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Porru S, Monaco MGL, Spiteri G, Carta A, Caliskan G, Violán C, Torán-Monserrat P, Vimercati L, Tafuri S, Boffetta P, Violante FS, Sala E, Sansone E, Gobba F, Casolari L, Wieser A, Janke C, Tardon A, Rodriguez-Suarez MM, Liviero F, Scapellato ML, dell'Omo M, Murgia N, Mates D, Calota VC, Strhársky J, Mrázová M, Pira E, Godono A, Magnano GC, Negro C, Verlato G. Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project. J Epidemiol Glob Health 2023; 13:577-588. [PMID: 37480426 PMCID: PMC10468456 DOI: 10.1007/s44197-023-00139-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/05/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. METHODS Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose. RESULTS 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days. CONCLUSIONS The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy.
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
| | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| | - Concepción Violán
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana Nord, Mare de Déu de Guadalupe 2, Planta 1ª, Mataro, 08303, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, S/N, Badalona, 08916, Barcelona, Spain
| | - Pere Torán-Monserrat
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana Nord, Mare de Déu de Guadalupe 2, Planta 1ª, Mataro, 08303, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, S/N, Badalona, 08916, Barcelona, Spain
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124, Bari, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25123, Brescia, Italy
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123, Brescia, Italy
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Loretta Casolari
- Health Surveillance Service, University Hospital of Modena, 41125, Modena, Italy
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site , 81377, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799, Munich, Germany
- Max Von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 80336, Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Adonina Tardon
- University of Oviedo, Health Research Institute of Asturias (ISPA) and CIBERESP, Asturias, Spain
| | | | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padua, Italy
- University Hospital of Padova, 35128, Padua, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padua, Italy
- University Hospital of Padova, 35128, Padua, Italy
| | - Marco dell'Omo
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123, Perugia, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121, Ferrara, Italy
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Jozef Strhársky
- Medical Microbiology Department, Regional Authority of Public Health, 97556, Banská Bystrica, Slovakia
| | - Mariana Mrázová
- Public Health Institute, St. Elizabeth University of Health and Social Work, 81106, Bratislava, Slovakia
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Torino, 10126, Turin, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Torino, 10126, Turin, Italy
| | - Greta Camilla Magnano
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Corrado Negro
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
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Meister T, Kolde A, Fischer K, Pisarev H, Kolde R, Kalda R, Suija K, Tisler A, Uusküla A. A retrospective cohort study of incidence and risk factors for severe SARS-CoV-2 breakthrough infection among fully vaccinated people. Sci Rep 2023; 13:8531. [PMID: 37237050 DOI: 10.1038/s41598-023-35591-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
SARS-CoV-2 vaccination is currently the mainstay in combating the COVID-19 pandemic. However, there are still people among vaccinated individuals suffering from severe forms of the disease. We conducted a retrospective cohort study based on data from nationwide e-health databases. The study included 184,132 individuals who were SARS-CoV-2 infection-naive and had received at least a primary series of COVID-19 vaccination. The incidence of BTI (breakthrough infection) was 8.03 (95% CI [confidence interval] 7.95⎼8.13/10,000 person-days), and for severe COVID-19 it was 0.093 (95% CI 0.084⎼ 0.104/10,000 person-days). The protective effect of vaccination against severe COVID-19 remained constant for up to six months, and the booster dose offered an additional pronounced benefit (hospitalization aHR 0.32, 95% CI 0.19⎼0.54). The risk of severe COVID-19 was higher among those ≥ 50 years of age (aHR [adjusted hazard ratio] 2.06, 95% CI 1.25⎼3.42) and increased constantly with every decade of life. Male sex (aHR 1.32, 95% CI 1.16⎼1.45), CCI (The Charlson Comorbidity Index) score ≥ 1 (aHR 2.09, 95% CI 1.54⎼2.83), and a range of comorbidities were associated with an increased risk of COVID-19 hospitalization. There are identifiable subgroups of COVID-19-vaccinated individuals at high risk of hospitalization due to SARS-CoV-2 infection. This information is crucial to driving vaccination programs and planning treatment strategies.
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Affiliation(s)
- Tatjana Meister
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia.
| | - Anastassia Kolde
- Institute of Mathematics and Statistics, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
- Institute of Genomics, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
| | - Krista Fischer
- Institute of Mathematics and Statistics, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
- Institute of Genomics, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
| | - Heti Pisarev
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Raivo Kolde
- Institute of Computer Science, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
| | - Ruth Kalda
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Kadri Suija
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Anna Tisler
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Anneli Uusküla
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
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Madsen JR, Holm BE, Pérez-Alós L, Bayarri-Olmos R, Rosbjerg A, Fogh K, Pries-Heje MM, Møller DL, Hansen CB, Heftdal LD, Hasselbalch RB, Hamm SR, Frikke-Schmidt R, Hilsted L, Nielsen SD, Iversen KK, Bundgaard H, Garred P. Short-Lived Antibody-Mediated Saliva Immunity against SARS-CoV-2 after Vaccination. Microbiol Spectr 2023; 11:e0494722. [PMID: 36877077 PMCID: PMC10101069 DOI: 10.1128/spectrum.04947-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/09/2023] [Indexed: 03/07/2023] Open
Abstract
Knowledge about the effect of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on immunity reflected in the saliva is sparse. We examined the antibody response in saliva compared to that in serum 2 and 6 months after the first vaccination with the BNT162b2 vaccine. Four hundred fifty-nine health care professionals were included in a prospective observational study measuring antibody levels in saliva and corresponding serum samples at 2 and 6 months after BNT162b2 vaccination. Vaccinated, previously SARS-CoV-2-infected individuals (hybrid immunity) had higher IgG levels in saliva at 2 months than vaccinated, infection-naive individuals (P < 0.001). After 6 months, saliva IgG levels declined in both groups (P < 0.001), with no difference between groups (P = 0.37). Furthermore, serum IgG levels declined from 2 to 6 months in both groups (P < 0.001). IgG antibodies in saliva and serum correlated in individuals with hybrid immunity at 2 and 6 months (ρ = 0.58, P = 0.001, and ρ = 0.53, P = 0.052, respectively). In vaccinated, infection-naive individuals, a correlation was observed at 2 months (ρ = 0.42, P < 0.001) but not after 6 months (ρ = 0.14, P = 0.055). IgA and IgM antibodies were hardly detectable in saliva at any time point, regardless of previous infection. In serum, IgA was detected at 2 months in previously infected individuals. BNT162b2 vaccination induced a detectable IgG anti-SARS-CoV-2 RBD response in saliva at both 2 and 6 months after vaccination, being more prominent in previously infected than infection-naive individuals. However, a significant decrease in salivary IgG was observed after 6 months, suggesting a rapid decline in antibody-mediated saliva immunity against SARS-CoV-2, after both infection and systemic vaccination. IMPORTANCE Knowledge about the persistence of salivary immunity after SARS-CoV-2 vaccination is limited, and information on this topic could prove important for vaccine strategy and development. We hypothesized that salivary immunity would wane rapidly after vaccination. We measured anti-SARS-CoV-2 IgG, IgA, and IgM concentrations in saliva and serum in both previously infected and infection-naive individuals, 2 and 6 months after first vaccination with BNT162b2, in 459 hospital employees from Copenhagen University Hospital. We observed that IgG was the primary salivary antibody 2 months after vaccination in both previously infected and infection-naive individuals, but dropped significantly after 6 months. Neither IgA nor IgM was detectable in saliva at either time point. Findings indicate that salivary immunity against SARS-CoV-2 rapidly declines following vaccination in both previously infected and infection-naive individuals. We believe this study shines a light on the workings of salivary immunity after SARS-CoV-2 infection, which could prove relevant for vaccine development.
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Affiliation(s)
- Johannes Roth Madsen
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bettina Eide Holm
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Laura Pérez-Alós
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Rafael Bayarri-Olmos
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Rosbjerg
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kamille Fogh
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Emergency Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mia Marie Pries-Heje
- The Heart Center, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Dina Leth Møller
- Viro-immunology Research Unit, Department of Infectious Diseases, Section 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Cecilie Bo Hansen
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Line Dam Heftdal
- Viro-immunology Research Unit, Department of Infectious Diseases, Section 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Haematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Bo Hasselbalch
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Emergency Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sebastian Rask Hamm
- Viro-immunology Research Unit, Department of Infectious Diseases, Section 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Linda Hilsted
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Viro-immunology Research Unit, Department of Infectious Diseases, Section 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Karmark Iversen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Emergency Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- The Heart Center, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Time-Varying Effect of Hybrid Immunity on the Risk of Breakthrough Infection after Booster Dose of mRNA COVID-19 Vaccine: The MOSAICO Study. Vaccines (Basel) 2022; 10:vaccines10081353. [PMID: 36016240 PMCID: PMC9413553 DOI: 10.3390/vaccines10081353] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
This longitudinal observational study investigated the risk of breakthrough SARS-CoV-2 infection up to 6 months after a booster dose of an mRNA COVID-19 vaccine in infection-naïve vs. previously infected healthcare workers (HCWs), and whether this difference varied over time. A Cox proportional hazard regression model with Aalen’s additive analysis was fitted to examine the association between the risk of infections and predictor variables. Overall, we observed an incidence rate of 2.5 cases per 1000 person-days (95% confidence interval [CI] 2.0–3.0), which dropped at 0.8 per 1000 person-days (95% CI 0.3–2.0) in recipients with prior SARS-CoV-2 infection. The fitted analysis indicated an adjusted hazard ratio of 0.32 (95% CI 0.13–0.80; p-value = 0.01) for those with hybrid immunity with a slope that became steeply negative roughly starting from day 90. No difference was seen according to participants’ smoking habits. Characteristics of infected HCWs were also described. Our study quantifies the time-varying effects of vaccine-induced and hybrid immunity after the booster dose (during the Omicron variant predominance in Italy) and observed that the protection waned more rapidly in infection-naïve recipients starting from the third month. The results add important evidence that can be used to inform COVID-19 vaccination strategies.
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Cohen MJ, Oster Y, Moses AE, Spitzer A, Benenson S. Association of Receiving a Fourth Dose of the BNT162b Vaccine With SARS-CoV-2 Infection Among Health Care Workers in Israel. JAMA Netw Open 2022; 5:e2224657. [PMID: 35917125 PMCID: PMC9346545 DOI: 10.1001/jamanetworkopen.2022.24657] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
IMPORTANCE Despite the high 3-dose vaccination rate among health care workers (HCWs) in Israel, a high rate of SARS-CoV-2 breakthrough infections in this group was observed during the Omicron wave. As a result, the Israeli Ministry of Health decided to recommend a fourth vaccine dose to medical staff. OBJECTIVE To evaluate the benefit of a fourth BNT162b2 vaccine dose on the breakthrough infection rate among HCWs. DESIGN, SETTING, AND PARTICIPANTS This multicenter cohort study was performed in January 2022, the first month of the 4-dose vaccination campaign, during a surge of the Omicron variant wave. All health care workers at 11 general hospitals in Israel who had been vaccinated with 3 doses up to September 30, 2021, and had not contracted COVID-19 before the vaccination campaign were included. EXPOSURES Vaccination with a fourth dose of the BNT162b2 vaccine during January 2022. MAIN OUTCOMES AND MEASURES Breakthrough COVID-19 infections in 4-dose recipients vs 3-dose recipients measured by a polymerase chain reaction test result positive for SARS-CoV-2. Health care workers were tested based on symptoms or exposure. RESULTS A total of 29 611 Israeli HCWs (19 381 [65%] female; mean [SD] age, 44 [12] years) had received 3 vaccine doses between August and September 2021; of these, 5331 (18%) received the fourth dose in January 2022 and were not infected by the first week after vaccination. Overall breakthrough infection rates were 368 of 5331 (7%) in the 4-dose group and 4802 of 24280 (20%) in the 3-dose group (relative risk, 0.35; 95% CI, 0.32-0.39). Similar reductions were found in a matched analysis by the exact day of receiving the third vaccine (relative risk, 0.61; 95% CI, 0.54-0.71) and in a time-dependent Cox proportional hazards regression model (adjusted hazard ratio, 0.56; 95% CI, 0.50-0.63). In both groups, no severe disease or death occurred. CONCLUSIONS AND RELEVANCE In this cohort study, the fourth BNT162b2 vaccine dose resulted in a reduced breakthrough infection rate among hospital staff. This reduction was lower than that observed after the third dose; nevertheless, considering the high infectivity of the Omicron variant, which led to critical medical staff shortages, a fourth vaccine dose should be considered to mitigate the infection rate among HCWs.
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Affiliation(s)
| | - Yonatan Oster
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Allon E. Moses
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Avishay Spitzer
- Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shmuel Benenson
- Unit for Infection Prevention and Control, Shaare-Zedek Medical Center, Jerusalem, Israel
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Second Booster BNT162b2 Restores SARS-CoV-2 Humoral Response in Patients With Multiple Myeloma, Excluding Those Under Anti-BCMA Therapy. Hemasphere 2022; 6:e764. [PMID: 35928542 PMCID: PMC9345642 DOI: 10.1097/hs9.0000000000000764] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/08/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 vaccination leads to a less intense humoral response in patients with multiple myeloma (MM) compared with healthy individuals, whereas the SARS-CoV-2-specific immunity fades over time. The purpose of this study was to explore the kinetics of SARS-CoV-2 neutralizing antibodies (NAbs) in patients with MM after vaccination with the BNT162b2 mRNA vaccine, focusing on their response before (B4D) and at 1 month after the fourth vaccination (M1P4D). Overall, 201 patients with a median age of 67 years were included, whereas 114 (56.7%) were men. The median NAbs levels B4D were 80.0% (±3.5%) and at M1P4D they increased to a median value of 96.1% (±3.7%). The NAb values at M1P4D were similar to those at 1 month post the third dose and superior to all previous timepoints. At M1P4D, the NAbs levels of all the treatment groups increased, apart from the anti-BCMA group. A significant increase in median NAbs values was observed for those receiving CD38-based treatment (n = 43, from 71.0% B4D to 96.0% at M1P4D) and those who did not receive CD38- or BCMA-targeted therapy (n = 137, from 89.6% B4D to 96.3% at M1P4D). Regarding the patients under BCMA-based therapy (n = 21), there was no remarkable increase in NAbs values following the second booster shot (from 3.0% B4D to 4.0% at M1P4D). In conclusion, booster vaccination with the BNT162b2 results in a substantially improved humoral response against SARS-CoV-2 in patients with MM. Anti-BCMA treatment remains an adverse predictive factor for NAbs response; thus, tailored prevention measures should be considered for this patient subgroup.
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7
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Porru S, Monaco MGL, Spiteri G, Carta A, Pezzani MD, Lippi G, Gibellini D, Tacconelli E, Dalla Vecchia I, Sala E, Sansone E, De Palma G, Bonfanti C, Lombardo M, Terlenghi L, Pira E, Mansour I, Coggiola M, Ciocan C, Godono A, Tardon A, Rodriguez-Suarez MM, Fernandez-Tardon G, Jimeno-Demuth FJ, Castro-Delgado RV, Iglesias Cabo T, Scapellato ML, Liviero F, Moretto A, Mason P, Pavanello S, Volpin A, Vimercati L, Tafuri S, De Maria L, Sponselli S, Stefanizzi P, Caputi A, Gobba F, Modenese A, Casolari L, Garavini D, D’Elia C, Mariani S, Filon FL, Cegolon L, Negro C, Ronchese F, Rui F, De Michieli P, Murgia N, Dell’Omo M, Muzi G, Fiordi T, Gambelunghe A, Folletti I, Mates D, Calota VC, Neamtu A, Perseca O, Staicu CA, Voinoiu A, Fabiánová E, Bérešová J, Adamčáková ZK, Nedela R, Lesňáková A, Holčíková J, Boffetta P, Abedini M, Ditano G, Asafo SS, Visci G, Violante FS, Zunarelli C, Verlato G. SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers. Vaccines (Basel) 2022; 10:vaccines10081193. [PMID: 36016081 PMCID: PMC9415790 DOI: 10.3390/vaccines10081193] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 12/23/2022] Open
Abstract
Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
- Correspondence: ; Tel.: +39-0458124294
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (M.G.L.M.); (G.S.)
| | - Maria Diletta Pezzani
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy; (M.D.P.); (E.T.)
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Davide Gibellini
- Section of Microbiology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Evelina Tacconelli
- Infectious Diseases Unit, University Hospital of Verona, 37134 Verona, Italy; (M.D.P.); (E.T.)
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Ilaria Dalla Vecchia
- Section of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy; (E.S.); (G.D.P.)
| | - Emanuele Sansone
- Unit of Occupational Health and Industrial Hygiene, Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy;
| | - Giuseppe De Palma
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25121 Brescia, Italy; (E.S.); (G.D.P.)
- Unit of Occupational Health and Industrial Hygiene, Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy;
| | - Carlo Bonfanti
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy; (C.B.); (L.T.)
| | - Massimo Lombardo
- Chief Executive Office, ASST Spedali Civili di Brescia, 25121 Brescia, Italy;
| | - Luigina Terlenghi
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia-ASST Spedali Civili, 25121 Brescia, Italy; (C.B.); (L.T.)
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Ihab Mansour
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
| | - Maurizio Coggiola
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Catalina Ciocan
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
- Occupational Medicine Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, Italy;
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (E.P.); (I.M.); (C.C.); (A.G.)
| | - Adonina Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Marta-Maria Rodriguez-Suarez
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Guillermo Fernandez-Tardon
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Francisco-Jose Jimeno-Demuth
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Rafael-Vicente Castro-Delgado
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Tania Iglesias Cabo
- Health Research Institute of Asturias (ISPA), CIBERESP and Public Health Department of the University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain; (A.T.); (M.-M.R.-S.); (G.F.-T.); (F.-J.J.-D.); (R.-V.C.-D.); (T.I.C.)
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy; (M.L.S.); (F.L.); (A.M.); (P.M.); (S.P.)
- University Hospital of Padova, 35128 Padova, Italy;
| | - Anna Volpin
- University Hospital of Padova, 35128 Padova, Italy;
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.V.); (S.T.); (L.D.M.); (S.S.); (P.S.); (A.C.)
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.G.); (A.M.)
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41125 Modena, Italy; (F.G.); (A.M.)
| | - Loretta Casolari
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Denise Garavini
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Cristiana D’Elia
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Stefania Mariani
- Health Surveillance Service, University Hospital of Modena, 41125 Modena, Italy; (L.C.); (D.G.); (C.D.); (S.M.)
| | - Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Luca Cegolon
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Corrado Negro
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Federico Ronchese
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Francesca Rui
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Paola De Michieli
- Unit of Occupational Medicine, Department of Medical Science, University of Trieste, 34149 Trieste, Italy; (F.L.F.); or (L.C.); (C.N.); (F.R.); (F.R.); (P.D.M.)
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Marco Dell’Omo
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Giacomo Muzi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Tiziana Fiordi
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Angela Gambelunghe
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Ilenia Folletti
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (N.M.); (M.D.); (G.M.); (T.F.); (A.G.); (I.F.)
| | - Dana Mates
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Violeta Claudia Calota
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Andra Neamtu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Ovidiu Perseca
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Catalin Alexandru Staicu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Angelica Voinoiu
- National Institute of Public Health, 050463 Bucharest, Romania; (D.M.); (V.C.C.); (A.N.); (O.P.); (C.A.S.); (A.V.)
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Jana Bérešová
- Epidemiology Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Zora Kľocová Adamčáková
- Health Promotion Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Roman Nedela
- Health Informatics Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia;
| | - Anna Lesňáková
- Infectology Clinic, Central Military Hospital, 03426 Ružomberok, Slovakia;
| | - Jana Holčíková
- Occupational Medicine Clinic, University Hospital, 83105 Bratislava, Slovakia;
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Shuffield Seyram Asafo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
- IRCCS, Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (P.B.); (M.A.); (G.D.); (S.S.A.); (G.V.); (F.S.V.); (C.Z.)
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
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8
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Zurac S, Vladan C, Dinca O, Constantin C, Neagu M. Immunogenicity evaluation after BNT162b2 booster vaccination in healthcare workers. Sci Rep 2022; 12:12716. [PMID: 35882871 PMCID: PMC9321272 DOI: 10.1038/s41598-022-16759-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/14/2022] [Indexed: 12/21/2022] Open
Abstract
Waning of the immune response upon vaccination in SARS-CoV-2 infection is an important subject of evaluation in this pandemic, mostly in healthcare workers (HCW) that are constantly in contact with infected samples and patients. Therefore, our study aimed to establish the specific humoral response of specific IgG and IgA antibodies upon vaccination, during the second year of pandemic and evaluating the booster shot with the same vaccine type. A group of 103 HCW with documented exposure to the virus were monitored for specific IgG and IgA levels prior to vaccination, after the first vaccination round, during the following 8 months and after the booster shot with the same vaccine type. After 8 months post-vaccination the humoral response in both IgG and IgA decreased, 2.4 times for IgG, and 2.7 times for IgA. Although the antibodies levels significantly decreased, no documented infection was registered in the group. After the booster shot, the entire group, displayed IgG increased levels, immediately after booster followed by the increase in specific IgA. IgG levels post-second round of vaccination are statistically higher compared to the first round, while IgA is restored at the same levels. Within the vaccination or booster routine for a multiple waves' pandemic that is generating new virus variants, populational immunity remains an important issue for future implementation of prevention/control measures.
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Affiliation(s)
- Sabina Zurac
- Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pathology, Colentina Clinical Hospital, Bucharest, Romania
| | - Cristian Vladan
- Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Prof. Dr. Dan Theodorescu" Clinical Hospital for Oro-Maxillo-Facial Surgery, Bucharest, Romania
| | - Octavian Dinca
- Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- "Prof. Dr. Dan Theodorescu" Clinical Hospital for Oro-Maxillo-Facial Surgery, Bucharest, Romania
| | - Carolina Constantin
- Department of Pathology, Colentina Clinical Hospital, Bucharest, Romania.
- Department of Immunology, Victor Babes National Institute of Pathology, Bucharest, Romania.
| | - Monica Neagu
- Department of Pathology, Colentina Clinical Hospital, Bucharest, Romania
- "Prof. Dr. Dan Theodorescu" Clinical Hospital for Oro-Maxillo-Facial Surgery, Bucharest, Romania
- Doctoral School, Faculty of Biology, University of Bucharest, Bucharest, Romania
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9
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Kawasuji H, Morinaga Y, Tani H, Saga Y, Kaneda M, Murai Y, Ueno A, Miyajima Y, Fukui Y, Nagaoka K, Ono C, Matsuura Y, Niimi H, Yamamoto Y. Effectiveness of the third dose of BNT162b2 vaccine on neutralizing Omicron variant in the Japanese population. J Infect Chemother 2022; 28:1273-1278. [PMID: 35691864 PMCID: PMC9186405 DOI: 10.1016/j.jiac.2022.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/25/2022] [Accepted: 05/16/2022] [Indexed: 11/26/2022]
Abstract
Introduction The vaccine against SARS-CoV-2 provides humoral immunity to fight COVID-19; however, the acquired immunity gradually declines. Booster vaccination restores reduced humoral immunity; however, its effect on newly emerging variants, such as the Omicron variant, is a concern. As the waves of COVID-19 cases and vaccine programs differ between countries, it is necessary to know the domestic effect of the booster. Methods Serum samples were obtained from healthcare workers (20–69 years old) in the Pfizer BNT162b2 vaccine program at the Toyama University Hospital 6 months after the second dose (6mA2D, n = 648) and 2 weeks after the third dose (2wA3D, n = 565). The anti-SARS-CoV-2 antibody level was measured, and neutralization against the wild-type and variants (Delta and Omicron) was evaluated using pseudotyped viruses. Data on booster-related events were collected using questionnaires. Results The median anti-SARS-CoV-2 antibody was >30.9-fold elevated after the booster (6mA2D, 710.0 U/mL [interquartile range (IQR): 443.0–1068.0 U/mL]; 2wA3D, 21927 U/mL [IQR: 15321.0–>25000.0 U/mL]). Median neutralizing activity using 100-fold sera against wild-type-, Delta-, and Omicron-derived variants was elevated from 84.6%, 36.2%, and 31.2% at 6mA2D to >99.9%, 99.1%, and 94.6% at 2wA3D, respectively. The anti-SARS-CoV-2 antibody levels were significantly elevated in individuals with fever ≥37.5 °C, general fatigue, and myalgia, local swelling, and local hardness. Conclusion The booster effect, especially against the Omicron variant, was observed in the Japanese population. These findings contribute to the precise understanding of the efficacy and side effects of the booster and the promotion of vaccine campaigns.
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Affiliation(s)
- Hitoshi Kawasuji
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yoshitomo Morinaga
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan; Clinical and Research Center for Infectious Diseases, Toyama University Hospital, Toyama, Japan.
| | - Hideki Tani
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan; Department of Virology, Toyama Institute of Health, Toyama, Japan
| | - Yumiko Saga
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan; Department of Virology, Toyama Institute of Health, Toyama, Japan
| | - Makito Kaneda
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yushi Murai
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Akitoshi Ueno
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yuki Miyajima
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yasutaka Fukui
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Kentaro Nagaoka
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan; Clinical and Research Center for Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Chikako Ono
- Laboratory of Virus Control, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan; Laboratory of Virus Control, Research Institute for Microbial Diseases (RIMD), Osaka University, Osaka, Japan
| | - Yoshiharu Matsuura
- Laboratory of Virus Control, Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan; Laboratory of Virus Control, Research Institute for Microbial Diseases (RIMD), Osaka University, Osaka, Japan
| | - Hideki Niimi
- Clinical and Research Center for Infectious Diseases, Toyama University Hospital, Toyama, Japan; Department of Clinical Laboratory and Molecular Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan; Clinical and Research Center for Infectious Diseases, Toyama University Hospital, Toyama, Japan
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10
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Calcoen B, Callewaert N, Vandenbulcke A, Kerstens W, Imbrechts M, Vercruysse T, Dallmeier K, Van Weyenbergh J, Maes P, Bossuyt X, Zapf D, Dieckmann K, Callebaut K, Thibaut HJ, Vanhoorelbeke K, De Meyer SF, Maes W, Geukens N. High Incidence of SARS-CoV-2 Variant of Concern Breakthrough Infections Despite Residual Humoral and Cellular Immunity Induced by BNT162b2 Vaccination in Healthcare Workers: A Long-Term Follow-Up Study in Belgium. Viruses 2022; 14:1257. [PMID: 35746728 PMCID: PMC9228150 DOI: 10.3390/v14061257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022] Open
Abstract
To mitigate the massive COVID-19 burden caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several vaccination campaigns were initiated. We performed a single-center observational trial to monitor the mid- (3 months) and long-term (10 months) adaptive immune response and to document breakthrough infections (BTI) in healthcare workers (n = 84) upon BNT162b2 vaccination in a real-world setting. Firstly, serology was determined through immunoassays. Secondly, antibody functionality was analyzed via in vitro binding inhibition and pseudovirus neutralization and circulating receptor-binding domain (RBD)-specific B cells were assessed. Moreover, the induction of SARS-CoV-2-specific T cells was investigated by an interferon-γ release assay combined with flowcytometric profiling of activated CD4+ and CD8+ T cells. Within individuals that did not experience BTI (n = 62), vaccine-induced humoral and cellular immune responses were not correlated. Interestingly, waning over time was more pronounced within humoral compared to cellular immunity. In particular, 45 of these 62 subjects no longer displayed functional neutralization against the delta variant of concern (VoC) at long-term follow-up. Noteworthily, we reported a high incidence of symptomatic BTI cases (17.11%) caused by alpha and delta VoCs, although vaccine-induced immunity was only slightly reduced compared to subjects without BTI at mid-term follow-up.
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Affiliation(s)
- Bas Calcoen
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, 8500 Kortrijk, Belgium; (B.C.); (A.V.); (K.V.); (S.F.D.M.)
| | - Nico Callewaert
- AZ Groeninge Hospital, Department of Laboratory Medicine, 8500 Kortrijk, Belgium; (K.C.); (N.C.)
| | - Aline Vandenbulcke
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, 8500 Kortrijk, Belgium; (B.C.); (A.V.); (K.V.); (S.F.D.M.)
| | - Winnie Kerstens
- Laboratory of Virology and Chemotherapy, Translational Platform Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, KU Leuven Rega Institute, 3000 Leuven, Belgium; (W.K.); (T.V.); (H.J.T.)
| | - Maya Imbrechts
- PharmAbs, the KU Leuven Antibody Center, KU Leuven, 3000 Leuven, Belgium; (M.I.); (N.G.)
| | - Thomas Vercruysse
- Laboratory of Virology and Chemotherapy, Translational Platform Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, KU Leuven Rega Institute, 3000 Leuven, Belgium; (W.K.); (T.V.); (H.J.T.)
| | - Kai Dallmeier
- Laboratory of Virology, Molecular Vaccinology and Vaccine Discovery, Department of Microbiology, Immunology and Transplantation, KU Leuven Rega Institute, 3000 Leuven, Belgium;
| | - Johan Van Weyenbergh
- Laboratory for Clinical and Epidemiological Virology, KU Leuven Rega Institute, 3000 Leuven, Belgium; (J.V.W.); (P.M.)
| | - Piet Maes
- Laboratory for Clinical and Epidemiological Virology, KU Leuven Rega Institute, 3000 Leuven, Belgium; (J.V.W.); (P.M.)
| | - Xavier Bossuyt
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium;
- Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Dorinja Zapf
- Institut für Experimentelle Immunologie, EUROIMMUN Medizinische Labordiagnostika AG, 23552 Lübeck, Germany; (D.Z.); (K.D.)
| | - Kersten Dieckmann
- Institut für Experimentelle Immunologie, EUROIMMUN Medizinische Labordiagnostika AG, 23552 Lübeck, Germany; (D.Z.); (K.D.)
| | - Kim Callebaut
- AZ Groeninge Hospital, Department of Laboratory Medicine, 8500 Kortrijk, Belgium; (K.C.); (N.C.)
| | - Hendrik Jan Thibaut
- Laboratory of Virology and Chemotherapy, Translational Platform Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, KU Leuven Rega Institute, 3000 Leuven, Belgium; (W.K.); (T.V.); (H.J.T.)
| | - Karen Vanhoorelbeke
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, 8500 Kortrijk, Belgium; (B.C.); (A.V.); (K.V.); (S.F.D.M.)
- PharmAbs, the KU Leuven Antibody Center, KU Leuven, 3000 Leuven, Belgium; (M.I.); (N.G.)
| | - Simon F. De Meyer
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, 8500 Kortrijk, Belgium; (B.C.); (A.V.); (K.V.); (S.F.D.M.)
| | - Wim Maes
- PharmAbs, the KU Leuven Antibody Center, KU Leuven, 3000 Leuven, Belgium; (M.I.); (N.G.)
| | - Nick Geukens
- PharmAbs, the KU Leuven Antibody Center, KU Leuven, 3000 Leuven, Belgium; (M.I.); (N.G.)
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