This study is clinical trial (intervention study with external comparison group) to test vaccination with reduced dose (half dose) of ChAdOx1 nCoV-19 (AZD1222), in a 2-dose schedule with an interval of 8 weeks, including all adults aged 18 to 49 years from Viana city - Espírito Santo (ES)/Brazil, on the incidence of new cases over 12 months following treatment, compared to an external group from same state and adjusted for socio-demographic and epidemiological variables.
This study is clinical trial (intervention study with external comparison group) to test vaccination with reduced dose (half dose) of ChAdOx1 nCoV-19 (AZD1222), in a 2-dose schedule with an interval of 8 weeks, including all adults aged 18 to 49 years from Viana city - Espírito Santo (ES)/Brazil, on the incidence of new cases over 12 months following treatment, compared to an external group from same state and adjusted for socio-demographic and epidemiological variables. Cellular and humoral immunity will be studied in a representative sub-sample compared to an external reference group (cohort of health workers) vaccinated with standard dose. The outcomes will be evaluated at 28 days after the second dose and follow-up after 6 months and 12 months. The main outcome will be to decrease in 60% the incidence of new cases over 6 months after receiving the vaccine. The clinical epidemiological variables will be obtained from e-SUS VS, e-SUS notifica and datasus: number of cases, number of deaths with specific ICD for covid-19, number of hospital admissions for covid-19; number of ICU admissions for the treatment of SARS, total number of tests (RT-PCR) performed and positive. The cellular and humoral immune response will be assessed by viral neutralization assay (neutralizing antibody test), serological assay by chemiluminescence, determination of specific IgM and IgG profiles, measurement of systemic soluble factors (chemokines, cytokines and growth factors), stimulation antigen-specific peripheral blood mononuclear cells in vitro and investigation of memory T and B lymphocytes and intracytoplasmic cytokines. It is estimated to include 29,637 people in the study, to reach 85% vaccination cover of individuals aged 18-49 years. The subsample size immunogenicity test is 600 individuals from the eligible population, estimating losses of 15% and study power of 90%, alpha error of 1%. The hypothesis of the study is that the reduction in the incidence of covid-19 and the cellular and humoral immune response achieved with a half dose will be similar to the reduction expected with the standard dose.
Study Type
INTERVENTIONAL
Vaccination with reduced dose (half dose) of ChAdOx1 nCoV-19 (AZD1222), in a 2-dose schedule with an interval of 8 weeks, including all adults aged 18 to 49 years, from non-priority groups, from Viana city - Espírito Santo (ES)/Brazil.
Vaccination with standad dose of ChAdOx1 nCoV-19 (AZD1222), in a 2-dose schedule with an interval of 8 weeks, in external cohort of health workers aged 18 to 49 years.
Federal University of Espirito Santo
Vitória, Espírito Santo, Brazil
RECRUITINGIncidence of new cases
Incidence of new cases over 12 months following treatment
Time frame: 12 months
Number of deaths
Number of deaths with specific ICD for covid-19
Time frame: 12 months
number of hospital admissions
number of hospital admissions for covid-19
Time frame: 12 months
number of intensive care unit (ICU) admissions
number of intensive care unit (ICU) admissions for the treatment of SARS
Time frame: 12 months
number of tests (RT-PCR)
number of tests (RT-PCR) performed and positive
Time frame: 12 months
Viral Neutralization Assay
Neutralizing antibody titers will be expressed by the ability of antibodies to neutralize up to 50% the number of plaques (PRNT50). Title \> 1:50 will be considered positive.
Time frame: 4 and 8 months
serological assay
Serological test by chemiluminescence. Results are expressed in U/mL and data interpretation will be done as follows: \<0.8 U/mL = non-reactive sample; ≥0.8 U/mL = reactive sample.
Time frame: 8 and 10 months
IgM
Determination of specific IgM profile. Results will be expressed in fluorescence intensity or pg/ml.
Time frame: 8 and 10 months
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Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
29,637
IgG
Determination of specific IgG profile. Results will be expressed in fluorescence intensity or pg/ml.
Time frame: 8 and 10 months
systemic soluble factors
Dosage of soluble systemic factors (chemokines, cytokines and growth factors). Results will be expressed in pg/ml.
Time frame: 8 and 10 months
Antigen-specific stimulation of peripheral blood mononuclear cells
Antigen-specific stimulation of peripheral blood mononuclear cells in vitro. The results will be expressed in percentage positive frequency for a specific cell phenotype.
Time frame: 10 and 12 months
Lymphocyte investigation
Investigation of memory T and B lymphocytes. The results will be expressed in percentage positive frequency for a specific cell phenotype.
Time frame: 10 and 12 months
Cytokine investigation
Investigation of intracytoplasmic cytokines. The results will be expressed in percentage positive frequency for a specific cell phenotype.
Time frame: 10 and 12 months