1
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Augello M, Wagenhäuser I, Krone M, Dauby N, Ferrara P, Sabbatucci M, Ruta S, Rezahosseini O, Velikov P, Gkrania-Klotsas E, Montes J, Franco-Paredes C, Goodman AL, Küçükkaya S, Tuells J, Harboe ZB, Epaulard O. Should SARS-CoV-2 serological testing be used in the decision to deliver a COVID-19 vaccine booster? A pro-con assessment. Vaccine 2024:126184. [PMID: 39097440 DOI: 10.1016/j.vaccine.2024.126184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 07/23/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024]
Abstract
Anti-SARS-CoV-2 vaccination has saved millions of lives in the past few years. To maintain a high level of protection, particularly in at-risk populations, booster doses are recommended to counter the waning of circulating antibody levels over time and the continuous emergence of immune escape variants of concern (VOCs). As anti-spike serology is now widely available, it may be considered a useful tool to identify individuals needing an additional vaccine dose, i.e., to screen certain populations to identify those whose plasma antibody levels are too low to provide protection. However, no recommendations are currently available on this topic. We reviewed the relevant supporting and opposing arguments, including areas of uncertainty, and concluded that in most populations, spike serology should not be used to decide about the administration of a booster dose. The main counterarguments are as follows: correlates of protection are imperfectly characterised, essentially owing to the emergence of VOCs; spike serology has an intrinsic inability to comprehensively reflect the whole immune memory; and booster vaccines are now VOC-adapted, while the commonly available commercial serological assays explore antibodies against the original virus.
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Affiliation(s)
- Matteo Augello
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Isabell Wagenhäuser
- University Hospital Würzburg, Infection Control and Antimicrobial Stewardship Unit, Würzburg, Germany
| | - Manuel Krone
- University Hospital Würzburg, Infection Control and Antimicrobial Stewardship Unit, Würzburg, Germany
| | - Nicolas Dauby
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Environmental health and occupational health, School of Public Health, Université Libre de Bruxelles (ULB), Brussel, Belgium
| | - Pietro Ferrara
- Center for Public Health Research, University of Milan - Bicocca, Monza, Italy; IRCCS Istituto Auxologico Italiano, Laboratory of Public Health, Milan, Italy
| | | | - Simona Ruta
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Stefan S Nicolau Institute of Virology, Bucharest, Romania
| | - Omid Rezahosseini
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Hillerød, Denmark
| | - Petar Velikov
- Clinic for Pediatric Infectious Diseases, Infectious Disease Hospital "Prof. Ivan Kirov", Sofia, Bulgaria; Department of Global Public Health, University of Tsukuba, Tsukuba, Japan
| | | | - Jose Montes
- Investigación en Resistencia Antibiótica (INVERA), Buenos Aires, Argentina; Fundación del Centro de Estudios Infectológicos (FUNCEI), Buenos Aires, Argentina
| | - Carlos Franco-Paredes
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, USA; Hospital Infantil de Mexico, Mexico City, Mexico
| | - Anna L Goodman
- Centre for Infection Diagnostics research, Department of Infection at at King's College London and Guys' and St Thomas NHS Foundation trust, London, UK
| | - Sertaç Küçükkaya
- Department of Medical Microbiology, Istanbul Faculty of Medicine, İstanbul University, Istanbul, Turkey
| | - Jose Tuells
- Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e historia de la ciencia, Universidad de Alicante, Alicante, Spain
| | | | - Olivier Epaulard
- Université Grenoble Alpes, Infectiologie, CHU Grenoble Alpes, Grenoble, France.
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2
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Durier C, Ninove L, van der Werf S, Lefebvre M, Desaint C, Bauer R, Attia M, Lecompte AS, Lachatre M, Maakaroun-Vermesse Z, Nicolas JF, Verdon R, Kiladjian JJ, Loubet P, Schmidt-Mutter C, Corbin V, Ansart S, Melica G, Resch M, Netzer E, Kherabi Y, Tardieu R, Lelièvre JD, Tartour E, Meyer L, de Lamballerie X, Launay O. Incidence of COVID-19 mRNA vaccine symptomatic breakthrough infections during Omicron circulation in adults with or without infection prior to vaccination. Infect Dis Now 2024; 54:104886. [PMID: 38494117 DOI: 10.1016/j.idnow.2024.104886] [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: 10/13/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES COVID-19 vaccine breakthrough infections were frequently reported during circulation of the Omicron variant. The ANRS|MIE CoviCompareP study investigated these infections in adults vaccinated and boosted with BNT162b2 [Pfizer-BioNTech] and with/without SARS-CoV-2 infection before vaccination. METHODS In the first half of 2021, healthy adults (aged 18-45, 65-74 and 75 or older) received either one dose of BNT162b2 (n = 120) if they had a documented history of SARS-CoV-2 infection at least five months previously, or two doses (n = 147) if they had no history confirmed by negative serological tests. A first booster dose was administered at least 6 months after the primary vaccination, and a second booster dose, if any, was reported in the database. Neutralizing antibodies (NAbs) against the European (D614G) strain and the Omicron BA.1 variant were assessed up to 28 days after the first booster dose. A case-control analysis was performed for the 252 participants who were followed up in 2022, during the Omicron waves. RESULTS From January to October 2022, 78/252 (31%) had a documented symptomatic breakthrough infection after full vaccination: 21/117 (18%) in those who had been infected before vaccination vs. 57/135 (42%) in those who had not. In a multivariate logistic regression model, factors associated with a lower risk of breakthrough infection were older age, a higher number of booster doses, and higher levels of Omicron BA.1 NAb titers in adults with infection before vaccination, but not in those without prior infection. CONCLUSION Our results highlight the need to consider immune markers of protection in association with infection and vaccination history.
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Affiliation(s)
| | - Laetitia Ninove
- Unité des Virus Émergents (UVE), Aix Marseille Univ, IRD 190, INSERM 1207, Marseille, France
| | - Sylvie van der Werf
- Institut Pasteur, Université Paris Cité, UMR 3569 CNRS, Unité de Génétique Moléculaire des Virus à ARN, Centre National de Référence Virus des Infections Respiratoires, Paris, France
| | - Maeva Lefebvre
- Service de maladies infectieuses et tropicales, Centre de prévention des maladies infectieuses et transmissibles CHU de Nantes - CIC1413 Nantes, Nantes, France
| | - Corinne Desaint
- INSERM US19, Villejuif, France; INSERM CIC 1417 Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Innovative Clinical Research Network in Vaccinology, Université de Paris, Sorbonne Paris Cité, Paris, France
| | | | - Mikael Attia
- Institut Pasteur, Université Paris Cité, UMR 3569 CNRS, Unité de Génétique Moléculaire des Virus à ARN, Centre National de Référence Virus des Infections Respiratoires, Paris, France
| | - Anne-Sophie Lecompte
- Service de maladies infectieuses et tropicales, Centre de prévention des maladies infectieuses et transmissibles CHU de Nantes - CIC1413 Nantes, Nantes, France
| | - Marie Lachatre
- INSERM CIC 1417 Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Innovative Clinical Research Network in Vaccinology, Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Zoha Maakaroun-Vermesse
- Centre de Vaccination CHU de Tours, Centre d'Investigation Clinique CIC 1415, INSERM, CHRU de Tours, Tours, France
| | - Jean-François Nicolas
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, Université Claude Bernard Lyon I, Lyon, France; CHU Lyon-Sud, Pierre-Bénite, France
| | - Renaud Verdon
- Service de Maladies Infectieuses, CHU de Caen, Dynamicure INSERM, UMR 1311, Normandie Univ, UNICAEN, Caen, France
| | - Jean-Jacques Kiladjian
- AP-HP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM, CIC1427, Université Paris Cité, Paris, France
| | - Paul Loubet
- VBMI, INSERM U1047, Department of Infectious and Tropical Diseases, Université de Montpellier, CHU Nîmes, Montpellier, France
| | | | - Violaine Corbin
- CHU Clermont-Ferrand, INSERM CIC1405, Clermont-Ferrand, France
| | | | - Giovanna Melica
- Service d'Immunologie Clinique et Maladies Infectieuses, APHP, Hôpital Henri Mondor, INSERM CIC 1430, Créteil, France
| | | | | | - Yousra Kherabi
- INSERM CIC 1417 Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Innovative Clinical Research Network in Vaccinology, Université de Paris, Sorbonne Paris Cité, Paris, France
| | | | | | - Eric Tartour
- APHP, Hôpital Européen Georges Pompidou, INSERM U970, PARCC, Université de Paris, Paris, France
| | - Laurence Meyer
- INSERM US19, Villejuif, France; INSERM, CESP U1018, Université Paris Saclay, APHP, Le Kremlin-Bicêtre, France
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE), Aix Marseille Univ, IRD 190, INSERM 1207, Marseille, France
| | - Odile Launay
- INSERM CIC 1417 Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Innovative Clinical Research Network in Vaccinology, Université de Paris, Sorbonne Paris Cité, Paris, France
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3
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Brook B, Duval V, Barman S, Speciner L, Sweitzer C, Khanmohammed A, Menon M, Foster K, Ghosh P, Abedi K, Koster J, Nanishi E, Baden LR, Levy O, VanCott T, Micol R, Dowling DJ. Adjuvantation of a SARS-CoV-2 mRNA vaccine with controlled tissue-specific expression of an mRNA encoding IL-12p70. Sci Transl Med 2024; 16:eadm8451. [PMID: 39047117 DOI: 10.1126/scitranslmed.adm8451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/18/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024]
Abstract
Messenger RNA (mRNA) vaccines were pivotal in reducing severe acute respiratory syndrome 2 (SARS-CoV-2) infection burden, yet they have not demonstrated robust durability, especially in older adults. Here, we describe a molecular adjuvant comprising a lipid nanoparticle (LNP)-encapsulated mRNA encoding interleukin-12p70 (IL-12p70). The bioactive adjuvant was engineered with a multiorgan protection (MOP) sequence to restrict transcript expression to the intramuscular injection site. Admixing IL-12-MOP (CTX-1796) with the BNT162b2 SARS-CoV-2 vaccine increased spike protein-specific immune responses in mice. Specifically, the benefits of IL-12-MOP adjuvantation included amplified humoral and cellular immunity and increased immune durability for 1 year after vaccination in mice. An additional benefit included the restoration of immunity in aged mice to amounts comparable to those achieved in young adult animals, alongside amplification with a single immunization. Associated enhanced dendritic cell and germinal center responses were observed. Together, these data demonstrate that an LNP-encapsulated IL-12-MOP mRNA-encoded adjuvant can amplify immunogenicity independent of age, demonstrating translational potential to benefit vulnerable populations.
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Affiliation(s)
- Byron Brook
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Valerie Duval
- Combined Therapeutics Incorporated, Boston, MA 02135, USA
| | - Soumik Barman
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | | | - Cali Sweitzer
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
| | | | - Manisha Menon
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
| | | | - Pallab Ghosh
- Combined Therapeutics Incorporated, Boston, MA 02135, USA
| | - Kimia Abedi
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
| | - Jacob Koster
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
| | - Etsuro Nanishi
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Lindsey R Baden
- Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Ofer Levy
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Thomas VanCott
- Combined Therapeutics Incorporated, Boston, MA 02135, USA
| | - Romain Micol
- Combined Therapeutics Incorporated, Boston, MA 02135, USA
| | - David J Dowling
- Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
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4
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Macdonald C, Palmateer N, McAuley A, Lindsay L, Hasan T, Hameed SS, Hall E, Jeffrey K, Grange Z, Gousias P, Mavin S, Jarvis L, Cameron JC, Daines L, Tibble H, Simpson CR, McCowan C, Katikireddi SV, Rudan I, Fagbamigbe AF, Ritchie L, Swallow B, Moss P, Robertson C, Sheikh A, Murray J. Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland. NPJ Vaccines 2024; 9:107. [PMID: 38877008 PMCID: PMC11178861 DOI: 10.1038/s41541-024-00898-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: 04/17/2023] [Accepted: 06/03/2024] [Indexed: 06/16/2024] Open
Abstract
Several population-level studies have described individual clinical risk factors associated with suboptimal antibody responses following COVID-19 vaccination, but none have examined multimorbidity. Others have shown that suboptimal post-vaccination responses offer reduced protection to subsequent SARS-CoV-2 infection; however, the level of protection from COVID-19 hospitalisation/death remains unconfirmed. We use national Scottish datasets to investigate the association between multimorbidity and testing antibody-negative, examining the correlation between antibody levels and subsequent COVID-19 hospitalisation/death among double-vaccinated individuals. We found that individuals with multimorbidity ( ≥ five conditions) were more likely to test antibody-negative post-vaccination and 13.37 [6.05-29.53] times more likely to be hospitalised/die from COVID-19 than individuals without conditions. We also show a dose-dependent association between post-vaccination antibody levels and COVID-19 hospitalisation or death, with those with undetectable antibody levels at a significantly higher risk (HR 9.21 [95% CI 4.63-18.29]) of these serious outcomes compared to those with high antibody levels.
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Affiliation(s)
- Calum Macdonald
- Usher Institute, University of Edinburgh, Teviot Pl, EH8 9AG, Edinburgh, UK.
- Health Data Research UK, Gibbs Building, 215 Euston Road, NW1 2BE, London, UK.
| | - Norah Palmateer
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens, Road, Glasgow, G4 0BA, UK.
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK.
| | - Andrew McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens, Road, Glasgow, G4 0BA, UK
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
| | - Laura Lindsay
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
| | - Taimoor Hasan
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
| | | | - Elliot Hall
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
| | - Karen Jeffrey
- Usher Institute, University of Edinburgh, Teviot Pl, EH8 9AG, Edinburgh, UK
| | - Zoë Grange
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
| | - Petros Gousias
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
| | - Sally Mavin
- Scottish Microbiology Reference Laboratory, Raigmore Hospital, Old Perth Road, Inverness, IV2 3UJ, UK
| | - Lisa Jarvis
- Scottish National Blood Transfusion Service, Jack Copland Centre, 52 Research Avenue North, EH14 4BE, Edinburgh, UK
| | - J Claire Cameron
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
| | - Luke Daines
- Usher Institute, University of Edinburgh, Teviot Pl, EH8 9AG, Edinburgh, UK
| | - Holly Tibble
- Usher Institute, University of Edinburgh, Teviot Pl, EH8 9AG, Edinburgh, UK
| | - Colin R Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, PO Box 600, Wellington, 6140, Wellington, New Zealand
| | - Colin McCowan
- School of Medicine, University of St Andrews, North Haugh, St Andrews, KY16 9TF, UK
| | - Srinivasa Vittal Katikireddi
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow Berkeley Square, 99 Berkeley St., G3 7HR, Glasgow, UK
| | - Igor Rudan
- Usher Institute, University of Edinburgh, Teviot Pl, EH8 9AG, Edinburgh, UK
| | - Adeniyi Francis Fagbamigbe
- Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill Rd, AB25 2ZD, Aberdeen, UK
| | - Lewis Ritchie
- Centre of Academic Primary Care, University of Aberdeen, Polwarth Building, Foresterhill Rd, AB25 2ZD, Aberdeen, UK
| | - Ben Swallow
- School of Mathematics and Statistics, University of St Andrews, KY16 9SS, St Andrews, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Cancer Sciences Building, Edgbaston, B15 2TT, Birmingham, UK
| | - Chris Robertson
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
- Department of Mathematics and Statistics, University of Strathclyde, Richmond Street Glasgow, G1 1XH, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Teviot Pl, EH8 9AG, Edinburgh, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, Oxford, UK
| | - Josie Murray
- Public Health Scotland, Meridian Court, 5 Cadogan Street, G2 6QE, Glasgow, UK
- School of Medicine, University of St Andrews, North Haugh, St Andrews, KY16 9TF, UK
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5
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Kawasuji H, Morinaga Y, Tani H, Yamada H, Yoshida Y, Ezaki M, Koshiyama Y, Takegoshi Y, Kaneda M, Murai Y, Kimoto K, Nagaoka K, Niimi H, Yamamoto Y. Low pre-infection levels of neutralizing antibody in breakthrough infections after bivalent BA.4-5 vaccine and practical application of dried blood spots. Vaccine 2024:S0264-410X(24)00656-X. [PMID: 38839519 DOI: 10.1016/j.vaccine.2024.05.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/07/2024] [Accepted: 05/31/2024] [Indexed: 06/07/2024]
Abstract
The level of neutralizing antibodies required to confer protection against COVID-19 breakthrough infections (BIs) is unclear, and the ability to know the immune status of individuals against the rapidly changing endemic variants is limited. We assessed longitudinal serum anti-RBD antibody levels and neutralizing activities (NTs) against Omicron BA.5 and XBB.1.5 in healthcare workers following the fourth monovalent and fifth bivalent BA.4-5 vaccines. The occurrence of BIs was also followed, and pre-infection antibody levels were compared between patients who developed BI and those who did not. In addition, we collected whole blood samples on the same day as the sera and stored them on filter papers (nos. 545, 590, and 424) for up to two months, then measured their NTs using dried blood spots (DBS) eluates, and compared them with the NTs in paired sera. Pre-infection levels of NTs were lower in patients who developed BI than those who did not, but the anti-RBD antibody levels were not different between them. The NTs below 50 % using 200-fold diluted sera might be one of the indicators of high risk for COVID-19 BI. However, the NTs against XBB.1.5 at 6 months after the fifth dose of bivalent BA.4-5 vaccine were lower than this threshold in almost half of infection-naïve participants. NTs measured using DBS eluates were strongly correlated with those measured using paired sera, but the time and temperature stability varied with the type of filter paper; no. 545 filter paper was found to most suitable for NT evaluation.
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Affiliation(s)
- Hitoshi Kawasuji
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yoshitomo Morinaga
- Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
| | - Hideki Tani
- Department of Virology, Toyama Institute of Health, Toyama, Japan
| | - Hiroshi Yamada
- Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yoshihiro Yoshida
- Department of Microbiology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Masayoshi Ezaki
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yuki Koshiyama
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yusuke Takegoshi
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Makito Kaneda
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yushi Murai
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kou Kimoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kentaro Nagaoka
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Hideki Niimi
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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6
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Di Chiara C, Boracchini R, Cantarutti A, Kakkar F, Oletto A, Padoan A, Donà D, Giaquinto C. Risk of SARS-CoV-2 Reinfection in Children Within the 12 Months Following Mild COVID-19: Insights From a Survey Study. Pediatr Infect Dis J 2024; 43:e128-e130. [PMID: 38241645 PMCID: PMC10919262 DOI: 10.1097/inf.0000000000004233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/21/2024]
Abstract
Understanding the correlation between immune response and protection from COVID-19 will play a pivotal role in predicting the effectiveness of vaccines in children. We studied SARS-CoV-2 reinfection risk in children 12 months post-mild COVID-19. Children under 5 years old exhibited lower reinfection risk than older infected or vaccinated siblings during 12 months postimmunization.
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Affiliation(s)
- Costanza Di Chiara
- From the Department for Women's and Children's Health, University of Padua, Padua, Italy
- Penta - Child Health Research, Padua, Italy
| | - Riccardo Boracchini
- Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Anna Cantarutti
- Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Fatima Kakkar
- Division of Infectious Diseases, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, Canada
| | | | - Andrea Padoan
- Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Daniele Donà
- From the Department for Women's and Children's Health, University of Padua, Padua, Italy
- Penta - Child Health Research, Padua, Italy
| | - Carlo Giaquinto
- From the Department for Women's and Children's Health, University of Padua, Padua, Italy
- Penta - Child Health Research, Padua, Italy
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7
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Choi MJ, Hyun H, Heo JY, Seo YB, Noh JY, Cheong HJ, Kim WJ, Kim HJ, Choi JY, Lee YJ, Chung EJ, Kim SH, Jeong H, Kim B, Song JY. Longitudinal immune kinetics of COVID-19 booster versus primary series vaccination: Insight into the annual vaccination strategy. Heliyon 2024; 10:e27211. [PMID: 38468934 PMCID: PMC10926122 DOI: 10.1016/j.heliyon.2024.e27211] [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: 08/25/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
Background Data on the durability of booster dose immunity of COVID-19 vaccines are relatively limited. Methods Immunogenicity was evaluated for up to 9-12 months after the third dose of vaccination in 94 healthy adults. Results Following the third dose, the anti-spike immunoglobulin G (IgG) antibody response against the wild-type was boosted markedly, which decreased gradually over time. However, even 9-12 months after the booster dose, both the median and geometric mean of anti-spike IgG antibody levels were higher than those measured 4 weeks after the second dose. Breakthrough infection during the Omicron-dominant period boosted neutralizing antibody titers against Omicron sublineages (BA.1 and BA.5) and the ancestral strain. T-cell immune response was efficiently induced and maintained during the study period. Conclusions mRNA vaccine booster dose elicited durable humoral immunity for up to 1 year after the third dose and T-cell immunity was sustained during the study period, supporting an annual COVID-19 vaccination strategy.
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Affiliation(s)
- Min Joo Choi
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Hakjun Hyun
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yu Bin Seo
- Division of Infectious Disease, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Ji Yun Noh
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center - Korea University College of Medicine, Seoul, Republic of Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center - Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center - Korea University College of Medicine, Seoul, Republic of Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, ASAN Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
| | - Ju-yeon Choi
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Republic of Korea
| | - Young Jae Lee
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Republic of Korea
| | - Eun Joo Chung
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Republic of Korea
| | - Su-Hwan Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Republic of Korea
| | - Hyeonji Jeong
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Republic of Korea
| | - Byoungguk Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Republic of Korea
| | - Joon Young Song
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Vaccine Innovation Center - Korea University College of Medicine, Seoul, Republic of Korea
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8
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Inoue W, Kimura Y, Okamoto S, Nogimori T, Sakaguchi-Mikami A, Yamamoto T, Tsunetsugu-Yokota Y. SARS-CoV-2-Specific Immune Responses in Vaccination and Infection during the Pandemic in 2020-2022. Viruses 2024; 16:446. [PMID: 38543812 PMCID: PMC10974545 DOI: 10.3390/v16030446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 05/23/2024] Open
Abstract
To gain insight into how immunity develops against SARS-CoV-2 from 2020 to 2022, we analyzed the immune response of a small group of university staff and students who were either infected or vaccinated. We investigated the levels of receptor-binding domain (RBD)-specific and nucleocapsid (N)-specific IgG and IgA antibodies in serum and saliva samples taken early (around 10 days after infection or vaccination) and later (around 1 month later), as well as N-specific T-cell responses. One patient who had been infected in 2020 developed serum RBD and N-specific IgG antibodies, but declined eight months later, then mRNA vaccination in 2021 produced a higher level of anti-RBD IgG than natural infection. In the vaccination of naïve individuals, vaccines induced anti-RBD IgG, but it declined after six months. A third vaccination boosted the IgG level again, albeit to a lower level than after the second. In 2022, when the Omicron variant became dominant, familial transmission occurred among vaccinated people. In infected individuals, the levels of serum anti-RBD IgG antibodies increased later, while anti-N IgG peaked earlier. The N-specific activated T cells expressing IFN γ or CD107a were detected only early. Although SARS-CoV-2-specific salivary IgA was undetectable, two individuals showed a temporary peak in RBD- and N-specific IgA antibodies in their saliva on the second day after infection. Our study, despite having a small sample size, revealed that SARS-CoV-2 infection triggers the expected immune responses against acute viral infections. Moreover, our findings suggest that the temporary mucosal immune responses induced early during infection may provide better protection than the currently available intramuscular vaccines.
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Affiliation(s)
- Wakana Inoue
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Yuta Kimura
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Shion Okamoto
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Takuto Nogimori
- Laboratory of Precision Immunology, Center for Intractable Diseases and ImmunoGenomics, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 567-0085, Japan; (T.N.); (T.Y.)
| | - Akane Sakaguchi-Mikami
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
| | - Takuya Yamamoto
- Laboratory of Precision Immunology, Center for Intractable Diseases and ImmunoGenomics, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 567-0085, Japan; (T.N.); (T.Y.)
- Laboratory of Aging and Immune Regulation, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka 565-0871, Japan
- Department of Virology and Immunology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yasuko Tsunetsugu-Yokota
- Department of Medical Technology, School of Health Sciences and Graduate School of Medical Technology, Tokyo University of Technology, Tokyo 144-8535, Japan; (W.I.); (Y.K.); (S.O.); (A.S.-M.)
- Laboratory of Precision Immunology, Center for Intractable Diseases and ImmunoGenomics, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 567-0085, Japan; (T.N.); (T.Y.)
- Research Institute, The World New Prosperity (WNP), Tokyo 169-0075, Japan
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9
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Stirrup O, Tut G, Krutikov M, Bone D, Lancaster T, Azmi B, Monakhov I, Moss P, Hayward A, Copas A, Shallcross L. Anti-nucleocapsid antibody levels following initial and repeat SARS-CoV-2 infections in a cohort of long-term care facility residents in England (VIVALDI). Wellcome Open Res 2024; 9:45. [PMID: 38818129 PMCID: PMC11137476 DOI: 10.12688/wellcomeopenres.20750.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 06/01/2024] Open
Abstract
Background We have previously demonstrated that older residents of long-term care facilities (LTCF) in the UK show levels of anti-spike antibodies that are comparable to the general population following primary series and booster vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, data on the humoral response to other SARS-CoV-2 proteins associated with natural infection are scarce in this vulnerable population. Methods We measured quantitative levels of anti-nucleocapsid antibodies in blood samples taken from LTCF residents and staff after initial and repeat SARS-CoV-2 infections, between December 2020 and March 2023. Data on SARS-CoV-2 infection and vaccination were obtained through linkage to national datasets. Linear mixed effects models were used to investigate anti-nucleocapsid antibody levels, using log10 scale, in relation to time from most recent infection. This included evaluation of associations between repeat infection, staff/resident status, age, sex, Omicron infection and vaccination history and peak antibody level and slope of decline with time. Results We analysed 405 antibody observations from 220 residents and 396 observations from 215 staff. Repeat infection was associated with 8.5-fold (95%CI 4.9-14.8-fold) higher initial (peak) median anti-nucleocapsid antibody level, with steeper subsequent slope of decline. There were no significant differences in antibody level associated with resident (vs. staff) status or age, but Omicron infection was associated with 3.6-fold (95%CI 2.4-5.4-fold) higher levels. There was stronger evidence of waning of antibody levels over time in a sensitivity analysis in which observations were censored in cases with suspected undetected repeat infection. Conclusions We found similar levels of anti-nucleocapsid antibody in residents and staff of LTCFs. Repeat infection and infection with an Omicron strain were associated with higher peak values. There was evidence of waning of anti-nucleocapsid antibody levels over time.
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Affiliation(s)
- Oliver Stirrup
- Institute for Global Health, University College London, London, England, UK
| | - Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Maria Krutikov
- Institute of Health Informatics, University College London, London, England, UK
| | - David Bone
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Tara Lancaster
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Borscha Azmi
- Institute of Health Informatics, University College London, London, England, UK
| | | | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, England, UK
| | - Andrew Hayward
- Institute of Epidemiology & Health Care, University College London, London, England, UK
- Health Data Research UK, London, England, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, England, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, England, UK
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10
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Di Chiara C, Cantarutti A, Raffaella Petrara M, Bonfante F, Benetti E, Boracchini R, Bosa L, Carmona F, Cosma C, Cotugno N, Le Prevost M, Martini G, Meneghel A, Pagliari M, Palma P, Ruffoni E, Zin A, De Rossi A, Giaquinto C, Donà D, Padoan A. Stronger and durable SARS-CoV-2 immune response to mRNA vaccines in 5-11 years old children with prior COVID-19. Vaccine 2024; 42:263-270. [PMID: 38071105 DOI: 10.1016/j.vaccine.2023.12.006] [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: 08/14/2023] [Revised: 11/08/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND AND OBJECTIVES mRNA vaccines elicit a durable humoral response to SARS-CoV-2 in adults, whereas evidence in children is scarce. This study aimed to assess the early and long-term immune response to the mRNA vaccine in children with or without previous SARS-CoV-2 infection. METHODS In a multicentre prospective observational study, we profiled the immune response to the Pfizer BioNTech (BNT162b2) vaccine in 5-11-year-old children attending the University Pediatric Hospital of Padua and Bambino-Gesù Hospital in Rome (Italy) from December-2021 to February-2023. Blood samples were collected pre-, 1-, and 6-months after vaccination. Neutralizing antibodies (NAbs) and anti-spike-receptor-binding-domain (anti-S-RBD) IgG titers were analyzed through Plaque Reduction Neutralization Test (PRNT) and chemiluminescent immune-enzymatic assay (CLIA), respectively. Immune cell phenotypes were analyzed by flow cytometry. RESULTS Sixty children (26 [43 %] female, median age = 8 years [IQR = 7-10.7]) were enrolled in the study, including 46 children with a laboratory-confirmed previous COVID-19 (SARS-CoV-2-recovered) and 14 SARS-CoV-2-naïve participants defined as the absence of antigen-specific antibodies before vaccination. SARS-CoV-2-recovered participants recorded higher anti-S-RBD IgG and Wild-type and Omicron BA.2 NAbs titers than SARS-CoV-2-naïve participants at both 1- and 6-months after vaccination. Antibody titers correlated with T (Tregs) and B (Bregs) regulatory cell frequencies in SARS-CoV-2-recovered children. Both SARS-CoV-2-recovered and SARS-CoV-2-naïve participants decreased antibody titers by approximately 100 to 250 % from 1 to 6 months. While children with immunocompromising underlying conditions developed immune responses comparable to those of healthy children, solid organ transplant recipients exhibited lower levels of NAbs and anti-S-RBD IgG titers, as well as reduced frequencies of Tregs and Bregs. CONCLUSIONS mRNA vaccination triggered a higher production of specific anti-SARS-CoV-2 antibodies along with increased levels of regulatory cells in children with previous SARS-CoV-2 infection up to the following 6 months. These findings provide insights into boosting pre-existing immunity.
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Affiliation(s)
- Costanza Di Chiara
- Department for Women's and Children's Health, University of Padova, Via Giustiniani, 3 - 35128 Padua, Italy; Penta - Child Health Research, Corso Stati Uniti, 4 - 35127 Padua, Italy.
| | - Anna Cantarutti
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1 - 20126 Milan, Italy.
| | - Maria Raffaella Petrara
- Oncology and Immunology Section, Department of Surgery, Oncology and Gastroenterology, University of Padova, Via Giustiniani, 2 - 35124 Padua, Italy.
| | - Francesco Bonfante
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università, 10 - 35020 Legnaro (Padua), Italy.
| | - Elisa Benetti
- Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128 Padua, Italy.
| | - Riccardo Boracchini
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1 - 20126 Milan, Italy.
| | - Luca Bosa
- Department for Women's and Children's Health, University of Padova, Via Giustiniani, 3 - 35128 Padua, Italy.
| | - Francesco Carmona
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64 - 35128 Padua, Italy.
| | - Chiara Cosma
- Department of Laboratory Medicine, University-Hospital of Padova, Via Giambattista Belzoni, 160 - 35121 Padua, Italy.
| | - Nicola Cotugno
- Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Piazza Sant'Onofrio, 4 - 00165 Rome, Italy.
| | - Marthe Le Prevost
- Medical Research Council Clinical Trials Unit at University College London, 90 High Holborn, WC1V 6LJ London, United Kingdom.
| | - Giorgia Martini
- Department for Women's and Children's Health, University of Padova, Via Giustiniani, 3 - 35128 Padua, Italy.
| | - Alessandra Meneghel
- Department for Women's and Children's Health, University of Padova, Via Giustiniani, 3 - 35128 Padua, Italy.
| | - Matteo Pagliari
- Division of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università, 10 - 35020 Legnaro (Padua), Italy.
| | - Paolo Palma
- Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Piazza Sant'Onofrio, 4 - 00165 Rome, Italy.
| | - Elena Ruffoni
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64 - 35128 Padua, Italy.
| | - Annachiara Zin
- Department for Women's and Children's Health, University of Padova, Via Giustiniani, 3 - 35128 Padua, Italy.
| | - Anita De Rossi
- Oncology and Immunology Section, Department of Surgery, Oncology and Gastroenterology, University of Padova, Via Giustiniani, 2 - 35124 Padua, Italy; Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64 - 35128 Padua, Italy.
| | - Carlo Giaquinto
- Department for Women's and Children's Health, University of Padova, Via Giustiniani, 3 - 35128 Padua, Italy; Penta - Child Health Research, Corso Stati Uniti, 4 - 35127 Padua, Italy.
| | - Daniele Donà
- Department for Women's and Children's Health, University of Padova, Via Giustiniani, 3 - 35128 Padua, Italy; Penta - Child Health Research, Corso Stati Uniti, 4 - 35127 Padua, Italy.
| | - Andrea Padoan
- Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128 Padua, Italy.
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11
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Das R, Hyer RN, Burton P, Miller JM, Kuter BJ. Emerging heterologous mRNA-based booster strategies within the COVID-19 vaccine landscape. Hum Vaccin Immunother 2023; 19:2153532. [PMID: 36629006 PMCID: PMC9980456 DOI: 10.1080/21645515.2022.2153532] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Messenger RNA (mRNA)-based vaccine platforms used for the development of mRNA-1273 and BNT162b2 have provided a robust adaptable approach to offer protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, as variants of concern (VoCs), such as omicron and associated sub-variants, emerge, boosting strategies must also adapt to keep pace with the changing landscape. Heterologous vaccination regimens involving the administration of booster vaccines different than the primary vaccination series offer a practical, effective, and safe approach to continue to reduce the global burden of coronavirus disease 2019 (COVID-19). To understand the immunogenicity, effectiveness, and safety of heterologous mRNA-based vaccination strategies, relevant clinical and real-world observational studies were identified and summarized. Overall, heterologous boosting strategies with mRNA-based vaccines that are currently available and those in development will play an important global role in protecting individuals from COVID-19 caused by emerging VoCs.
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Affiliation(s)
- Rituparna Das
- Infectious Diseases, Moderna, Inc., Cambridge, MA, USA,CONTACT Rituparna Das Moderna, Inc., 200 Technology Square, Cambridge, MA02139, USA
| | - Randall N. Hyer
- Experimental Therapeutics, Baruch S. Blumberg Institute, Doylestown, PA, USA
| | - Paul Burton
- Infectious Diseases, Moderna, Inc., Cambridge, MA, USA
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12
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Holdenrieder S, Dos Santos Ferreira CE, Izopet J, Theel ES, Wieser A. Clinical and laboratory considerations: determining an antibody-based composite correlate of risk for reinfection with SARS-CoV-2 or severe COVID-19. Front Public Health 2023; 11:1290402. [PMID: 38222091 PMCID: PMC10788057 DOI: 10.3389/fpubh.2023.1290402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024] Open
Abstract
Much of the global population now has some level of adaptive immunity to SARS-CoV-2 induced by exposure to the virus (natural infection), vaccination, or a combination of both (hybrid immunity). Key questions that subsequently arise relate to the duration and the level of protection an individual might expect based on their infection and vaccination history. A multi-component composite correlate of risk (CoR) could inform individuals and stakeholders about protection and aid decision making. This perspective evaluates the various elements that need to be accommodated in the development of an antibody-based composite CoR for reinfection with SARS-CoV-2 or development of severe COVID-19, including variation in exposure dose, transmission route, viral genetic variation, patient factors, and vaccination status. We provide an overview of antibody dynamics to aid exploration of the specifics of SARS-CoV-2 antibody testing. We further discuss anti-SARS-CoV-2 immunoassays, sample matrices, testing formats, frequency of sampling and the optimal time point for such sampling. While the development of a composite CoR is challenging, we provide our recommendations for each of these key areas and highlight areas that require further work to be undertaken.
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Affiliation(s)
- Stefan Holdenrieder
- Institute of Laboratory Medicine, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | | | - Jacques Izopet
- Laboratory of Virology, Toulouse University Hospital and INFINITY Toulouse Institute for Infections and Inflammatory Diseases, INSERM UMR 1291 CNRS UMR 5051, University Toulouse III, Toulouse, France
| | - Elitza S. Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Munich, Germany
- Faculty of Medicine, Max Von Pettenkofer Institute, LMU Munich, Munich, Germany
- Immunology, Infection and Pandemic Research, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Munich, Germany
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13
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Yamamoto S, Matsuda K, Maeda K, Horii K, Okudera K, Oshiro Y, Inamura N, Nemoto T, Takeuchi JS, Li Y, Konishi M, Tsuchiya K, Gatanaga H, Oka S, Mizoue T, Sugiyama H, Aoyanagi N, Mitsuya H, Sugiura W, Ohmagari N. Preinfection Neutralizing Antibodies, Omicron BA.5 Breakthrough Infection, and Long COVID: A Propensity Score-Matched Analysis. J Infect Dis 2023; 228:1652-1661. [PMID: 37756608 DOI: 10.1093/infdis/jiad317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/04/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Data are limited on the role of preinfection humoral immunity protection against Omicron BA.5 infection and long coronavirus disease (COVID) development. METHODS We conducted nested case-control analysis among tertiary hospital staff in Tokyo who donated blood samples in June 2022 (1 month before Omicron BA.5 wave), approximately 6 months after receiving a third dose of COVID-19 mRNA vaccine. We measured live virus-neutralizing antibody titers against wild type and Omicron BA.5, and anti-receptor-binding domain (RBD) antibody titers at preinfection, and compared them between cases and propensity-matched controls. Among the breakthrough cases, we examined association between preinfection antibody titers and incidence of long COVID. RESULTS Preinfection anti-RBD and neutralizing antibody titers were lower in cases than controls. Neutralizing titers against wild type and Omicron BA.5 were 64% (95% confidence interval [CI], 42%-77%) and 72% (95% CI, 53%-83%) lower, respectively, in cases than controls. Individuals with previous Omicron BA.1/BA.2 infections were more frequent among controls than cases (10.3% vs 0.8%), and their Omicron BA.5 neutralizing titers were 12.8-fold higher than infection-naive individuals. Among cases, preinfection antibody titers were not associated with incidence of long COVID. CONCLUSIONS Preinfection immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play a role in protecting against the Omicron BA.5 infection but not preventing long COVID.
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Affiliation(s)
- Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kouki Matsuda
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Japan Foundation for AIDS Prevention, Tokyo, Japan
- Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Kenji Maeda
- Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kumi Horii
- Infection Control Office, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Kaori Okudera
- Infection Control Office, Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Yusuke Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Natsumi Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Takashi Nemoto
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Junko S Takeuchi
- Department of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yunfei Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kiyoto Tsuchiya
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Nobuyoshi Aoyanagi
- Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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14
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Ye W, Li K, Zhao Z, Wu S, Qu H, Guo Y, Abudunaibi B, Chen W, Cai S, Chen C, Lin J, Xie Z, Zhan M, Ou J, Deng Y, Chen T, Zheng K. Inactivated vaccine effectiveness against symptomatic COVID-19 in Fujian, China during the Omicron BA.2 outbreak. Front Public Health 2023; 11:1269194. [PMID: 38162626 PMCID: PMC10757624 DOI: 10.3389/fpubh.2023.1269194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/10/2023] [Indexed: 01/03/2024] Open
Abstract
Objective More than 90% of the Chinese population have completed 2 doses of inactivated COVID-19 vaccines in Mainland China. However, after China government abandoned strict control measures, many breakthrough infections appeared, and vaccine effectiveness against Omicron BA.2 infection was uncertain. This study aims to investigate the real-world effectiveness of widely used inactivated vaccines during the wave of Omicron variants. Methods Test-negative case-control study was conducted in this study to analyze the vaccine effectiveness against symptomatic disease caused by the Omicron variant (BA.2) in Fujian, China. Conditional logistic regression was selected to estimate the vaccine effectiveness. Results The study found the vaccine effectiveness against symptomatic COVID-19 is 32.46% (95% CI, 8.08% to 50.37%) at 2 to 8 weeks, and 27.05% (95% CI, 1.23% to 46.12%) at 12 to 24 weeks after receiving booster doses of the inactivated vaccine. Notably, the 3-17 years group had higher vaccine effectiveness after 2 doses than the 18-64 years and over 65 years groups who received booster doses. Conclusion Inactivated vaccines alone may not offer sufficient protection for all age groups before the summer of 2022. To enhance protection, other types of vaccines or bivalent vaccines should be considered.
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Affiliation(s)
- Wenjing Ye
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Kangguo Li
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang an Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Zeyu Zhao
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang an Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Shenggen Wu
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Huimin Qu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang an Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Yichao Guo
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang an Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Buasiyamu Abudunaibi
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang an Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Wu Chen
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Shaojian Cai
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Cailin Chen
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Jiawei Lin
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Zhonghang Xie
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Meirong Zhan
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Jianming Ou
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yanqin Deng
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Tianmu Chen
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang an Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Kuicheng Zheng
- Institute of Emergency Response and Epidemic Management, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
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15
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Mögling R, Reimerink J, Stanoeva KR, Keramarou M, Guiomar R, Costa I, Haveri A, Holzer B, Korukluoğlu G, Nguyen T, Pakarna G, Pancer K, Trilar KP, Protic J, Stojanović M, De Santis R, Lista F, Vremera T, Leustean M, Pistol A, Zelena H, Reusken C, Broberg EK. Comparative study between virus neutralisation testing and other serological methods detecting anti-SARS-CoV-2 antibodies in Europe, 2021. J Virol Methods 2023; 322:114825. [PMID: 37778539 PMCID: PMC10682845 DOI: 10.1016/j.jviromet.2023.114825] [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: 05/25/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/03/2023]
Abstract
One consequence of the ongoing coronavirus disease pandemic was the rapid development of both in-house and commercial serological assays detecting anti-SARS-CoV-2 antibodies, in an effort to reliably detect acute and past SARS-CoV-2 infections. It is crucial to evaluate the quality of these serological tests and consequently the sero-epidemiological studies that are performed with the respective tests. Here, we describe the set-up and results of a comparative study, in which a laboratory contracted by the European Centre for Disease Prevention and Control offered a centralised service to EU/EEA Member and pre-accession Member States to test representative serum specimens with known serological results, with the gold standard technique (virus neutralisation tests) to determine the presence of neutralising antibodies. Laboratories from 12 European countries shared 719 serum specimens with the contractor laboratory. We found that in-house serological tests detecting neutralising antibodies showed the highest percent agreement, both positive and negative, with the virus neutralisation test results. Despite extensive differences in virus neutralisation protocols neutralisation titres showed a strong correlation. From the commercial assays, the best positive percent agreement was found for SARS-CoV-2 IgG (sCOVG) (Siemens - Atellica IM Analyzer). Despite lower positive percent agreement of LIAISON SARS-CoV-2 TrimericS IgG kit (Diasorin Inc.), the obtained results showed relatively good correlation with neutralisation titres. The set-up of this study allowed for high comparability between laboratories and enabled laboratories that do not have the capacity or capability to perform VNTs themselves. Given the variety of in-house protocols detecting SARS-CoV-2 specific neutralising antibodies, including the virus strain, it could be of interest to select reference isolates for SARS-CoV-2 diagnostic to be made available for interested EU Member States and pre-accession countries.
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Affiliation(s)
- Ramona Mögling
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Johan Reimerink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Kamelia R Stanoeva
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Maria Keramarou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Raquel Guiomar
- The National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Inês Costa
- The National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Anu Haveri
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Barbara Holzer
- Austrian Agency for Health and Food Safety GmbH, Vienna, Austria
| | | | - Trung Nguyen
- Laboratoire National de Santé, Dudelange, Luxembourg
| | - Gatis Pakarna
- Riga East Clinical University Hospital, Riga, Latvia
| | | | | | - Jelena Protic
- Institute of Virology, Vaccines, and Sera - Torlak, Belgrade, Serbia
| | | | | | | | | | | | - Adriana Pistol
- National Institute for Public Health, Bucharest, Romania
| | - Hana Zelena
- Public Health Institute Ostrava, Ostrava, Czech Republic
| | - Chantal Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Eeva K Broberg
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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16
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Tan-Lim CSC, Gonzales MLAM, Dans LF, Cordero CP, Alejandria MM, Dela Paz ECC, Dator MA, Infantado-Alejandro MAJ, Sulit MVV, Lansang MAD. Reinfection rates, change in antibody titers and adverse events after COVID-19 vaccination among patients previously infected with COVID-19 in Metro Manila, Philippines: a secondary analysis of a completed cohort study. BMC Infect Dis 2023; 23:750. [PMID: 37915006 PMCID: PMC10621145 DOI: 10.1186/s12879-023-08743-6] [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: 07/03/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Variation in immune response to COVID-19 vaccines is observed among different ethnicities. We aimed to describe the reinfection rates, change in antibody titers, and adverse events among Filipinos. METHODS This is a secondary analysis of a cohort study of 307 participants within one year of having COVID-19 infection. We measured COVID-19 antibody levels at pre-determined timepoints (Days 21, 90, 180, 270, and 360 from initial infection). We monitored for COVID-19 symptoms and obtained details on COVID-19 vaccination. An adjudication committee classified the participants as probable, possible, or unlikely COVID-19 reinfection. We determined the probable reinfection rate, adverse events, and the geometric mean titer (GMT) ratio of pre- and post-vaccination antibody levels according to type and brand of COVID-19 vaccine. RESULTS At the end of the follow-up period, 287 (93.5%) out of 307 study participants were fully vaccinated, 1 was partially vaccinated (0.3%), and 19 were unvaccinated (6.2%). Among the fully vaccinated participants, those given mRNA vaccines had the lowest reinfection rate (19.2 cases/100 person-years, 95% CI 9.6, 38.4), followed by viral vector vaccines (29.8 cases/100 person-years, 95% CI 16.9, 52.4). We observed the highest reinfection rate among those given inactivated virus vaccines (32.7 cases/100 person-years, 95% CI 23.6, 45.3). The reinfection rate was 8.6 cases/100 person-years (95% CI 4.1, 17.9) for unvaccinated participants and 3.6 cases/100 person-years (95% CI 0.5, 25.3) for partially vaccinated participants. We observed the largest rise in antibody titers among those given mRNA vaccines (GMT ratio 288.5), and the smallest rise among those given inactivated virus vaccines (GMT ratio 16.7). We observed the highest percentage of adverse events following immunization with viral vector vaccines (63.8%), followed by mRNA vaccines (62.7%), and the lowest for inactivated virus vaccines (34.7%). No serious adverse events were reported. CONCLUSION Vaccinees given the mRNA vaccines had the lowest reinfection rate and the highest rise in antibody titers. Vaccinees given inactivated virus vaccines had the highest reinfection rate, smallest rise in antibody titers, and lowest percentage of adverse events. The small sample size and imbalanced distribution of the type of vaccines received limits the external generalizability of our results. STUDY REGISTRATION The cohort study was registered at the Philippine Health Research Registry on December 14, 2020 (PHRR201214-003199).
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Affiliation(s)
- Carol Stephanie C Tan-Lim
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines.
| | - Ma Liza Antoinette M Gonzales
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Leonila F Dans
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Cynthia P Cordero
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Marissa M Alejandria
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Eva C Cutiongco Dela Paz
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Melissa A Dator
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Myzelle Anne J Infantado-Alejandro
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Maria Vanessa V Sulit
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
| | - Mary Ann D Lansang
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
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17
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Schest S, Langer C, Stiegler Y, Karnuth B, Arends J, Stiegler H, Masetto T, Peter C, Grimmler M. Vaccine-induced SARS-CoV-2 antibody response: the comparability of S1-specific binding assays depends on epitope and isotype discrimination. Front Immunol 2023; 14:1257265. [PMID: 37965324 PMCID: PMC10641008 DOI: 10.3389/fimmu.2023.1257265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/28/2023] [Indexed: 11/16/2023] Open
Abstract
Background Quantification of the SARS-CoV-2-specific immune response by serological immunoassays is critical for the management of the COVID-19 pandemic. In particular, neutralizing antibody titers to the viral spike (S) protein have been proposed as a correlate of protection (CoP). The WHO established the First International Standard (WHO IS) for anti-SARS-CoV-2 immunoglobulin (Ig) (NIBSC 20/136) to harmonize binding assays with the same antigen specificity by assigning the same unitage in binding antibody units (BAU)/ml. Method In this study, we analyzed the S1-specific antibody response in a cohort of healthcare workers in Germany (n = 76) during a three-dose vaccination course over 8.5 months. Subjects received either heterologous or homologous prime-boost vaccination with ChAdOx1 nCoV-19 (AstraZeneca) and BNT162b2 (Pfizer-BioNTech) or three doses of BNT162b2. Antibodies were quantified using three anti-S1 binding assays (ELISA, ECLIA, and PETIA) harmonized to the WHO IS. Serum levels of neutralizing antibodies were determined using a surrogate virus neutralization test (sVNT). Binding assays were compared using Spearman's rank correlation and Passing-Bablok regression. Findings All assays showed good correlation and similar antibody kinetics correlating with neutralizing potential. However, the assays show large proportional differences in BAU/ml. ECLIA and PETIA, which detect total antibodies against the receptor- binding domain (RBD) within the S1 subunit, interact similarly with the convalescent plasma-derived WHO IS but differently with vaccine serum, indicating a high sensitivity to the IgG/IgM/IgA ratio. Conclusion All three binding assays allow monitoring of the antibody response in COVID-19-vaccinated individuals. However, the assay-specific differences hinder the definition of a common protective threshold in BAU/ml. Our results highlight the need for the thoughtful use of conversion factors and consideration of method-specific differences. To improve the management of future pandemics and harmonize total antibody assays, we should strive for reference material with a well-characterized Ig isotype composition.
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Affiliation(s)
- Silvia Schest
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
- Health University of Applied Sciences Tyrol, Innsbruck, Austria
| | - Claus Langer
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Yuriko Stiegler
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Bianca Karnuth
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Jan Arends
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Hugo Stiegler
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Thomas Masetto
- Institute of Molecular Medicine I, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
| | - Christoph Peter
- Institute of Molecular Medicine I, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Matthias Grimmler
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Idstein, Germany
- DiaServe Laboratories GmbH, Iffeldorf, Germany
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18
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Schiffner J, Eisemann N, Baltus H, Jensen S, Wunderlich K, Schuesseler S, Eicker C, Teegen B, Boniakowsky D, Solbach W, Mischnik A. Dynamics of immunity over time: decline of anti-SARS-CoV-2 IgG antibodies and T-cell responses after mRNA vaccination in residents and health care workers in nursing homes and homes with assisted living support. GMS INFECTIOUS DISEASES 2023; 11:Doc02. [PMID: 37830111 PMCID: PMC10565841 DOI: 10.3205/id000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Background In the present study, we investigated the dynamics of immunity over time by measuring anti SARS-CoV-2 IgG antibodies and SARS-CoV-2 specific T-cell responses (interferon-gamma release assay) after two doses of vaccines in residents and health care workers (HCW). Mostly, 224 (98%) residents and 244 (89%) HCW received two doses of mRNA vaccine (BNT162b2, Pfizer-BioNTech); the rest of the participants received heterologous vaccinations with mRNA and vector vaccines. The study was conducted at the time when the Delta variant of SARS-CoV-2 prevailed. Methods We analyzed blood samples of 228 residents (median age 83.8 years) and of 273 HCW (median age 49.7 years) from five nursing homes and one home for the elderly with assisted living support at one specific time point. Participants received two vaccinations. The blood samples were analyzed for SARS-CoV-2 specific IgG antibody and T-cell responses. Results The initial immune responses in the younger participants were about 30% higher than in the older age group. Over time the estimated mean of the parameters (estimated from the study sample for the total population) decreased in all groups within the maximum observation period of 232 days. Comorbidities such as coronary heart disease or diabetes mellitus reduced the initial immune responses regardless of age. With regard to measured IgG antibody levels, absolute values decreased over time, whereas the interferon-gamma response remained at a constant level between day 120 and 180 and seemed to be less dependent on the time elapsed after vaccination. Conclusions Based on our data, it does not seem possible to determine a reliable threshold of robust immunity, but we suggest that high titres of neutralizing capacity and interferon-gamma response might be an indicator of protection against severe COVID-19 courses.
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Affiliation(s)
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Hannah Baltus
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Sina Jensen
- Health Protection Authority, Luebeck, Germany
| | | | | | | | - Bianca Teegen
- Klinisch-Immunologisches Labor Stoecker, Luebeck, Germany
| | | | - Werner Solbach
- Center for Infection and Inflammation Research, University of Luebeck, Germany
- German Center for Infection Research (DZIF), Luebeck, Germany
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19
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Bnaya A, Nacasch N, Einbinder Y, Shavit L, Erez D, Shashar M, Grupper A, Benchetrit S, Wand O, Cohen-Hagai K. Dialysis modality, humoral response to vaccine, and SARS-CoV-2 infection risk: Comparative prospective evaluation. Semin Dial 2023; 36:382-389. [PMID: 37042666 DOI: 10.1111/sdi.13155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/21/2023] [Accepted: 03/26/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND COVID-19 vaccinations have a central role in decreasing severe SARS-CoV-2 disease complications. This study investigated the long-term humoral immune response to BNT162b2 vaccine among hemodialysis (HD) versus peritoneal dialysis (PD) patients, and their relative risk for COVID-19 infection. METHODS This prospective, observational study included maintenance HD and PD patients who had received at least two BNT162b2 vaccine doses. Levels of antibodies targeting SARS-CoV-2 spike protein were measured 6 and 12 months after the first vaccine dose, and 2-3 weeks after the third and fourth vaccine doses. Patients were divided according to dialysis modality (HD or PD). Humoral response was evaluated at different time points among different vaccine regimens (two vs. three vs. four doses of vaccine). An adjusted multivariate model was used to assess cumulative risk for SARS-CoV-2 infection. RESULTS Eighty-seven HD and 36 PD patients were included. Among them, 106 (86%) received at least three vaccine doses. Both HD and PD patients demonstrated marked increases in humoral response 2-3 weeks after the third dose (mean anti-S antibody increased from 452 ± 501 AU/mL to 19,556 ± 14,949 AU/mL, p < 0.001). By 6 months after the third dose, antibody titers had declined significantly (mean anti-S antibody 9841 ± 10,493 AU/mL, p < 0.001). HD patients had higher risk for SARS-CoV-2 infection than PD patients (OR 4.4 [95% CI 1.4-13.6], p = 0.006). In multivariate analysis, the most important predictor for SARS-CoV-2 infection was dialysis modality. CONCLUSION This study found a high antibody response rate after the third and fourth doses of BNT162b2 vaccine among dialysis patients. Hemodialysis as dialysis modality is an important predictor of COVID-19 infection, despite similar humoral responses to vaccine in peritoneal dialysis.
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Affiliation(s)
- Alon Bnaya
- Institute of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linda Shavit
- Institute of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel Erez
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
| | - Moshe Shashar
- Department of Nephrology and Hypertension, Laniado Hospital, Netanya, Israel
| | - Ayelet Grupper
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ori Wand
- Pulmonary Division, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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de Gier B, Huiberts AJ, Hoeve CE, den Hartog G, van Werkhoven H, van Binnendijk R, Hahné SJM, de Melker HE, van den Hof S, Knol MJ. Effects of COVID-19 vaccination and previous infection on Omicron SARS-CoV-2 infection and relation with serology. Nat Commun 2023; 14:4793. [PMID: 37558656 PMCID: PMC10412579 DOI: 10.1038/s41467-023-40195-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
An increasing proportion of the population has acquired immunity through COVID-19 vaccination and previous SARS-CoV-2 infection, i.e., hybrid immunity, possibly affecting the risk of new infection. We aim to estimate the protective effect of previous infections and vaccinations on SARS-CoV-2 Omicron infection, using data from 43,257 adult participants in a prospective community-based cohort study in the Netherlands, collected between 10 January 2022 and 1 September 2022. Our results show that, for participants with 2, 3 or 4 prior immunizing events (vaccination or previous infection), hybrid immunity is more protective against infection with SARS-CoV-2 Omicron than vaccine-induced immunity, up to at least 30 weeks after the last immunizing event. Differences in risk of infection are partly explained by differences in anti-Spike RBD (S) antibody concentration, which is associated with risk of infection in a dose-response manner. Among participants with hybrid immunity, with one previous pre-Omicron infection, we do not observe a relevant difference in risk of Omicron infection by sequence of vaccination(s) and infection. Additional immunizing events increase the protection against infection, but not above the level of the first weeks after the previous event.
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Affiliation(s)
- Brechje de Gier
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Anne J Huiberts
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Christina E Hoeve
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Gerco den Hartog
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Henri van Werkhoven
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Rob van Binnendijk
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan J M Hahné
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan van den Hof
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
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21
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Hertz T, Levy S, Ostrovsky D, Oppenheimer H, Zismanov S, Kuzmina A, Friedman LM, Trifkovic S, Brice D, Chun-Yang L, Cohen-Lavi L, Shemer-Avni Y, Cohen-Lahav M, Amichay D, Keren-Naus A, Voloshin O, Weber G, Najjar-Debbiny R, Chazan B, McGargill MA, Webby R, Chowers M, Novack L, Novack V, Taube R, Nesher L, Weinstein O. Correlates of protection for booster doses of the SARS-CoV-2 vaccine BNT162b2. Nat Commun 2023; 14:4575. [PMID: 37516771 PMCID: PMC10387073 DOI: 10.1038/s41467-023-39816-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/28/2023] [Indexed: 07/31/2023] Open
Abstract
Vaccination, especially with multiple doses, provides substantial population-level protection against COVID-19, but emerging variants of concern (VOC) and waning immunity represent significant risks at the individual level. Here we identify correlates of protection (COP) in a multicenter prospective study following 607 healthy individuals who received three doses of the Pfizer-BNT162b2 vaccine approximately six months prior to enrollment. We compared 242 individuals who received a fourth dose to 365 who did not. Within 90 days of enrollment, 239 individuals contracted COVID-19, 45% of the 3-dose group and 30% of the four-dose group. The fourth dose elicited a significant rise in antibody binding and neutralizing titers against multiple VOCs reducing the risk of symptomatic infection by 37% [95%CI, 15%-54%]. However, a group of individuals, characterized by low baseline titers of binding antibodies, remained susceptible to infection despite significantly increased neutralizing antibody titers upon boosting. A combination of reduced IgG levels to RBD mutants and reduced VOC-recognizing IgA antibodies represented the strongest COP in both the 3-dose group (HR = 6.34, p = 0.008) and four-dose group (HR = 8.14, p = 0.018). We validated our findings in an independent second cohort. In summary combination IgA and IgG baseline binding antibody levels may identify individuals most at risk from future infections.
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Affiliation(s)
- Tomer Hertz
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Research Center, Seattle, USA.
| | - Shlomia Levy
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniel Ostrovsky
- Clinical Research Center, Soroka University Medical Center, and the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hanna Oppenheimer
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shosh Zismanov
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Alona Kuzmina
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lilach M Friedman
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sanja Trifkovic
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - David Brice
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lin Chun-Yang
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Liel Cohen-Lavi
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yonat Shemer-Avni
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Laboratory of Virology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Merav Cohen-Lahav
- Laboratory of Management, Soroka University Medical Center, Beer-Sheva, Israel
| | - Doron Amichay
- Central Laboratory, Clalit Health Services & Dept. of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Ayelet Keren-Naus
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Laboratory of Virology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Olga Voloshin
- Laboratory of Virology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Gabriel Weber
- Infectious Diseases Unit, Lady Davis Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ronza Najjar-Debbiny
- Infectious Diseases Unit, Lady Davis Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Bibiana Chazan
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Infectious Diseases Unit, Emek Medical Center, Afula, Israel
| | - Maureen A McGargill
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Richard Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Michal Chowers
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Meir Medical Center, Kfar Saba, Israel
| | - Lena Novack
- Clinical Research Center, Soroka University Medical Center, and the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center, and the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ran Taube
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Lior Nesher
- Infectious Disease Institute, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel.
| | - Orly Weinstein
- Dept. of Health systems management, faculty of health sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Hospital division, Clalit Health Services, Tel Aviv, Israel
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22
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Morgan G, Briollais L, Clausen M, Casalino S, Mighton C, Chowdhary S, Frangione E, Yiu Jordan Fung C, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Dagher M, Devine L, Friedman SM, Khan Z, McGeer A, McLeod SL, Richardson D, Stern S, Taher A, Wong I, Zarei N, Bombard Y, Lerner-Ellis J, Taher J. Public knowledge of SARS-CoV-2 serological and viral lineage laboratory testing and result interpretation: A GENCOV study cross-sectional survey. Clin Biochem 2023:110607. [PMID: 37406717 DOI: 10.1016/j.clinbiochem.2023.110607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES Concepts related to SARS-CoV-2 laboratory testing and result interpretation can be challenging to understand. A cross-sectional survey of COVID-19 positive adults residing in Ontario, Canada was conducted to explore how well people understand SARS-CoV-2 laboratory tests and their associated results. DESIGN AND METHODS Participants were recruited through fliers or by prospective recruitment of outpatients and hospitalized inpatients with COVID-19. Enrolled participants included consenting adults with a positive SARS-CoV-2 polymerase chain reaction test result. An 11-item questionnaire was developed by researchers, nurses, and physicians in the study team and was administered online between April 2021 to May 2022 upon enrolment into the study. RESULTS Responses were obtained from 940 of 1106 eligible participants (85% participation rate). Most respondents understood 1) that antibody results should not influence adherence to social distancing measures (n=602/888, 68%), 2) asymptomatic SARS-CoV-2 infection following test positivity (n=698/888, 79%), 3) serological test sensitivity in relation to post-infection timeline (n=540/891, 61%), and 4) limitations of experts' knowledge related to SARS-CoV-2 serology (n=693/887, 78%). Conversely, respondents demonstrated challenges understanding 1) conflicting molecular and serological test results and their relationship with immune protection (n=162/893, 18%) and 2) the impact of SARS-CoV-2 variants on vaccine effectiveness (n=235/891, 26%). Analysis of responses stratified by sociodemographic variables identified that respondents who were either: 1) female, 2) more educated, 3) aged 18-44, 4) from a high-income household, or 5) healthcare workers responded expectedly more often. CONCLUSIONS We have highlighted concepts related to SARS-CoV-2 laboratory tests and associated results which may be challenging to understand. The findings of this study enable us to identify 1) misconceptions related to various SARS-CoV-2 test results, 2) groups of individuals at risk, and 3) strategies to improve people's understanding of their test results.
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Affiliation(s)
- Gregory Morgan
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Marc Clausen
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Selina Casalino
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Chloe Mighton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sunakshi Chowdhary
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Erika Frangione
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Chun Yiu Jordan Fung
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; William Osler Health System, Brampton, ON, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Bjug Borgundvaag
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Department of Emergency Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Marc Dagher
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital, Toronto, ON, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Steven M Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Emergency Medicine, University Health Network, Toronto, ON, Canada
| | | | - Allison McGeer
- Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shelley L McLeod
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON, Canada
| | | | - Seth Stern
- Mackenzie Health, Richmond Hill, ON, Canada
| | - Ahmed Taher
- Mackenzie Health, Richmond Hill, ON, Canada; Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Iris Wong
- Mackenzie Health, Richmond Hill, ON, Canada
| | | | - Yvonne Bombard
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Jennifer Taher
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
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23
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DeJonge PM, Lambrou AS, Segaloff HE, Bateman A, Sterkel A, Griggs C, Baggott J, Kelly P, Thornburg N, Epperson M, Desamu-Thorpe R, Abedi G, Hsu CH, Nakayama JY, Ruffin J, Turner-Harper D, Matanock A, Almendares O, Whaley M, Chakrabarti A, DeGruy K, Daly M, Westergaard R, Tate JE, Kirking HL. Assessment of Anti-SARS-CoV-2 antibody levels among university students vaccinated with different COVID-19 primary and booster doses - fall 2021, Wisconsin. BMC Infect Dis 2023; 23:374. [PMID: 37277736 DOI: 10.1186/s12879-023-08332-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/16/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND University students commonly received COVID-19 vaccinations before returning to U.S. campuses in the Fall of 2021. Given likely immunologic variation among students based on differences in type of primary series and/or booster dose vaccine received, we conducted serologic investigations in September and December 2021 on a large university campus in Wisconsin to assess anti-SARS-CoV-2 antibody levels. METHODS We collected blood samples, demographic information, and COVID-19 illness and vaccination history from a convenience sample of students. Sera were analyzed for both anti-spike (anti-S) and anti-nucleocapsid (anti-N) antibody levels using World Health Organization standardized binding antibody units per milliliter (BAU/mL). Levels were compared across categorical primary COVID-19 vaccine series received and binary COVID-19 mRNA booster status. The association between anti-S levels and time since most recent vaccination dose was estimated by mixed-effects linear regression. RESULTS In total, 356 students participated, of whom 219 (61.5%) had received a primary vaccine series of Pfizer-BioNTech or Moderna mRNA vaccines and 85 (23.9%) had received vaccines from Sinovac or Sinopharm. Median anti-S levels were significantly higher for mRNA primary vaccine series recipients (2.90 and 2.86 log [BAU/mL], respectively), compared with those who received Sinopharm or Sinovac vaccines (1.63 and 1.95 log [BAU/mL], respectively). Sinopharm and Sinovac vaccine recipients were associated with a significantly faster anti-S decline over time, compared with mRNA vaccine recipients (P <.001). By December, 48/172 (27.9%) participants reported receiving an mRNA COVID-19 vaccine booster, which reduced the anti-S antibody discrepancies between primary series vaccine types. CONCLUSIONS Our work supports the benefit of heterologous boosting against COVID-19. COVID-19 mRNA vaccine booster doses were associated with increases in anti-SARS-CoV-2 antibody levels; following an mRNA booster dose, students with both mRNA and non-mRNA primary series receipt were associated with comparable levels of anti-S IgG.
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Affiliation(s)
- Peter M DeJonge
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, 30329, USA.
- Wisconsin Department of Health Services, Division of Public Health, Madison, Wisconsin, 53703, USA.
| | | | - Hannah E Segaloff
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, 30329, USA
- Wisconsin Department of Health Services, Division of Public Health, Madison, Wisconsin, 53703, USA
| | - Allen Bateman
- Wisconsin State Laboratory of Hygiene, Madison, Wisconsin, 53703, USA
| | - Alana Sterkel
- Wisconsin State Laboratory of Hygiene, Madison, Wisconsin, 53703, USA
| | - Carol Griggs
- University Health Services, University of Wisconsin - Madison, Madison, Wisconsin, 53703, USA
| | - Jake Baggott
- University Health Services, University of Wisconsin - Madison, Madison, Wisconsin, 53703, USA
| | - Patrick Kelly
- University Health Services, University of Wisconsin - Madison, Madison, Wisconsin, 53703, USA
| | | | | | | | - Glen Abedi
- CDC COVID-19 Response Team, Atlanta, Georgia, 30329, USA
| | | | - Jasmine Y Nakayama
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, 30329, USA
- CDC COVID-19 Response Team, Atlanta, Georgia, 30329, USA
| | - Jasmine Ruffin
- CDC COVID-19 Response Team, Atlanta, Georgia, 30329, USA
| | | | - Almea Matanock
- CDC COVID-19 Response Team, Atlanta, Georgia, 30329, USA
| | | | - Melissa Whaley
- CDC COVID-19 Response Team, Atlanta, Georgia, 30329, USA
| | | | - Kyle DeGruy
- CDC COVID-19 Response Team, Atlanta, Georgia, 30329, USA
| | - Michele Daly
- CDC COVID-19 Response Team, Atlanta, Georgia, 30329, USA
| | - Ryan Westergaard
- Wisconsin Department of Health Services, Division of Public Health, Madison, Wisconsin, 53703, USA
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24
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Perez-Saez J, Zaballa ME, Lamour J, Yerly S, Dubos R, Courvoisier DS, Villers J, Balavoine JF, Pittet D, Kherad O, Vuilleumier N, Kaiser L, Guessous I, Stringhini S, Azman AS. Long term anti-SARS-CoV-2 antibody kinetics and correlate of protection against Omicron BA.1/BA.2 infection. Nat Commun 2023; 14:3032. [PMID: 37230973 DOI: 10.1038/s41467-023-38744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Binding antibody levels against SARS-CoV-2 have shown to be correlates of protection against infection with pre-Omicron lineages. This has been challenged by the emergence of immune-evasive variants, notably the Omicron sublineages, in an evolving immune landscape with high levels of cumulative incidence and vaccination coverage. This in turn limits the use of widely available commercial high-throughput methods to quantify binding antibodies as a tool to monitor protection at the population-level. Here we show that anti-Spike RBD antibody levels, as quantified by the immunoassay used in this study, are an indirect correlate of protection against Omicron BA.1/BA.2 for individuals previously infected by SARS-CoV-2. Leveraging repeated serological measurements between April 2020 and December 2021 on 1083 participants of a population-based cohort in Geneva, Switzerland, and using antibody kinetic modeling, we found up to a three-fold reduction in the hazard of having a documented positive SARS-CoV-2 infection during the Omicron BA.1/BA.2 wave for anti-S antibody levels above 800 IU/mL (HR 0.30, 95% CI 0.22-0.41). However, we did not detect a reduction in hazard among uninfected participants. These results provide reassuring insights into the continued interpretation of SARS-CoV-2 binding antibody measurements as an independent marker of protection at both the individual and population levels.
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Affiliation(s)
- Javier Perez-Saez
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - María-Eugenia Zaballa
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Lamour
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sabine Yerly
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
| | - Richard Dubos
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Delphine S Courvoisier
- General Directorate of Health, Geneva, Switzerland
- Division of Quality of Care, Geneva University Hospitals, Geneva, Switzerland
| | - Jennifer Villers
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | | | - Didier Pittet
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Infection Control Program and World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals, Geneva, Switzerland
| | - Omar Kherad
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Internal Medicine, Hôpital de la Tour, Geneva, Switzerland
| | - Nicolas Vuilleumier
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Kaiser
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Andrew S Azman
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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25
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Doucette EJ, Gray J, Fonseca K, Charlton C, Kanji JN, Tipples G, Kuhn S, Dunn J, Sayers P, Symonds N, Wu G, Freedman SB, Kellner JD. A longitudinal seroepidemiology study to evaluate antibody response to SARS-CoV-2 virus infection and vaccination in children in Calgary, Canada from July 2020 to April 2022: Alberta COVID-19 Childhood Cohort (AB3C) Study. PLoS One 2023; 18:e0284046. [PMID: 37023007 PMCID: PMC10079115 DOI: 10.1371/journal.pone.0284046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Measurement of SARS-CoV-2 antibody seropositivity is important to accurately understand exposure to infection and/or vaccination in specific populations. This study aimed to estimate the serologic response to SARS-CoV-2 virus infection and vaccination in children in Calgary, Alberta over a two-year period. METHODS Children with or without prior SARS-CoV-2 infections, were enrolled in Calgary, Canada in 2020. Venous blood was sampled 4 times from July 2020 to April 2022 for SARS-CoV-2 nucleocapsid and spike antibodies. Demographic and clinical information was obtained including SARS-CoV-2 testing results and vaccination records. RESULTS 1035 children were enrolled and 88.9% completed all 4 visits; median age 9 years (IQR: 5,13); 519 (50.1%) female; and 815 (78.7%) Caucasian. Before enrolment, 118 (11.4%) had confirmed or probable SARS-CoV-2. By April 2022, 39.5% of previously uninfected participants had a SARS-CoV-2 infection. Nucleocapsid antibody seropositivity declined to 16.4% of all infected children after more than 200 days post diagnosis. Spike antibodies remained elevated in 93.6% of unvaccinated infected children after more than 200 days post diagnosis. By April 2022, 408 (95.6%) children 12 years and older had received 2 or more vaccine doses, and 241 (61.6%) 5 to 11 year-old children had received 2 vaccine doses. At that time, all 685 vaccinated children had spike antibodies, compared with 94/176 (53.4%) of unvaccinated children. CONCLUSIONS In our population, after the first peak of Omicron variant infections and introduction of COVID-19 vaccines for children, all vaccinated children, but just over one-half of unvaccinated children, had SARS-CoV-2 spike antibodies indicating infection and/or vaccination, highlighting the benefit of vaccination. It is not yet known whether a high proportion of seropositivity at the present time predicts sustained population-level protection against future SARS-CoV-2 transmission, infection or severe COVID-19 outcomes in children.
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Affiliation(s)
- Emily J. Doucette
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Joslyn Gray
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin Fonseca
- Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
- Public Health Laboratory, Alberta Precision Laboratories, Alberta, Canada
| | - Carmen Charlton
- Public Health Laboratory, Alberta Precision Laboratories, Alberta, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alberta, Canada
| | - Jamil N. Kanji
- Public Health Laboratory, Alberta Precision Laboratories, Alberta, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Division of Infectious Diseases, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Graham Tipples
- Public Health Laboratory, Alberta Precision Laboratories, Alberta, Canada
- Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alberta, Canada
- Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Susan Kuhn
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jessica Dunn
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Payton Sayers
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nicola Symonds
- School of Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Guosong Wu
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Stephen B. Freedman
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada
| | - James D. Kellner
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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26
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Yamamoto S, Matsuda K, Maeda K, Horii K, Okudera K, Oshiro Y, Inamura N, Takeuchi JS, Konishi M, Ozeki M, Mizoue T, Sugiyama H, Aoyanagi N, Mitsuya H, Sugiura W, Ohmagari N. Neutralizing antibodies after three doses of the BNT162b2 vaccine, breakthrough infection, and symptoms during the Omicron-predominant wave. Int J Infect Dis 2023; 128:347-354. [PMID: 36693493 PMCID: PMC9867771 DOI: 10.1016/j.ijid.2023.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To investigate the role of immunogenicity after the third vaccine dose against Omicron infection and COVID-19-compatible symptoms of infection. METHODS First, we examined vaccine effectiveness (VE) of the third dose against the second dose during the Omicron wave among the staff at a tertiary hospital in Tokyo. In a case-control study of third vaccine recipients, we compared the preinfection live-virus neutralizing antibodies (NAb) against Omicron between breakthrough cases and their controls who had close contact with patients with COVID-19. Among these cases, we examined the association between NAb levels and the number of COVID-19-compatible symptoms. RESULTS Among the 1456 participants for VE analysis, 60 breakthrough infections occurred during the Omicron wave. The third dose VE for infection was 54.6%. Among the third dose recipients, NAb levels against Omicron did not differ between the cases (n = 22) and controls (n = 21). Among the cases, those who experienced COVID-19-compatible symptoms had lower NAb levels against Omicron than those who did not. CONCLUSION The third vaccine dose was effective in decreasing the risk of SARS-CoV-2 infection during Omicron wave compared with the second dose. Among third dose recipients, higher preinfection NAb levels may not be associated with a lower risk of Omicron infection. Contrarily, they may be associated with fewer symptoms of infection.
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Affiliation(s)
- Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Kouki Matsuda
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Kumi Horii
- Infection Control Office, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Kaori Okudera
- Infection Control Office, Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Yusuke Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Natsumi Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Junko S Takeuchi
- Department of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuru Ozeki
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Haruhito Sugiyama
- Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Nobuyoshi Aoyanagi
- Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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27
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Aurisicchio L, Brambilla N, Cazzaniga ME, Bonfanti P, Milleri S, Ascierto PA, Capici S, Vitalini C, Girolami F, Giacovelli G, Caselli G, Visintin M, Fanti F, Ghirri M, Conforti A, Compagnone M, Lione L, Salvatori E, Pinto E, Muzi A, Marra E, Palombo F, Roscilli G, Manenti A, Montomoli E, Cadossi M, Rovati LC. A first-in-human trial on the safety and immunogenicity of COVID-eVax, a cellular response-skewed DNA vaccine against COVID-19. Mol Ther 2023; 31:788-800. [PMID: 36575794 PMCID: PMC9792419 DOI: 10.1016/j.ymthe.2022.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/05/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
The COVID-19 pandemic and the need for additional safe, effective, and affordable vaccines gave new impetus into development of vaccine genetic platforms. Here we report the findings from the phase 1, first-in-human, dose-escalation study of COVID-eVax, a DNA vaccine encoding the receptor binding domain (RBD) of the SARS-CoV-2 spike protein. Sixty-eight healthy adults received two doses of 0.5, 1, or 2 mg 28 days apart, or a single 2-mg dose, via intramuscular injection followed by electroporation, and they were monitored for 6 months. All participants completed the primary safety and immunogenicity assessments after 8 weeks. COVID-eVax was well tolerated, with mainly mild to moderate solicited adverse events (tenderness, pain, bruising, headache, and malaise/fatigue), less frequent after the second dose, and it induced an immune response (binding antibodies and/or T cells) at all prime-boost doses tested in up to 90% of the volunteers at the highest dose. However, the vaccine did not induce neutralizing antibodies, while particularly relevant was the T cell-mediated immunity, with a robust Th1 response. This T cell-skewed immunological response adds significant information to the DNA vaccine platform and should be assessed in further studies for its protective capacity and potential usefulness also in other therapeutic areas, such as oncology.
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Affiliation(s)
| | - Nadia Brambilla
- Rottapharm Biotech, Via Valosa di Sopra 9, 20900 Monza, Italy
| | - Marina E Cazzaniga
- Phase 1 Research Centre and Division of Medical Oncology, San Gerardo Hospital, University of Milano-Bicocca School of Medicine, 20900 Monza, Italy
| | - Paolo Bonfanti
- Infectious Diseases Unit, San Gerardo Hospital, University of Milano-Bicocca School of Medicine, 20900 Monza, Italy
| | - Stefano Milleri
- CRC - Centro Ricerche Cliniche di Verona, 37134 Verona, Italy
| | - Paolo A Ascierto
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, 80131 Napoli, Italy
| | - Serena Capici
- Phase 1 Research Centre and Division of Medical Oncology, San Gerardo Hospital, University of Milano-Bicocca School of Medicine, 20900 Monza, Italy
| | | | | | | | | | | | - Francesca Fanti
- Rottapharm Biotech, Via Valosa di Sopra 9, 20900 Monza, Italy
| | - Matteo Ghirri
- Rottapharm Biotech, Via Valosa di Sopra 9, 20900 Monza, Italy
| | - Antonella Conforti
- Takis Biotech, Via Castel Romano 100, 00128 Rome, Italy; Evvivax Biotech, Via Castel Romano 100, 00128 Rome, Italy
| | | | - Lucia Lione
- Takis Biotech, Via Castel Romano 100, 00128 Rome, Italy
| | | | | | - Alessia Muzi
- Takis Biotech, Via Castel Romano 100, 00128 Rome, Italy
| | | | - Fabio Palombo
- Takis Biotech, Via Castel Romano 100, 00128 Rome, Italy
| | | | | | - Emanuele Montomoli
- VisMederi Research, 53100 Siena, Italy; Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | | | - Lucio C Rovati
- Rottapharm Biotech, Via Valosa di Sopra 9, 20900 Monza, Italy; University of Milano-Bicocca School of Medicine, 20900 Monza, Italy.
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Dimech WJ, Vincini GA, Plebani M, Lippi G, Nichols JH, Sonntag O. Time to address quality control processes applied to antibody testing for infectious diseases. Clin Chem Lab Med 2023; 61:205-212. [PMID: 36345644 DOI: 10.1515/cclm-2022-0986] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
As testing for infectious diseases moves from manual, biological testing such as complement fixation to high throughput automated autoanalyzer, the methods for controlling these assays have also changed to reflect those used in clinical chemistry. However, there are many differences between infectious disease serology and clinical chemistry testing, and these differences have not been considered when applying traditional quality control methods to serology. Infectious disease serology, which is highly regulated, detects antibodies of varying classes and to multiple and different antigens that change according to the organisms' genotype/serotype and stage of disease. Although the tests report a numerical value (usually signal to cut-off), they are not measuring an amount of antibodies, but the intensity of binding within the test system. All serology assays experience lot-to-lot variation, making the use of quality control methods used in clinical chemistry inappropriate. In many jurisdictions, the use of the manufacturer-provided kit controls is mandatory to validate the test run. Use of third-party controls, which are highly recommended by ISO 15189 and the World Health Organization, must be manufactured in a manner whereby they have minimal lot-to-lot variation and at a level where they detect exceptional variation. This paper outlines the differences between clinical chemistry and infectious disease serology and offers a range of recommendations when addressing the quality control of infectious disease serology.
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Affiliation(s)
- Wayne J Dimech
- National Serology Reference Laboratory, Melbourne, Australia
| | | | | | - Giuseppe Lippi
- Department of Clinical Biochemistry, University of Verona, Verona, Italy
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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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Bailey AJ, Maganti HB, Cheng W, Shorr R, Arianne Buchan C, Allan DS. Humoral and Cellular Response of Transplant Recipients to a Third Dose of mRNA SARS-CoV-2 Vaccine: A Systematic Review and Meta-analysis. Transplantation 2023; 107:204-215. [PMID: 36398334 PMCID: PMC9746229 DOI: 10.1097/tp.0000000000004386] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND High rates of nonresponse to 2 doses of mRNA severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine have been reported in transplant recipients. Several studies have investigated the efficacy of a third dose in this population. However, efficacy remains unclear, as response rates vary across studies. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in transplant recipients. METHODS Preferred Reporting Items for Systematic Review and Meta-Analysis reporting guidelines (PROSPERO:CRD42021281498) were followed. Medline, Embase, and CENTRAL were searched from inception to December 2, 2021, without restrictions. All full-text studies reporting on the efficacy of a third dose of any mRNA SARS-CoV-2 vaccine in pediatric and adult transplant recipients were included. The National Institutes of Health quality assessment tool for case series and the Cochrane risk of bias tool determined study quality. Meta-analysis was performed via the DerSimonian-Laird random-effect model. RESULTS Of 84 records, 12 studies totaling 1257 patients met inclusion criteria. One study was a randomized controlled trial, whereas all other studies were observational. Across 7 studies (801 patients), humoral response after 3 doses was observed in 66.1% (95% confidence interval, 62.8%-69.4%; I2 = 0%) of transplant recipients. Triple immunosuppression, mycophenolate, antiproliferatives, and belatacept use were associated with reduced odds of humoral response in studies reporting multivariate analyses. Transplant recipients receiving a third dose displayed higher levels of neutralizing antibodies to SARS-CoV-2 variants (Alpha, Beta, and Delta) compared with placebo. CONCLUSIONS A third dose SARS-CoV-2 mRNA vaccine should be strongly considered in transplant recipients. Limitations included lack of controlled studies and clinically relevant thresholds to determine response to vaccination.
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Affiliation(s)
- Adrian J.M. Bailey
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Canadian Blood Services, Stem Cells and Centre for Innovation, Ottawa, ON, Canada
| | - Harinad B. Maganti
- Canadian Blood Services, Stem Cells and Centre for Innovation, Ottawa, ON, Canada
- Clinical Epidemiology and Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Wei Cheng
- Department of Biostatistics, Yale School of Public Health, New Haven, CT
| | - Risa Shorr
- Library and Information Services, The Ottawa Hospital, Ottawa, ON, Canada
| | - C. Arianne Buchan
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Infectious Diseases, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - David S. Allan
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Canadian Blood Services, Stem Cells and Centre for Innovation, Ottawa, ON, Canada
- Clinical Epidemiology and Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Blood and Marrow Transplant Program, Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
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Escudero-Pérez B, Lawrence P, Castillo-Olivares J. Immune correlates of protection for SARS-CoV-2, Ebola and Nipah virus infection. Front Immunol 2023; 14:1156758. [PMID: 37153606 PMCID: PMC10158532 DOI: 10.3389/fimmu.2023.1156758] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/20/2023] [Indexed: 05/09/2023] Open
Abstract
Correlates of protection (CoP) are biological parameters that predict a certain level of protection against an infectious disease. Well-established correlates of protection facilitate the development and licensing of vaccines by assessing protective efficacy without the need to expose clinical trial participants to the infectious agent against which the vaccine aims to protect. Despite the fact that viruses have many features in common, correlates of protection can vary considerably amongst the same virus family and even amongst a same virus depending on the infection phase that is under consideration. Moreover, the complex interplay between the various immune cell populations that interact during infection and the high degree of genetic variation of certain pathogens, renders the identification of immune correlates of protection difficult. Some emerging and re-emerging viruses of high consequence for public health such as SARS-CoV-2, Nipah virus (NiV) and Ebola virus (EBOV) are especially challenging with regards to the identification of CoP since these pathogens have been shown to dysregulate the immune response during infection. Whereas, virus neutralising antibodies and polyfunctional T-cell responses have been shown to correlate with certain levels of protection against SARS-CoV-2, EBOV and NiV, other effector mechanisms of immunity play important roles in shaping the immune response against these pathogens, which in turn might serve as alternative correlates of protection. This review describes the different components of the adaptive and innate immune system that are activated during SARS-CoV-2, EBOV and NiV infections and that may contribute to protection and virus clearance. Overall, we highlight the immune signatures that are associated with protection against these pathogens in humans and could be used as CoP.
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Affiliation(s)
- Beatriz Escudero-Pérez
- WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel-Reims, Braunschweig, Germany
- *Correspondence: Beatriz Escudero-Pérez, ; Javier Castillo-Olivares,
| | - Philip Lawrence
- CONFLUENCE: Sciences et Humanités (EA 1598), Université Catholique de Lyon (UCLy), Lyon, France
| | - Javier Castillo-Olivares
- Laboratory of Viral Zoonotics, University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Beatriz Escudero-Pérez, ; Javier Castillo-Olivares,
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Ailsworth SM, Keshavarz B, Richards NE, Workman LJ, Murphy DD, Nelson MR, Platts-Mills TA, Wilson JM. Enhanced SARS-CoV-2 IgG durability following COVID-19 mRNA booster vaccination and comparison of BNT162b2 with mRNA-1273. Ann Allergy Asthma Immunol 2023; 130:67-73. [PMID: 36241020 PMCID: PMC9553965 DOI: 10.1016/j.anai.2022.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND BNT162b2 (Pfizer/BioNTech, Comirnaty) and mRNA-1273 (Moderna, Spikevax) are messenger RNA (mRNA) vaccines that elicit antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (S-RBD) and have been approved by the US Food and Drug Administration to combat the coronavirus disease 2019 (COVID-19) pandemic. Because vaccine efficacy and antibody levels waned over time after the 2-shot primary series, the US Food and Drug Administration authorized a booster (third) dose for both mRNA vaccines to adults in the fall of 2021. OBJECTIVE To evaluate the magnitude and durability of S-RBD immunoglobulin (Ig)G after the booster mRNA vaccine dose in comparison to the primary series. We also compared S-RBD IgG levels after BNT162b2 and mRNA-1273 boosters and explored effects of age and prior infection. METHODS Surrounding receipt of the second and third homologous mRNA vaccine doses, adults in an employee-based cohort provided serum and completed questionnaires, including information about previous COVID-19 infection. The IgG to S-RBD was measured using an ImmunoCAP-based system. A subset of samples were assayed for IgG to SARS-CoV-2 nucleocapsid by commercial assay. RESULTS There were 228 subjects who had samples collected between 7 and 150 days after their primary series vaccine and 117 subjects who had samples collected in the same time frame after their boost. Antibody levels from 7 to 31 days after the primary series and booster were similar, but S-RBD IgG was more durable over time after the boost, regardless of prior infection status. In addition, mRNA-1273 post-boost antibody levels exceeded BNT162b2 out to 5 months. CONCLUSION The COVID-19 mRNA vaccine boosters increase antibody durability, suggesting enhanced long-term clinical protection from SARS-CoV-2 infection compared with the 2-shot regimen.
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Affiliation(s)
| | | | | | | | | | | | | | - Jeffrey M. Wilson
- Reprints: Jeffrey M. Wilson, MD, PhD, Division of Allergy & Clinical Immunology, University of Virginia, PO Box 801355, Charlottesville, VA 22908-1355
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Atti A, Insalata F, Carr EJ, Otter AD, Castillo-Olivares J, Wu M, Harvey R, Howell M, Chan A, Lyall J, Temperton N, Cantoni D, da Costa K, Nadesalingam A, Taylor-Kerr A, Hettiarachchi N, Tranquillini C, Hewson J, Cole MJ, Foulkes S, Munro K, Monk EJM, Milligan ID, Linley E, Chand MA, Brown CS, Islam J, Semper A, Charlett A, Heeney JL, Beale R, Zambon M, Hopkins S, Brooks T, Hall V. Antibody correlates of protection from SARS-CoV-2 reinfection prior to vaccination: A nested case-control within the SIREN study. J Infect 2022; 85:545-556. [PMID: 36089104 PMCID: PMC9458758 DOI: 10.1016/j.jinf.2022.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/05/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To investigate serological differences between SARS-CoV-2 reinfection cases and contemporary controls, to identify antibody correlates of protection against reinfection. METHODS We performed a case-control study, comparing reinfection cases with singly infected individuals pre-vaccination, matched by gender, age, region and timing of first infection. Serum samples were tested for anti-SARS-CoV-2 spike (anti-S), anti-SARS-CoV-2 nucleocapsid (anti-N), live virus microneutralisation (LV-N) and pseudovirus microneutralisation (PV-N). Results were analysed using fixed effect linear regression and fitted into conditional logistic regression models. RESULTS We identified 23 cases and 92 controls. First infections occurred before November 2020; reinfections occurred before February 2021, pre-vaccination. Anti-S levels, LV-N and PV-N titres were significantly lower among cases; no difference was found for anti-N levels. Increasing anti-S levels were associated with reduced risk of reinfection (OR 0·63, CI 0·47-0·85), but no association for anti-N levels (OR 0·88, CI 0·73-1·05). Titres >40 were correlated with protection against reinfection for LV-N Wuhan (OR 0·02, CI 0·001-0·31) and LV-N Alpha (OR 0·07, CI 0·009-0·62). For PV-N, titres >100 were associated with protection against Wuhan (OR 0·14, CI 0·03-0·64) and Alpha (0·06, CI 0·008-0·40). CONCLUSIONS Before vaccination, protection against SARS-CoV-2 reinfection was directly correlated with anti-S levels, PV-N and LV-N titres, but not with anti-N levels. Detectable LV-N titres were sufficient for protection, whilst PV-N titres >100 were required for a protective effect. TRIAL REGISTRATION NUMBER ISRCTN11041050.
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Affiliation(s)
- Ana Atti
- UK Health Security Agency, Smith Square, London SW1P, UK.
| | | | - Edward J Carr
- The Francis Crick Institute, 1 Midland Rd, London NW1 1AT, UK
| | - Ashley D Otter
- UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Javier Castillo-Olivares
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge University, Madingley Road, Cambridge CB3 0ES, UK
| | - Mary Wu
- The Francis Crick Institute, 1 Midland Rd, London NW1 1AT, UK
| | - Ruth Harvey
- The Francis Crick Institute, 1 Midland Rd, London NW1 1AT, UK
| | - Michael Howell
- The Francis Crick Institute, 1 Midland Rd, London NW1 1AT, UK
| | - Andrew Chan
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge University, Madingley Road, Cambridge CB3 0ES, UK
| | - Jonathan Lyall
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge University, Madingley Road, Cambridge CB3 0ES, UK
| | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Greenwich and Kent at Medway, Central Ave, Gillingham, Chatham ME4 4BF, UK
| | - Diego Cantoni
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Greenwich and Kent at Medway, Central Ave, Gillingham, Chatham ME4 4BF, UK
| | - Kelly da Costa
- Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Greenwich and Kent at Medway, Central Ave, Gillingham, Chatham ME4 4BF, UK
| | - Angalee Nadesalingam
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge University, Madingley Road, Cambridge CB3 0ES, UK
| | | | | | | | | | | | - Sarah Foulkes
- UK Health Security Agency, Smith Square, London SW1P, UK
| | - Katie Munro
- UK Health Security Agency, Smith Square, London SW1P, UK
| | | | | | - Ezra Linley
- Manchester Royal Infirmary, UK Health Security Agency, Oxford Road, Manchester M139WL, UK
| | - Meera A Chand
- UK Health Security Agency, Smith Square, London SW1P, UK
| | - Colin S Brown
- UK Health Security Agency, Smith Square, London SW1P, UK; The National Institute for Health Research Health Protection Research (NIHR) Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Old Road Campus, Headington, Oxford OX3 7BN, UK
| | - Jasmin Islam
- UK Health Security Agency, Smith Square, London SW1P, UK
| | - Amanda Semper
- UK Health Security Agency, Smith Square, London SW1P, UK
| | - Andre Charlett
- UK Health Security Agency, Smith Square, London SW1P, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol in partnership with Public Health England, Queens Road, Bristol BS8 1QU, UK; NIHR Health Protection Research Unit in Immunisation at the London School of Hygiene and Tropical Medicine in partnership with Public Health England, Keppel St, London WC1E 7HT, UK
| | | | - Rupert Beale
- The Francis Crick Institute, 1 Midland Rd, London NW1 1AT, UK
| | - Maria Zambon
- UK Health Security Agency, Smith Square, London SW1P, UK
| | - Susan Hopkins
- UK Health Security Agency, Smith Square, London SW1P, UK; The National Institute for Health Research Health Protection Research (NIHR) Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Old Road Campus, Headington, Oxford OX3 7BN, UK
| | - Tim Brooks
- UK Health Security Agency, Smith Square, London SW1P, UK
| | - Victoria Hall
- UK Health Security Agency, Smith Square, London SW1P, UK; The National Institute for Health Research Health Protection Research (NIHR) Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Old Road Campus, Headington, Oxford OX3 7BN, UK
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Anzinger JJ, Cameron-McDermott SM, Phillips YZR, Mendoza L, Anderson M, Cloherty G, Strachan-Johnson S, Lindo JF, Figueroa JP. Prevalence of SARS-CoV-2 antibodies after the Omicron surge, Kingston, Jamaica, 2022. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 2:100124. [PMID: 36415687 PMCID: PMC9671617 DOI: 10.1016/j.jcvp.2022.100124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
A cross-sectional SARS-CoV-2 serosurvey was conducted after the Omicron surge in Jamaica using 1,540 samples collected during March - May 2022 from persons attending antenatal, STI and non-communicable diseases clinics in Kingston, Jamaica. SARS-CoV-2 spike receptor binding domain (RBD) and/or nucleocapsid IgG antibodies were detected for 88.4% of the study population, with 77.0% showing evidence of previous SARS-CoV-2 infection. Of persons previously infected with SARS-CoV-2 and/or with COVID-19 vaccination, 9.6% were negative for spike RBD IgG, most of which were unvaccinated previously infected persons. Amongst unvaccinated previously infected people, age was associated with testing spike RBD IgG negative. When considering all samples, median spike RBD IgG levels were 131.6 BAU/mL for unvaccinated persons with serological evidence of past infection, 90.3 BAU/mL for vaccinated persons without serological evidence of past infection, and 896.1 BAU/mL for vaccinated persons with serological evidence of past infection. Our study of the first reported SARS-CoV-2 serosurvey in Jamaica shows extensive SARS-CoV-2 population immunity, identifies a substantial portion of the population lacking spike RBD IgG, and provides additional evidence for increasing COVID-19 vaccine coverage in Jamaica.
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Affiliation(s)
- Joshua J Anzinger
- The University of the West Indies, Kingston, Jamaica
- The Global Virus Network Jamaica Affiliate, Kingston, Jamaica
- Abbott Pandemic Defense Coalition, The University of the West Indies, Mona, Jamaica
| | | | | | | | - Mark Anderson
- Abbott Laboratories, Infectious Disease Research, Abbott Park, IL, United States of America
- Abbott Pandemic Defense Coalition, Abbott Park, Illinois, United States of America
| | - Gavin Cloherty
- Abbott Laboratories, Infectious Disease Research, Abbott Park, IL, United States of America
- Abbott Pandemic Defense Coalition, Abbott Park, Illinois, United States of America
| | | | - John F Lindo
- The University of the West Indies, Kingston, Jamaica
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Golec M, Konka A, Fronczek M, Zembala-John J, Chrapiec M, Wystyrk K, Kasperczyk S, Brzoza Z, Bułdak RJ. The Antibody Response to the BNT162b2 mRNA COVID-19 Booster in Healthcare Workers: Association between the IgG Antibody Titers and Anthropometric and Body Composition Parameters. Vaccines (Basel) 2022; 10:1638. [PMID: 36298503 PMCID: PMC9611156 DOI: 10.3390/vaccines10101638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Research shows that in most people, two-dose vaccination helps to shape the humoral response to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Further studies are required to learn about the vaccine's effectiveness after boosting. METHODS We conducted a prospective study among 103 healthcare workers (HCWs) from a regional multi-specialty hospital vaccinated with three doses of the BNT162b2 vaccine. We compared their immunoglobulin G (IgG) titers 14 days after the second dose with those 21 days after the booster. We also compared their anthropometric and body composition parameters with IgG concentrations at the same time points. RESULTS Twenty-one days after the booster, all study participants were seropositive. Their mean IgG antibody titers were significantly lower than 14 days after the second dose (158.94 AU/mL ± 90.34 AU/mL vs. 505.79 AU/mL ± 367.16 AU/mL). Post-booster Spearman's correlation analysis showed a significantly weak correlation between the IgG antibody titer and parameters related to muscle tissue and adipose tissue (including body fat mass). CONCLUSIONS The BNT162b2 booster stimulates the humoral response to a lesser extent than the two-dose BNT162b2 primary vaccination. The adipose and muscle tissue parameters show a weak positive correlation with the SARS-CoV-2 IgG antibody titers.
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Affiliation(s)
- Marlena Golec
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Adam Konka
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Martyna Fronczek
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 38, 41-808 Zabrze, Poland
| | - Joanna Zembala-John
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
- Department of Medicine and Environmental Epidemiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 19, 41-808 Zabrze, Poland
- Silesian Center for Heart Diseases in Zabrze, M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Martyna Chrapiec
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Karolina Wystyrk
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
| | - Sławomir Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 19, 41-808 Zabrze, Poland
| | - Zenon Brzoza
- Department of Internal Diseases, Allergology, Endocrinology and Gastroenterology, Institute of Medical Sciences, University of Opole, Al. W. Witosa 26, 40-451 Opole, Poland
| | - Rafał Jakub Bułdak
- Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Skłodowskiej 10C, 41-800 Zabrze, Poland
- Department of Clinical Biochemistry and Laboratory Diagnostics, Institute of Medical Sciences, University of Opole, Oleska 48, 45-052 Opole, Poland
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Williams E, Colson J, Valiathan R, Carreño JM, Krammer F, Hoffer M, Pallikkuth S, Pahwa S, Andrews D. Permissive omicron breakthrough infections in individuals with binding or neutralizing antibodies to ancestral SARS-CoV-2. Vaccine 2022; 40:5868-5872. [PMID: 36088193 PMCID: PMC9424516 DOI: 10.1016/j.vaccine.2022.08.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 08/12/2022] [Accepted: 08/24/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Breakthrough infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant (B.1.1.529) has occurred in populations with high vaccination rates. METHODS In a longitudinal cohort study, pre-breakthrough infection sera for Omicron breakthroughs (n = 12) were analyzed. Assays utilized include a laboratory-developed solid phase binding assay to recombinant spike protein, a commercial assay to the S1 domain of the spike protein calibrated to the World Health Organization (WHO) standard, and a commercial solid-phase surrogate neutralizing activity (SNA) assay. All assays employed spike protein preparations based on sequences from the Wuhan-Hu-1 strain. RESULTS Pre-breakthrough binding antibody titers ranged from 1:800 to 1:51,200 for the laboratory-developed binding assay, which correlated well and agreed quantitatively with the commercial spike S1 domain WHO calibrated assay. SNA was detected in 10/12 (83%) samples. CONCLUSIONS Neither high binding titers nor SNA were markers of protection from Omicron infection/re-infection.
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Affiliation(s)
- Erin Williams
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Biomedical Engineering, University of Miami, Miami, FL 33136, USA
| | - Jordan Colson
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Ranjini Valiathan
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Center for Vaccine Research and Pandemic Preparedness (C-VARPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Center for Vaccine Research and Pandemic Preparedness (C-VARPP), Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Hoffer
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Neurological Surgery, University of Miami, Miller School of Medicine, Miami, FL 33136, USA
| | - Suresh Pallikkuth
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Savita Pahwa
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - David Andrews
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Anzinger JJ, Cameron-McDermott SM, Phillips YZ, Mendoza L, Anderson M, Cloherty G, Strachan-Johnson S, Lindo JF, Figueroa JP. Prevalence of SARS-CoV-2 Antibodies after the Omicron Surge, Kingston, Jamaica, 2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.09.20.22280173. [PMID: 36172133 PMCID: PMC9516860 DOI: 10.1101/2022.09.20.22280173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A cross-sectional SARS-CoV-2 serosurvey was conducted after the Omicron surge in Jamaica using 1,540 samples collected during March â€" May 2022 from persons attending antenatal, STI and non-communicable diseases clinics in Kingston, Jamaica. SARS-CoV-2 spike receptor binding domain (RBD) and/or nucleocapsid IgG antibodies were detected for 88.4% of the study population, with 77.0% showing evidence of previous SARS-CoV-2 infection. Of persons previously infected with SARS-CoV-2 and/or with COVID-19 vaccination, 9.6% were negative for spike RBD IgG, most of which were unvaccinated previously infected persons. Amongst unvaccinated previously infected people, age was associated with testing spike RBD IgG negative. When considering all samples, median spike RBD IgG levels were 131.6 BAU/mL for unvaccinated persons with serological evidence of past infection, 90.3 BAU/mL for vaccinated persons without serological evidence of past infection, and 896.1 BAU/mL for vaccinated persons with serological evidence of past infection. Our study of the first reported SARS-CoV-2 serosurvey in Jamaica shows extensive SARS-CoV-2 population immunity, identifies a substantial portion of the population lacking spike RBD IgG, and provides additional evidence for increasing COVID-19 vaccine coverage in Jamaica.
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Affiliation(s)
- Joshua J. Anzinger
- The University of the West Indies, Kingston, Jamaica
- The Global Virus Network Jamaica Affiliate, Kingston, Jamaica
- Abbott Pandemic Defense Coalition, The University of the West Indies, Mona, Jamaica
| | | | | | | | - Mark Anderson
- Abbott Laboratories, Infectious Disease Research, Abbott Park, Illinois, United States of America
- Abbott Pandemic Defense Coalition, Abbott Park, Illinois, United States of America
| | - Gavin Cloherty
- Abbott Laboratories, Infectious Disease Research, Abbott Park, Illinois, United States of America
- Abbott Pandemic Defense Coalition, Abbott Park, Illinois, United States of America
| | | | - John F. Lindo
- The University of the West Indies, Kingston, Jamaica
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Seroprevalence of Anti-SARS-CoV-2 IgG Antibodies in Tyrol, Austria: Updated Analysis Involving 22,607 Blood Donors Covering the Period October 2021 to April 2022. Viruses 2022; 14:v14091877. [PMID: 36146684 PMCID: PMC9502884 DOI: 10.3390/v14091877] [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: 07/28/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Because a large proportion of the Austrian population has been infected with SARS-CoV-2 during high incidence periods in winter 2021/2022, up-to-date estimates of seroprevalence of anti-SARS-CoV-2 antibodies are required to inform upcoming public health policies. We quantified anti-Spike IgG antibody levels in 22,607 individuals that donated blood between October 2021 and April 2022 across Tyrol, Austria (participation rate: 96.0%). Median age of participants was 45.3 years (IQR: 30.9−55.1); 41.9% were female. From October 2021 to April 2022, seropositivity increased from 84.9% (95% CI: 83.8−86.0%) to 95.8% (94.9−96.4%), and the geometric mean anti-Spike IgG levels among seropositive participants increased from 283 (95% CI: 271−296) to 1437 (1360−1518) BAU/mL. The percentages of participants in categories with undetectable levels and detectable levels at <500, 500−<1000, 1000−<2000, 2000−<3000, and ≥3000 BAU/mL were 15%, 54%, 15%, 10%, 3%, and 3% in October 2021 vs. 4%, 18%, 17%, 18%, 11%, and 32% in April 2022. Of 2711 participants that had repeat measurements taken a median 4.2 months apart, 61.8% moved to a higher, 13.9% to a lower, and 24.4% remained in the same category. Among seropositive participants, antibody levels were 16.8-fold in vaccinated individuals compared to unvaccinated individuals (95% CI: 14.2−19.9; p-value < 0.001). In conclusion, anti-SARS-CoV-2 seroprevalence in terms of seropositivity and average antibody levels has increased markedly during the winter 2021/2022 SARS-CoV-2 waves in Tyrol, Austria.
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Ben Hamida A, Charles M, Murrill C, Henao O, Gallagher K. U.S. CDC support to international SARS-CoV-2 seroprevalence surveys, May 2020-February 2022. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000658. [PMID: 36157894 PMCID: PMC9490761 DOI: 10.1371/journal.pgph.0000658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/14/2022] [Indexed: 06/16/2023]
Abstract
SARS-CoV-2 seroprevalence surveys provide critical information to assess the burden of COVID-19, describe population immunity, and guide public health strategies. Early in the pandemic, most of these surveys were conducted within high-income countries, leaving significant knowledge gaps in low-and middle-income (LMI) countries. To address this gap, the U.S. Centers for Disease Control and Prevention (CDC) is supporting serosurveys internationally. We conducted a descriptive analysis of international serosurveys supported by CDC during May 12, 2020-February 28, 2022, using an internal tracker including data on the type of assistance provided, study design, population surveyed, laboratory testing performed, and status of implementation. Since the beginning of the pandemic, CDC has supported 72 serosurveys (77 serosurvey rounds) in 35 LMI countries by providing technical assistance (TA) on epidemiologic, statistical, and laboratory methods, financial assistance (FA), or both. Among these serosurvey rounds, the majority (61%) received both TA and FA from CDC, 30% received TA only, 3% received only FA, and 5% were part of informal reviews. Fifty-four percent of these serosurveys target the general population, 13% sample pregnant women, 7% sample healthcare workers, 7% sample other special populations (internally displaced persons, patients, students, and people living with HIV), and 18% assess multiple or other populations. These studies are in different stages of implementation, ranging from protocol development to dissemination of results. They are conducted under the leadership of local governments, who have ownership over the data, in collaboration with international partners. Thirty-four surveys rounds have completed data collection. CDC TA and FA of SARS-CoV-2 seroprevalence surveys will enhance the knowledge of the COVID-19 pandemic in almost three dozen LMI countries. Support for these surveys should account for current limitations with interpreting results, focusing efforts on prospective cohorts, identifying, and forecasting disease patterns over time, and helping understand antibody kinetics and correlates of protection.
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Affiliation(s)
- Amen Ben Hamida
- Division of Global Health Protection, U.S. CDC, Atlanta, GA, United States of America
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
| | - Myrna Charles
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
- Influenza Division, U.S CDC, Atlanta, GA, United States of America
| | - Christopher Murrill
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
- Global Immunization Division, U.S. CDC, Atlanta, GA, United States of America
| | - Olga Henao
- Division of Global Health Protection, U.S. CDC, Atlanta, GA, United States of America
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
| | - Kathleen Gallagher
- Division of Global Health Protection, U.S. CDC, Atlanta, GA, United States of America
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
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Hirsch C, Park YS, Piechotta V, Chai KL, Estcourt LJ, Monsef I, Salomon S, Wood EM, So-Osman C, McQuilten Z, Spinner CD, Malin JJ, Stegemann M, Skoetz N, Kreuzberger N. SARS-CoV-2-neutralising monoclonal antibodies to prevent COVID-19. Cochrane Database Syst Rev 2022; 6:CD014945. [PMID: 35713300 PMCID: PMC9205158 DOI: 10.1002/14651858.cd014945.pub2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Monoclonal antibodies (mAbs) are laboratory-produced molecules derived from the B cells of an infected host. They are being investigated as potential prophylaxis to prevent coronavirus disease 2019 (COVID-19). OBJECTIVES To assess the effects of SARS-CoV-2-neutralising mAbs, including mAb fragments, to prevent infection with SARS-CoV-2 causing COVID-19; and to maintain the currency of the evidence, using a living systematic review approach. SEARCH METHODS We searched the Cochrane COVID-19 Study Register, MEDLINE, Embase, and three other databases on 27 April 2022. We checked references, searched citations, and contacted study authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated SARS-CoV-2-neutralising mAbs, including mAb fragments, alone or combined, versus an active comparator, placebo, or no intervention, for pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) of COVID-19. We excluded studies of SARS-CoV-2-neutralising mAbs to treat COVID-19, as these are part of another review. DATA COLLECTION AND ANALYSIS Two review authors independently assessed search results, extracted data, and assessed risk of bias using Cochrane RoB 2. Prioritised outcomes were infection with SARS-CoV-2, development of clinical COVID-19 symptoms, all-cause mortality, admission to hospital, quality of life, adverse events (AEs), and serious adverse events (SAEs). We rated the certainty of evidence using GRADE. MAIN RESULTS We included four RCTs of 9749 participants who were previously uninfected and unvaccinated at baseline. Median age was 42 to 76 years. Around 20% to 77.5% of participants in the PrEP studies and 35% to 100% in the PEP studies had at least one risk factor for severe COVID-19. At baseline, 72.8% to 82.2% were SARS-CoV-2 antibody seronegative. We identified four ongoing studies, and two studies awaiting classification. Pre-exposure prophylaxis Tixagevimab/cilgavimab versus placebo One study evaluated tixagevimab/cilgavimab versus placebo in participants exposed to SARS-CoV-2 wild-type, Alpha, Beta, and Delta variant. About 39.3% of participants were censored for efficacy due to unblinding and 13.8% due to vaccination. Within six months, tixagevimab/cilgavimab probably decreases infection with SARS-CoV-2 (risk ratio (RR) 0.45, 95% confidence interval (CI) 0.29 to 0.70; 4685 participants; moderate-certainty evidence), decreases development of clinical COVID-19 symptoms (RR 0.18, 95% CI 0.09 to 0.35; 5172 participants; high-certainty evidence), and may decrease admission to hospital (RR 0.03, 95% CI 0 to 0.59; 5197 participants; low-certainty evidence). Tixagevimab/cilgavimab may result in little to no difference on mortality within six months, all-grade AEs, and SAEs (low-certainty evidence). Quality of life was not reported. Casirivimab/imdevimab versus placebo One study evaluated casirivimab/imdevimab versus placebo in participants who may have been exposed to SARS-CoV-2 wild-type, Alpha, and Delta variant. About 36.5% of participants opted for SARS-CoV-2 vaccination and had a mean of 66.1 days between last dose of intervention and vaccination. Within six months, casirivimab/imdevimab may decrease infection with SARS-CoV-2 (RR 0.01, 95% CI 0 to 0.14; 825 seronegative participants; low-certainty evidence) and may decrease development of clinical COVID-19 symptoms (RR 0.02, 95% CI 0 to 0.27; 969 participants; low-certainty evidence). We are uncertain whether casirivimab/imdevimab affects mortality regardless of the SARS-CoV-2 antibody serostatus. Casirivimab/imdevimab may increase all-grade AEs slightly (RR 1.14, 95% CI 0.98 to 1.31; 969 participants; low-certainty evidence). The evidence is very uncertain about the effects on grade 3 to 4 AEs and SAEs within six months. Admission to hospital and quality of life were not reported. Postexposure prophylaxis Bamlanivimab versus placebo One study evaluated bamlanivimab versus placebo in participants who may have been exposed to SARS-CoV-2 wild-type. Bamlanivimab probably decreases infection with SARS-CoV-2 versus placebo by day 29 (RR 0.76, 95% CI 0.59 to 0.98; 966 participants; moderate-certainty evidence), may result in little to no difference on all-cause mortality by day 60 (R 0.83, 95% CI 0.25 to 2.70; 966 participants; low-certainty evidence), may increase all-grade AEs by week eight (RR 1.12, 95% CI 0.86 to 1.46; 966 participants; low-certainty evidence), and may increase slightly SAEs (RR 1.46, 95% CI 0.73 to 2.91; 966 participants; low-certainty evidence). Development of clinical COVID-19 symptoms, admission to hospital within 30 days, and quality of life were not reported. Casirivimab/imdevimab versus placebo One study evaluated casirivimab/imdevimab versus placebo in participants who may have been exposed to SARS-CoV-2 wild-type, Alpha, and potentially, but less likely to Delta variant. Within 30 days, casirivimab/imdevimab decreases infection with SARS-CoV-2 (RR 0.34, 95% CI 0.23 to 0.48; 1505 participants; high-certainty evidence), development of clinical COVID-19 symptoms (broad-term definition) (RR 0.19, 95% CI 0.10 to 0.35; 1505 participants; high-certainty evidence), may result in little to no difference on mortality (RR 3.00, 95% CI 0.12 to 73.43; 1505 participants; low-certainty evidence), and may result in little to no difference in admission to hospital. Casirivimab/imdevimab may slightly decrease grade 3 to 4 AEs (RR 0.50, 95% CI 0.24 to 1.02; 2617 participants; low-certainty evidence), decreases all-grade AEs (RR 0.70, 95% CI 0.61 to 0.80; 2617 participants; high-certainty evidence), and may result in little to no difference on SAEs in participants regardless of SARS-CoV-2 antibody serostatus. Quality of life was not reported. AUTHORS' CONCLUSIONS For PrEP, there is a decrease in development of clinical COVID-19 symptoms (high certainty), infection with SARS-CoV-2 (moderate certainty), and admission to hospital (low certainty) with tixagevimab/cilgavimab. There is low certainty of a decrease in infection with SARS-CoV-2, and development of clinical COVID-19 symptoms; and a higher rate for all-grade AEs with casirivimab/imdevimab. For PEP, there is moderate certainty of a decrease in infection with SARS-CoV-2 and low certainty for a higher rate for all-grade AEs with bamlanivimab. There is high certainty of a decrease in infection with SARS-CoV-2, development of clinical COVID-19 symptoms, and a higher rate for all-grade AEs with casirivimab/imdevimab. Although there is high-to-moderate certainty evidence for some outcomes, it is insufficient to draw meaningful conclusions. These findings only apply to people unvaccinated against COVID-19. They are only applicable to the variants prevailing during the study and not other variants (e.g. Omicron). In vitro, tixagevimab/cilgavimab is effective against Omicron, but there are no clinical data. Bamlanivimab and casirivimab/imdevimab are ineffective against Omicron in vitro. Further studies are needed and publication of four ongoing studies may resolve the uncertainties.
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Affiliation(s)
- Caroline Hirsch
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Yun Soo Park
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Vanessa Piechotta
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Khai Li Chai
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lise J Estcourt
- Haematology/Transfusion Medicine, NHS Blood and Transplant, Oxford, UK
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Susanne Salomon
- Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Erica M Wood
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Zoe McQuilten
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Jakob J Malin
- Department I for Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Miriam Stegemann
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nina Kreuzberger
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Worsley CM, van der Mescht MA, Hoffmann D, Meyer PWA, Ueckermann V, Rossouw TM. Decline in antibody responses to SARS-CoV-2 post-vaccination poses a risk to health care workers. J Infect 2022; 85:334-363. [PMID: 35705136 PMCID: PMC9188487 DOI: 10.1016/j.jinf.2022.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Catherine M Worsley
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa; National Health Laboratory Service, South Africa.
| | - Mieke A van der Mescht
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa
| | - Daniel Hoffmann
- National Health Laboratory Service, South Africa; Department of Chemical Pathology, Faculty of Health Science, University of Pretoria, South Africa
| | - Pieter W A Meyer
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa; National Health Laboratory Service, South Africa
| | - Veronica Ueckermann
- Department of Internal Medicine, Faculty of Health Science, University of Pretoria, South Africa
| | - Theresa M Rossouw
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa
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