Mucosal SARS-CoV-2 infection in the context of Vaccination

Following the observation of a cluster of atypical pneumonias in Wuhan in late 2019, a novel coronavirus, SARS-CoV-2 was identified as the pathogen for a disease that was named COVID-19. The international spread of infection occurred rapidly and has had profound medical, social, and economic consequences for the global community. The COVID-19 pandemic has exacerbated existing inequalities and caused significant suffering not only from the disease and death it has caused, but also from the second and third order effects from measures implemented to control the virus.
In 2020, the University of Oxford developed the ChAdOx1 nCoV-19 vaccine, a replication deficient simian adenovirus with a full-length spike protein as the insert. This vaccine was rapidly tested in Phase 1/2 and 2/3 trials (Folegatti et al., 2020; Voysey et al., 2021). Original non-human primate data suggested that whilst vaccination protected the lower respiratory tract, there was no difference in the viral shedding in the upper respiratory tract between controls and vaccinees. (van Doremalen et al., 2020) There was also evidence from the pre-clinical animal studies that viral shedding may be more likely to occur following SARS-CoV-2 challenge in vaccinated animals. At the initiation of this project the viral dynamics of SARS-CoV-2 infection in humans were being established but there were no licensed vaccines for COVID-19 at that time.

The aim of this project is to study the symptom profiles and viral dynamics in individuals in the ChAdOx1 nCoV-19 trials to assess the impact of ChAdOx1 nCoV-19 vaccination on mucosal infection.

This project will meet this aim by:

i. Weekly sampling of trial participants in the Phase 2/3 study in addition to testing indicated by symptomatic episodes

ii. Analysis of stool samples from SARS-CoV-2 positive individuals