: Figure S9B). On the other hand, neutralization of Omicron was substantially diminished compared to either of the other two strains .The design of COVID-19 vaccines and clinical trials is rapidly evolving in face of pre-existing vaccination, widespread infection, and new variants. The interim portion of this phase 2 trial evaluation of ECV19 was carried out in South Korea between July and October 2021.
ECV19 induced strong RBD-specific immune responses. Serological analysis revealed dose-dependent and boosting-dependent antibody responses among both high- and low-dose ECV19 groups. Although an obvious increase in antigen-specific antibodies occurred following boosting, it should be noted that there was no control group that received a single vaccine injection; therefore, it is not possible to rule out that antibodies may have increased from day 21 to day 42 without the boost.
As is the case with COVID-19 vaccine development, it is difficult for vaccine design to keep up with emergent strains. ECV19 was designed and the trial approved prior to the emergence of SARS-CoV-2 variants, including the Delta and Omicron strains, the latter which features a highly mutated RBD.
Several limitations of this study should be noted. The ratio of females was higher in the high-dose ECV19 group compared to the low-dose ECV19 group. Based on meta-analysis studies, in the case of COVID-19 vaccines, women tend to show the same or slightly better vaccine efficacy than men and also report more adverse reactions [
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