1
|
Rouvinski A, Friedman A, Kirillov S, Attal JH, Kumari S, Fahoum J, Wiener R, Magen S, Plotkin Y, Chemtob D, Bercovier H. Antibody response in elderly vaccinated four times with an mRNA anti-COVID-19 vaccine. Sci Rep 2023; 13:14165. [PMID: 37644113 PMCID: PMC10465611 DOI: 10.1038/s41598-023-41399-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023] Open
Abstract
The humoral response after the fourth dose of a mRNA vaccine against COVID-19 has not been adequately described in elderly recipients, particularly those not exposed previously to SARS-CoV-2. Serum anti-RBD IgG levels (Abbott SARS-CoV-2 IgG II Quant assay) and neutralizing capacities (spike SARS-CoV-2 pseudovirus Wuhan and Omicron BA.1 variant) were measured after the third and fourth doses of a COVID-19 mRNA vaccine among 46 elderly residents (median age 85 years [IQR 81; 89]) of an assisted living facility. Among participants never infected by SARS-CoV-2, the mean serum IgG levels against RBD (2025 BAU/ml), 99 days after the fourth vaccine, was as high as 76 days after the third vaccine (1987 BAU/ml), and significantly higher (p = 0.030) when the latter were corrected for elapsed time. Neutralizing antibody levels against the historical Wuhan strain were significantly higher (Mean 1046 vs 1573; p = 0.002) and broader (against Omicron) (Mean 170 vs 375; p = 0.018), following the fourth vaccine. The six individuals with an Omicron breakthrough infection mounted strong immune responses for anti-RBD and neutralizing antibodies against the Omicron variant indicating that the fourth vaccine dose did not prevent a specific adaptation of the immune response. These findings point out the value of continued vaccine boosting in the elderly population.
Collapse
Affiliation(s)
- Alexander Rouvinski
- Department of Microbiology and Molecular Genetics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Ahuva Friedman
- Department of Microbiology and Molecular Genetics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Saveliy Kirillov
- Department of Microbiology and Molecular Genetics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of General Biology and Genomics, L.N. Gumilyov Eurasian National University, Astana, Kazakhstan
| | - Jordan Hannink Attal
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Tuberculosis and AIDS, State of Israel Ministry of Health, Jerusalem, Israel
| | - Sujata Kumari
- Department of Microbiology and Molecular Genetics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jamal Fahoum
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Reuven Wiener
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sophie Magen
- Department of Clinical Biochemistry, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Yevgeni Plotkin
- Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel Chemtob
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Tuberculosis and AIDS, State of Israel Ministry of Health, Jerusalem, Israel
| | - Herve Bercovier
- Department of Microbiology and Molecular Genetics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
2
|
Axfors C, Pezzullo AM, Contopoulos-Ioannidis DG, Apostolatos A, Ioannidis JPA. Differential COVID-19 infection rates in children, adults, and elderly: Systematic review and meta-analysis of 38 pre-vaccination national seroprevalence studies. J Glob Health 2023; 13:06004. [PMID: 36655924 PMCID: PMC9850866 DOI: 10.7189/jogh.13.06004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Debate exists about whether extra protection of elderly and other vulnerable individuals is feasible in COVID-19. We aimed to assess the relative infection rates in the elderly vs the non-elderly and, secondarily, in children vs adults. Methods We performed a systematic review and meta-analysis of seroprevalence studies conducted in the pre-vaccination era. We identified representative national studies without high risk of bias through SeroTracker and PubMed searches (last updated May 17, 2022). We noted seroprevalence estimates for children, non-elderly adults, and elderly adults, using cut-offs of 20 and 60 years (or as close to these ages, if they were unavailable) and compared them between different age groups. Results We included 38 national seroprevalence studies from 36 different countries comprising 826 963 participants. Twenty-six of these studies also included pediatric populations and twenty-five were from high-income countries. The median ratio of seroprevalence in elderly vs non-elderly adults (or non-elderly in general, if pediatric and adult population data were not offered separately) was 0.90-0.95 in different analyses, with large variability across studies. In five studies (all in high-income countries), we observed significant protection of the elderly with a ratio of <0.40, with a median of 0.83 in high-income countries and 1.02 elsewhere. The median ratio of seroprevalence in children vs adults was 0.89 and only one study showed a significant ratio of <0.40. The main limitation of our study is the inaccuracies and biases in seroprevalence studies. Conclusions Precision shielding of elderly community-dwelling populations before the availability of vaccines was indicated in some high-income countries, but most countries failed to achieve any substantial focused protection. Registration Open Science Framework (available at: https://osf.io/xvupr).
Collapse
Affiliation(s)
- Cathrine Axfors
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA,Department for Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Angelo Maria Pezzullo
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA,Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Despina G Contopoulos-Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA,Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Alexandre Apostolatos
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - John PA Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA,Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, Stanford University, Stanford, California, USA
| |
Collapse
|
3
|
Neutralizing Antibody Responses Among Residents and Staff of Long-Term Care Facilities in the State of New Jersey During the First Wave of the COVID-19 Pandemic. J Community Health 2023; 48:50-58. [PMID: 36197535 PMCID: PMC9532818 DOI: 10.1007/s10900-022-01142-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2022] [Indexed: 10/24/2022]
Abstract
Expanding a previous study of the immune response to SARS-CoV-2 in 10 New Jersey long-term care facilities (LTCFs) during the first wave of the pandemic, this study characterized the neutralizing antibody (NAb) response to infection and vaccination among residents and staff. Sera from the original study were tested using the semi-quantitative enzyme-linked immunosorbent cPass neutralization-antibody detection assay. Almost all residents (97.8%) and staff (98.1%) who were positive for IgG S antibody to the spike protein were positive for NAb. In non-vaccinated subjects with a history of infection (positive polymerase chain reaction (PCR) or antigen test), the distribution of mean intervals from infection to serology date was not significantly different for S antibody positives versus negatives. More than 80% of both were positive at 10 months. Similarly, the mean NAb titer for residents and staff was not associated with interval from PCR/antigen positive to serology date, F = 0.1.01, Pr > F = 0.4269 and F = 0.77, Pr > F = 0.6548 respectively. Titers remained high as the interval reached 10 months. In vaccinees who had no history of infection, the NAb titer was near the test maximum when the serum was drawn seven or more days after the second vaccine dose. In staff the mean NAb titer increased significantly as the vaccine number increased from one to two doses, F = 11.69, Pr > F < 0.0001. NAb titers to SARS-CoV-2 in residents and staff of LTCFs were consistently high 10 months after infection and after two doses of vaccine. Ongoing study is needed to determine whether this antibody provides protection as the virus continues to mutate.
Collapse
|