A Prefusion SARS-CoV-2 Spike RNA Vaccine 2020.09.08.280818v1.full
A Prefusion SARS-CoV-2 Spike RNA Vaccine 2020.09.08.280818v1.full
A Prefusion SARS-CoV-2 Spike RNA Vaccine 2020.09.08.280818v1.full
4 Authors
5 Annette B. Vogel1#, Isis Kanevsky2#, Ye Che3, Kena A. Swanson2, Alexander Muik1, Mathias
6 Vormehr1, Lena M. Kranz1, Kerstin C. Walzer1, Stephanie Hein1, Alptekin Güler1, Jakob
7 Loschko2, Mohan S. Maddur2, Kristin Tompkins2, Journey Cole4, Bonny G. Lui1, Thomas
8 Ziegenhals1, Arianne Plaschke1, David Eisel1, Sarah C. Dany1, Stephanie Fesser1, Stephanie
9 Erbar1, Ferdia Bates1, Diana Schneider1, Bernadette Jesionek1, Bianca Sänger1, Ann-Kathrin
10 Wallisch1, Yvonne Feuchter1, Hanna Junginger1, Stefanie A. Krumm1, André P. Heinen1, Petra
11 Adams-Quack1, Julia Schlereth1, Christoph Kröner1, Shannan Hall-Ursone4, Kathleen Brasky4,
12 Matthew C. Griffor3, Seungil Han3, Joshua A. Lees3, Ellene H. Mashalidis3, Parag V.
13 Sahasrabudhe3, Charles Y. Tan2, Danka Pavliakova2, Guy Singh2, Camila Fontes-Garfias5,
14 Michael Pride2, Ingrid L. Scully2, Tara Ciolino2, Jennifer Obregon2, Michal Gazi6, Ricardo
15 Carrion, Jr.4, Kendra J. Alfson6, Warren V. Kalina2, Deepak Kaushal4, Pei-Yong Shi5, Thorsten
16 Klamp1, Corinna Rosenbaum1, Andreas N. Kuhn1, Özlem Türeci1, Philip R. Dormitzer2,
17 Kathrin U. Jansen2 , Ugur Sahin1,7
18
19 # Contributed equally
20
21 Affiliations:
1
22 BioNTech, An der Goldgrube 12, 55131 Mainz, Germany;
2
23 Pfizer, 401 N. Middletown Rd., Pearl River, NY 10965, United States;
3
24 Pfizer, 280 Shennecossett Rd., Groton, CT 06340, United States;
4
25 Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W.
26 Military Dr, San Antonio, TX 78227, United States;
5
27 University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, United
28 States;
6
29 Texas Biomedical Research Institute, 8715 W Military Dr, San Antonio, TX 78227, United
30 States;
7
31 TRON gGmbH – Translational Oncology at the University Medical Center of the Johannes
32 Gutenberg University, Freiligrathstraße 12, 55131 Mainz, Germany;
33
34 Correspondence: Prof. Dr. Ugur Sahin, BioNTech SE, An der Goldgrube 12, 55131 Mainz,
35 Germany, Tel: +49 6131 2161 201; Email: [email protected]
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36 Abstract
37 To contain the coronavirus disease 2019 (COVID-19) pandemic, a safe and effective vaccine
38 against the new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is urgently
39 needed in quantities sufficient to immunise large populations. In this study, we report the
40 design, preclinical development, immunogenicity and anti-viral protective effect in rhesus
41 macaques of the BNT162b2 vaccine candidate. BNT162b2 contains an LNP-formulated
42 nucleoside-modified mRNA that encodes the spike glycoprotein captured in its prefusion
43 conformation. After expression of the BNT162b2 coding sequence in cells, approximately 20%
44 of the spike molecules are in the one-RBD ‘up’, two-RBD ‘down’ state. Immunisation of mice
45 with a single dose of BNT162b2 induced dose level-dependent increases in pseudovirus
46 neutralisation titers. Prime-boost vaccination of rhesus macaques elicited authentic SARS-
47 CoV-2 neutralising geometric mean titers 10.2 to 18.0 times that of a SARS-CoV-2
48 convalescent human serum panel. BNT162b2 generated strong TH1 type CD4+ and IFNγ+ CD8+
49 T-cell responses in mice and rhesus macaques. The BNT162b2 vaccine candidate fully
50 protected the lungs of immunised rhesus macaques from infectious SARS-CoV-2 challenge.
51 BNT162b2 is currently being evaluated in a global, pivotal Phase 2/3 trial (NCT04368728).
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52 Main
53 Introduction
54 Due to the shattering impact of the coronavirus disease 2019 (COVID-19) pandemic on human
55 health and society, multiple collaborative research programs have been launched, leading to
56 new insights and progress towards vaccine development. Soon after it emerged in December
57 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was identified as a β-
58 coronavirus with high sequence similarity to bat-derived SARS-like coronaviruses1,2. The
59 globalised response is mirrored by the upload of over 92,000 viral genome sequences as of
60 August 29, 2020, to GISAID (Global Initiative on Sharing All Influenza Data).
61 The trimeric spike glycoprotein (S) of SARS-CoV-2 binds its cellular receptor, angiotensin
62 converting enzyme 2 (ACE2), through a receptor-binding domain (RBD), which is part of its
63 N-terminal furin cleavage fragment (S1)3,4. S rearranges to translocate the virus into cells by
64 membrane fusion5,6. The C-terminal furin cleavage fragment (S2) contains the fusion
65 machinery7. Membrane fusion can be blocked by mutating S residues 986 and 987 to prolines,
66 producing an S antigen stabilised in the prefusion conformation (P2 S)8–10. The RBD is a key
67 target for virus neutralising antibodies, with an ’up’ conformation, in which more neutralising
68 epitopes are exposed, and a ‘down’ conformation in which many epitopes are buried5,10–12. In
69 addition, some neutralising antibodies bind S epitopes outside the RBD.
70 During this pandemic, fast vaccine availability is critical. COVID-19 vaccine candidates based
71 on different platforms are already in clinical trials, with the most advanced based on viral vector
72 and nucleic acid technologies13–16. We report the preclinical development of BNT162b2, a lipid-
74 (modRNA) vaccine candidate that encodes P2 S with a native furin cleavage site resulting in
75 the S1 and S2 cleavage fragments (Fig. 1a). The m1Ψ-modification dampens innate immune
76 sensing, and, together with optimised non-coding sequence elements, increases RNA
77 translation in vivo17–19. ModRNA vaccines have already proven immunogenic for several viral
78 targets20,21. BNT162b2 has been evaluated in phase 1 clinical trials in the US (NCT04368728)
79 and Germany (NCT04380701, EudraCT: 2020-001038-36), and is now being evaluated in a
80 pivotal, global, phase 2/3 safety and efficacy study15.
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81 Results
82 BNT162b2 RNA in vitro transcribed by T7 polymerase from a plasmid DNA template has a
83 single, sharp-peak microfluidic capillary electrophoresis profile, consistent with its calculated
84 length of 4,283 nucleotides, indicating purity and integrity (Fig. 1b). When HEK293T/17 cells
85 were incubated with BNT162b2 (which is LNP-formulated) or with BNT162b2 RNA mixed
86 with a transfection reagent, robust expression of P2 S was detectable by flow cytometry
87 (Extended Data Fig. 1a).
88 For structural characterisation, P2 S was expressed in Expi293F cells from DNA that encodes
89 the same amino acid sequence as BNT162b2 RNA, with the addition of a C-terminal TwinStrep
90 tag for affinity purification. The trimeric P2 S bound the human ACE2 peptidase domain (PD),
91 and an anti-RBD human neutralising antibody B38 with high affinity (KD 1 nM, Extended Data
92 Fig. 1b,c)22. Structural analysis by cryo-electron microscopy (cyro-EM) produced a 3.29 Å
93 nominal resolution mass density map, into which a previously published atomic model10 was
94 fitted and rebuilt (Fig. 1c,d; Extended Data Fig. 2, Extended Data Table 1). The rebuilt model
95 shows good agreement with reported structures of prefusion full-length wild type S and its
96 ectodomain with P2 mutations5,10. Three-dimensional classification of the dataset showed a
97 class of particles that was in the one RBD ‘up’ (accessible for receptor binding), two RBD
98 ‘down’ (closed) conformation and represented 20.4% of the trimeric molecules. The remainder
99 were in the all RBD ‘down’ conformation (Fig. 1e, Extended Data Fig. 2c). The RBD in the
100 ‘up’ conformation was less well resolved than other parts of the structure, suggesting
101 conformational flexibility and a dynamic equilibrium between RBD ‘up’ and RBD ‘down’
102 states as also suggested by others5,23. Nevertheless, the binding and structural analyses indicate
103 that the BNT162b2 RNA sequence encodes a recombinant P2 S that authentically presents the
104 ACE2 binding site and other epitopes targeted by SARS-CoV-2 neutralising antibodies.
105 To characterise BNT162b2-elicited B- and T-cell responses, BALB/c mice were immunized
106 intramuscularly (IM) once with 0.2, 1, or 5 µg BNT162b2 or received a buffer control. S1- and
107 RBD-binding serum IgG developed rapidly at all dose levels in a dose-dependent manner. For
108 S1-binding antibodies, the geometric mean concentration (GMC) in the 5 µg group was 386
109 µg/mL at Day 28 (Fig. 2a, Extended Data Fig. 3a). At Day 28 after immunisation, vaccine-
110 elicited IgG had a strong binding affinity for S1 (geometric mean KD 12 nM) and the RBD
111 (geometric mean KD 0.99 nM), with both having a low off-rate (Extended Data Fig. 3b). SARS-
112 CoV-2 neutralising activity in mouse serum was measured by a vesicular stomatitis virus
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117 A high fraction of splenocytes of CD4+ and CD8+ T-cell phenotype isolated from mice on Days
118 12 and 28 after BNT162b2-immunisation had a strong antigen-specific IFNγ and IL-2 response
119 in ELISpot and intracellular cytokine staining flow cytometry analysis when re-stimulated ex
120 vivo with a full-length S peptide pool (Fig. 2c-e). Total splenocytes harvested on Day 28 and
121 ex vivo re-stimulated with the full-length S peptide pool secreted high levels of the TH1
122 cytokines IL-2 or IFNγ, but minute amounts of the TH2 cytokines IL-4, IL-5 and IL-13 as
123 measured in multiplex immunoassays (Fig. 2f).
124 BNT162b2-induced effects on proliferation and dynamics of immune cell populations were
125 assessed in injection site draining lymph nodes (dLNs), which are the principal immune-
126 educated compartments for proficient T- and B-cell priming, and in blood and spleen for
127 evaluation of its systemic effects. Higher numbers of plasma cells, class switched IgG1- and
128 IgG2a-positive B cells, and germinal center B cells were observed in dLNs and spleens of mice
129 12 days after immunisation with 5 µg BNT162b2 than after immunisation with buffer
130 (Extended Data Fig. 4a, b). In Day 7 post-immunisation blood, there were significantly fewer
131 circulating B cells than in blood from buffer-immunised mice (Extended Data Fig. 4c), which
132 may imply that B-cell homing to lymphoid compartments augments B cell counts in dLN and
133 spleen. The dLNs from BNT162b2-immunised mice also have significantly elevated counts of
134 CD8+ and CD4+ T cells, which was most pronounced for T follicular helper (TFH) cells,
135 including ICOS+ subsets essential for germinal center formation (Extended Data Fig. 4a)24.
136 BNT162b2 immunisation increased CD8+ T cell counts in the blood and TFH cell counts in the
137 spleen and blood (Extended Data Fig. 4b, c). These data indicate that BNT162b2 concurrently
138 elicits strong SARS-CoV-2 pseudovirus neutralising titers and systemic TH1-driven CD4+ and
139 CD8+ T-cell responses.
140 To assess BNT162b2-mediated protection in non-human primates, groups of six male, 2-4 year
141 old rhesus macaques were immunised IM with 30 or 100 µg of BNT162b2 or saline control on
142 Days 0 and 21. S1-binding IgG was readily detectable by Day 21 after Dose 1, and levels
143 increased further after Dose 2 through Day 28 (Fig. 3a). Seven days after Dose 2 (Day 28), the
144 GMCs of S1-binding IgG were 30,339 units (U)/mL (30 µg dose level) and 34,668 U/mL
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145 (100 µg dose level). For comparison, the S1-binding IgG GMC of a panel of 38 SARS-CoV-2
146 convalescent human sera was 631 U/mL, substantially lower than the GMCs of the immunised
147 rhesus macaques after one or two doses.
148 Fifty percent virus neutralisation GMTs, measured by an authentic SARS-CoV-2 neutralisation
149 assay25, were detectable in rhesus macaque sera by Day 21 after Dose 1 and peaked at a GMT
150 of 962 (Day 35, 14 days after Dose 2 of 30 µg) or 1,689 (Day 28, 7 days after Dose 2 of 100 µg;
151 Fig. 3b). Robust GMTs of 285 for 30 µg and 310 for 100 µg dose levels persisted to at least
152 Day 56 (most recent time point tested). For comparison, the neutralisation GMT of the human
153 convalescent serum panel was 94.
154 S-specific T-cell responses were analysed in BNT162b2-immunised rhesus macaques and
155 saline-immunised controls by ELISpot and intracellular cytokine staining (ICS). Peripheral
156 blood mononuclear cells (PBMCs) were collected before immunisation and at the times
157 indicated after Doses 1 and 2. Strong IFNγ but minimal IL-4 responses were detected by
158 ELISpot after Dose 2 (Fig. 3c,d, Extended Data Fig. 5). ICS confirmed that BNT162b2 elicited
159 strong S-specific IFNγ producing T-cell responses, including a high frequency of CD4+ T cells
160 that produced IFNγ, IL-2, and TNF but a low frequency of CD4+ T cells that produced IL-4,
161 indicating a TH1-biased response (Fig. 3e,f). BNT162b2 also elicited S-specific
162 IFNγ+ producing CD8+ T cells (Fig. 3g).
163 Six rhesus macaques that had received two immunisations with 100 µg BNT162b2 and three
164 age-matched macaques that had received saline were challenged 55 days after Dose 2 with
165 1.05 × 106 plaque forming units of SARS-CoV-2 (strain USA-WA1/2020), split equally
166 between intranasal and intratracheal routes, as previously described26. Three additional non-
167 immunised, age-matched rhesus macaques (sentinels) were mock-challenged with cell culture
168 medium. Nasal and oropharyngeal (OP) swabs were collected and bronchoalveolar lavage
169 (BAL) was performed at the times indicated, and samples were tested for SARS-CoV-2 RNA
170 (genomic RNA or subgenomic transcripts) by reverse-transcription quantitative polymerase
171 chain reaction (RT-qPCR; Fig. 4). All personnel performing clinical, radiological,
172 histopathological, or RT-qPCR evaluations were blinded to the group assignments of the
173 macaques.
174 Viral RNA was detected in BAL fluid from 2 of the 3 control-immunised macaques on Day 3
175 after challenge and from 1 of 3 on Day 6 (Fig. 4a). At no time point sampled was viral RNA
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176 detected in BAL fluid from the BNT162b2-immunised and SARS-CoV-2 challenged macaques
177 (Fig. 4a). The difference in viral RNA detection in BAL fluid between BNT162b2-immunised
178 and control-immunised rhesus macaques after challenge is highly statistically significant (by a
179 nonparametric test, p=0.0014).
180 From control-immunised macaques, viral RNA was detected in nasal swabs obtained on Days
181 1, 3, and 6 after SARS-CoV-2 challenge; from BNT162b2-immunised macaques, viral RNA
182 was detected only in nasal swabs obtained on Day 1 after challenge and not in swabs obtained
183 on Day 3 or subsequently (Fig. 4b). The pattern of viral RNA detection from OP swabs was
184 similar to that for nasal swabs (Fig. 4c).
188 Discussion
189 We demonstrate that BNT162b2, an LNP-formulated, m1Ψ nucleoside-modified mRNA
190 encoding SARS-CoV-2 S captured in a prefusion conformation is highly immunogenic in mice
191 and rhesus macaques. Expression from DNA of protein with the BNT162b2-encoded amino
192 acid sequence confirmed the P2 S prefusion conformation by cryo-EM. This analysis confirmed
193 that the antigenically important RBD can assume the ‘up’ conformation, with the receptor
194 binding site, rich in neutralising epitopes, accessible in a proportion of the molecules27. The
195 alternative states observed likely reflect a dynamic equilibrium between RBD ‘up’ and ‘down’
196 positions10,23. Binding of expressed and purified P2 S to ACE2 and a neutralising monoclonal
197 antibody further demonstrates its conformational and antigenic integrity.
198 In mice, a single injection of BNT162b2 elicited high neutralizing titers and strong TH1 and TFH
199 type CD4+ and IFNγ+IL-2+ CD8+ T-cell responses. Both BNT162b2 induced CD4+ T-cell types
200 may support antigen-specific antibody generation and maturation, and potentially protection
201 from infectious challenge. Limitation and clearance of virus infection is promoted by the
202 interplay of neutralising antibodies with CD8+ T cells that eliminate intracellular virus
203 reservoirs. CD8+ T cells may also reduce the influx of monocytes into infected lung tissue,
204 which can be associated with undesirable IL-6 and TNF production and impaired antigen
205 presentation28,29. The contributions of the immune effector systems to human protection from
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206 SARS-CoV-2 is not yet understood. Therefore, it appears prudent to develop COVID-19
207 vaccines that enlist concomitant cognate B cell, CD4+ T cell, and CD8+ T-cell responses.
208 The immunogenicity of BNT162b2 in rhesus macaques paralleled its immunogenicity in mice.
209 Seven days after Dose 2 of 100 µg, the neutralising GMT reached 18-times that of a human
210 SARS-CoV-2 convalescent serum panel and remained 3.3-times higher than this benchmark
211 five weeks after the last immunisation. The strongly TH1-biased CD4+ T-cell response and
212 IFNγ+ CD8+ T-cell response to BNT162b2 is a pattern favoured for vaccine safety and efficacy,
213 providing added reassurance for clinical translation30. BNT162b2 protected 2-4 year old rhesus
214 macaques from infectious SARS-CoV-2 challenge, with reduced detection of viral RNA in
215 immunised animals compared to those that received saline and with no evidence of clinical
216 exacerbation. Strong RT-qPCR evidence for lower respiratory tract protection was
217 demonstrated by the absence of detectable SARS-CoV-2 RNA in serial BAL samples obtained
218 starting 3 days after challenge of BNT162b2-immunised rhesus macaques.
219 We recently presented data from immunisation with BNT162b1, a vaccine candidate that has
220 the same LNP-formulated m1Ψ nucleoside-modified RNA platform but expresses a trimerised,
221 secreted RBD (Vogel et al., manuscript in preparation). The pattern, magnitude and durability
222 of humoral and cellular responses to BNT162b1 in mice and macaques were in the range of
223 those elicited by BNT162b2, as was protection of macaques from virus challenge, indicating
224 that these features are largely class-intrinsic for this particular vaccine platform. BNT162b1
225 elicits high SARS-CoV-2 neutralizing titers and strong TH1-biased CD4+ and IFNγ+ and IL-2+
226 CD8+ T cell responses in humans, consistent with the preclinical findings15,31,32.
227 The selection of BNT162b2 over BNT162b1 for further clinical testing was largely driven by
228 greater tolerability of BNT162b2 with comparable immunogenicity in clinical trials15 and the
229 broader range of T-cell epitopes on the much larger full length spike. A global, pivotal, phase
230 3 safety and efficacy study of immunisation with BNT162b2 (NCT04368728) is now well
231 under way and may answer those open questions that cannot be addressed by preclinical
232 models.
233
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240 Immunisations for the non-human primate (NHP) study were performed at the University of
241 Louisiana at Lafayette-New Iberia Research Center (NIRC), which is accredited by the
242 Association for Assessment and Accreditation of Laboratory Animal Care (AAALAC, Animal
243 Assurance #: 000452). The work was in accordance with USDA Animal Welfare Act and
244 Regulations and the NIH Guidelines for Research Involving Recombinant DNA Molecules, and
245 Biosafety in Microbiological and Biomedical Laboratories. All procedures performed on these
246 animals were in accordance with regulations and established guidelines and were reviewed and
247 approved by an Institutional Animal Care and Use Committee or through an ethical review
248 process. Infectious SARS-CoV-2 challenge for the NHP study was performed at the Southwest
249 National Primate Research Center. Animal husbandry followed standards recommended by
250 AAALAC International and the NIH Guide for the Care of Use of Laboratory Animals. This
251 study was approved by the Texas Biomedical Research Institute Animal Care and Use
252 Committee.
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308 To express P2 S for structural characterisation, a gene encoding the full length of SARS-CoV-
309 2 (GenBank: MN908947) with two prolines substituted at residues 986 and 987 followed with
310 a C-terminal HRV3C protease site and a TwinStrep tag was cloned into a modified
311 pcDNA3.1(+) vector with the CAG promoter. The TwinStrep-tagged P2 S was expressed in
312 Expi293 cells. Purification of the recombinant protein was based on a procedure described
313 previously, with minor modifications5. Upon cell lysis, P2 S was solubilized in 1% NP-40
314 detergent. The TwinStrep-tagged protein was then captured with StrepTactin Sepharose HP
315 resin in 0.5% NP-40. P2 S was further purified by size-exclusion chromatography and eluted
316 as three distinct peaks in 0.02 % NP-40 as previously reported5. Peak 1, which consists of intact
317 P2 S migrating at around 150 kDa, as well as dissociated S1 and S2 subunits, which co-migrate
318 at just above 75 kDa, was used in the structural characterisation. Spontaneous dissociation of
319 the S1 and S2 subunits mostly occurs throughout the course of the protein purification, starting
320 at the point of detergent-mediated protein extraction.
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322 The binding of detergent NP-40 solubilized, purified P2 S to human ACE2 peptidase domain
323 (ACE2 PD) and human neutralising monoclonal antibody B3822 was performed on Octet
324 RED384 (FortéBio) at 25 ⁰C in a running buffer (RB) consisting of 25 mM Tris pH7.5, 150 mM
325 NaCl, 1 mM EDTA and 0.02% NP-40. Avi-tagged ACE2-PD was captured on streptavidin
326 coated sensors and B38 antibody was captured on sensors coated with protein G. After initial
327 baseline equilibration of 120 s, the sensors were dipped in 10 µg/mL solution of Avi-tagged
328 ACE2-PD or B38 mAb for 300 s to achieve capture levels of 1 nM using the threshold function.
329 The sensors were dipped in RB for 120 s for collecting baseline before they were dipped in a
330 concentration series of purified P2 S samples for 300 s (association phase). The sensors were
331 immersed in RB for measuring 600 s (dissociation phase). Data were reference subtracted and
332 fit to a 1:1 binding model with R2 value greater than 0.95, to determine kinetics and affinity of
333 binding, using Octet Data Analysis Software v10.0 (FortéBio).
334 Cryo-electron microscopy sample preparation, data collection and data processing.
335 For TwinStrep-tagged P2 S, 4 μL purified protein at 0.5 mg/mL were applied to gold Quantifoil
336 R1.2/1.3 300 mesh grids freshly overlaid with graphene oxide. Sample was blotted using a
337 Vitrobot Mark IV for 4 s with a force of -2 before being plunged into liquid ethane cooled by
338 liquid nitrogen. 27,701 micrographs were collected from a two identically prepared grids on a
339 Titan Krios operating at 300 keV equipped with a Gatan K2 Summit direct electron detector in
340 super-resolution mode at a magnification of 165,000x, for a magnified pixel size of 0.435 Å at
341 the specimen level. Data were collected from each grid over a defocus range of -1.2 to -3.4 μm
342 with a total electron dose of 50.32 and 50.12 e-/Å2, respectively, fractionated into 40 frames
343 over a 6-second exposure for 1.26 and 1.25 e-/Å2/frame. On-the-fly motion correction, CTF
344 estimation, and particle picking and extraction with a box size of 450 pixels were performed in
345 Warp38, during which super-resolution data were binned to give a pixel size of 0.87 Å. A total
346 of 1,119,906 particles were extracted. All subsequent processing was performed in RELION
347 3.1-beta39. Particle heterogeneity was filtered out with 2D and 3D classification to filter out bad
348 particles, yielding a set of 73,393 particles, which refined to 3.6 Å with C3 symmetry. 3D
349 classification of this dataset without particle alignment separated out one class with a single
350 RBD up, representing 15,098 particles. The remaining 58,295 particles, in three RBD ‘down’
351 conformation, were refined to give a final model at 3.29 Å. The atomic model from PDB ID
352 6XR85 was rigid-body fitted into the map density, then flexibly fitted to the density using real-
353 space refinement in Phenix40 alternating with manual building in Coot41. The cryo-EM model
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354 validation is provided in Extended Data Fig 3b, the full cryo-EM data processing workflow in
355 Extended Data Fig. 3c, and the model refinement statistics in Extended Data Table 1.
356 Immunisation.
357 Mice. Female BALB/c mice (Janvier; 8-12 weeks) and were randomly allocated to groups.
358 BNT162b2 was diluted in PBS, 300 mM sucrose or saline (0.9% NaCl) and injected IM into
359 the gastrocnemius muscle at a volume of 20 µL under isoflurane anaesthesia.
360 Rhesus macaques (Macaca mulatta). Male rhesus macaques (2–4 years) were randomly
361 assigned to receive either BNT162b2 or saline placebo control in 0.5 mL volume administered
362 by IM injection in the left quadriceps muscle on Days 0 and 21.
384 control. For rhesus macaque and human sera, a recombinant SARS-CoV-2 S1 containing a C-
385 terminal Avitag™ (Acro Biosystems) was bound to streptavidin-coated Luminex microspheres.
386 Bound rhesus macaque or human anti-S1 antibodies present in the serum were detected with a
387 fluorescently labelled goat anti-human polyclonal secondary antibody (Jackson
388 ImmunoResearch). Data were captured as median fluorescent intensities (MFIs) using a
389 Bioplex200 system (Bio-Rad) and converted to U/mL antibody concentrations using a reference
390 standard consisting of 5 pooled human COVID-19 convalescent serum samples (obtained >14
391 days PCR diagnosis), diluted in antibody depleted human serum with arbitrary assigned
392 concentrations of 100 U/mL and accounting for the serum dilution factor.
393 Binding kinetics of antigen-specific IgGs using surface plasmon resonance spectroscopy
394 Binding kinetics of murine S1- and RBD-specific serum IgGs was determined using a Biacore
395 T200 device (Cytiva) with HBS-EP running buffer (BR100669, Cytiva) at 25 °C. Carboxyl
396 groups on the CM5 sensor chip matrix were activated with a mixture of 1-ethyl-3-(3-
397 dimethylaminopropyl) carbodiimidehydrochloride (EDC) and N-hydroxysuccinimide (NHS) to
398 form active esters for the reaction with amine groups. Anti-mouse-Fc-antibody (Jackson
399 ImmunoResearch) was diluted in 10 mM sodium acetate buffer pH 5 (30 µg/mL) for covalent
400 coupling to immobilisation level of ~10,000 response units (RU). Free N-hydroxysuccinimide
401 esters on the sensor surface were deactivated with ethanolamine.
402 Mouse serum was diluted 1:50 in HBS-EP buffer and applied at 10 µL/min for 30 seconds to
403 the active flow cell for capture by immobilised antibody, while the reference flow cell was
404 treated with buffer. Binding analysis of captured murine IgG antibodies to S1-His or RBD-His
405 (Sino Biological) was performed using a multi-cycle kinetic method with concentrations
406 ranging from 25 to 400 nM or 1.5625 to 50 nM, respectively. An association period of 180
407 seconds was followed by a dissociation period of 600 seconds with a constant flow rate of 40
408 μL/min and a final regeneration step. Binding kinetics were calculated using a global kinetic fit
409 model (1:1 Langmuir, Biacore T200 Evaluation Software Version 3.1, Cytiva).
415 CΔ19) were inoculated with VSVΔG-GFP vector. After incubation for 1 hour at 37 °C, the
416 inoculum was removed and cells were washed with PBS before medium supplemented with
417 anti-VSV-G antibody (clone 8G5F11, Kerafast Inc.) was added to neutralise residual input
418 virus. VSV/SARS-CoV-2 pseudovirus-containing medium was harvested 20 hours after
419 inoculation, 0.2 µm filtered and stored at -80 °C.
420 Serial dilutions of mouse serum samples were prepared and pre-incubated for 10 minutes at
421 room temperature with VSV/SARS-CoV-2 pseudovirus suspension (4.8 × 103 infectious units
422 [IU]/mL) before transferring the mix to Vero 76 cells. Inoculated Vero-76 cells were incubated
423 for 20 hours at 37 °C. Plates were placed in an IncuCyte Live Cell Analysis system (Sartorius)
424 and incubated for 30 minutes prior to the analysis (IncuCyte 2019B Rev2 software). Whole
425 well scanning for brightfield and GFP fluorescence was performed using a 4× objective. The
426 50% pseudovirus neutralisation titre (pVNT50) was reported as the reciprocal of the first serum
427 dilution yielding a 50% reduction in GFP-positive infected cell number per well compared to
428 the mean of the no serum pseudovirus positive control. Each serum sample dilution was tested
429 in duplicates.
431 Murine ELISpot assays were performed with mouse IFNγ ELISpotPLUS kits according to the
432 manufacturer’s instructions (Mabtech). A total of 5 × 105 splenocytes was ex vivo restimulated
433 with the full-length S peptide mix (0.1 µg/mL final concentration per peptide) or controls
434 (gp70-AH1 [SPSYVYHQF]33, 4 µg/mL; Concanavalin A [ConA], 2 µg/mL [Sigma]).
435 Streptavidin-alkaline phosphatase (ALP) and BCIP/NBT-plus substrate were added, and spots
436 counted using an ELISpot plate reader (ImmunoSpot® S6 Core Analyzer [CTL]). Spot numbers
437 were evaluated using ImmunoCapture Image Aquision Software V7.0 and ImmunoSpot
438 7.0.17.0 Professional. Spot counts denoted too numerous to count by the software were set to
439 1,500. For T-cell subtyping, CD8+ T cells and CD4+ T cells were isolated from splenocyte
440 suspensions using MACS MicroBeads (CD8a [Ly-2] and CD4 [L3T4] [Miltenyi Biotec])
441 according to the manufacturer’s instructions. 1 × 105 CD8+ or CD4+ T cells were subsequently
442 restimulated with 5 × 104 syngeneic bone marrow-derived dendritic cells loaded with full-
443 length S peptide mix (0.1 µg/mL final concentration per peptide) or cell culture medium as
444 control. Purity of isolated T-cell subsets was determined by flow cytometry.
445 Rhesus macaque PBMCs were tested with commercially available NHP IFNγ and IL-4 ELISpot
446 assay kits (Mabtech, Sweden). Cryopreserved rhesus macaque PBMCs were thawed in pre-
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447 warmed AIM-V media (Thermo Fisher Scientific, US) with Benzonase (EMD Millipore, US).
448 For IFNγ ELISpot, 1.0 x 105 PBMCs and 2.5 x 105 PBMCs for IL-4 ELISpot were stimulated
449 ex vivo with 1 μg/mL of the full-length S overlapping peptide mix. Tests were performed in
450 triplicate wells and media-DMSO, a CMV peptide pool and PHA (Sigma) were included as
451 controls. After 24 hours for IFNγ and 48 hours for IL-4, Streptavidin-HRP and AEC substrate
452 (BD Bioscience) were added, and spots counted using a CTL ImmunoSpot S6 Universal
453 Analyzer (CTL, US). Results shown are background (Media-DMSO) subtracted and
454 normalized to SFC/106 PBMCs.
467 For mouse T-cell analysis in lymphoid tissues, 1.5 × 106 lymph node and 4 × 106 spleen cells
468 were stained for viability and extracellular antigens with directly labelled antibodies. Fixation,
469 permeabilisation and intracellular staining was performed as described for blood T-cell staining.
470 For mouse B-cell subtyping in lymphoid tissues, 2.5 × 105 lymph node and 1 × 106 spleen cells
471 were treated with Fc block, stained for viability and extracellular antigens as described for blood
472 T-cell staining and fixed with 2% RotiHistofix overnight.
473 For mouse intracellular cytokine staining in T cells, 4 x 106 spleen cells were ex vivo
474 restimulated with 0.5 µg/mL final concentration per peptide of full-length S peptide mix or cell
475 culture medium (no peptide) as control in the presence of GolgiStop and GolgiPlug (both BD
476 Bioscience) for 5 hours. Cells were stained for viability and extracellular antigens as described
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477 for lymphoid T-cell staining. Cells were fixed with 2% RotiHistofix and permeabilised
478 overnight. Intracellular staining was performed as described for blood T-cell staining.
479 Mouse cells were acquired on a BD Symphony A3 or BD Celesta (B-cell subtyping) flow
480 cytometer (BD Bioscience) using BD FACSDiva software version 9.1 or 8.0.1.1, respectively,
481 and analysed with FlowJo 10.6 (FlowJo LLC, BD Biosciences).
482 For rhesus macaques intracellular cytokine staining in T cells, 1.5 x 106 PBMCs were stimulated
483 with the full-length S peptide mix at 1 μg/mL, Staphyloccocus enterotoxin B (SEB; 2 μg/mL)
484 as positive control, or 0.2% DMSO as negative control. GolgiStop and GolgiPlug (both BD
485 Bioscience) were added. Following 37 °C incubation for 12 to 16 h, cells were stained for
486 viability and extracellular antigens after blocking Fc binding sites with directly labelled
487 antibodies. Cells were then fixed and permeabilized with BDCytoFix/CytoPerm solution (BD
488 Bioscience), intracellular staining was performed in perm buffer for 30 min at RT. Cells were
489 washed, resuspended in 2% FBS/PBS buffer and acquired on a LSR Fortessa. Data analyzed
490 by FlowJo (10.4.1). Results shown are background (Media-DMSO) subtracted.
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507 of heat-inactivated sera were incubated with the reporter virus (2 x 104 PFU per well) to yield
508 approximately a 10-30% infection rate of the Vero CCL81 monolayer for 1 hour at 37 °C before
509 inoculating Vero CCL81 cell monolayers (targeted to have 8,000 to 15,000 cells in the central
510 field of each well at the time of seeding, one day before infection) in 96-well plates to allow
511 accurate quantification of infected cells. Cell counts were enumerated by nuclear stain (Hoechst
512 33342) and fluorescent virally infected foci were detected 16-24 hours after inoculation with a
513 Cytation 7 Cell Imaging Multi-Mode Reader (Biotek) with Gen5 Image Prime version 3.09.
514 Titers were calculated in GraphPad Prism version 8.4.2 by generating a 4- parameter (4PL)
515 logistical fit of the percent neutralisation at each serial serum dilution. The 50% neutralisation
516 titre (VNT50) was reported as the interpolated reciprocal of the dilution yielding a 50%
517 reduction in fluorescent viral foci.
519 The SARS-CoV-2 inoculum was obtained from a stock of 2.1 × 106 PFU/mL previously
520 prepared at Texas Biomedical Research Institute (San Antonio, TX), aliquoted into single use
521 vials, and stored at -70 °C. The working virus stock was generated from two passages of the
522 SARS-CoV-2 USA-WA1/2020 isolate (a 4th passage seed stock purchased from BEI Resources;
523 NR-52281) in Vero 76 cells. The virus was confirmed to be SARS-CoV-2 by deep sequencing
524 and identical to the published sequence (GenBank accession number MN985325.1).
525 BNT162b2-immunised (n=6) and age-matched saline control-immunised (n=3) male rhesus
526 macaques (control) were challenged with 1.05 × 106 plaque forming units of SARS-CoV-2
527 USA-WA1/2020 isolate, split equally between the intranasal (IN; 0.25 mL) and intratracheal
528 (IT; 0.25 mL) routes as previously described26. The challenge was performed 55 days after the
529 second immunisation. A separate sentinel group of non-immunised age- and sex-matched
530 animals (n=3) was mock challenged with DMEM supplemented with 10% FCS IN (0.25 mL)
531 and IT (0.25 mL). Approximately two weeks prior to challenge, animals were moved to the
532 ABSL-3 facility at Southwest National Primate Research Center (SNPRC; San Antonio, TX).
533 Animals were monitored regularly by a board-certified veterinary clinician for rectal body
534 temperature, weight and physical examination. Specimen collection was performed under
535 tiletamine zolazepam (Telazol) anaesthesia as described26. Nasal and oropharyngeal swabs
536 were collected from all macaques at Day 0, 1, 3, and 6 (relative to the day of challenge), from
537 BNT162b2-immunised macaques on Day 7 or 8, and from control and sentinel macaques on
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538 Day 10. Bronchoalveolar lavage (BAL) was performed on all macaques the week before
539 challenge and on Days 3 and 6 post-challenge and on BNT162b2-immunised macaques on Day
540 7 or 8. BAL was performed by instilling four times 20 mL of saline. These washings were
541 pooled, aliquoted and stored frozen at -70 °C. Necropsy was performed on BNT162b2-
542 immunised animals on Day 7 or 8. Control and sentinel animals were not necropsied to allow
543 re-challenge (control) or challenge (sentinel) on a subsequent day.
545 To detect and quantify SARS-CoV-2 in NHP, viral RNA was extracted from nasal swabs, OP
546 swabs, and BAL specimens as previously described45–47 and tested by RT-qPCR as previously
547 described26. Briefly, 10 µg yeast tRNA and 1 × 103 PFU of MS2 phage (Escherichia coli
548 bacteriophage MS2, ATCC) were added to each thawed sample, and RNA extraction performed
549 using the NucleoMag Pathogen kit (Macherey-Nagel). The SARS-CoV-2 RT-qPCR was
550 performed on extracted RNA using a CDC-developed 2019-nCoV_N1 assay on a QuantStudio
551 3 instrument (Applied Biosystems). The cut-off for positivity (limit of detection, LOD) was
552 established at 10 gene equivalents (GE) per reaction (800 GE/mL). Samples were tested in
553 duplicate. On day 6, one BAL specimen from the control group and one day 1 nasal swab from
554 the BNT162b1-immunised group had, on repeated measurements, viral RNA levels on either
555 side of the LLOD. These specimens were categorised as indeterminate and excluded from the
556 graphs and the analysis.
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569 Acknowledgements
570 We thank T. Garretson for advice on NHP serology studies, R. F. Sommese and K. F. Fennell
571 for technical assistance for molecular cloning and cell based binding. Valuable support and
572 assistance from R. de la Caridad Güimil Garcia1, A. Su, M. Dvorak, M. Drude, F. Zehner, T.
573 Lapin, B. Ludloff, S. Hinz, F. Bayer, J. Scholz, A.L. Ernst, T. Sticker and S. Wittig resulted in
574 a rapid availability of oligonucleotides and DNA templates. E. Boehm, K. Goebel, R. Frieling,
575 C. Berger, S. Koch, T. Wachtel, J. Leilich, M. Mechler, R. Wysocki, M. Le Gall, A. Czech and
576 S. Klenk carried out RNA production and analysis. Without their commitment during this
577 pandemic situation, this vaccine candidate could not have been transferred to non-clinical
578 studies in light speed. B. Weber, J. Vogt, S. Krapp, K. Zwadlo, J. Mottl, J. Mühl and P.
579 Windecker supported the mouse studies and serological analysis with excellent technical
580 assistance. We thank A. Ota-Setlik for ELISpot testing of NHP samples. Radiologists A. K.
581 Voges, M. R. Gutman and E. Clemmons advised on the radiographic scoring. We thank
582 Polymun Scientific for excellent formulation services as well as Acuitas Therapeutics for
583 fruitful discussions.
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595 B.S., A.W., C.F.-G. and P.-Y.S. performed and analysed pVNT and VNT assays. D.E., D.S.,
596 B.J., Y.F, H.J. performed in vivo studies and ELISpot assays. A.B.V., K.C.W. J.L., M.S.M. and
597 M.V. planned, analysed and interpreted ELISpot assays. L.M.K., J.L., D.E., Y.F., H.J., A.P.H.
598 M.S.M. and P.A planned, performed and analysed flow cytometry assays. A.B.V., L.M.K., Y.F.
599 and H.J. planned, performed, analysed and interpreted cytokine release assays. I.K., K.A.S.,
600 K.T., D.K. and P.R.D. designed NHP studies and analysed and interpreted data. K.T., M.P.,
601 I.L.S. and W.K. oversaw NHP immunogenicity and serology testing. S.H.-U. and K.B. provided
602 veterinary services for NHPs. J.C., T.C. and J.O managed the NHP colony. A.B.V., I.K., Y.C.,
603 A.M., M.V, L.M.K., C.T., K.S., Ö.T., P.R.D, K.U.J. and U.S. wrote the manuscript. All authors
604 supported the review of the manuscript.
617 C.F.-G. and P.-Y.S. received compensation from Pfizer to perform neutralisation assays;
618 J.C., S.H.-U, K.B., R.C., jr., K.J.A. and D.K., are employees of Southwest National Primate
619 Research Center, which received compensation from Pfizer to conduct the animal challenge
620 work;
621 no other relationships or activities that could appear to have influenced the submitted work.
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622 Funding
623 BioNTech is the Sponsor of the study, and Pfizer it its agent. BioNTech and Pfizer are
624 responsible for the design, data collection, data analysis, data interpretation, and writing of the
625 report. The corresponding authors had full access to all the data in the study and had final
626 responsibility for the decision to submit the data for publication. This study was not supported
627 by any external funding at the time of submission.
630 Correspondence and requests for materials should be addressed to Ugur Sahin.
631
632
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preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission.
20,000
10,000
0
1,600 1,800 2,000 2,200
Time [s]
c d e
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28 days after immunisation with 1 µg BNT162b2. e, CD8+ T-cell specific cytokine release by splenocytes
collected 12 days after immunisation with 5 µg BNT162b2 or buffer (Control), determined by flow
cytometry. S-peptide specific responses are corrected for background (no peptide). f, Cytokine production
by splenocytes collected 28 days after immunisation with 1 µg BNT162b2, determined by bead-based
multiplex analysis (n=7 for IL-4, IL-5 and IL-13, one outlier removed via routs test [Q=1%] for the S
peptide stimulated samples).
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a S1-specific IgG
(rhesus macaques)
b SARS-CoV-2 neutralisation assay
(rhesus macaques)
10 6 1,689
30,339 34,668 10 4 962 1,277
14,978 18,603 809 1,007
10,288 12,879 637 94
10 5 4,236 6,317 631 285
310
2,698
IgG [U/mL]
1,921
BNT162b2 10 3 81
10 4 65 BNT162b2
VNT50
30 g 30 g
10 3 100 g 100 g
10 2
10 2
10 1 10 1
21 28 35 42 56 21 28 35 42 56 HCS 21 28 35 42 56 21 28 35 42 56 HCS
* * * *
Days after 1st vaccination Days after 1st vaccination
c PBMCs d PBMCs
(rhesus macaques) (rhesus macaques)
4000 0 g 30 g 100 g BNT162b2 4,000 0 g 30 g 100 g BNT162b2
IFN spots per 1 x 106 cells
1,000 1,000
500 500
0 0
0 14 28 42 0 14 28 42 0 14 28 42 0 142842 0 142842 0 142842
* * * * * * * * * * * *
Days after 1st vaccination Days after 1st vaccination
0.20
0 g 30 g 100 g BNT162b2
Per cent IL-4+of CD4+ T cells
1.0 1.0
0.15
of CD4+ T cells
0.8 0.8
0.4 0.4
0.05
0.2 0.2
c Oropharyngeal swab
(rhesus macaques)
10 10
Sentinel
Control
Viral RNA (copies)
10 8 BNT162b2
3/3
10 6 3/3
3/6
2/6
10 4
0/3 0/6 0/3 1/3 1/6
0/3 0/3 0/3 0/3 0/6 0/3
10 2
Pre 1 3 6 10/ EOP
Days after challenge
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a
In vitro transfection
100
Per cent P2-S+ cells
80
60
40
20
0
l 2 A
tro 2b N
on 16 2 R
C T 2b
BN 1 6
T
BN
b c
P2 S (peak A) binding to ACE2-PD P2 S (peak A) binding to B38
0.8 KD = 1.17 nM 0.4 KD = 1.21 nM
kon = 2.72X105 M-1*s-1 kon = 2.68X105 M-1*s-1
BLI response (nm)
0.4 0.2
0.2 0.1
0.0 0.0
0 300 600 900 0 300 600 900
Time (s) Time (s)
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0.8
0.6
0.4
0.2
0.0
0.1 0.2 0.3 0.4 0.5 0.6
-0.2
Resolution (1/Å)
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S1-specific affinity
a RBD-specific IgG b (mouse)
RBD-specific affinity
(mouse)
(mouse)
40
0 0.2 1 5 g BNT162b2 kon = 3.33x104 1/Ms
15
1,000 P= kon = 6.02x105 1/Ms
< 0.0001 koff = 4.00x10-4 1/s
30 koff = 5.97x10-4 1/s
Response [RU]
KD = 1.20x10-8 M
Response [RU]
< 0.0001
10 KD = 9.93x10-10 M
IgG [µg/mL]
100 0.0007
20
10
5
10
1
0
0
< 0.1
0 10 20 30 0 200 400 600 800 0 200 400 600 800
Days after vaccination Time [s] Time [s]
c
0.2 µg BNT162b2 1 µg BNT162b2 5 µg BNT162b2
400 400 400
Infected cells per well
Infected cells/well
Infected cells/well
300 Virus Ctrl 300 Virus Ctrl 300 Virus Ctrl
0 0 0
8 16 32 64 128 256 512 1024 2048 8 16 32 64 128 256 512 1024 2048 8 16 32 64 128 256 512 1024 2048
-1
(serum dilution) -1
(serum dilution) (serum dilution)-1
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a dLN
Day 12 B cells Plasma cells Class switched B cells Germinal center B cells IgG1+ B cells IgG2a+ B cells
P= P= P= 2.5×10 5 P= 1×10 3 P=
2.5×10 1 2×10 4 P= 8×10 5 8×10 5
0 0 0 0 0 0
l l b2 l b2 l b2
b2
2
b2
T1 l
ro ro ro ro
T1 l
BN tro
2b
BN tro
nt nt 62 nt 62 nt 62
62
62
on
6
on
C
o
T1 C
o T1 C
o T1 o T1
C
C
C
BN BN BN BN
T cells CD8+ T cells CD4+ T cells TH1 cells TFH cells ICOS+ TFH cells
P= P= P= P=
8×10 6 P= 2×10 6 0.0012 5×10 6 1×10 4 P= 1×10 5 60
0 0 0 0 0 0
l 2 l l 2 l l 2
tro 2b ro 2 tro 2b ro 2
tro 2b
T1 ol
b2
b b
on 16 nt nt 62
B N n tr
62 on 16 on 16
62
o o
T1 T1
o
C T C C T C C T
C
N N
B BN B BN BN
<0.0001
CD95+ B cells per spleen
2×10 6
3×10 6 1.5×10 5
1×10 6
1.5×10 6
2×10 6 1×10 5
1×10 6
5×10 5
1×10 6 5×10 4
5×10 5
0 0 0 0
l b2 l b2 l 2
b2
ro ro tro 2b
T1 l
BN tro
nt 62 nt 62
62
on 16
on
C
o T1 C
o T1 C T
C
BN BN BN
P= P=
60 50 80 1.5
Per cent CD4+ of CD3+ cells
Per cent CD8 of CD3 cells
P= <0.0001 P= 0.0002
<0.0001 <0.0001
Per cent CD19 of alive
+
+
40
60
40 1.0
+
30
40
+
20
20 0.5
20
10
0 0 0 0.0
l b2 l l l
ro ro 2b
2 ro 2b
2
tro b2
nt 62 o nt 6 o nt 6 on 62
C
o T1 C T1 C T1 C T1
BN BN BN BN
Extended Data Figure 4. B-cell and T-cell phenotyping in lymph nodes, spleen and blood of
BNT162b2 immunised mice.
Mice (n=8 per group) were immunised with 5 µg BNT162b2 or buffer (Control). P-values were determined
by an unpaired two-tailed t-test. a+b, B-cell and T-cell numbers 12 days after immunisation in (a) draining
lymph nodes (dLN; for B-cell subtyping only: n=4 for control, n=7 for BNT162b2 immunised group) or
(b) the spleen, determined by flow cytometry. The percentage of ICOS+ cells among T follicular helper
cells (TFH) in dLNs is depicted on the lower right in (a). c, B- and T-cell fractions in the blood seven days
after immunisation.
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1,000
500
0
0 500 1,000 1,500 2,000
IL-4 spots per 1 x 106 cells
Extended Data Figure 5. Scatterplot of IL-4 vs. IFN ELISpot of S peptide stimulated PBMCs
collected on Day 42.
Rhesus macaques (n=6 per group) were immunised on Days 0 and 21 with 30 µg or 100 µg BNT162b2
(see Fig. 3c,d) and individual animal values are shown.
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Extended Data Table 1. Electron cryomicroscopy data collection, 3D reconstruction and refinement
statistics.
Data collection
Titan Krios
EM equipment
(Thermo Fisher Scientific)
Detector K2 Summit
Grid 1 Grid 2
- 2
Electron dose (e /Å ) 50.32 50.12
Page 38