Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trial

A randomized, double-blind, controlled phase 3 trial was conducted during a COVID-19 outbreak after the initial, stringent zero-Covid policy was relaxed in three provinces. Eligible adults aged ≥18 years who had received three doses of inactivated COVID-19 vaccines 6 months earlier were randomly ass...

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Main Authors: Xiao-Qiang Liu, Yang-Yang Qi, Tao Huang, Li-Li Huang, Ming-Xuan Zhao, Zhong-Fang Wang, Jun Dai, Yan-Xia Wang, Jing-Jing Chen, Xiao-Yun Yang, Hui-Lan Fan, Xue-Mei Yan, Jian-Chang He, Yan-Xiang Zou, Zhi-Wei Jiang, Zhi-Fei Zhan, Si-Wen Tao, De-Fang Dai, Feng Shi, Qiong-Na Zhang, Xiu-Liang Yang, Xiao-Zhong Li, Wei Li, Jing Lu, Jiang-Bing Zheng, Zhi-Hua Zhang, Gao-Xiang Chen, Hong Su, Wei-Min Gao, Lorenz von Seidlein, Xuan-Yi Wang, Lin Yuan, Jin-Zhong Lin
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Human Vaccines & Immunotherapeutics
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Online Access:https://www.tandfonline.com/doi/10.1080/21645515.2025.2502250
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author Xiao-Qiang Liu
Yang-Yang Qi
Tao Huang
Li-Li Huang
Ming-Xuan Zhao
Zhong-Fang Wang
Jun Dai
Yan-Xia Wang
Jing-Jing Chen
Xiao-Yun Yang
Hui-Lan Fan
Xue-Mei Yan
Jian-Chang He
Yan-Xiang Zou
Zhi-Wei Jiang
Zhi-Fei Zhan
Si-Wen Tao
De-Fang Dai
Feng Shi
Qiong-Na Zhang
Xiu-Liang Yang
Xiao-Zhong Li
Wei Li
Jing Lu
Jiang-Bing Zheng
Zhi-Hua Zhang
Gao-Xiang Chen
Hong Su
Wei-Min Gao
Lorenz von Seidlein
Xuan-Yi Wang
Lin Yuan
Jin-Zhong Lin
author_facet Xiao-Qiang Liu
Yang-Yang Qi
Tao Huang
Li-Li Huang
Ming-Xuan Zhao
Zhong-Fang Wang
Jun Dai
Yan-Xia Wang
Jing-Jing Chen
Xiao-Yun Yang
Hui-Lan Fan
Xue-Mei Yan
Jian-Chang He
Yan-Xiang Zou
Zhi-Wei Jiang
Zhi-Fei Zhan
Si-Wen Tao
De-Fang Dai
Feng Shi
Qiong-Na Zhang
Xiu-Liang Yang
Xiao-Zhong Li
Wei Li
Jing Lu
Jiang-Bing Zheng
Zhi-Hua Zhang
Gao-Xiang Chen
Hong Su
Wei-Min Gao
Lorenz von Seidlein
Xuan-Yi Wang
Lin Yuan
Jin-Zhong Lin
author_sort Xiao-Qiang Liu
collection DOAJ
description A randomized, double-blind, controlled phase 3 trial was conducted during a COVID-19 outbreak after the initial, stringent zero-Covid policy was relaxed in three provinces. Eligible adults aged ≥18 years who had received three doses of inactivated COVID-19 vaccines 6 months earlier were randomly assigned in a 1:1 ratio to receive either one intramuscular injection of RQ3013 or ZF2001 vaccine. The primary end point was protection against PCR-confirmed symptomatic SARS-CoV-2 infection with onset at least 7 days after the booster. A total of 3,167 and 3,169 eligible participants received one dose of RQ3013 or ZF2001 vaccine, respectively. COVID-19 illness was confirmed in 91 participants in the ZF2001 group (11.8 per 100 person years; 95% confidence interval [CI]: 9.6–14.6) and in 45 participants in the RQ3013 group (5.7 per 100 person-years; 95% CI: 4.3–7.7) during a 4-month follow-up, resulting in a relative efficacy of 51.7% (95% CI, 30.9–66.2%) (p < .001) in an intention-to-treat analysis. The RQ3013 vaccine was also found to be significantly more immunogenic against omicron BA.5 compared to the ZF2001 vaccine. Moderate, transient adverse reaction after vaccination occurred more frequently in the RQ3013 group than in the ZF2001 group. Serious adverse events (SAEs) were rare and occurred almost equally in two groups. All SAEs were not related to the vaccination. These findings suggest that a chimeric mRNA vaccine design involving multiple antigenic epitopes provides broader protection across subvariants and variants of SARS-CoV-2 than the subunit vaccine ZF2001.
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series Human Vaccines & Immunotherapeutics
spelling doaj-art-bb073bb5b4f2440baeacfc86cd6662242025-08-20T03:09:44ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2502250Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trialXiao-Qiang Liu0Yang-Yang Qi1Tao Huang2Li-Li Huang3Ming-Xuan Zhao4Zhong-Fang Wang5Jun Dai6Yan-Xia Wang7Jing-Jing Chen8Xiao-Yun Yang9Hui-Lan Fan10Xue-Mei Yan11Jian-Chang He12Yan-Xiang Zou13Zhi-Wei Jiang14Zhi-Fei Zhan15Si-Wen Tao16De-Fang Dai17Feng Shi18Qiong-Na Zhang19Xiu-Liang Yang20Xiao-Zhong Li21Wei Li22Jing Lu23Jiang-Bing Zheng24Zhi-Hua Zhang25Gao-Xiang Chen26Hong Su27Wei-Min Gao28Lorenz von Seidlein29Xuan-Yi Wang30Lin Yuan31Jin-Zhong Lin32Immunization Planning Unit, Yunnan Center for Disease Control and Prevention, Kunming, People’s Republic of ChinaShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of ChinaImmunization Planning Unit, Hunan Center for Disease Control and Prevention, Changsha, People’s Republic of ChinaImmunization Planning Unit, Henan Center for Disease Control and Prevention, Zhengzhou, People’s Republic of ChinaClinical Research, First People’s Hospital, Shanghai, People’s Republic of ChinaState Key Laboratory of Respiratory Disease &amp; National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of ChinaInspection and Quarantine Branch, Guangzhou Customs Technical Center, Guangzhou, People’s Republic of ChinaImmunization Planning Unit, Henan Center for Disease Control and Prevention, Zhengzhou, People’s Republic of ChinaRegistry and Medical Center, Yunnan Walvax Biotechnology Co., Ltd., Kunming, People’s Republic of ChinaState Key Laboratory of Respiratory Disease &amp; National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of ChinaRegistry and Medical Center, Yunnan Walvax Biotechnology Co., Ltd., Kunming, People’s Republic of ChinaRegistry and Medical Center, Yunnan Walvax Biotechnology Co., Ltd., Kunming, People’s Republic of ChinaClinical Research, First People’s Hospital, Shanghai, People’s Republic of ChinaImmunization Planning Unit, Yunnan Center for Disease Control and Prevention, Kunming, People’s Republic of ChinaDepartment of Statistics, Beijing Key Tech Statistical Consulting Co., Ltd., Beijing, People’s Republic of ChinaImmunization Planning Unit, Hunan Center for Disease Control and Prevention, Changsha, People’s Republic of ChinaRegistry and Medical Center, Yunnan Walvax Biotechnology Co., Ltd., Kunming, People’s Republic of ChinaImmunization Planning Unit, Hunan Center for Disease Control and Prevention, Changsha, People’s Republic of ChinaImmunization Planning Unit, Puer County Center for Disease Control and Prevention, Puer, People’s Republic of ChinaImmunization Planning Unit, Xiangyun County Center for Disease Control and Prevention, Dali, People’s Republic of ChinaImmunization Planning Unit, Luxi County Center for Disease Control and Prevention, Hmong Autonomous Region, People’s Republic of ChinaImmunization Planning Unit, Wuyang County Center for Disease Control and Prevention, Luohe, People’s Republic of ChinaRegistry and Medical Center, Yunnan Walvax Biotechnology Co., Ltd., Kunming, People’s Republic of ChinaResearch and Development Center, Shanghai RNACure Biopharma Co., Ltd., Shanghai, People’s Republic of ChinaImmunization Planning Unit, Wenxian County Center for Disease Control and Prevention, Jiaozuo, People’s Republic of ChinaImmunization Planning Unit, Huarong County Center for Disease Control and Prevention, Yueyang, People’s Republic of ChinaImmunization Planning Unit, Hengnan County Center for Disease Control and Prevention, Hengyang, People’s Republic of ChinaImmunization Planning Unit, Longyang County Center for Disease Control and Prevention, Baoshan, People’s Republic of ChinaImmunization Planning Unit, Yucheng County Center for Disease Control and Prevention, Shangqiu, People’s Republic of ChinaMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of ChinaRegistry and Medical Center, Yunnan Walvax Biotechnology Co., Ltd., Kunming, People’s Republic of ChinaShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of ChinaA randomized, double-blind, controlled phase 3 trial was conducted during a COVID-19 outbreak after the initial, stringent zero-Covid policy was relaxed in three provinces. Eligible adults aged ≥18 years who had received three doses of inactivated COVID-19 vaccines 6 months earlier were randomly assigned in a 1:1 ratio to receive either one intramuscular injection of RQ3013 or ZF2001 vaccine. The primary end point was protection against PCR-confirmed symptomatic SARS-CoV-2 infection with onset at least 7 days after the booster. A total of 3,167 and 3,169 eligible participants received one dose of RQ3013 or ZF2001 vaccine, respectively. COVID-19 illness was confirmed in 91 participants in the ZF2001 group (11.8 per 100 person years; 95% confidence interval [CI]: 9.6–14.6) and in 45 participants in the RQ3013 group (5.7 per 100 person-years; 95% CI: 4.3–7.7) during a 4-month follow-up, resulting in a relative efficacy of 51.7% (95% CI, 30.9–66.2%) (p < .001) in an intention-to-treat analysis. The RQ3013 vaccine was also found to be significantly more immunogenic against omicron BA.5 compared to the ZF2001 vaccine. Moderate, transient adverse reaction after vaccination occurred more frequently in the RQ3013 group than in the ZF2001 group. Serious adverse events (SAEs) were rare and occurred almost equally in two groups. All SAEs were not related to the vaccination. These findings suggest that a chimeric mRNA vaccine design involving multiple antigenic epitopes provides broader protection across subvariants and variants of SARS-CoV-2 than the subunit vaccine ZF2001.https://www.tandfonline.com/doi/10.1080/21645515.2025.2502250EfficacysafetymRNA vaccineCOVID-19chimeric
spellingShingle Xiao-Qiang Liu
Yang-Yang Qi
Tao Huang
Li-Li Huang
Ming-Xuan Zhao
Zhong-Fang Wang
Jun Dai
Yan-Xia Wang
Jing-Jing Chen
Xiao-Yun Yang
Hui-Lan Fan
Xue-Mei Yan
Jian-Chang He
Yan-Xiang Zou
Zhi-Wei Jiang
Zhi-Fei Zhan
Si-Wen Tao
De-Fang Dai
Feng Shi
Qiong-Na Zhang
Xiu-Liang Yang
Xiao-Zhong Li
Wei Li
Jing Lu
Jiang-Bing Zheng
Zhi-Hua Zhang
Gao-Xiang Chen
Hong Su
Wei-Min Gao
Lorenz von Seidlein
Xuan-Yi Wang
Lin Yuan
Jin-Zhong Lin
Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trial
Human Vaccines & Immunotherapeutics
Efficacy
safety
mRNA vaccine
COVID-19
chimeric
title Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trial
title_full Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trial
title_fullStr Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trial
title_full_unstemmed Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trial
title_short Efficacy, immunogenicity, and safety of heterologous boosting with a novel chimera Chinese mRNA (RQ3013) SARS-CoV-2 vaccine: A randomized, double-blind, active-controlled trial
title_sort efficacy immunogenicity and safety of heterologous boosting with a novel chimera chinese mrna rq3013 sars cov 2 vaccine a randomized double blind active controlled trial
topic Efficacy
safety
mRNA vaccine
COVID-19
chimeric
url https://www.tandfonline.com/doi/10.1080/21645515.2025.2502250
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