The first peer-reviewed study in North America examining the timing between the first and second doses of COVID-19 mRNA vaccines shows that a longer dose interval leads to a stronger immune response. The study is funded by the Government of Canada through its COVID-19 Immunity Task Force (CITF).  

Principal investigator Dr. Brian Grunau, Assistant Professor in UBCโ€™s Department of Emergency Medicine and Scientist at the Centre for Health Evaluation and Outcome Sciences, indicates that these resultsโ€”published today in Clinical Infectious Diseases โ€”could inform ongoing international COVID-19 vaccination efforts.

The peer-reviewed study compared blood test results from a total of 186 paramedics, some of whom were vaccinated within the earlier recommended interval of less than four weeks, and others who received their second doses after six to seven weeks.


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โ€œWe found significantly higher levels of antibodies in individuals who had longer vaccine intervals, and this was consistent regardless of which mRNA vaccine was administered,โ€ said Dr. Grunau.

mRNA vaccines include the Pfizer-BioNTech Comirnaty vaccine and the Moderna Spikevax vaccine. Although antibody levels are only one way to measure the bodyโ€™s immune response, they play a very important role.

Trade-off between vaccination strategies

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These findings have implications for the ongoing global vaccination effort, as half the worldโ€™s population has yet to be vaccinated.  Widening the recommended vaccine dosing interval has the potential to lead to a stronger long-term immune response in individuals and will also facilitate faster community-level access to the first vaccine dose.

โ€œThis longer interval strategy enables early access to first doses in the population and ensuring the best protection possible with the two-dose series,โ€ added Dr. Grunau.

Although measures of immunity are correlated with the risk of contracting COVID-19, this study did not assess actual breakthrough infections.

Informing immunization strategy decisions

Study participants are enrolled in the larger COVID-19 Occupational Risks, Seroprevalence and Immunity among Paramedics (CORSIP) project, a national study examining how the pandemic has impacted paramedics. The team is co-led by Dr. Grunau and Dr. David Goldfarb, Clinical Associate Professor in the Department of Pathology and Laboratory Medicine at UBC and Medical Microbiologist and Infectious Disease Specialist at BC Childrenโ€™s Hospital and BC Womenโ€™s Hospital and Health Centre, as well as Drs. Tracy Kirkham and Paul Demers from the University of Toronto. They began recruiting paramedics less than 10 months ago, but researchers continue to provide data in real-time to the CITF to determine if there are implications for policy decisions.

While this constant stream of new information can make things difficult when making public health decisions, it has been rewarding for researchers to see their efforts translate into clinically relevant findings.

โ€œThat is the real goal of any researcher,โ€ said Dr. Grunau. โ€œWe want to do research that will actually positively impact peopleโ€™s lives and affect policy.โ€

โ€œThese results support the decisions across many jurisdictions in Canada for first doses fast with an extended dosing interval,โ€ said Dr. Tim Evans, CITF Executive Director.  โ€œThe results are also very important in informing the roll out of vaccines in other countries where extending the dose interval may help to promote vaccine equity.โ€ 

About the COVID-19 Immunity Task Force

The Government of Canada established the COVID-19 Immunity Task Force (CITF) in late April 2020 to mobilize knowledge on SARS-CoV-2 immunity for federal, provincial, and territorial decision-makers in their efforts to protect Canadians and minimize the impact of COVID-19. To date, the CITF has supported over 100 studies across Canada that are generating critical insights on the levels, trends, nature, and duration of immunity arising from SARS-CoV-2 infection and COVID-19 vaccination. The CITF is overseen by a Leadership Group of volunteers that includes leading scientists and policymakers from across Canada. The Task Force and its Secretariat work closely with a range of partners, including governments, public health agencies, institutions, health organizations, research teams, other task forces, and engages communities and stakeholders.

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