This was a phase I, randomized, placebo-controlled, observer-blind study, for evaluation of safety and immunogenicity of SARS-CoV-2 mRNA vaccine (BNT162b1) in Chinese healthy population.

The participants were screened for 2 weeks (Day -14 to Day 0) before randomization, and received 1 dose of SARS-CoV-2 vaccine (BNT162b1) or placebo intramuscularly (IM) on Day 1 and Day 22, respectively. After randomization, the study for each participant lasted for approximately 12 months.

Inclusion Criteria:

For adult group (age ≥18 and ≤55)

• Male or female subjects of ≥18 years old and ≤55 years old with body mass index (BMI) ≥18 and ≤30 at the Screening Visit.
• Individuals who are in good health condition at the time of entry into the trial as determined by medical history, physical examination (including vital signs, electrocardiogram [ECG]) and eligibility screening test (hematology, blood chemistry and urine analysis) and clinical judgment of the investigator at Screening Visit.
• The subject can provide with informed consent and signs and dates a written informed consent form (ICF) prior to the initiation of any trial procedures.
• They must be able to understand and follow trial-related instructions.
• They must be willing and able to comply with planned visits, treatment schedule, laboratory tests and other requirements of the trial.
• Negative in antibodies screening of SARS-CoV-2 (fingerstick).
• Normal in chest computed tomography (CT) scans (no imaging features of COVID-19).
• Axillary temperature ≤ 37.0ºC.
• Negative SARS-CoV-2 test in throat swabs by reverse transcription-polymerase chain reaction (RT-PCR).
• Women of childbearing potential (WOCBP) must have a negative beta-human chorionic gonadotropin (β-hCG) in serum sample at Screening Visit. Women that are postmenopausal (Menopause≥12 consecutive months) or permanently sterilized will be considered as not having reproductive potential.
• WOCBP must have used effective contraception 14 days prior to screening and agree to use effective contraception continuously during the trial period, from 14 days prior to Screening Visit to 60 days after the last immunization.
• WOCBP must agree not to donate eggs (ova, oocytes) for the purposes of assisted reproduction during trial, starting from Screening Visit and continuously until 60 days after being given the last immunization.
• Men who are sexually active with a WOCBP and have not had a vasectomy must agree to practice an effective form of contraception with their female partner of childbearing potential during the trial, starting from Screening Visit and continuously until 60 days after being given the last immunization.
• Men must be willing to refrain from sperm donation, starting from Screening Visit and continuously until 60 days after receiving the last immunization.

For the elderly group (age ≥65 and ≤85)

• Male or female subjects ≥65 years old and ≤85 years old at Screening Visit
• Individuals who are in a health condition that can receive the investigational vaccine, at the time of entry into the trial as determined by medical history, physical examination (including vital signs, ECG) and eligibility screening tests (hematology, biochemistry and urinalysis) and clinical judgment of the investigator at Screening Visit.
• The subject can provide with informed consent and signs and dates a written ICF prior to the initiation of any trial procedures.
• They must be able to understand and follow trial-related instructions.
• They must be willing and able to comply with planned visits, treatment schedule, laboratory tests and other requirements of the trial.
• Negative in antibodies screening of SARS-CoV-2 (blood sample from fingertip).
• No imaging features of COVID-19 in chest CT.
• Axillary temperature ≤ 37.0ºC.
• Negative SARS-CoV-2 test in throat swabs by RT-PCR.
• WOCBP must have a negative serum β-hCG at Screening Visit. Women that are postmenopausal (Menopause ≥12 consecutive months) or permanently sterilized will be considered as not having reproductive potential.
• WOCBP must have used effective contraception 14 days prior to screening and agree to use effective contraception continuously during the trial period, from 14 days prior to Screening Visit to 60 days after the last immunization.
• WOCBP must agree not to donate eggs (ova, oocytes) for the purposes of assisted reproduction during trial, starting from Screening Visit and continuously until 60 days after being given the last immunization.
• Men who are sexually active with a WOCBP and have not had a vasectomy must agree to practice an effective form of contraception with their female partner of childbearing potential during the trial, starting from Screening Visit and continuously until 60 days after being given the last immunization.
• Men must be willing to refrain from sperm donation, starting from Screening Visit and continuously until 60 days after receiving the last immunization.

Exclusion Criteria:

For adult group (age ≥18 and ≤55)

• Have had any acute illness, as determined by the investigator, with or without fever, within 72 hours prior to the prime vaccination. An acute illness which is nearly resolved with only minor residual symptoms remaining is allowable if, in the opinion of the investigator, the residual symptoms will not compromise their well-being if they participate as trial subjects in the trial, or that could prevent, limit, or confound the protocol-specified assessments.
• Are breastfeeding on the day of Screening Visit or who plan to breastfeed during the trial, starting from Screening Visit and continuously until at least 90 days after the last immunization. Women or partners who plan to become pregnant within 1 year post the Screening Visit.
• Have a known allergy, hypersensitivity, or intolerance to the planned vaccine for trial including any excipients.
• Used to have a history of hypersensitivity or serious reactions to vaccination.
• Received any vaccination within 4 weeks prior to Visit 1.
• Don't agree to not be vaccinated during the trial, starting from Screening Visit and continuously until 28 days after receiving the last immunization, except emergency vaccination (e.g. rabies vaccine, tetanus vaccine).
• Had any medical condition (e.g., autoimmune disease) or any major surgery (e.g., requiring general anesthesia) within the past 5 years, which in the opinion of the investigator, could compromise their well-being if they participate as trial subjects in the trial, or that could prevent, limit, or confound the protocol-specified assessments.
• Have any surgery planned during the trial, starting from Screening Visit and continuously until at least 90 days after the last immunization.
• Had any chronic use (more than 14 continuous days) of any systemic medications that affects immune function, including immunosuppressant or other immune-modifying drugs, within 6 months prior to Screening Visit unless in the opinion of the investigator, the medication would not prevent, limit, or confound the protocol-specified assessments or could compromise safety of subjects.
• Had administration of any immunoglobulins and/or any blood products within the 3 months prior to Screening Visit.
• Had administration of another investigational product including vaccines within 60 days or 5 half-lives (whichever is longer), prior to Screening Visit.
• With known history of AIDS or human immunodeficiency virus (HIV) test positive.
• History of hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, through medical inquiry.
• History of SARS, SARS-CoV-2 or middle east respiratory syndrome (MERS) infection. Suspected SARS patients should be screened for SARS antibodies.
• Previously participated in a clinical trial involving lipid nanoparticles.
• Are subject to exclusion periods of other clinical trials or simultaneous participation in another clinical trial.
• Have any affiliation with the study site (e.g., are close relative of the investigator or dependent person, such as an employee or student of the study site).
• Have a history of drug abuse or known medical, psychological, or social conditions within the past 5 years. In the opinion of the investigator, could comprise their well-being if they participate as trial subjects in the trial, or that could prevent, limit, or confound the protocol-specified assessments.
• Have a history of narcolepsy.
• Have history of alcohol abuse or drug addiction within 1 year prior to Screening Visit.
• Have a history of or suspected immunosuppressive condition, acquired or congenital, as determined by medical history and/or physical examination at Screening Visit.
• Have any abnormality or permanent body art (e.g., tattoo), that in the opinion of the investigator, would obstruct the ability to observe local reactions at the vaccination site.
• Have had any blood loss >400 mL, e.g., due to donation of blood or blood products or injury, within the 28 days prior to Screening Visit or plan to donate blood or plasma during the trial, starting from Screening Visit and continuously until at least 28 days after being given the last immunization.
• Travel or live in any country or region with a high SARS-CoV-2 infection risk (as defined at Screening Visit) within the 14 days prior to Screening Visit.
• They plan to visit any country or region with a high SARS-CoV-2 infection risk (as defined at Screening Visit), from Screening Visit until 14 days after being given the last immunization.
• Symptoms of COVID-19, e.g., respiratory symptoms, fever, cough, shortness of breath and breathing difficulties.
• Have had contact with confirmed COVID-19 patients or persons tested positive for SARS-CoV-2 within the 30 days prior to Screening Visit.
• Are vulnerable persons, e.g., soldiers, subjects in detention, contract research organization (CRO) or Fosun staff or their family members.

For the elderly group (age ≥65 and ≤85)

• Baseline laboratory abnormalities with Grade ≥3 (for hematology abnormalities with Grade ≥2) during screening visits, by physical examination and eligibility screening.
• Have had any acute illness, as determined by the investigator, with or without fever, within 72 hours prior to the prime vaccination. An acute illness which is nearly resolved with only minor residual symptoms remaining is allowable if, in the opinion of the investigator, the residual symptoms will not compromise their well-being if they participate as trial subjects in the trial, or that will not prevent, limit, or confound the protocol-specified assessments.
• Have a known allergy, hypersensitivity, or intolerance to the planned vaccine for trial including any excipients.
• Used to have a history of hypersensitivity or serious reactions to vaccination.
• Received any vaccination within 4 weeks prior to Visit 1.
• Don't agree to not be vaccinated during the trial, starting from Screening Visit and continuously until 28 days after receiving the last immunization, except emergency vaccination (e.g. rabies vaccine, tetanus vaccine).
• Had administration of any immunoglobulins and/or any blood products within the 3 months prior to Screening Visit.
• Had any serious or life-threatening medical condition (e.g., autoimmune disease, cardiovascular disease) within the past 5 years, which in the opinion of the investigator, could compromise their well-being if they participate as trial subjects in the trial, or that could prevent, limit, or confound the protocol-specified assessments.
• Have any surgery planned during the trial, starting from Screening Visit and continuously until at least 90 days after the last immunization.
• Had any chronic use (more than 14 continuous days) of any systemic medications that affects immune function, including immunosuppressant or other immune-modifying drugs, within 6 months prior to Screening Visit unless in the opinion of the investigator, the medication would not prevent, limit, or confound the protocol-specified assessments or could compromise safety of subjects.
• Had administration of another investigational product including vaccines within 60 days or 5 half-lives (whichever is longer), prior to Screening Visit.
• With known history of AIDS or HIV test positive.
• History of HBV or HCV infection.
• History of SARS, SARS-CoV-2 or MERS infection. Suspected SARS patients should be screened for SARS antibodies.
• Previously participated in a clinical trial involving lipid nanoparticles.
• Are subject to exclusion periods of other clinical trials or simultaneous participation in another clinical trial.
• Have any affiliation with the study site (e.g., are close relative of the investigator or dependent person, such as an employee or student of the study site).
• Have a history of drug abuse or known medical, psychological, or social conditions within the past 5 years. In the opinion of the investigator, could comprise their well-being if they participate as trial subjects in the trial, or that could prevent, limit, or confound the protocol-specified assessments.
• Have a history of narcolepsy.
• Have history of alcohol abuse or drug addiction within 1 year prior to Screening Visit.
• Have a history of or suspected immunosuppressive condition, acquired or congenital, as determined by medical history and/or physical examination at Screening Visit.
• Have any abnormality or permanent body art (e.g., tattoo), that in the opinion of the investigator, would obstruct the ability to observe local reactions at the vaccination site.
• Have had any blood loss >400 mL, e.g., due to donation of blood or blood products or injury, within the 28 days prior to Screening Visit or plan to donate blood or plasma during the trial, starting from Screening Visit and continuously until at least 28 days after being given the last immunization.
• Travel or live in any country or region with a high SARS-CoV-2 infection risk (as defined at Screening Visit) within the 14 days prior to Screening Visit.
• They plan to visit any country or region with a high SARS-CoV-2 infection risk (as defined at Screening Visit), from Screening Visit until 14 days after being given the last immunization.
• Symptoms of COVID-19, e.g., respiratory symptoms, fever, cough, shortness of breath and breathing difficulties.
• Have had contact with confirmed COVID-19 patients or persons tested positive for SARS-CoV-2 nucleic acids or antibodies within the 30 days prior to Screening Visit.
• Are vulnerable persons, e.g., soldiers, subjects in detention, CRO or Fosun staff or their family members.

From Day 1 (Dose 1) up to last visit (approximately 12 months after first dose)

Treatment-emergent AEs (TEAEs) are presented, including solicited and unsolicited AEs.

An TEAE is defined as any AE with an onset date on or after the first dose (if the AE was absent before the first dose) or worsened after the first dose (if the AE was present before the first dose). AEs with an onset date more than 28 days after the last dose will be considered as treatment emergent only if assessed as related to the vaccine (BNT162b1 or placebo) by the investigator.