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We conducted a randomised, double-blinded, controlled, phase 2 trial to assess the immunogenicity and safety of the heterologous prime-boost vaccination with an inactivated COVID-19 vaccine (BBIBP-CorV) followed by a recombinant protein-based vaccine (NVSI-06-07), using homologous boost with BBIBP-CorV as control. Three groups of healthy adults (600 individuals per group) who had completed two-dose BBIBP-CorV vaccinations 1\u20133 months, 4\u20136 months and \u22656 months earlier, respectively, were randomly assigned in a 1:1 ratio to receive either NVSI-06-07 or BBIBP-CorV boost. Immunogenicity assays showed that in NVSI-06-07 groups, neutralizing antibody geometric mean titers (GMTs) against the prototype SARS-CoV-2 increased by 21.01\u201363.85 folds on day 28 after vaccination, whereas only 4.20\u201316.78 folds of increases were observed in control groups. For Omicron variant, the neutralizing antibody GMT elicited by homologous boost was 37.91 on day 14, however, a significantly higher neutralizing GMT of 292.53 was induced by heterologous booster. Similar results were obtained for other SARS-CoV-2 variants of concerns (VOCs), including Alpha, Beta and Delta. Both heterologous and homologous boosters have a good safety profile. Local and systemic adverse reactions were absent, mild or moderate in most participants, and the overall safety was quite similar between two booster schemes. Our findings indicated that NVSI-06-07 is safe and immunogenic as a heterologous booster in BBIBP-CorV recipients and was immunogenically superior to the homologous booster against not only SARS-CoV-2 prototype strain but also VOCs, including Omicron.<\/jats:p>","DOI":"10.1038\/s41392-022-00984-2","type":"journal-article","created":{"date-parts":[[2022,6,5]],"date-time":"2022-06-05T20:02:37Z","timestamp":1654459357000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Immunogenicity and safety of NVSI-06-07 as a heterologous booster after priming with BBIBP-CorV: a phase 2 trial"],"prefix":"10.1038","volume":"7","author":[{"given":"Nawal Al","family":"Kaabi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun 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Y.K.Y., T.Y., M.L., X.Z., C.Q., D.Y.L., Z.N.W., J.L.Y., L.Q., Y.T.Z. and X.M.Y. are employees of the China National Biotec Group Company Limited. X.J.G. and X.Y.M. are employees of Lanzhou Institute of Biological Products Company Limited. H.W. and J.Z. are employees of Beijing Institute of Biological Products Company Limited. J.Z.(NVSI), Y.L., J.G.S., S.S., N.L. and Q.M.L. are listed as inventors of the patent applications for the trimeric RBD-based vaccines (Application numbers: 202110348881.6, 202110464788.1 and 202110676901.2) and a patent (Application number: 202110676901.2) has been authorized. The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"172"}}