{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:42:55Z","timestamp":1790430175925,"version":"4.1.0"},"reference-count":76,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objective<\/jats:title>\n                    <jats:p>Heterologous prime\u2013boost doses of COVID-19 vaccines (\u2018mix-and-match\u2019 approach) are being studied to test for the effectiveness of Oxford (AZD1222), Pfizer (BNT162b2), Moderna (mRNA-1273) and Novavax (NVX-CoV2373) vaccines for COVID in \u2018Com-Cov2 trial\u2019 in UK, and that of Oxford and Pfizer vaccines in \u2018CombivacS trial\u2019 in Spain. Later, other heterologous combinations of CoronaVac (DB15806), Janssen (JNJ-78436735), CanSino (AD5-nCOV) and other were also being trialled to explore their effectiveness. Previously, such a strategy was deployed for HIV, Ebola virus, malaria, tuberculosis, influenza and hepatitis B to develop the artificial acquired active immunity. The present review explores the science behind such an approach for candidate COVID-19 vaccines developed using 11 different platforms approved by the World Health Organization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The candidate vaccines\u2019 pharmaceutical parameters (e.g. platforms, number needed to vaccinate and intervals, adjuvanted status, excipients and preservatives added, efficacy and effectiveness, vaccine adverse events, and boosters), and clinical aspects must be analysed for the mix-and-match approach. Results prime\u2013boost trials showed safety, effectiveness, higher systemic reactogenicity, well tolerability with improved immunogenicity, and flexibility profiles for future vaccinations, especially during acute and global shortages, compared to the homologous counterparts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Still, large controlled trials are warranted to address challenging variants of concerns including Omicron and other, and to generalize the effectiveness of the approach in regular as well as emergency use during vaccine scarcity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taab191","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T07:09:50Z","timestamp":1639206590000},"source":"Crossref","is-referenced-by-count":47,"title":["Heterologous prime\u2013boost strategies for COVID-19 vaccines"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4125-9866","authenticated-orcid":false,"given":"Binaya","family":"Sapkota","sequence":"first","affiliation":[{"name":"Nobel College Faculty of Health Sciences, Department of Pharmaceutical Sciences, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3030-3382","authenticated-orcid":false,"given":"Bhuvan","family":"Saud","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Lalitpur, Nepal"},{"name":"Central Department of Biotechnology, Institute of Science and Technology, Tribhuvan University, Kirtipur, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0137-1888","authenticated-orcid":false,"given":"Ranish","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Infection Control Unit, Outbreak Investigation and Response Sub-committee, Nepal Cancer Hospital and Research Center, Lalitpur, Nepal"},{"name":"Nepal Health Research and Innovation Foundation, Lalitpur, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6027-6656","authenticated-orcid":false,"given":"Dhurgham","family":"Al-Fahad","sequence":"additional","affiliation":[{"name":"Department of Pathological Analysis, College of Science, University of Thi-Qar, Thi-Qar, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2695-8714","authenticated-orcid":false,"given":"Ranjit","family":"Sah","sequence":"additional","affiliation":[{"name":"Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, 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