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Cheetham NJ, Kibble M, Wong A, Silverwood RJ, Knuppel A, Williams DM, Hamilton OKL, Lee PH, Bridger Staatz C, Di Gessa G, Zhu J, Katikireddi SV, Ploubidis GB, Thompson EJ, Bowyer RCE, Zhang X, Abbasian G, Garcia MP, Hart D, Seow J, Graham C, Kouphou N, Acors S, Malim MH, Mitchell RE, Northstone K, Major-Smith D, Matthews S, Breeze T, Crawford M, Molloy L, Kwong ASF, Doores K, Chaturvedi N, Duncan EL, Timpson NJ, Steves CJ. Antibody levels following vaccination against SARS-CoV-2: associations with post-vaccination infection and risk factors in two UK longitudinal studies. eLife 2023; 12:e80428. [PMID: 36692910 PMCID: PMC9940912 DOI: 10.7554/elife.80428] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/22/2022] [Indexed: 01/25/2023] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels can be used to assess humoral immune responses following SARS-CoV-2 infection or vaccination, and may predict risk of future infection. Higher levels of SARS-CoV-2 anti-Spike antibodies are known to be associated with increased protection against future SARS-CoV-2 infection. However, variation in antibody levels and risk factors for lower antibody levels following each round of SARS-CoV-2 vaccination have not been explored across a wide range of socio-demographic, SARS-CoV-2 infection and vaccination, and health factors within population-based cohorts. Methods Samples were collected from 9361 individuals from TwinsUK and ALSPAC UK population-based longitudinal studies and tested for SARS-CoV-2 antibodies. Cross-sectional sampling was undertaken jointly in April-May 2021 (TwinsUK, N=4256; ALSPAC, N=4622), and in TwinsUK only in November 2021-January 2022 (N=3575). Variation in antibody levels after first, second, and third SARS-CoV-2 vaccination with health, socio-demographic, SARS-CoV-2 infection, and SARS-CoV-2 vaccination variables were analysed. Using multivariable logistic regression models, we tested associations between antibody levels following vaccination and: (1) SARS-CoV-2 infection following vaccination(s); (2) health, socio-demographic, SARS-CoV-2 infection, and SARS-CoV-2 vaccination variables. Results Within TwinsUK, single-vaccinated individuals with the lowest 20% of anti-Spike antibody levels at initial testing had threefold greater odds of SARS-CoV-2 infection over the next 6-9 months (OR = 2.9, 95% CI: 1.4, 6.0), compared to the top 20%. In TwinsUK and ALSPAC, individuals identified as at increased risk of COVID-19 complication through the UK 'Shielded Patient List' had consistently greater odds (two- to fourfold) of having antibody levels in the lowest 10%. Third vaccination increased absolute antibody levels for almost all individuals, and reduced relative disparities compared with earlier vaccinations. Conclusions These findings quantify the association between antibody level and risk of subsequent infection, and support a policy of triple vaccination for the generation of protective antibodies. Funding Antibody testing was funded by UK Health Security Agency. The National Core Studies program is funded by COVID-19 Longitudinal Health and Wellbeing - National Core Study (LHW-NCS) HMT/UKRI/MRC ([MC_PC_20030] and [MC_PC_20059]). Related funding was also provided by the NIHR 606 (CONVALESCENCE grant [COV-LT-0009]). TwinsUK is funded by the Wellcome Trust, Medical Research Council, Versus Arthritis, European Union Horizon 2020, Chronic Disease Research Foundation (CDRF), Zoe Ltd and the National Institute for Health Research (NIHR) Clinical Research Network (CRN) and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. The UK Medical Research Council and Wellcome (Grant ref: [217065/Z/19/Z]) and the University of Bristol provide core support for ALSPAC.
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Affiliation(s)
- Nathan J Cheetham
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
| | - Milla Kibble
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
- Department of Applied Mathematics and Theoretical Physics, University of CambridgeCambridgeUnited Kingdom
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing, University College LondonLondonUnited Kingdom
| | | | - Anika Knuppel
- MRC Unit for Lifelong Health and Ageing, University College LondonLondonUnited Kingdom
| | - Dylan M Williams
- MRC Unit for Lifelong Health and Ageing, University College LondonLondonUnited Kingdom
- Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetStockholmSweden
| | - Olivia KL Hamilton
- MRC/CSO Social and Public Health Sciences Unit, University of GlasgowGlasgowUnited Kingdom
| | - Paul H Lee
- Department of Health Sciences, University of LeicesterLeicesterUnited Kingdom
| | | | - Giorgio Di Gessa
- Department of Epidemiology and Public Health, University College LondonLondonUnited Kingdom
| | - Jingmin Zhu
- Department of Epidemiology and Public Health, University College LondonLondonUnited Kingdom
| | | | - George B Ploubidis
- Centre for Longitudinal Studies, University College LondonLondonUnited Kingdom
| | - Ellen J Thompson
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
- MRC Unit for Lifelong Health and Ageing, University College LondonLondonUnited Kingdom
| | - Ruth CE Bowyer
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
- AI for Science and Government, The Alan Turing InstituteLondonUnited Kingdom
| | - Xinyuan Zhang
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
| | - Golboo Abbasian
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
| | - Maria Paz Garcia
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
| | - Deborah Hart
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
| | - Jeffrey Seow
- Department of Infectious Diseases, King's College LondonLondonUnited Kingdom
| | - Carl Graham
- Department of Infectious Diseases, King's College LondonLondonUnited Kingdom
| | - Neophytos Kouphou
- Department of Infectious Diseases, King's College LondonLondonUnited Kingdom
| | - Sam Acors
- Department of Infectious Diseases, King's College LondonLondonUnited Kingdom
| | - Michael H Malim
- Department of Infectious Diseases, King's College LondonLondonUnited Kingdom
| | - Ruth E Mitchell
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Daniel Major-Smith
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Sarah Matthews
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Thomas Breeze
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Michael Crawford
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Lynn Molloy
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Alex SF Kwong
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
- Division of Psychiatry, University of EdinburghEdinburghUnited Kingdom
| | - Katie Doores
- Department of Infectious Diseases, King's College LondonLondonUnited Kingdom
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing, University College LondonLondonUnited Kingdom
| | - Emma L Duncan
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
- Guy’s & St Thomas’s NHS Foundation TrustLondonUnited Kingdom
| | - Nicholas J Timpson
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King’s College LondonLondonUnited Kingdom
- Guy’s & St Thomas’s NHS Foundation TrustLondonUnited Kingdom
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