Photo Credit: nejm.org

๐Ÿ’‰ COVID-19 Novavax Nuvaxovid COVID-19 Vaccine Receives Expanded Authorization in Canada as a Booster in Adults

Monday, 28 November 2022 12:00.PM

Novavax, Inc., a biotechnology company dedicated to developing and commercializing next-generation vaccines for serious infectious diseases, today announced that Health Canada has granted expanded authorization for Nuvaxovidโ„ข (COVID-19 Vaccine (Recombinant protein, Adjuvanted)) (NVX-CoV2373) for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a homologous booster in adults aged 18 and older.

"Canadians now have access to our protein-based Nuvaxovid COVID-19 vaccine as an adult booster," said Stanley C. Erck, President and Chief Executive Officer, Novavax. "With the winter months upon us, it's important to have options for vaccination to help protect against COVID-19."

The expanded authorization was based on data from a Phase 2 trial conducted in South Africa and from the Prevent-19 Phase 3 trial conducted in the U.S. and Mexico. As part of the trials, a single booster dose of Nuvaxovid was administered to healthy adult participants approximately six to 11 months after their primary series of two doses administered three weeks apart. The third (booster) dose produced increased immune responses to levels comparable to or exceeding those associated with protection against COVID-19 in Phase 3 clinical trials.

In the trials, following the booster, local and systemic reactions had a median duration of approximately two days. The incidence of Grade 3 or higher events remained relatively low. Safety reporting of reactogenicity events showed an increasing incidence across all three doses of Nuvaxovid, often seen with increased immunogenicity. The most frequent adverse reactions were injection site tenderness (68%), injection site pain (56%), fatigue (45%), myalgia (44%), headache (41%), malaise (35%), arthralgia (20%), and nausea or vomiting (11%). Following the booster vaccination in adults, frequencies and severity (all grades) of solicited adverse events generally increased, with most events being mild to moderate in severity.

Novavax' vaccine has been authorized as a heterologous and homologous booster in the U.S., European Union, United Kingdom (U.K.), Japan, Australia, New Zealand, and Switzerland, and a number of other countries have policy recommendations allowing use of the vaccine as a heterologous or homologous booster dose. Novavax has ongoing trials to further explore the vaccine's immunogenicity and safety as a heterologous booster.

Health Canada previously authorized Nuvaxovid as a primary series in adults aged 18 and older in February 2022.
Novavax filed in Canada for the vaccine's use as a primary series in adolescents aged 12 through 17 in June 2022.

Trade Name in the U.S.

The trade name Nuvaxovidโ„ข has not yet been approved by the U.S. Food and Drug Administration (FDA).

Authorized Use of Nuvaxovidโ„ข in Canada

Health Canada has granted authorization for registration of Nuvaxovidโ„ข COVID-19 Vaccine (Recombinant protein, Adjuvanted) to COVID-19 caused by SARS-CoV-2 as a primary series and as a homologous booster dose in individuals 18 years of age and older. There are no data available on the interchangeability of Nuvaxovid with other COVID- 19 vaccines to complete the primary vaccination series.

Important Safety Information: Canada

โ€ข Nuvaxovid is contraindicated in individuals who are hypersensitive to the active ingredient or to any ingredients in the formulation, including any non-medicinal ingredient, or component of the container.
โ€ข Vaccination should be postponed in individuals suffering from an acute severe febrile illness or acute infection.
โ€ข Individuals may not be optimally protected until seven days after their second dose.
โ€ข Events of anaphylaxis have been reported with administration of COVID-19 vaccines. Appropriate medical treatment and supervision should be available in case of an anaphylactic reaction following the administration of the vaccine. A second dose of the vaccine should not be given to those who have experienced anaphylaxis to the first dose of Nuvaxovid.
โ€ขNuvaxovid should be given with caution in individuals receiving anticoagulant therapy or those with thrombocytopenia or any coagulation disorder (such as haemophilia) because bleeding or bruising may occur following an intramuscular administration in these individuals.
โ€ขThe effects with Nuvaxovid may temporarily affect the ability to drive or use machines.
โ€ข Immunocompromised persons, including individuals receiving immunosuppressant therapy, may have a diminished immune response to the vaccine.
โ€ข Anxiety-related reactions, including vasovagal reactions, hyperventilation, or stressโ€“related reactions may occur in association with vaccination. Syncope (fainting) can occur following, or even before, any vaccination as a psychogenic response to the needle injection. It is important that precautions are in place to avoid injury from fainting and manage syncopal reactions.
โ€ข Administration of Nuvaxovid in pregnancy should only be considered when the potential benefits outweigh any potential risks for the mother and fetus.
โ€ข The most common adverse reactions observed during clinical studies were injection site tenderness, injection site pain, fatigue, myalgia, headache, malaise, arthralgia, and nausea or vomiting.

For more information on Nuvaxovid, including the Summary of Product Characteristics with Package Leaflet, adverse event reporting instructions, or to request additional information, please visit the following websites:

โ€ข Health Canada
โ€ข Novavax global authorization website

About Nuvaxovidโ„ข (NVX-CoV2373)

Nuvaxovid (NVX-CoV2373) is a protein-based vaccine engineered from the genetic sequence of the first strain of SARS-CoV-2, the virus that causes COVID-19 disease. The vaccine was created using Novavax' recombinant nanoparticle technology to generate antigen derived from the coronavirus spike protein and is formulated with Novavax' patented saponin-based Matrix-Mโ„ข adjuvant to enhance the immune response and stimulate high levels of neutralizing antibodies. Nuvaxovid contains purified protein antigen and can neither replicate, nor can it cause COVID-19.

Nuvaxovid is packaged as a ready-to-use liquid formulation in a vial containing ten doses. The vaccination regimen calls for two 0.5 ml doses (5 mcg antigen and 50 mcg Matrix-M adjuvant) given intramuscularly 21 days apart. The vaccine is stored at 2ยฐ- 8ยฐ Celsius, enabling the use of existing vaccine supply and cold chain channels. Use of the vaccine should be in accordance with official recommendations.

Novavax has established partnerships for the manufacture, commercialization, and distribution of Nuvaxovid worldwide. Existing authorizations leverage Novavax' manufacturing partnership with Serum Institute of India, the world's largest vaccine manufacturer by volume. They will later be supplemented with data from additional manufacturing sites throughout Novavax' global supply chain.

About the NVX-CoV2373 Phase 3 Trials

NVX-CoV2373 continues being evaluated in two pivotal Phase 3 trials.

PREVENT-19 (theโ€ฏPRE-fusion protein subunitโ€ฏVaccineโ€ฏEfficacyโ€ฏNovavaxโ€ฏTrial | COVID-19) is a 2:1 randomized, placebo-controlled, observer-blinded trial to evaluate the efficacy, safety and immunogenicity of the Novavax COVID-19 vaccine with Matrix-M adjuvant in 29,960 participants 18 years of age and over in 119 locations inโ€ฏthe U.S.โ€ฏandโ€ฏMexico. The primary endpoint for PREVENT-19 was the first occurrence of PCR-confirmed symptomatic (mild, moderate or severe) COVID-19 with onset at least seven days after the second dose in serologically negative (to SARS-CoV-2) adult participants at baseline. The statistical success criterion included a lower bound of 95% CI >30%. A secondary endpoint was the prevention of PCR-confirmed, symptomatic moderate or severe COVID-19. Both endpoints were assessed at least seven days after the second study vaccination in volunteers who had not been previously infected with SARS-CoV-2. In the trial, NVX-CoV2373 achieved 90.4% efficacy overall. It was generally well-tolerated and elicited a robust antibody response after the second dose in both studies. Full results of the trial were published in theโ€ฏNew England Journal of Medicine (NEJM).

The pediatric expansion of PREVENT-19 is a 2:1 randomized, placebo-controlled, observer-blinded trial to evaluate the safety, effectiveness, and efficacy of NVX-CoV2373 with Matrix-M adjuvant in 2,247 adolescent participants 12 to 17 years of age in 73 locations in the U.S., compared with placebo. In the pediatric trial, the vaccine achieved its primary effectiveness endpoint (non-inferiority of the neutralizing antibody response compared to young adult participants 18 through 25 years of age from PREVENT-19) and demonstrated 80% efficacy overall at a time when the Delta variant of concern was the predominant circulating strain in the U.S.โ€ฏAdditionally, immune responses were about two-to-three-fold higher in adolescents than in adults against all variants studied.

Additionally, a trial conducted in the U.K. with 14,039 participants aged 18 years and over was designed as a randomized, placebo-controlled, observer-blinded study and achieved overall efficacy of 89.7%. The primary endpoint was based on the first occurrence of PCR-confirmed symptomatic (mild, moderate, or severe) COVID-19 with onset at least seven days after the second study vaccination in serologically negative (to SARS-CoV-2) adult participants at baseline. Full results of the trial were published in NEJM.

About Matrix-Mโ„ข Adjuvant

Novavax' patented saponin-based Matrix-M adjuvant has demonstrated a potent and well-tolerated effect by stimulating the entry of antigen-presenting cells into the injection site and enhancing antigen presentation in local lymph nodes, boosting immune response.

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