BNT162b vaccines are immunogenic and protect non-human primates against SARS-CoV-2

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Abstract

A safe and effective vaccine against COVID-19 is urgently needed in quantities sufficient to immunise large populations. We report the preclinical development of two BNT162b vaccine candidates, which contain lipid-nanoparticle (LNP) formulated nucleoside-modified mRNA encoding SARS-CoV-2 spike glycoprotein-derived immunogens. BNT162b1 encodes a soluble, secreted, trimerised receptor-binding domain (RBD-foldon). BNT162b2 encodes the full-length transmembrane spike glycoprotein, locked in its prefusion conformation (P2 S). The flexibly tethered RBDs of the RBD-foldon bind ACE2 with high avidity. Approximately 20% of the P 2S trimers are in the two-RBD ‘down,’ one-RBD ‘up’ state. In mice, one intramuscular dose of either candidate elicits a dose-dependent antibody response with high virus-entry inhibition titres and strong TH1 CD4 + and IFNγ + CD8 + T-cell responses. Prime/boost vaccination of rhesus macaques with BNT162b candidates elicits SARS-CoV-2 neutralising geometric mean titres 8.2 to 18.2 times that of a SARS-CoV-2 convalescent human serum panel. The vaccine candidates protect macaques from SARS-CoV-2 challenge, with BNT162b2 protecting the lower respiratory tract from the presence of viral RNA and with no evidence of disease enhancement. Both candidates are being evaluated in phase 1 trials in Germany and the United States. BNT162b2 is being evaluated in an ongoing global, pivotal Phase 2/3 trial ( NCT04380701 , NCT04368728 ).

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  1. SciScore for 10.1101/2020.12.11.421008: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIACUC: All procedures performed on these animals were in accordance with regulations and established guidelines and were reviewed and approved by an Institutional Animal Care and Use Committee or through an ethical review process.
    Randomizationnot detected.
    BlindingImages were interpreted by a board-certified veterinary radiologist blinded to treatment groups.
    Power Analysisnot detected.
    Sex as a biological variableBNT162b1-immunised (n=6), BNT162b2-immunised (n=6), and age-matched saline-immunised (n=9) male rhesus macaques (control) were challenged with 1.05 × 106 plaque forming units of SARS-CoV-2 USA-WA1/2020 isolate, split equally between the intranasal (IN; 0.25 mL) and intratracheal (IT; 0.25 mL) routes as previously described28.
    Cell Line AuthenticationContamination: Cell lines were tested for mycoplasma contamination after receipt, before expansion and cryopreservation.

    Table 2: Resources

    Antibodies
    SentencesResources
    Blotted proteins were detected with a monoclonal antibody that recognizes SARS-CoV-2 S1 (SinoBiological) and a secondary anti-rabbit horse radish peroxidase (HRP)-conjugated antibody (Sigma Aldrich).
    anti-rabbit
    suggested: None
    Free binding sites were blocked and cells incubated with a rabbit monoclonal antibody that recognizes the SARS-CoV-2 S1 subunit (SinoBiological), an anti-rabbit IgG secondary antibody (Jackson ImmunoResearch), labelled lectin HPA (Thermo Fisher Scientific) and concanavalin A (Fisher Scientific GmbH).
    anti-rabbit IgG
    suggested: None
    labelled lectin HPA
    suggested: None
    Binding analysis of captured murine IgG antibodies to S1-His or RBD-His (Sino Biological Inc.) was performed using a multi-cycle kinetic method with concentrations ranging from 25 to 400 nM or 1.5625 to 50 nM, respectively.
    murine IgG
    suggested: (Novus Cat# NB120-5625, RRID:AB_2292017)
    S1-His
    suggested: None
    After incubation for 1 h at 37 °C, the inoculums was removed, and cells were washed with PBS before medium supplemented with anti-VSV-G antibody (clone 8G5F11, Kerafast Inc.) was added to neutralise residual input virus.
    anti-VSV-G
    suggested: (Absolute Antibody Cat# Ab01401-2.0, RRID:AB_2883992)
    Experimental Models: Cell Lines
    SentencesResources
    Cell culture: Human embryonic kidney (HEK)293T and Vero 76 cells (both ATCC) were cultured in Dulbecco’s modified Eagle’s medium (DMEM) with GlutaMAX™ (Gibco) supplemented with 10% fetal bovine serum (FBS [Sigma-Aldrich]).
    HEK)293T
    suggested: None
    Vero 76
    suggested: None
    Transfection of HEK cells: HEK293T cells were transfected with 1 µg RiboJuice transfection reagent-mixed BNT162b1 RNA or BNT162b2 RNA or with the vaccine candidates BNT162b1 (LNP-formulated BNT162b1 RNA) or BNT162b2 (LNP-formulated BNT162b2 RNA) by incubation for 18 hours.
    HEK
    suggested: None
    Western blot analysis of size fractions of the medium of BNT162b1 RNA transfected cells: Medium from cultured HEK293T cells were collected.
    HEK293T
    suggested: NCBI_Iran Cat# C498, RRID:CVCL_0063)
    Vero-76 cells were seeded in 96-well plates.
    Vero-76
    suggested: None
    Serial dilutions of heat-inactivated sera were incubated with the reporter virus (2 x 104 plaque forming units [PFU] per well) to yield an approximately 10-30% infection rate of the Vero CCL81 monolayer for 1 h at 37 °C before inoculating Vero CCL81 cell monolayers (targeted to have 8,000 to 15,000 cells in the central field of each well at the time of seeding, one day before infection) in 96-well plates to allow accurate quantification of infected cells.
    Vero CCL81
    suggested: None
    The working virus stock was generated from two passages of the SARS-CoV-2 USA-WA1/2020 isolate (a 4th passage seed stock purchased from BEI Resources; NR-52281) in Vero E6 cells.
    Vero E6
    suggested: RRID:CVCL_XD71)
    Software and Algorithms
    SentencesResources
    Blots were developed with Clarity Western ECL Substrate (Bio-Rad) and imaged with a Fusion FX Imager (Vilber) using the Image Lab software version 6.0.
    Image Lab
    suggested: (Image Lab Software, RRID:SCR_014210)
    Cells were acquired on a FACSCanto II flow cytometer (BD Biosciences) using BD FACSDiva software version 8.0.1 and analysed by FlowJo software version 10.6.2 (FlowJo LLC, BD Biosciences).
    BD FACSDiva
    suggested: (BD FACSDiva Software, RRID:SCR_001456)
    FlowJo
    suggested: (FlowJo, RRID:SCR_008520)
    The resulting particle set was subjected to 2D classification in RELION 3.0.644.
    RELION
    suggested: (RELION, RRID:SCR_016274)
    The microscope was operated for image acquisition using SerialEM software version 3.8.0 beta48.
    SerialEM
    suggested: (SerialEM, RRID:SCR_017293)
    Cell counts were enumerated by nuclear stain (Hoechst 33342), and fluorescent virus-infected foci were detected 16-24 hours after inoculation with a Cytation 7 Cell Imaging Multi-Mode Reader (BioTek) with Gen5 Image Prime version 3.09.
    Gen5
    suggested: (Gen5, RRID:SCR_017317)
    Twelve to nineteen days prior to challenge, animals were moved from the NIRC, in New Iberia, LA, where they had been immunised, to the animal biosafety level 3 facility at SNPRC (in San Antonio, TX).
    NIRC
    suggested: None
    SNPRC
    suggested: (Southwest National Primate Research Center, RRID:SCR_008292)
    PROC RANK and PROC GLM from SAS® 9.4 were used to calculate the p-values.
    SAS®
    suggested: (SASqPCR, RRID:SCR_003056)
    All remaining analyses were two-tailed and carried out using GraphPad Prism 8.4.
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitation and clearance of virus infections is promoted by the interplay of neutralising antibodies that eliminate infectious particles with CD8+ T cells that target intracellular virus reservoirs. CD8+ T cells may also reduce the influx of monocytes into infected lung tissue, which can be associated with undesirable IL-6 and TNF production and impaired antigen presentation35, 36. The responses elicited by the vaccine candidates reflect a pattern favourable for vaccine safety and efficacy, providing added reassurance for clinical translation37. The contributions of the individual immune effector systems to human protection from SARS-CoV-2 are not yet understood. Therefore, it appears prudent to develop COVID-19 vaccines that enlist concomitant cognate B cells, CD4+ T cells, and CD8+ T-cell responses. Both candidates protected 2-4 year old rhesus macaques from infectious SARS-CoV-2 challenge, with reduced detection of viral RNA in immunised animals compared to those that received saline. Immunisation with BNT162b2 provided particularly strong RT-qPCR evidence for lower respiratory tract protection, as demonstrated by the absence of detectable SARS-CoV-2 RNA in serial BAL samples obtained starting 3 days after challenge. The lack of serological response to the SARS-CoV-2 challenge in BNT162b1- or BNT162b2-immunised macaques, despite a neutralising response to challenge in control-immunised macaques, suggests suppression of infection by the vaccine candidates. Clinical signs of...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04380701RecruitingA Trial Investigating the Safety and Effects of Four BNT162 …
    NCT04368728Active, not recruitingStudy to Describe the Safety, Tolerability, Immunogenicity, …


    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap(s) used on pages 66, 67, 68, 69, 70 and 71. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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