioPharmaceuticals Research and Development, AstraZeneca, Cambridge, United Kingdom.
¹⁶ Janssen Research and Development, Beerse, Belgium.
¹⁷ Novavax, Inc, Gaithersburg, Maryland, USA.
¹⁸ Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.

PMID: 39225478
DOI: 10.1093/infdis/jiae400

Abstract

Coronavirus disease 2019 (COVID-19) vaccines reduce severe disease and mortality and may lessen transmission, measured by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (VL). Evaluating vaccine associations in VL at COVID-19 diagnosis in 4 phase 3 randomized, placebo-controlled vaccine trials, July 2020 to July 2021, VL reductions were 2.78 log10 copies/mL (95% confidence interval [CI], 1.38-4.18; n = 60 placebo, 11 vaccine) and 2.12 log10 copies/mL (95% CI, 1.44-2.80; n = 594 placebo, 36 vaccine) for NVX-CoV2373 and mRNA-1273, respectively. Associations were not significant for AZD1222 (0.59 log10 copies/mL; 95% CI, -.19 to 1.36; n = 90 placebo, 78 vaccine) or Ad26.COV2.S (0.23 log10 copies/mL; 95% CI, -.01 to .47; n = 916 placebo, 424 vaccine). Thus, vaccines potentially decreased transmission when ancestral SARS-CoV-2 predominated. Clinical Trials Registration. NCT04470427, NCT04505722, NCT04516746, NCT04611802.

Keywords: COVID-19 transmission; COVID-19 vaccine; SARS-CoV-2 viral load; infectiousness; randomized trial.

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Associated data

ClinicalTrials.gov/NCT04505722
ClinicalTrials.gov/NCT04516746
ClinicalTrials.gov/NCT04611802
ClinicalTrials.gov/NCT04470427

Abstract

Associated data

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