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Mix and Match of the COVID-19 Vaccine for Safety and Immunogenicity (MOSAIC)

Primary Purpose

COVID-19

Status
Active
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
mRNA-1273 SARS-CoV-2 vaccine
BNT162b2
ChAdOx1-S [recombinant]
0, 28 day schedule
0, 112 day schedule
Covifenz
Sponsored by
Canadian Immunization Research Network
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for COVID-19 focused on measuring SARS-CoV-2, vaccine, clinical trial

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Participant is willing and able to give written informed consent to participate in the study
  2. Age 18 years of age or older in good health or with mild or moderate stable co-morbidities at the time of enrolment
  3. Able and willing to complete all the scheduled study procedures during the whole study follow-up period
  4. If female of child-bearing potential and heterosexually active, has practiced adequate contraception for 30 days prior to injection, has a negative pregnancy test on the day of injection, and has agreed to continue adequate contraception until 3 months after the final dose of study vaccine (Please refer to the definition section for a description of child-bearing potential and adequate contraception)
  5. MOSAIC-1 Vaccine-exposed subgroups: have received or are booked to receive the first dose of an authorized COVID-19 vaccine in the 55 days prior to Visit 1 (documentation of receipt required)
  6. MOSAIC -1 Vaccine naïve subgroups: have not received an authorized COVID-19 vaccine at any time
  7. MOSAIC-2 participants have received two doses of COVID-19 vaccines authorized in Canada ≥6 months prior to study vaccine administration (documentation of receipt required)

Exclusion Criteria:

  1. Inability or unwillingness of participant or legally acceptable representative to give written informed consent
  2. Any confirmed or suspected immunosuppressive or immunodeficient state; asplenia, or immunosuppressant medication within the past 6 months except short term oral steroids (≤14 days duration) or topical steroids
  3. Current diagnosis or treatment for cancer (except basal cell carcinoma of the skin)
  4. Administration of immunoglobulins and/or any blood products within 3 months preceding the first dose of study vaccine and for one month after the last dose of study vaccine
  5. Allergy to any study vaccine or any active substance in a study vaccine
  6. Bleeding disorder or history of significant bleeding following IM injections or venipuncture
  7. Continuous use of anticoagulants
  8. A history of anaphylaxis to a previous vaccine
  9. Pregnancy or intent to become pregnant during the study or within 3 months of the last dose of study vaccine
  10. MOSAIC-1: History of laboratory-confirmed COVID-19 disease prior to enrolment by participant report
  11. Administration of a live virus vaccine within 4 weeks prior to study vaccine receipt.

Sites / Locations

  • Royal Inland Hospital
  • Penticton Regional Hospital
  • BC Children's Hospital Research Institute
  • Children's Hospital Research Institute of Manitoba
  • Canadian Center for Vaccinology
  • Ottawa Hospital Research Institute, University of Ottawa
  • McGill University Health Centre Vaccine Study Centre
  • CHU de Québec, Université Laval

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm 12

Arm 13

Arm 14

Arm 15

Arm 16

Arm 17

Arm 18

Arm 19

Arm 20

Arm 21

Arm 22

Arm 23

Arm 24

Arm 25

Arm 26

Arm 27

Arm 28

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Experimental

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Experimental

Arm Label

Group 1: Moderna, Moderna - 28 Days apart

Group 2: Moderna, Moderna - 112 days apart

Group 3: Moderna, Pfizer/BioNTech - 28 days apart

Group 4: Moderna, Pfizer/BioNTech - 112 days apart

Group 5: Pfizer/BioNTech, Pfizer/BioNTech - 28 days apart

Group 6: Pfizer/BioNTech, Pfizer/BioNTech - 112 days apart

Group 7: Pfizer/BioNTech, Moderna - 28 days apart

Group 8: Pfizer/BioNTech, Moderna - 112 days apart

Group 9: Astra Zeneca, Moderna - 28 days apart

Group 10: Astra Zeneca, Moderna - 112 days apart

Group 11: Astra Zeneca, Pfizer/BioNTech - 28 days apart

Group 12: Astra Zeneca, Pfizer/BioNTech - 112 days apart

Group 1b

Group 2b

Group 3b

Group 4b

Group 5b

Group 6b

Group 7b

Group 8b

Group 9b

Group 1c

Group 2c

Group 3c

Group 4c

Group 5c

Group 6c

Group 7c

Arm Description

Participants will be blinded and receive two doses (0.20 mg/mL each) of mRNA-1273 SARS-CoV-2 vaccine via intramuscular injection in the deltoid muscle 28 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive two doses (0.20 mg/mL each) of mRNA-1273 SARS-CoV-2 vaccine at 0.20 mg/mL via intramuscular injection in the deltoid muscle 112 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3mL) of BNT162b2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3mL) of BNT162b2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive two doses (0.3mL each) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle 28 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive two doses (0.3mL each) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle 112 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3 mL) of BNT162b2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3 mL) of BNT162b2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.

Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.

Participants will receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive either one dose (0.3mL) of BNT162b2 or one half dose (0.25mL) of mRNA-1273 via intramuscular injection in the deltoid muscle.

Participants will be blinded and receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.

Participants will receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.

Outcomes

Primary Outcome Measures

Antibody response to SARS-CoV-2 S protein after 2 doses
The co-primary outcome for the non-inferiority comparison of 0, 28-day schedules with heterologous second dose is the immune response to SARS-CoV-2 at day 56 (28 days after the second dose of vaccine) based on anti-spike antibody titers.
Antibody response to SARS-CoV-2 S protein after 2 doses
The co-primary outcome for the non-inferiority comparison of schedules in which the timing of the second dose of vaccine is different (0, 28 days v 0, 112 days) is the immune response to SARS-CoV-2 at day 140 (28 days after the last dose in the 0, 112 day schedule) based on anti-spike antibody titers.
Antibody response to SARS-CoV-2 S protein after 3 doses
To determine if a vaccination schedule with a heterologous third dose of a COVID-19 vaccine induces a non-inferior serum immune response to SARS-CoV-2, compared to a third dose/booster with a homologous vaccine.
Antibody response to SARS-CoV-2 S protein after 4 doses
To determine if a vaccination schedule with a heterologous fourth dose of a COVID-19 vaccine induces a non-inferior serum immune response to SARS-CoV-2, compared to a third dose/booster with a homologous vaccine.

Secondary Outcome Measures

Durability of antibody response to SARS-CoV-2 S over 12 months after 2 doses
Assess durability of immune responses in each study group over 12 months based on anti-spike antibody titers and pseudoneutralization assay.
Pseudoneutralization assay, T cell testing, Antibody dependent cellular cytotoxicity (ADCC), Antibody avidity, RNA seq after 2 doses
Characterization of the immune response to COVID-19 vaccines in schedules with 0, 28 days versus 0, 112 days dosing and heterologous schedules to day 365.
Incidence of grade 3 solicited local and systemic adverse events, SAEs, AEFIs, MAAEs, AESIs in the 7 days following vaccine receipt after 2 doses
Description of safety outcomes over 12 months post-vaccination including SAEs (serious adverse events), provincially reportable AEFIs (adverse events following immunization), MAAEs (medically attended adverse events), AESIs (adverse events of special interest).
Incidence of grade 3 solicited local and systemic adverse events, SAEs, AEFIs, MAAEs, AESIs in the 7 days following vaccine receipt after 3 doses
Description of safety outcomes over 12 months post-vaccination including SAEs (serious adverse events), provincially reportable AEFIs (adverse events following immunization), MAAEs (medically attended adverse events), AESIs (adverse events of special interest).
Acceptability of vaccines as determined by participant-completed questionnaire after 2 doses
Four 5 point likert scale type questions asking whether they would want to receive the vaccine again, recommend it to a friend, whether they were anxious about receiving it, and whether they would prefer a more painful injection if it conferred better protection.
Acceptability of vaccines as determined by participant-completed questionnaire after 3 doses
Four 5 point likert scale type questions asking whether they would want to receive the vaccine again, recommend it to a friend, whether they were anxious about receiving it, and whether they would prefer a more painful injection if it conferred better protection.
Antibody to SARS-CoV-2 S and N, RBD after 3 doses
Assess durability of the immune responses in each study group over 12 months after the study vaccine.
Pseudoneutralization assay, T cell testing, Antibody dependent cellular cytotoxicity after 3 doses
Further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365
Incidence of grade 3 solicited local and systemic adverse events, SAEs, AEFIs, MAAEs, AESIs in the 7 days following vaccine receipt after 4 doses
Description of safety outcomes over 12 months post-vaccination including SAEs (serious adverse events), provincially reportable AEFIs (adverse events following immunization), MAAEs (medically attended adverse events), AESIs (adverse events of special interest).
Acceptability of vaccines as determined by participant-completed questionnaire after 4 doses
Four 5 point likert scale type questions asking whether they would want to receive the vaccine again(Yes, definitely; Yes, probably; I don't know; No, probably not; No, definitely not), recommend it to a friend(Yes, definitely; Yes, probably; I don't know; No, probably not; No, definitely not), whether they were anxious about receiving it(Not at all; A little; Moderately; Very; Extremely), and whether they would prefer a more painful injection if it conferred better protection(Vaccine A; Vaccine B; No preference; Unsure/don't know).
Antibody to SARS-CoV-2 S and N, RBD after 4 doses
Assess durability of the immune responses in each study group over 12 months after the study vaccine.
Antibody dependent cellular cytotoxicity after 4 doses
Further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365
Pseudoneutralization assay after 4 doses
Measuring the 50% Neutralization Titer to further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365
T cell testing after 4 doses
Measuring the number of T cells to further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365

Full Information

First Posted
May 18, 2021
Last Updated
July 13, 2023
Sponsor
Canadian Immunization Research Network
Collaborators
Canadian Center for Vaccinology, BC Children's Hospital Research Institute, Children's Hospital Research Institute of Manitoba, CHU de Quebec-Universite Laval, Ottawa Hospital Research Institute, Ontario Agency for Health Protection and Promotion, University of Toronto, Massachusetts General Hospital, Interior Health, McGill University Health Centre/Research Institute of the McGill University Health Centre
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1. Study Identification

Unique Protocol Identification Number
NCT04894435
Brief Title
Mix and Match of the COVID-19 Vaccine for Safety and Immunogenicity
Acronym
MOSAIC
Official Title
Immunogenicity and Adverse Events Following Immunization (AEFI) With Alternate Schedules of COVID-19 Vaccines in Canada: is "Mix and Match" of the Second Dose (MOSAIC-1;CT24a) and Additional Doses (MOSAIC-2 and MOSAIC-3;CT24b and CT24c) Safe and Immunogenic?
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 20, 2021 (Actual)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
March 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Canadian Immunization Research Network
Collaborators
Canadian Center for Vaccinology, BC Children's Hospital Research Institute, Children's Hospital Research Institute of Manitoba, CHU de Quebec-Universite Laval, Ottawa Hospital Research Institute, Ontario Agency for Health Protection and Promotion, University of Toronto, Massachusetts General Hospital, Interior Health, McGill University Health Centre/Research Institute of the McGill University Health Centre

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The main goals of this study are to assess the immune response and safety of two different vaccines for first, second, third and fourth doses as well as for differing intervals between the first and second dose of two-dose vaccines.
Detailed Description
For dose 1 and 2, the currently available mRNA vaccines (Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273) are two dose vaccines which were studied in schedules of either 0 and 21 days or 0 and 28 days, respectively. The ChAdOx1 nCOV-19 (Astra-Zeneca) adenovirus-vectored vaccine is authorized to be given in two doses one month to 12 weeks apart. We will compare the interval 0, 28 days to a 0, 112 days (16 weeks) schedule, and assess the immunogenicity of both heterogeneous and heterologous second doses using the Canadian schedule. For dose 3, the currently available mRNA vaccines (Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273) and plant-based virus-like particle (Medicago Covifenz) are anticipated to be administered 6 months apart. We will assess the immunogenicity of both heterogeneous and heterologous third doses using the Canadian schedule. For dose 4, the currently available mRNA vaccines (Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273) and plant-based virus-like particle (Medicago Covifenz) are anticipated to be administered 3 months apart. We will assess the immunogenicity of both heterogeneous and heterologous third doses using the Canadian schedule.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
SARS-CoV-2, vaccine, clinical trial

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
M=Moderna SpikeVax mRNA; P=Pfizer/BioNTech Comirnaty mRNA; A=AstraZeneca Vaxzervia; C=Medicago Covifenz VLP MOSAIC 1: Group 1 - M, M - 28 days Group 2 - M, M - 112 days Group 3 - M, P - 28 days Group 4 - M, P - 112 days Group 5 - P, P - 28 days Group 6 - P, P - 112 days Group 7 - P, M - 28 days Group 8 - P, M - 112 days Group 9 - A, M - 28 days Group 10 - A, M - 112 days Group 11 - A, P - 28 days Group 12 - A, P - 112 days MOSAIC 2: Group 1b - P, P, P Group 2b - P, P, M Group 3b - M, M, M Group 4b - M, M, P Group 5b - P and M in any order, M Group 6b - P and M in any order, P Group 7b - A, P or M, P Group 8b - A, P or M, M Group 9b - Any vaccine in any order, C (open-label) MOSAIC 3: Group 1c - P, P, P, P Group 2c - P, P, P, C Group 3c - M, M, M, M Group 4c - M, M, M, C Group 5c - Any 3 in any order, P or M Group 6c - Any 3 in any order, C Group 7c - Any 3 in any order, C (open-label)
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
Participants, laboratory staff, and statistical analysis personnel will be blinded to which vaccine they are receiving for those in randomized arms. Laboratory staff and statistical analysis personnel will be blinded to which vaccine they are receiving for those in open-label arms.
Allocation
Randomized
Enrollment
669 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1: Moderna, Moderna - 28 Days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive two doses (0.20 mg/mL each) of mRNA-1273 SARS-CoV-2 vaccine via intramuscular injection in the deltoid muscle 28 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 2: Moderna, Moderna - 112 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive two doses (0.20 mg/mL each) of mRNA-1273 SARS-CoV-2 vaccine at 0.20 mg/mL via intramuscular injection in the deltoid muscle 112 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 3: Moderna, Pfizer/BioNTech - 28 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3mL) of BNT162b2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 4: Moderna, Pfizer/BioNTech - 112 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3mL) of BNT162b2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 5: Pfizer/BioNTech, Pfizer/BioNTech - 28 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive two doses (0.3mL each) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle 28 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 6: Pfizer/BioNTech, Pfizer/BioNTech - 112 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive two doses (0.3mL each) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle 112 days apart. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 7: Pfizer/BioNTech, Moderna - 28 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 8: Pfizer/BioNTech, Moderna - 112 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 9: Astra Zeneca, Moderna - 28 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 10: Astra Zeneca, Moderna - 112 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.20 mg/mL) of mRNA-1273 SARS-CoV-2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 11: Astra Zeneca, Pfizer/BioNTech - 28 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3 mL) of BNT162b2 vaccine after 28 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 12: Astra Zeneca, Pfizer/BioNTech - 112 days apart
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.5 ml) of ChAdOx1-S [recombinant] vaccine via intramuscular injection in the deltoid muscle followed by one dose (0.3 mL) of BNT162b2 vaccine after 112 days. Vaccine-exposed participants will only be blinded to, and receive, the second injection.
Arm Title
Group 1b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 2b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 3b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 4b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 5b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 6b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 7b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 8b
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 9b
Arm Type
Experimental
Arm Description
Participants will receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 1c
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.3mL) of BNT162b2 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 2c
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 3c
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one half dose (0.25mL) of mRNA-1273 vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 4c
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 5c
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive either one dose (0.3mL) of BNT162b2 or one half dose (0.25mL) of mRNA-1273 via intramuscular injection in the deltoid muscle.
Arm Title
Group 6c
Arm Type
Active Comparator
Arm Description
Participants will be blinded and receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.
Arm Title
Group 7c
Arm Type
Experimental
Arm Description
Participants will receive one dose (0.5mL) of Covifenz vaccine via intramuscular injection in the deltoid muscle.
Intervention Type
Biological
Intervention Name(s)
mRNA-1273 SARS-CoV-2 vaccine
Other Intervention Name(s)
COVID-19 Vaccine Moderna, Spikevax
Intervention Description
Contains 1.26 mg of CX-024414 mRNA and 24.38 mg of SM-102 LNP as a white to off-white dispersion in preservative-free diluent buffer at pH 7.5.
Intervention Type
Biological
Intervention Name(s)
BNT162b2
Other Intervention Name(s)
Pfizer-BioNTech COVID-19 Vaccine, Comirnaty
Intervention Description
A white to off-white, sterile, preservative-free, frozen suspension for intramuscular injection, supplied with 0.9% sodium chloride diluent for injection plastic ampoules.
Intervention Type
Biological
Intervention Name(s)
ChAdOx1-S [recombinant]
Other Intervention Name(s)
Astra Zeneca COVID-19 Vaccine, COVISHIELD AstraZeneca COVID-19 Vaccine, Vaxzevria
Intervention Description
A colourless to slightly brown, clear to slightly opaque solution containing 5 x 1010 viral particles (not less than 2.5 x 108 infectious units).
Intervention Type
Other
Intervention Name(s)
0, 28 day schedule
Intervention Description
Second injection administered 28 days post first injection
Intervention Type
Other
Intervention Name(s)
0, 112 day schedule
Intervention Description
Second injection administered 112 days post first injection
Intervention Type
Biological
Intervention Name(s)
Covifenz
Other Intervention Name(s)
Medicago COVID-19 vaccine
Intervention Description
COVIFENZ is an emulsion for intramuscular injection. The 3.75 mcg antigen component of COVIFENZ is a suspension, which must be mixed 1:1 with the 0.25 mL AS03 adjuvant emulsion component prior to administration
Primary Outcome Measure Information:
Title
Antibody response to SARS-CoV-2 S protein after 2 doses
Description
The co-primary outcome for the non-inferiority comparison of 0, 28-day schedules with heterologous second dose is the immune response to SARS-CoV-2 at day 56 (28 days after the second dose of vaccine) based on anti-spike antibody titers.
Time Frame
Day 56
Title
Antibody response to SARS-CoV-2 S protein after 2 doses
Description
The co-primary outcome for the non-inferiority comparison of schedules in which the timing of the second dose of vaccine is different (0, 28 days v 0, 112 days) is the immune response to SARS-CoV-2 at day 140 (28 days after the last dose in the 0, 112 day schedule) based on anti-spike antibody titers.
Time Frame
Day 140
Title
Antibody response to SARS-CoV-2 S protein after 3 doses
Description
To determine if a vaccination schedule with a heterologous third dose of a COVID-19 vaccine induces a non-inferior serum immune response to SARS-CoV-2, compared to a third dose/booster with a homologous vaccine.
Time Frame
Day 28
Title
Antibody response to SARS-CoV-2 S protein after 4 doses
Description
To determine if a vaccination schedule with a heterologous fourth dose of a COVID-19 vaccine induces a non-inferior serum immune response to SARS-CoV-2, compared to a third dose/booster with a homologous vaccine.
Time Frame
Day 28
Secondary Outcome Measure Information:
Title
Durability of antibody response to SARS-CoV-2 S over 12 months after 2 doses
Description
Assess durability of immune responses in each study group over 12 months based on anti-spike antibody titers and pseudoneutralization assay.
Time Frame
Baseline and Days 28, 56, 112, 140, 365
Title
Pseudoneutralization assay, T cell testing, Antibody dependent cellular cytotoxicity (ADCC), Antibody avidity, RNA seq after 2 doses
Description
Characterization of the immune response to COVID-19 vaccines in schedules with 0, 28 days versus 0, 112 days dosing and heterologous schedules to day 365.
Time Frame
Days 28, 56, 112, 140, 365
Title
Incidence of grade 3 solicited local and systemic adverse events, SAEs, AEFIs, MAAEs, AESIs in the 7 days following vaccine receipt after 2 doses
Description
Description of safety outcomes over 12 months post-vaccination including SAEs (serious adverse events), provincially reportable AEFIs (adverse events following immunization), MAAEs (medically attended adverse events), AESIs (adverse events of special interest).
Time Frame
From time of first study injection through Day 365.
Title
Incidence of grade 3 solicited local and systemic adverse events, SAEs, AEFIs, MAAEs, AESIs in the 7 days following vaccine receipt after 3 doses
Description
Description of safety outcomes over 12 months post-vaccination including SAEs (serious adverse events), provincially reportable AEFIs (adverse events following immunization), MAAEs (medically attended adverse events), AESIs (adverse events of special interest).
Time Frame
From time of first study injection through Day 365.
Title
Acceptability of vaccines as determined by participant-completed questionnaire after 2 doses
Description
Four 5 point likert scale type questions asking whether they would want to receive the vaccine again, recommend it to a friend, whether they were anxious about receiving it, and whether they would prefer a more painful injection if it conferred better protection.
Time Frame
Days 56, 140, and 365
Title
Acceptability of vaccines as determined by participant-completed questionnaire after 3 doses
Description
Four 5 point likert scale type questions asking whether they would want to receive the vaccine again, recommend it to a friend, whether they were anxious about receiving it, and whether they would prefer a more painful injection if it conferred better protection.
Time Frame
Days 28, 180
Title
Antibody to SARS-CoV-2 S and N, RBD after 3 doses
Description
Assess durability of the immune responses in each study group over 12 months after the study vaccine.
Time Frame
Days 180 and 365
Title
Pseudoneutralization assay, T cell testing, Antibody dependent cellular cytotoxicity after 3 doses
Description
Further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365
Time Frame
Day 365
Title
Incidence of grade 3 solicited local and systemic adverse events, SAEs, AEFIs, MAAEs, AESIs in the 7 days following vaccine receipt after 4 doses
Description
Description of safety outcomes over 12 months post-vaccination including SAEs (serious adverse events), provincially reportable AEFIs (adverse events following immunization), MAAEs (medically attended adverse events), AESIs (adverse events of special interest).
Time Frame
From time of first study injection through Day 365.
Title
Acceptability of vaccines as determined by participant-completed questionnaire after 4 doses
Description
Four 5 point likert scale type questions asking whether they would want to receive the vaccine again(Yes, definitely; Yes, probably; I don't know; No, probably not; No, definitely not), recommend it to a friend(Yes, definitely; Yes, probably; I don't know; No, probably not; No, definitely not), whether they were anxious about receiving it(Not at all; A little; Moderately; Very; Extremely), and whether they would prefer a more painful injection if it conferred better protection(Vaccine A; Vaccine B; No preference; Unsure/don't know).
Time Frame
Days 28, 180
Title
Antibody to SARS-CoV-2 S and N, RBD after 4 doses
Description
Assess durability of the immune responses in each study group over 12 months after the study vaccine.
Time Frame
Days 180 and 365
Title
Antibody dependent cellular cytotoxicity after 4 doses
Description
Further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365
Time Frame
Day 365
Title
Pseudoneutralization assay after 4 doses
Description
Measuring the 50% Neutralization Titer to further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365
Time Frame
Day 365
Title
T cell testing after 4 doses
Description
Measuring the number of T cells to further characterize the immune response to COVID-19 vaccine in schedules with homologous and heterologous third doses to day 365
Time Frame
Day 365
Other Pre-specified Outcome Measures:
Title
Exploratory assessment of interval between dose 1 and 2 on immune response after 3 or 4 doses
Description
Assess the role of intervals between first and second doses of the primary immunization schedule, and between 2nd and 3rd doses, on immune responses after the third dose over the study period.
Time Frame
From time of first study injection through Day 365.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participant is willing and able to give written informed consent to participate in the study Age 18 years of age or older in good health or with mild or moderate stable co-morbidities at the time of enrolment Able and willing to complete all the scheduled study procedures during the whole study follow-up period If female of child-bearing potential and heterosexually active, has practiced adequate contraception for 30 days prior to injection, has a negative pregnancy test on the day of injection, and has agreed to continue adequate contraception until 3 months after the final dose of study vaccine (Please refer to the definition section for a description of child-bearing potential and adequate contraception) MOSAIC-1 Vaccine-exposed subgroups: have received or are booked to receive the first dose of an authorized COVID-19 vaccine in the 55 days prior to Visit 1 (documentation of receipt required) MOSAIC -1 Vaccine naïve subgroups: have not received an authorized COVID-19 vaccine at any time MOSAIC-2 participants have received two doses of COVID-19 vaccines authorized in Canada ≥6 months prior to study vaccine administration (documentation of receipt required) MOSAIC-3 participants have received three doses of COVID-19 vaccines authorized in Canada ≥3 months prior to study vaccine administration (documentation of receipt required) Exclusion Criteria: Inability or unwillingness of participant or legally acceptable representative to give written informed consent Any confirmed or suspected immunosuppressive or immunodeficient state; asplenia, or immunosuppressant medication within the past 6 months except short term oral steroids (≤14 days duration) or topical steroids Current diagnosis or treatment for cancer (except basal cell carcinoma of the skin) Administration of immunoglobulins and/or any blood products within 3 months preceding the first dose of study vaccine and for one month after the last dose of study vaccine Allergy to any study vaccine or any active substance in a study vaccine Bleeding disorder or history of significant bleeding following IM injections or venipuncture Continuous use of anticoagulants A history of anaphylaxis to a previous vaccine Pregnancy or intent to become pregnant during the study or within 3 months of the last dose of study vaccine MOSAIC-1: History of laboratory-confirmed COVID-19 disease prior to enrolment by participant report Administration of a live virus vaccine within 4 weeks prior to study vaccine receipt.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joanne Langley
Organizational Affiliation
Dalhousie University/CIRN
Official's Role
Principal Investigator
Facility Information:
Facility Name
Royal Inland Hospital
City
Kamloops
State/Province
British Columbia
Country
Canada
Facility Name
Penticton Regional Hospital
City
Penticton
State/Province
British Columbia
Country
Canada
Facility Name
BC Children's Hospital Research Institute
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4H4
Country
Canada
Facility Name
Children's Hospital Research Institute of Manitoba
City
Winnipeg
State/Province
Manitoba
Country
Canada
Facility Name
Canadian Center for Vaccinology
City
Halifax
State/Province
Nova Scotia
Country
Canada
Facility Name
Ottawa Hospital Research Institute, University of Ottawa
City
Ottawa
State/Province
Ontario
Country
Canada
Facility Name
McGill University Health Centre Vaccine Study Centre
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H9H 4Y6
Country
Canada
Facility Name
CHU de Québec, Université Laval
City
Québec City
State/Province
Quebec
Country
Canada

12. IPD Sharing Statement

Learn more about this trial

Mix and Match of the COVID-19 Vaccine for Safety and Immunogenicity

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