mRNA or ChAd0x1 COVID-19 Vaccination of Adolescents Induces Robust Antibody and Cellular Responses With Continued Recognition of Omicron Following mRNA-1273


Frontiers in Immunology

Contributing to research themes:

Children and adolescents generally experience mild COVID-19. However, those with underlying physical health conditions are at a significantly increased risk of severe disease. Here, we present a comprehensive analysis of antibody and cellular responses in adolescents with severe neuro-disabilities who received COVID-19 vaccination with either ChAdOx1 (n=6) or an mRNA vaccine (mRNA-1273, n=8, BNT162b2, n=1). Strong immune responses were observed after vaccination and antibody levels and neutralisation titres were both higher after two doses. Both measures were also higher after mRNA vaccination and were further enhanced by prior natural infection where one vaccine dose was sufficient to generate peak antibody response. Robust T-cell responses were generated after dual vaccination and were also higher following mRNA vaccination. Early T-cells were characterised by a dominant effector-memory CD4+ T-cell population with a type-1 cytokine signature with additional production of IL-10. Antibody levels were well-maintained for at least 3 months after vaccination and 3 of 4 donors showed measurable neutralisation titres against the Omicron variant. T-cell responses also remained robust, with generation of a central/stem cell memory pool and showed strong reactivity against Omicron spike. These data demonstrate that COVID-19 vaccines display strong immunogenicity in adolescents and that dual vaccination, or single vaccination following prior infection, generate higher immune responses than seen after natural infection and develop activity against Omicron. Initial evidence suggests that mRNA vaccination elicits stronger immune responses than adenoviral delivery, although the latter is also higher than seen in adult populations. COVID-19 vaccines are therefore highly immunogenic in high-risk adolescents and dual vaccination might be able to provide relative protection against the Omicron variant that is currently globally dominant.

Author list:


  1. Institute of Immunology & Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
  2. Immunisation and Vaccine Preventable Diseases Division, United Kingdom (UK) Health Security Agency, London, United Kingdom
  3. Medical Research Council (MRC)-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
  4. University Hospitals of Derby and Burton National Health Service (NHS) Foundation Trust, Derby, United Kingdom
  5. East London National Health Service (NHS) Foundation Trust, London, United Kingdom
  6. Manchester University National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
  7. Birmingham Community Healthcare National Health Service (NHS) Trust, Aston, United Kingdom
  8. Nuffield Department of Medicine, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
  9. University of Oxford, Oxford, United Kingdom
  10. Department of General Paediatrics, Evelina London Children’s Hospital, London, United Kingdom
  11. The National Children’s Hospital, Tallaght University Hospital, Dublin, Ireland
  12. Children’s Neurosciences, Evelina London Children’s Hospital at Guy’s and St Thomas’ National Health Service (NHS) Foundation Trust, King’s Health Partners Academic Health Science Centre, London, United Kingdom
  13. Department Women and Children’s Health, School of Life Course Sciences (SoLCS), King’s College London, London, United Kingdom
  14. Department of Paediatric Infectious Diseases and Immunology Evelina London Children’s Hospital, London, United Kingdom
  15. United Kingdom (UK) Health Security Agency, Manchester Royal Infirmary, Manchester, United Kingdom
  16. Bradford Institute for Health Research, Bradford Teaching Hospitals National Health Service (NHS) Foundation Trust, Bradford, United Kingdom
  17. Paediatric Infectious Diseases Research Group, St. George’s University of London, London, United Kingdom


Alexander C. Dowell1†, Annabel A. Powell2†, Chris Davis3, Sam Scott3, Nicola Logan3, Brian J. Willett3, Rachel Bruton1, Morenike Ayodele1, Elizabeth Jinks1, Juliet Gunn1, Eliska Spalkova1, Panagiota Sylla1, Samantha M. Nicol1, Jianmin Zuo1, Georgina Ireland2, Ifeanyichukwu Okike2,4, Frances Baawuah2, Joanne Beckmann5, Shazaad Ahmad6, Joanna Garstang7, Andrew J. Brent8,9, Bernadette Brent8, Marie White10, Aedin Collins11, Francesca Davis10, Ming Lim12,13, Jonathan Cohen14, Julia Kenny13,14, Ezra Linley15, John Poh2, Gayatri Amirthalingam2, Kevin Brown2, Mary E. Ramsay2, Rafaq Azad16, John Wright16, Dagmar Waiblinger16, Paul Moss1† and Shamez N. Ladhani2,17*†