RT Journal Article SR Electronic T1 Oral subunit SARS-CoV-2 vaccine induces systemic neutralizing IgG, IgA and cellular immune responses and can boost neutralizing antibody responses primed by an injected vaccine JF bioRxiv FD Cold Spring Harbor Laboratory SP 2021.06.09.447656 DO 10.1101/2021.06.09.447656 A1 Jacob Pitcovski A1 Nady Gruzdev A1 Anna Abzach A1 Chen Katz A1 Ran Ben-Adiva A1 Michal Brand Schwartz A1 Itamar Yadid A1 Hadar Haviv A1 Irena Rapoport A1 Itai Bloch A1 Roy Shadmon A1 Zohar Eitan A1 Dalia Eliahu A1 Talia Hilel A1 Morris Laster A1 Sigal Kremer Tal A1 Tamara Byk Tennenbaum A1 Ehud Shahar YR 2021 UL http://biorxiv.org/content/early/2021/06/09/2021.06.09.447656.abstract AB The rapid spread of the COVID-19 pandemic, with its devastating medical and economic impacts, triggered an unprecedented race toward development of effective vaccines. The commercialized vaccines are parenterally administered, which poses logistic challenges, while adequate protection at the mucosal sites of virus entry is questionable. Furthermore, essentially all vaccine candidates target the viral spike (S) protein, a surface protein that undergoes significant antigenic drift. This work aimed to develop an oral multi-antigen SARS-CoV-2 vaccine comprised of the receptor binding domain (RBD) of the viral S protein, two domains of the viral nucleocapsid protein (N), and heat-labile enterotoxin B (LTB), a potent mucosal adjuvant. The humoral, mucosal and cell-mediated immune responses of both a three-dose vaccination schedule and a heterologous subcutaneous prime and oral booster regimen were assessed in mice and rats, respectively. Mice receiving the oral vaccine compared to control mice showed significantly enhanced post-dose-3 virus-neutralizing antibody, anti-S IgG and IgA production and N-protein-stimulated IFN-γ and IL-2 secretion by T cells. When administered as a booster to rats following parenteral priming with the viral S1 protein, the oral vaccine elicited markedly higher neutralizing antibody titres than did oral placebo booster. A single oral booster following two subcutaneous priming doses elicited serum IgG and mucosal IgA levels similar to those raised by three subcutaneous doses. In conclusion, the oral LTB-adjuvanted multi-epitope SARS-CoV-2 vaccine triggered versatile humoral, cellular and mucosal immune responses, which are likely to provide protection, while also minimizing technical hurdles presently limiting global vaccination, whether by priming or booster programs.HighlightsMigVax-101 is a multi-epitope oral vaccine for SARS-CoV-2.MigVax-101 elicits neutralizing IgG and IgA production and cellular responses in miceMigVax-101 serves as an effective booster in rats to a parenteral anti-S1 vaccine.Competing Interest StatementThe authors are in collaboration with MigVax Ltd in the development of its vaccine.