Safety and Immunogenicity of a DNA SARS-CoV-2 vaccine (ZyCoV-D): Results of an open-label, non-randomized phase I part of phase I/II clinical study by intradermal route in healthy subjects in India

• Main Authors: Taufik Momin, Kevinkumar Kansagra, Hardik Patel, Sunil Sharma, Bhumika Sharma, Jatin Patel, Ravindra Mittal, Jayesh Sanmukhani, Kapil Maithal, Ayan Dey, Harish Chandra, Chozhavel TM Rajanathan, Hari PR Pericherla, Pawan Kumar, Anjali Narkhede, Deven Parmar
• Format: Article
• Language: English
• Published: Elsevier 2021-08-01
• Series: EClinicalMedicine
• Subjects: DNA; SARS-CoV-2; Vaccine; Neutralizing antibody; COVID-19
• Online Access: http://www.sciencedirect.com/science/article/pii/S258953702100300X

Background: ZyCoV-D is a DNA vaccine candidate, which comprises a plasmid DNA carrying spike-S gene of SARS-CoV-2 virus along with gene coding for signal peptide. The spike(S) region includes the receptor-binding domain (RBD), which binds to the human angiotensin converting Enzyme (ACE)-2 receptor and mediates the entry of virus inside the cell. Methods: We conducted a single-center, open-label, non-randomized, Phase 1 trial in India between July 2020 and October 2020. Healthy adults aged between 18 and 55 years were sequentially enrolled and allocated to one of four treatment arms in a dose escalation manner. Three doses of vaccine were administered 28 days apart and each subject was followed up for 28 days post third dose to evaluate safety and immunogenicity. Findings: Out of 126 individuals screened for eligibility. Forty-eight subjects (mean age 34·9 years) were enrolled and vaccinated in the Phase 1 study Overall, 12/48 (25%) subjects reported at least one AE (i.e. combined solicited and unsolicited) during the study. There were no deaths or serious adverse events reported in Phase 1 of the study. The proportion of subjects who seroconverted based on IgG titers on day 84 was 4/11 (36·36%), 4/12 (33·33%), 10/10 (100·00%) and 8/10 (80·00%) in the treatment Arm 1 (1 mg: Needle), Arm 2 (1 mg: NFIS), Arm 3 (2 mg: Needle) and Arm 4 (2 mg: NFIS), respectively. Interpretation: ZyCoV-D vaccine is found to be safe, well-tolerated and immunogenic in the Phase 1 trial. Our findings suggest that the DNA vaccine warrants further investigation. Funding: Development of ZyCoV-D was supported by a grant-in-aid from COVID-19 Consortium under National Biopharma Mission, Department of Biotechnology, Government of India, to Cadila Healthcare Ltd. (Grant no. BT/COVID0003/01/20).