Vaxzevria (ChAdOx1-S recombinant) / University of Oxford, Emergent Biosolutions, Jenner Institute, Barinthus Bio, AstraZeneca - LARVOL DELTA

Functional analyses of vitt patient-derived PF4-antibodies and adenoviral vaccine compounds reveal unique patient-specific profiles of multicellular activation (ASH 2025) - "Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare but life-threatening adverse reaction toCOVID-19 vaccines resulting in thrombosis and thrombocytopenia; particularly due to adenoviral vector-based vaccines (ChAdOx1 nCoV-19, Ad26.COV2.S). We will also test this in conjunction with VITT antibodies.Taken together, we have constructed a blueprint of VITT anti-PF4-induced multicellular activation whichreveals unique VITT patient-specific features, as demonstrated using 8 VITT-antibodies derived from 4different patients. This advances our understanding of VITT antibody heterogeneity from a functionalperspective, which may be exploited for novel diagnostic and therapeutic strategies."

Clinical • Cardiovascular • Hematological Disorders • Infectious Disease • Novel Coronavirus Disease • Thrombocytopenia • Thrombosis • ANXA5 • CDH5 • CEACAM8 • ITGAM • SELP

Association between sars-cov-2 infection, COVID-19 vaccines and immune thrombocytopenia in adults. a nationwide population-based study in France. (ASH 2025) - P=N/A | "Although such cases were expected to be sporadic, the possibility of an increased risk at thepopulation level remained uncertain to date.Therefore, we aimed to measure the association between COVID-19 vaccines overall and by type (mRNAvaccines: Comirnaty Pfizer - BNT162b2; Spikevax Moderna - mRNA-12773; and adenovirus-basedvaccines: Vaxzevria AstraZeneca -ChadOx-1-S, and JCovden Janssen AD26COV-2.S) and the occurrence ofITP at the nationwide scale in France. This nationwide population-based study using three different designs showed an associationbetween SARS-CoV-2 infection and ChadOx1-S vaccine with ITP occurrence, while no association wasfound for mRNA vaccines."

Clinical • Hematological Disorders • Immune Thrombocytopenic Purpura • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • Thrombocytopenia • Thrombocytopenic Purpura

Assessing the association between COVID-19 vaccination and thrombotic thrombocytopenia syndrome (ATTEST Study): Analyses of English data, 2020-2022. (PubMed, Int J Infect Dis) - "Consistent with previous studies, we found an association between TTS and receiving a first dose of AZD1222. There were no associations of TTS with AZD1222 second dose and BNT162b2 first or second doses."

Journal • Cardiovascular • Hematological Disorders • Infectious Disease • Novel Coronavirus Disease • Thrombocytopenia • Thrombosis

Platelet Factor 4 Antibody Persistence and Long-term Pathogenicity in Vaccine-induced Immune Thrombotic Thrombocytopenia. (PubMed, medRxiv) - "To study this, acute and follow-up samples were obtained from six Ad26.COV2.S-associated VITT patients, with a median time to follow-up of 244 days from acute presentation (Range, 114-664 days). While none of these six antibodies caused long-term thrombocytopenia or thrombosis, platelet-activating anti-PF4 antibodies were seen four years after the acute event in an additional ChAdOx1 nCoV-19-associated VITT patient. These antibodies continued to cause chronic low-grade thrombocytopenia, highlighting the potential for long-term sequelae in what is generally viewed as a transient thrombotic thrombocytopenic syndrome."

Journal • Cardiovascular • Hematological Disorders • Monoclonal Gammopathy • Thrombocytopenia • Thrombosis

Immunogenicity and safety to SARS-Cov-2 vaccination in patients with systemic vasculitis. (PubMed, Front Immunol) - "ChAdOx1 nCoV-19 (AstraZeneca/Oxford) (n=36) and CoronaVac (Sinovac) (n=25) were primarily the most common vaccines, while BNT162b2 (Pfizer-BioNTech) was usually the booster vaccine...Different SARS-CoV-2 vaccines demonstrated immunogenicity and clinical effectiveness in systemic vasculitis. The three-dose schedule was safe without increasing relapse risk."

Journal • ANCA Vasculitis • Infectious Disease • Novel Coronavirus Disease • Rare Diseases • Respiratory Diseases • Rheumatology • Vasculitis

A Self-Reported Survey-Based Evaluation of the Real-World Effectiveness of Non-mRNA COVID-19 Vaccines During the Second Pandemic Wave in India. (PubMed, Cureus) - "BI rates were similar between Covishield (12.7%) and Covaxin (13.9%) recipients (p=0.4). Despite higher exposure, healthcare workers had lower infection severity and mortality. These findings highlight the importance of optimized vaccine dosing, booster doses for high-risk groups, and continued public health measures."

Journal • Real-world evidence • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Third Booster Half Dose of ChAdOx1-nCov-19 Is Effective, Safe, and Induces Long-Duration Humoral and Cellular Immune Response to Omicron: 1-Year Follow-Up of Viana Study. (PubMed, Vaccines (Basel)) - P2/3 | "Homologous regimen with 3 half doses or 3 full doses induced a similar increase in antibody titers and robust cellular response. ClinicalTrials.gov (NCT05059106)."

Journal • Infectious Disease • Novel Coronavirus Disease • CD4

Primary and Booster COVID-19 Vaccination in Patients with Sjögren's Disease: Data from the Longitudinal SAFER Cohort Study. (PubMed, Vaccines (Basel)) - "COVID-19 vaccination in patients with SjD was safe and induced high anti-spike antibody titers and seropositivity. Heterologous boosting, particularly with BNT162b2, demonstrated superior immunogenicity. No association was found between vaccination and SjD disease flares or worsening activity."

Journal • Immunology • Infectious Disease • Novel Coronavirus Disease • Sjogren's Syndrome

Immunogenicity and safety of Biological E's CORBEVAX™ vaccine as a heterologous booster dose in adult volunteers previously vaccinated with two doses of either COVISHIELD™ or COVAXIN: A prospective double-blind randomized phase III clinical study. (PubMed, IJID Reg) - "One serious adverse event occurred and was deemed unrelated to the booster. In conclusion, heterologous boosting with CORBEVAX™ substantially enhanced humoral and cellular immunity against SARS-CoV-2 VoCs while being well tolerated."

Clinical • Journal • P3 data • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • IFNG

Long-term trends in reporting of cardiac adverse drug reactions to COVID-19 vaccines - an exploratory analysis of the EudraVigilance database. (PubMed, BMC Infect Dis) - "The frequency of reporting suspected SCADRs after COVID-19 vaccinations appears to change dynamically over time. Concerning the administration of vaccine doses, the reporting of potential post-vaccination ADRs seems to be more distributed in time. These observations suggest that post-approval long-term monitoring of suspected ADRs may be valuable for improving data capture and supporting vaccine safety assessment. This underlines the potential importance of comprehensive surveillance in the context of infectious diseases and vaccine development programs."

Adverse drug reaction • Journal • Cardiovascular • Hematological Disorders • Infectious Disease • Inflammation • Novel Coronavirus Disease • Thrombosis

A Novel Adenovirus (Adv)-Vaccinated Murine Model Simulates the Prothrombotic Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) Clinical Disorder (ASH 2023) - " Transgenic FcγRIIA mice (n>5/group) that lack mPF4 (PF4KO), but express human (h) PF4 were injected intramuscularly with 5x109 viral particles/mouse of ChadOx1-nCoV-19 ("nCoV-19 AdV") leading to expression of the COVID-19 spike protein or control ChadOx-GFP, ("GFP AdV") expressing the green fluorescent protein... We have developed a murine model to simulate the development of VITT that supports AdV:chemokine complex formation as being key to the development of Abs and the prothrombotic state in VITT. This model indicates that anti-PBP/NAP2 Abs can develop after AdV immunization. We also show that the inclusion of an oligonucleotide adjuvant switched antigenic targeting to hPF4."

Preclinical • Cardiovascular • Hematological Disorders • Immunology • Infectious Disease • Novel Coronavirus Disease • Thrombocytopenia • Thrombosis • NAPSB

Clonal Persistence of Anti-PF4 Antibodies in VITT Represents an MGTS-like State (ASH 2024) - "Results : Follow-up samples were obtained from 6 VITT patients after Ad26.COV2.S vaccination...This patient, who experienced severe thrombosis after ChAdOx1 nCoV19 vaccination, demonstrated persistent ELISA and PEA positivity even three years after symptom onset but had not experienced breakthrough thrombosis while on anticoagulation therapy...This study also demonstrates the first example of a VITT antibody with a kappa light chain. The requirement for anticoagulation in patients demonstrating ELISA-positive/functional test-negative results is not clear, but the persistence of mono/oligoclonal anti-PF4 antibodies raises the possibility for the upregulation of pathogenic antibody production in proinflammatory settings."

Cardiovascular • Hematological Disorders • Monoclonal Gammopathy • Thrombocytopenia • Thrombosis

Clinical and Serological Characteristics of Vaccine-Associated Immune Thrombocytopenia Following COVID-19 Vaccination (ASH 2024) - "Culprit vaccines were the ChAdOx1 nCoV-19 adenoviral vector (n=3, 50%; first vaccine only), and the BNT16B2b2 mRNA vaccine [n= 3, 50%; after first (n=1), third (n=1) or fourth vaccine (n=1)]...Treatments for VA-ITP included corticosteroids (n=6), IVIg (n=5), thrombopoietin receptor agonists (n=3), rituximab (n=2), and splenectomy (n=1)...Conclusion : We found that 3 (50%) of 6 patients with VA-ITP after adenoviral vector and mRNA COVID-19 vaccines had detectable anti-platelet antibodies, including 2 patients with anti-GPIbIX and one patient with both anti-GPIbIX and anti-GPIIbIIIa. Antibody-positive VA-ITP tended to be more severe and require more treatment."

Clinical • Cardiovascular • Hematological Disorders • Immune Thrombocytopenic Purpura • Infectious Disease • Novel Coronavirus Disease • Thrombocytopenia • Thrombocytopenic Purpura • Thrombosis

Perspectives on the impact of regulatory measures on national COVID-19 vaccination programs: a qualitative study from six EU member states. (PubMed, J Pharm Policy Pract) - "The European Medicines Agency (EMA) issued regulatory recommendations and communications in 2021 about the risk of thrombosis with thrombocytopenia syndrome (TTS) associated with COVID-19 adenoviral vector vaccines Vaxzevria and Jcovden...National decision-makers country reverted to their preferred sources. The use of varying sources explains some of the variations in the vaccination strategies."

Journal • Cardiovascular • Hematological Disorders • Infectious Disease • Novel Coronavirus Disease • Thrombocytopenia • Thrombosis

Discovering metabolic pathways associated with immune activation in people living with HIV following ChAdOx1 nCoV-19 vaccination using mass spectrometry. (PubMed, J Pharm Biomed Anal) - "Arachidonic acid metabolism emerged as one of the most affected pathways, with > 2-fold upregulation (p < 0.05) of pro-inflammatory lipid mediators, including leukotriene B4 (LTB4) and prostaglandin E2 (PGE2). These results indicate that vaccination induces marked metabolic reprogramming in PLHIV, particularly within lipid-derived inflammatory pathways, providing novel insights into vaccine-induced immune regulation in the PLHIV."

Journal • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Novel Coronavirus Disease

Free Nucleic acids in ChAdOx1 nCoV-19 adenovirus vector vaccine contribute to an anti-platelet factor 4 antibody response. (PubMed, Thromb Haemost) - "Virion-unbound DNA in ChAdOx1 nCoV-19 contributes to anti-PF4 antibody formation. This highlights the potential of reducing virion-unbound DNA in vaccine formulations to mitigate unintended immune responses to PF4."

Journal • Cardiovascular • Hematological Disorders • Immune Thrombocytopenic Purpura • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • Thrombocytopenia • Thrombocytopenic Purpura • Thrombosis

Serological Response to COVID-19 Vaccination in Saudi Arabia: A Comparative Study of IgG and Neutralising Antibodies Across Vaccine Platforms. (PubMed, Vaccines (Basel)) - "This study aimed to assess the serological responses to Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and AstraZeneca (ChAdOx1 nCoV-19) vaccines in a diverse population living in KSA. All COVID-19 vaccines administered in Saudi Arabia elicited robust antibody responses, particularly the mRNA-based vaccines. Our findings support their continued use and justify varied vaccination approaches, including mix-and-match booster strategies, to enhance community immunity."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

A Case of Prolonged SARS-CoV-2 Shedding and HIV Co-infection: Clinical and Diagnostic Challenges. (PubMed, Infect Disord Drug Targets) - "To our knowledge, this is the first study reporting accidental finding of HIV in a SARS-CoV-2 asymptomatic patient who was previously false negative. The persis-tence of SARS-CoV-2 in this case highlights the importance of comprehensive diagnostic workups and careful clinical management in patients with co-infections. This report also highlights the high risk of silent transmission of SARS-CoV-2 by asymptomatic individu-als, emphasizing the need to include such cases in dynamic surveillance strategies to pre-vent further spread. Along with this, the study highlights the need for further investigation into the interplay between HIV co-infection, COVID-19 vaccination outcomes, and the dynamics of SARS-CoV-2 shedding."

Journal • Human Immunodeficiency Virus • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

A Systematic Review of Ocular Complications Following Different Types of Covid-19 Vaccines. (PubMed, J Immunol Res) - "Ocular complications were diagnosed more often in Pfizer-BioNTech COVID-19 vaccine and Oxford-AstraZeneca COVID-19 vaccine (AstraZeneca) recipients than in others...These findings emphasize the importance of postvaccination ocular surveillance. This is particularly important in individuals with a history of ocular inflammation and suggests a potential immunological mechanism that requires further investigation."

Journal • Review • Infectious Disease • Inflammation • Novel Coronavirus Disease • Ocular Inflammation • Ophthalmology • Respiratory Diseases • Uveitis

Neutralization and Anti-S Antibody Titers in SARS-CoV-2 Boosted Adults in Mexico: A Comparison Across Five Vaccine Types. (PubMed, Int J Microbiol) - "We observed that the highest anti-protein S GMTs were in the group that received a heterologous booster with BNT162b2, AZD1222, Ad5-nCoV, or CoronaVac; the group without a booster showed the lowest GMTs...Boosters increased GMTs for all people, independently of their primary vaccine scheme. Yet, our findings suggest that a heterologous booster produced higher titers against SARS-CoV-2 protein S. Efforts should be made to reach people who received AZD1222 and Ad5-nCoV as their primary scheme and did not get boosted, as neutralization in those groups was particularly low."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • PROS1

Impaired antibody responses to heterologous ChAdOx1 nCoV-19 and BNT162b2 vaccination in individuals with type 2 diabetes. (PubMed, Sci Rep) - "Thus, a shorter interval between boosters might be necessary for DM individuals. These findings could inform the selection of optimal vaccination protocols for individuals with or without DM and contribute to the development of an efficacious COVID-19 vaccine for individuals with underlying health conditions, particularly DM."

Journal • Diabetes • Infectious Disease • Metabolic Disorders • Novel Coronavirus Disease • Respiratory Diseases • Type 2 Diabetes Mellitus

A statistical method for evaluating vaccine-induced immune correlates of protection against infection and disease progression: application to the ChAdOx1-S nCoV-19 phase 3 trial. (PubMed, Vaccine) - P2/3 | "Integrated analysis of multiple disease outcomes and candidate CoPs enables the identification of CoPs that operate at different stages of disease progression, which are missed when evaluating outcomes separately."

Journal • P3 data • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Identification of novel genetic biomarkers for ChAdOx1 nCoV-19 mediated immunogenicity. (PubMed, Front Immunol) - "The synergic host effect highlights the value of integrating genetic information with other host factors as a biomarker to predict individual vaccine responses. Our findings can contribute to personalized vaccination strategies and future vaccination policies."

Biomarker • Journal • Infectious Disease • Novel Coronavirus Disease

Reproduction of antibody levels following five distinct ChAdOx1 nCoV-19 vaccine regimens through virtual patient cohorts. (PubMed, Comput Biol Med) - "Analysis of the VC identified timing strategies for two- and three-dose regimens that promote sustained antibody responses. These results illustrate how computational models and virtual populations can inform vaccine scheduling and support optimisation of vaccination strategies."

Journal • Infectious Disease • Novel Coronavirus Disease

Vaccine-Induced and Hybrid Immunity Against SARS-CoV-2 Variants of Concern in Two Cohorts in Queensland, Australia (2021-2022). (PubMed, J Med Virol) - "To assess the immunogenicity and virus-neutralisation ability of antibodies induced by individual or combination of Vaxzevria (AstraZeneca: AZ) and Comirnaty (Pfizer: PZ) vaccines and of a hybrid immunity induced in people who were also infected with SARS-CoV-2, longitudinal sera samples of participants recruited through the David Serisier Research biobank (Mater Research Hospital) or at the University of Queensland were collected. We showed the attenuation of the QLD02Δ3678 virus in Vero E6 and human Caco2 cells. We demonstrated that neutralization assays with the wild-type QLD02 virus and QLD02Δ3678 virus were concordant, providing a safe platform for neutralisation assays in BSL2/PC2 settings."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases