Mucosal immunization with a delta-inulin adjuvanted recombinant spike vaccine elicits lung-resident immune memory and protects mice against SARS-CoV-2

Multiple SARS-CoV-2 vaccine candidates have been approved for use and have had a major impact on the COVID-19 pandemic. There
remains, however, a significant need for vaccines that are safe, easily transportable and protective against infection, as well as disease.
Mucosal vaccination is favored for its ability to induce immune memory at the site of infection, making it appealing for SARS-CoV-2
vaccine strategies. In this study we performed in-depth analysis of the immune responses in mice to a subunit recombinant spike
protein vaccine formulated with the delta-inulin adjuvant Advax when administered intratracheally (IT), versus intramuscular delivery
(IM). Both routes produced robust neutralizing antibody titers (NAb) and generated sterilizing immunity against SARS-CoV-2. IT
delivery, however, produced significantly higher systemic and lung-local NAb that resisted waning up to six months post vaccination,
and only IT delivery generated inducible bronchus-associated lymphoid tissue (iBALT), a site of lymphocyte antigen presentation and
proliferation. This was coupled with robust and long-lasting lung tissue-resident memory CD4+ and CD8+ T cells that were not
observed in IM-vaccinated mice. This study provides a detailed view of the lung-resident cellular response to IT vaccination against
SARS-CoV-2 and demonstrates the importance of delivery site selection in the development of vaccine candidates.