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Ciccone EJ, Zhu DR, Gunderson AK, Hawke S, Ajeen R, Lodge EK, Shook-Sa BE, Abernathy H, Garrett HE, King E, Alavian N, Reyes R, Taylor JL, Beatty C, Chung C, Mendoza CE, Weber DJ, Markmann AJ, Premkumar L, Juliano JJ, Boyce RM, Aiello AE. Magnitude and Durability of the Antibody Response to mRNA-Based Vaccination Among SARS-CoV-2 Seronegative and Seropositive Health Care Personnel. Open Forum Infect Dis 2024; 11:ofae009. [PMID: 38293246 PMCID: PMC10826795 DOI: 10.1093/ofid/ofae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Few studies have described changes in SARS-CoV-2 antibody levels in response to infection and vaccination at frequent intervals and over extended follow-up periods. The purpose of this study was to assess changes in SARS-CoV-2-specific antibody responses among a prospective cohort of health care personnel over 18 months with up to 22 samples per person. Antibody levels and live virus neutralization were measured before and after mRNA-based vaccination with results stratified by (1) SARS-CoV-2 infection status prior to initial vaccination and (2) SARS-CoV-2 infection at any point during follow-up. We found that the antibody response to the first dose was almost 2-fold higher in individuals who were seropositive prior to vaccination, although neutralization titers were more variable. The antibody response induced by vaccination appeared to wane over time but generally persisted for 8 to 9 months, and those who were infected at any point during the study had slightly higher antibody levels over time vs those who remained uninfected. These findings underscore the need to account for SARS-CoV-2 natural infection as a modifier of vaccine responses, and they highlight the importance of frequent testing of longitudinal antibody titers over time. Together, our results provide a clearer understanding of the trajectories of antibody response among vaccinated individuals with and without prior SARS-CoV-2 infection.
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Affiliation(s)
| | - Deanna R Zhu
- Department of Epidemiology, Gillings School of Global Public Health
| | | | - Sam Hawke
- Department of Biostatistics, Gillings School of Global Public Health
| | - Rawan Ajeen
- Institute for Global Health and Infectious Diseases
| | - Evans K Lodge
- Department of Epidemiology, Gillings School of Global Public Health
| | - Bonnie E Shook-Sa
- Department of Biostatistics, Gillings School of Global Public Health
| | | | - Haley E Garrett
- Department of Epidemiology, Gillings School of Global Public Health
| | - Elise King
- Institute for Global Health and Infectious Diseases
| | - Naseem Alavian
- Division of Hospital Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Raquel Reyes
- Division of Hospital Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | | | - Cherese Beatty
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, New York
| | | | - Carmen E Mendoza
- Department of Epidemiology, Gillings School of Global Public Health
| | - David J Weber
- Division of Infectious Diseases, School of Medicine
- Department of Epidemiology, Gillings School of Global Public Health
| | | | - Lakshmanane Premkumar
- Department of Microbiology and Immunology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Jonathan J Juliano
- Division of Infectious Diseases, School of Medicine
- Department of Epidemiology, Gillings School of Global Public Health
| | - Ross M Boyce
- Division of Infectious Diseases, School of Medicine
- Department of Epidemiology, Gillings School of Global Public Health
| | - Allison E Aiello
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, New York
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2
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Goto T, Chong Y, Tani N, Susai N, Yoshinaga T, Sasaki T, Taniguchi M, Kusakabe T, Shimono N, Akashi K, Ikematsu H. Distinct features of SARS-CoV-2 humoral immunity against Omicron breakthrough infection. Vaccine 2023; 41:7019-7025. [PMID: 37858449 DOI: 10.1016/j.vaccine.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/27/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND SARS-CoV-2 Omicron breakthrough infection (Omicron-BTI) after vaccination has been frequently observed. A more detailed understanding of the humoral immunity against Omicron-BTI is required. METHODS We measured strain-specific live-virus based neutralizing activity, anti-spike IgG, and anti-receptor-binding domain (RBD) IgG titers in individuals with Omicron/BA.1-BTI and directly compared them with controls with diverse combinations of wild-type (WT) mRNA vaccination and infection history. RESULTS Omicron-BTI individuals showed markedly higher neutralizing titers against all the WT, Delta, and Omicron strains in convalescent sera, compared with unvaccinated Omicron-infection individuals with only Omicron neutralizing activity. Similar tendencies were found in strain-specific anti-spike and anti-RBD IgG titers. The Omicron-specificity (BA.1/WT neutralizing ratio), Omicron-neutralizing efficiency per antibody unit, and anti-Omicron RBD-directivity of anti-spike antibodies in Omicron-BTI individuals were all significantly lower than those in unvaccinated Omicron-infection individuals, but they were equivalent to or higher than those in uninfected vaccinees. The induction of Omicron-specific neutralizing activity after Omicron-BTI was not weakened for eight months from the last vaccination. CONCLUSIONS These findings suggest that cross-reactive vaccine-induced immunity was intensively stimulated following Omicron breakthrough infection, which contributed to Omicron neutralization. Measuring SARS-CoV-2 variant-specific antibody levels as well as neutralizing activity is useful for evaluating humoral immunity after breakthrough infection in the current situation of antigenic gaps between vaccinated and epidemic (Omicron sub-lineages) strains.
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Affiliation(s)
- Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan.
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Natsumi Susai
- Laboratory for Bio-Drug Discovery, Shionogi & Co., Ltd., Osaka, Japan
| | - Tomoyo Yoshinaga
- Laboratory for Bio-Drug Discovery, Shionogi & Co., Ltd., Osaka, Japan
| | - Tomoki Sasaki
- R&D Department, KAICO Ltd., Fukuoka, Japan; Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | | | - Takahiro Kusakabe
- Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
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3
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Chong Y, Goto T, Watanabe H, Tani N, Yonekawa A, Ikematsu H, Shimono N, Tanaka Y, Akashi K. Achievement of sufficient antibody response after a fourth dose of wild-type SARS-CoV-2 mRNA vaccine in nursing home residents. Immun Inflamm Dis 2023; 11:e962. [PMID: 37647452 PMCID: PMC10461422 DOI: 10.1002/iid3.962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Infection control during COVID-19 outbreaks in nursing facilities is a critical public health issue. Antibody responses before and after the fourth (second booster) dose of wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in nursing home residents have not been fully characterized. METHODS This study included 112 individuals: 54 nursing home residents (mean age: 84.4 years; 35 SARS-CoV-2-naive and 19 previously infected) and 58 healthcare workers (mean age: 47.7 years; 25 SARS-CoV-2-naive and 33 previously infected). Antispike and antinucleocapsid antibody responses to messenger RNA vaccination were evaluated using serum samples collected shortly and 5 months after the third dose, and shortly after the fourth dose. RESULTS The median immunoglobulin G (IgG) level in SARS-CoV-2-naive residents was similar to that in SARS-CoV-2-naive healthcare workers after the fourth dose (24,026.3 vs. 30,328.6 AU/mL, p = .79), whereas after the third dose the IgG level of SARS-CoV-2-naive residents was approximately twofold lower than that in SARS-CoV-2-naive healthcare workers. In residents with previous SARS-CoV-2 infection, timing of infection in relation to vaccination affected the kinetics of antibody responses. Residents infected after the third dose showed the highest IgG levels after the fourth dose among all groups (median: 64,328.8 AU/mL), in contrast to residents infected before initiating vaccination with antibody levels similar to those of SARS-CoV-2-naive residents. CONCLUSIONS Advanced aged nursing home residents, poor responders in the initial SARS-CoV-2 vaccine series, could achieve sufficient antibody responses after the fourth (second booster) vaccination, comparable to those of younger adults.
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Affiliation(s)
- Yong Chong
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Takeyuki Goto
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Haruka Watanabe
- Department of Clinical Immunology, Rheumatology, and Infectious DiseaseKyushu University HospitalFukuokaJapan
| | - Naoki Tani
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Akiko Yonekawa
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Hideyuki Ikematsu
- Division of Influenza ResearchJapan Physicians AssociationTokyoJapan
| | - Nobuyuki Shimono
- Department of Center for the Study of Global InfectionCenter for the Study of Global Infection, Kyushu University HospitalFukuokaJapan
| | - Yosuke Tanaka
- Department of Internal MedicineMedical Corporation SOUSEIKAI, Kanenokuma HospitalFukuokaJapan
| | - Koichi Akashi
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
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4
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Yan LN, Li D, Wang ZD, Jiang ZZ, Xiao X, Yu XJ. Neutralizing antibodies and T-cell responses to inactivated SARS-CoV-2 vaccine in COVID-19 convalescents one and a half years after infection. Virus Res 2023; 323:198977. [PMID: 36283534 PMCID: PMC9595495 DOI: 10.1016/j.virusres.2022.198977] [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] [Received: 06/08/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022]
Abstract
Vaccines have been considered the most promising solution for ending the coronavirus disease 2019 (COVID-19) pandemic. Information regarding neutralizing antibodies (NAbs) and T-cell immune response in inactivated SARS-CoV-2 vaccine-immunized COVID-19 convalescent patients were either only available for a short time after illness recovered or not available at all (T-cell immunity). We evaluated SARS-CoV-2 NAbs and cellular immune responses to the SARS-CoV-2 inactivated vaccine in convalescent patients who recovered from infection for about one and a half years. We found that compared to before vaccination, SARS-CoV-2 NAbs and specific T-cell responses were significantly boosted by the inactivated vaccine in convalescent patients, which confirmed the pre-existing adaptive immunity in SARS-CoV-2 infected people. We observed that NAbs and IFN-γ-secreting T-cell response elicited by a single vaccine dose in subjects with prior COVID-19 infection were higher than after two doses of vaccine in SARS-CoV-2 naïve subjects. Both humoral and cellular immune responses elicited by one and two doses of inactivated vaccine were comparable in COVID-19-recovered persons. In conclusion, inactivated COVID-19 vaccine induced robust NAbs and T-cell responses to SARS-CoV-2 in COVID-19 convalescent patients and immune responses after one dose were equal to that after receiving two doses, which highlighted that robust humoral and cellular immune response can be reactivated by the inactivated vaccine in SARS-CoV-2 convalescent patients.
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Affiliation(s)
- Li-Na Yan
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan 430070, PR China
| | - Dan Li
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan 430070, PR China
| | - Zhen-Dong Wang
- School of Public Health, Xi'an Medical University, Xi'an 710021, PR China
| | - Ze-Zheng Jiang
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan 430070, PR China
| | - Xiao Xiao
- Institute of Epidemic Research, Hubei University of Chinese Medicine, Wuhan 430065, PR China.
| | - Xue-Jie Yu
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan 430070, PR China.
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5
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Tuaillon E, Pisoni A, Veyrenche N, Rafasse S, Niel C, Gros N, Muriaux D, Picot MC, Aouinti S, Van de Perre P, Bousquet J, Blain H. Antibody response after first and second BNT162b2 vaccination to predict the need for subsequent injections in nursing home residents. Sci Rep 2022; 12:13749. [PMID: 35962053 PMCID: PMC9373891 DOI: 10.1038/s41598-022-18041-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
We explored antibody response after first and second BNT162b2 vaccinations, to predict the need for subsequent injections in nursing home (NH) residents. 369 NH residents were tested for IgG against SARS-CoV-2 Receptor-Binding Domain (RBD-IgG) and nucleoprotein-IgG (SARS-CoV-2 IgG II Quant and SARS-CoV-2 IgG Alinity assays, Abbott Diagnostics). In NH residents with prior SARS-CoV-2 infection, the first dose elicited high RBD-IgG levels (≥ 4160 AU/mL) in 99/129 cases (76.9%), with no additional antibody gain after the second dose in 74 cases (74.7%). However, a low RBD-IgG level (< 1050 AU/mL) was observed in 28 (21.7%) residents. The persistence of nucleoprotein-IgG and a longer interval between infection and the first dose were associated with a higher RBD-IgG response (p < 0.0001 and p = 0.0013, respectively). RBD-IgG below 50 AU/mL after the first dose predicted failure to reach the antibody concentration associated with a neutralizing effect after the second dose (≥ 1050 AU/mL). The BNT162b2 vaccine elicited a strong humoral response after the first dose in a majority of NH residents with prior SARS-CoV-2 infection. However, about one quarter of these residents require a second injection. Consideration should be given to immunological monitoring in NH residents to optimize the vaccine response in this vulnerable population.
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Affiliation(s)
- Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France.
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Nicolas Veyrenche
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Sophia Rafasse
- CEMIPAI, University of Montpellier, UAR3725 CNRS, Montpellier, France
| | - Clémence Niel
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Nathalie Gros
- CEMIPAI, University of Montpellier, UAR3725 CNRS, Montpellier, France
| | - Delphine Muriaux
- CEMIPAI, University of Montpellier, UAR3725 CNRS, Montpellier, France
| | | | - Safa Aouinti
- Clinical Research and Epidemiology Unit, University Hospital, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Jean Bousquet
- Department of Dermatology and Allergy, Charité, Univeersitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany.,University Hospital, Montpellier, France
| | - Hubert Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier University, Montpellier, France
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6
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Chong Y, Goto T, Tani N, Yonekawa A, Ikematsu H, Shimono N, Tanaka Y, Akashi K. Pronounced antibody elevation after SARS-CoV-2 BNT162b2 mRNA booster vaccination in nursing home residents. Influenza Other Respir Viruses 2022; 16:1066-1071. [PMID: 35962568 PMCID: PMC9530588 DOI: 10.1111/irv.13030] [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] [Received: 04/29/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background Infection control during COVID‐19 outbreaks in nursing facilities is a critical public health issue. Antibody responses before and after the third (booster) dose of SARS‐CoV‐2 vaccination in nursing home residents have not been fully characterized. Methods This study included 117 individuals: 54 nursing home residents (mean age, 83.8 years; 39 SARS‐CoV‐2‐naive and 15 previously infected) and 63 healthcare workers (mean age, 45.8 years; 32 SARS‐CoV‐2‐naive and 31 previously infected). Anti‐spike (receptor‐binding domain [RBD]) and anti‐nucleocapsid antibody responses to BNT162b2 mRNA vaccination and their related factors were evaluated using pre‐ (shortly and 6 months after the second dose) and post‐booster vaccination samples. Results The median anti‐spike (RBD) IgG level in SARS‐CoV‐2‐naive residents 6 months after the second dose was the lowest among the four groups, with a decreasing rate of over 90%. The median rate of increase before and after the third dose in SARS‐CoV‐2‐naive residents was significantly higher than that in SARS‐CoV‐2‐naive healthcare workers (64.1‐ vs. 37.0‐fold, P = 0.003), with the highest level among the groups. The IgG ratio of SARS‐CoV‐2‐naive residents to healthcare workers after the second and third doses changed from one‐fifth (20%) to one‐half (50%). The rate of increase after the third dose in previously infected individuals was three‐ to fourfold, regardless of residents or healthcare workers. Conclusions Advanced aged nursing home residents, poor responders in the initial SARS‐CoV‐2 vaccine series, could obtain sufficient antibody responses with the additional booster dose, despite more than 6 months after the second.
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Affiliation(s)
- Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Akiko Yonekawa
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | | | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yosuke Tanaka
- Medical Corporation SOUSEIKAI, Kanenokuma Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
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7
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Goto T, Tani N, Ikematsu H, Gondo K, Oishi R, Minami J, Onozawa K, Kuwano H, Akashi K, Shimono N, Chong Y. Post-vaccination antibody evaluation for nosocomial SARS-CoV-2 delta variant breakthrough infection. PLoS One 2022; 17:e0272056. [PMID: 35877668 PMCID: PMC9312404 DOI: 10.1371/journal.pone.0272056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Waning humoral immunity after mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a significant problem for public health. Breakthrough infection in hospitals over several months after vaccination has not been fully characterized, especially against the delta (B.1.617.2) variant. Here, we describe an outbreak in our hospital in September of 2021, mainly through serological evaluation of the breakthrough infection. This retrospective observational study was done at an emergency and acute care hospital with 204 beds and 486 staff members where most staff members (92.6%) had had their second BNT162b2 vaccination by May of 2021. The peri-infection anti-spike RBD protein IgG (anti-S IgG) titers (lowest values between 11 days before and 7 days after onset or diagnosis) of serum samples from the breakthrough-infected persons were quantified. We also logarithmically estimated the anti-S IgG titers during the exposure period in September of uninfected staff members from their samples collected in May and December 2021. Whole-genome sequencing was done on obtained samples. In this outbreak, twelve persons (ten inpatients and two staff members) were diagnosed with SARS-CoV-2 infection by Loop-Mediated Isothermal Amplification (LAMP) or RT-PCR, eight of whom had been vaccinated twice. Peri-infection anti-S IgG titers could be determined in seven of the eight breakthrough cases, with a geometric mean titer (GMT) of 1,034 AU/ml (95% confidence interval [CI], 398 to 2,686). Among 289 uninfected staff members with data from the two sampling points, the GMT of the estimated anti-S IgG titers during the exposure period in 51 staff members, who were working at the outbreak ward and potentially exposed but uninfected, and 238 other unexposed staff members were 1,458 AU/ml (95% CI, 1,196 to 1,777) and 1,628 AU/ml (95% CI, 1,500 to 1,766), respectively. All viruses from the eight samples for which whole-genome sequencing was available were identified as delta variants. Of the infected persons, one remained asymptomatic throughout the course of treatment, and eleven had an illness of mild to moderate severity, including ten who received monoclonal antibody cocktail (Casirivimab/imdevimab) therapy. Measurement and estimation of anti-spike antibody levels after SARS-CoV-2 vaccination would be helpful for evaluating the risk of breakthrough infection and for determining the necessity of booster vaccination.
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Affiliation(s)
- Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | | | - Kei Gondo
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
| | - Ryo Oishi
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Junya Minami
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Kyoko Onozawa
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | | | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
- * E-mail:
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8
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Salmerón Ríos S, Cortés Zamora EB, Avendaño Céspedes A, Romero Rizos L, Sánchez-Jurado PM, Sánchez-Nievas G, Mas Romero M, Tabernero Sahuquillo MT, Blas Señalada JJ, Murillo Romero A, García Nogueras I, Estrella Cazalla JDD, Andrés-Pretel F, Lauschke VM, Stebbing J, Abizanda P. Immunogenicity after 6 months of BNT162b2 vaccination in frail or disabled nursing home residents: The COVID-A Study. J Am Geriatr Soc 2021; 70:650-658. [PMID: 34894403 DOI: 10.1111/jgs.17620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/02/2021] [Accepted: 12/05/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND There is incomplete information regarding evolution of antibody titers against SARS-CoV-2 after a two-dose strategy vaccination with BNT162b2 in older adults in long-term care facilities (LTCFs) with frailty, disability, or cognitive impairment. We aimed to determine IgG antibody titer loss in older adults in LTCFs. METHODS This is a multicenter longitudinal cohort study including 127 residents (90 females and 37 males) with a mean age of 82.7 years (range 65-99) with different frailty and disability profiles in two LTCFs in Albacete, Spain. Residents received two doses of BNT162b2 as per label, and antibody levels were determined 1 and 6 months after the second dose. Age, sex, previous history of coronavirus disease 2019 (COVID-19), comorbidity (Charlson Index), performance in activities of daily living (Barthel Index), frailty (FRAIL instrument), and cognitive status were assessed. RESULTS The mean antibody titers 1 and 6 months after the second vaccine dose were 32,145 AU/ml (SD 41,206) and 6182 AU/ml (SD 13,316), respectively. Across all participants, the median antibody titer loss measured 77.6% (interquartile range [IQR] 23.8%). Notably, the decline of titers in individuals with pre-vaccination COVID-19 infection was significantly lower than in those without a history of SARS-CoV-2 infection (72.2% vs. 85.3%; p < 0.001). The median titer decrease per follow-up day was 0.47% (IQR 0.14%) and only pre-vaccination COVID-19 was associated with lower rate of antibody decline at 6 months (hazard ratio 0.17; 95% confidence interval 0.07-0.41; p < 0.001). Frailty, disability, older age, cognitive impairment, or comorbidity were not associated with the extent of antibody loss. CONCLUSIONS Older adults in LTCFs experience a rapid loss of antibodies over the first 6 months after the second dose of BNT162b2 vaccine. Only pre-vaccination COVID-19 is associated with a slower rate of antibody decrease. Our data support immunization with a third dose in this vulnerable, high-risk population.
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Affiliation(s)
- Sergio Salmerón Ríos
- Residencia de Mayores San Vicente de Paúl, Diputación de Albacete, Albacete, Spain
| | - Elisa Belén Cortés Zamora
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.,CIBERFES, Ministerio de Economía y Competitividad, Madrid, Spain
| | - Almudena Avendaño Céspedes
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.,CIBERFES, Ministerio de Economía y Competitividad, Madrid, Spain.,Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Luis Romero Rizos
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.,CIBERFES, Ministerio de Economía y Competitividad, Madrid, Spain.,Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Pedro Manuel Sánchez-Jurado
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.,CIBERFES, Ministerio de Economía y Competitividad, Madrid, Spain.,Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Ginés Sánchez-Nievas
- Department of Rheumatology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Marta Mas Romero
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | | | | | | | | | - Juan de Dios Estrella Cazalla
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.,CIBERFES, Ministerio de Economía y Competitividad, Madrid, Spain.,Residencia de Mayores Núñez de Balboa, Albacete, Spain
| | - Fernando Andrés-Pretel
- Department of Statistics, Foundation of the National Paraplegics Hospital of Toledo, Toledo, Spain
| | - Volker Martin Lauschke
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Justin Stebbing
- Department of Surgery and Cancer, Imperial College, Hammersmith Hospital, London, UK
| | - Pedro Abizanda
- Department of Geriatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.,CIBERFES, Ministerio de Economía y Competitividad, Madrid, Spain.,Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, Spain
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