Local and systemic reactogenicity after mRNA and protein-based COVID-19 vaccines compared to meningococcal vaccine (MenACWY) in a UK blinded, randomized phase 2 trial (COV-BOOST)

Vaccine. 2025 Jan 12:44:126569. doi: 10.1016/j.vaccine.2024.126569. Epub 2024 Dec 5.

Abstract

Reactogenicity, the occurrence of vaccine side effects, can impact vaccine acceptance. There is limited data comparing the reactogenicity of COVID-19 vaccines to other routinely used vaccines, such as the meningococcal conjugate vaccine (MenACWY). In a trial of UK adults, participants received a third COVID-19 vaccine dose (NVX-CoV2373, BNT162b2, or mRNA1273) alongside MenACWY as an active control. Compared to MenACWY, we found that mRNA vaccines, particularly mRNA1273, showed the greatest relative increase in side effects, while protein-based NVX-CoV2373 generally elicited similar reactogenicity to MenACWY. These findings suggest that platform type can influence vaccine reactogenicity, and further research is needed to compare COVID-19 vaccines with other routinely administered vaccines.

Keywords: COVID-19; MenACWY; Meningococcus; Reactogenicity; Vaccine.

Publication types

  • Randomized Controlled Trial
  • Clinical Trial, Phase II
  • Comparative Study

MeSH terms

  • 2019-nCoV Vaccine mRNA-1273 / immunology
  • Adult
  • BNT162 Vaccine / immunology
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19 Vaccines* / adverse effects
  • COVID-19 Vaccines* / immunology
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • Female
  • Humans
  • Immunization, Secondary
  • Male
  • Meningococcal Vaccines* / administration & dosage
  • Meningococcal Vaccines* / adverse effects
  • Meningococcal Vaccines* / immunology
  • Middle Aged
  • SARS-CoV-2 / immunology
  • United Kingdom
  • Vaccines, Conjugate / administration & dosage
  • Vaccines, Conjugate / adverse effects
  • Vaccines, Conjugate / immunology
  • Young Adult
  • mRNA Vaccines

Substances

  • Meningococcal Vaccines
  • COVID-19 Vaccines
  • MenACWY
  • mRNA Vaccines
  • BNT162 Vaccine
  • Vaccines, Conjugate
  • 2019-nCoV Vaccine mRNA-1273