Expert Review of Vaccines (Dec 2023)

Safety, efficacy, and immunogenicity of the NVX-CoV2373 vaccine

  • Eddie Underwood,
  • Lisa M. Dunkle,
  • Shabir A. Madhi,
  • Cynthia L. Gay,
  • Paul T. Heath,
  • Karen L. Kotloff,
  • Katherine Smith,
  • Gordon Chau,
  • Shirley Galbiati,
  • Alice McGarry,
  • Wayne Woo,
  • Iksung Cho,
  • Katia Alves,
  • Germán Áñez,
  • Chijioke Bennett,
  • Vivek Shinde,
  • Louis Fries,
  • Raburn M. Mallory,
  • Gregory M. Glenn,
  • Seth Toback

DOI
https://doi.org/10.1080/14760584.2023.2218913
Journal volume & issue
Vol. 22, no. 1
pp. 501 – 517

Abstract

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Introduction The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality worldwide. As SARS-CoV-2 moves into endemic status, vaccination remains a key element in protecting the health of individuals, societies, and economies worldwide. Areas covered NVX-CoV2373 (Novavax, Gaithersburg, MD) is a recombinant protein vaccine composed of SARS-CoV-2 spike trimer nanoparticles formulated with saponin-based Matrix-M™ adjuvant (Novavax, Gaithersburg, MD). NVX-CoV2373 is authorized for emergency use in adults and adolescents aged ≥12 years in the United States and numerous other countries. Expert opinion In clinical trials, NVX-CoV2373 showed tolerable reactogenicity and favorable safety profiles characterized by mostly mild-to-moderate adverse events of short duration and by low rates of severe and serious adverse events comparable to those seen with placebo. The two-dose primary vaccination series resulted in robust increases in anti-spike protein immunoglobulin G, neutralizing antibody titers, and cellular immune responses. NVX-CoV2373 vaccination was associated with complete protection against severe disease and a high (90%) rate of protection against symptomatic disease in adults, including symptomatic disease caused by SARS-CoV-2 variants. Additionally, the NVX-CoV2373 adjuvanted recombinant protein platform offers a means to address issues of COVID-19 vaccination hesitancy and global vaccine equity.

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