Fig. 1: Study design and trial profile.

Twenty-three individuals completed a homologous primary immunization with two vaccinations (Day (D) 0 (D0) and D28) of either 1 × 107 plaque-forming units (PFU) (low dose (LD), blue) or 1 × 108 PFU MVA-MERS-S (high dose (HD), red), and were followed-up for 180 days, which concluded this part of the study (End of Study). Participants were invited to return for an additional third vaccination as a booster 1 year ±4 months after prime. 10 participants (3 from the LD, 7 from the HD group) were re-enrolled and received a dose of 1 × 108 PFU MVA-MERS-S. Safety and tolerability were assessed on Boost (B) Days (B:D) 0 (B:D0, baseline), B:D1, B:D3 (not depicted), B:D7, B:D14, and B:D28; humoral immunogenicity was assessed on B:D0, B:D7, B:D14, and B:D28 (End of Study). All 10 participants completed the extension trial and were included in the analyses. Created with BioRender.com.