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Jacobsen H, Sitaras I, Katzmarzyk M, Cobos Jiménez V, Naughton R, Higdon MM, Deloria Knoll M. Systematic review and meta-analysis of the factors affecting waning of post-vaccination neutralizing antibody responses against SARS-CoV-2. NPJ Vaccines 2023; 8:159. [PMID: 37863890 PMCID: PMC10589259 DOI: 10.1038/s41541-023-00756-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/02/2023] [Indexed: 10/22/2023] Open
Abstract
Mass COVID-19 vaccination and continued introduction of new SARS-CoV-2 variants increased prevalence of hybrid immunity at various stages of waning protection. We systematically reviewed waning of post-vaccination neutralizing antibody titers in different immunological settings to investigate differences. We searched published and pre-print studies providing post-vaccination neutralizing antibody responses against the Index strain or Omicron BA.1. We used random effects meta-regression to estimate fold-reduction from months 1 to 6 post last dose by primary vs booster regimen and infection-naïve vs hybrid-immune cohorts. Among 26 eligible studies, 65 cohorts (range 3-21 per stratum) were identified. Month-1 titers varied widely across studies within each cohort and by vaccine platform, number of doses and number of prior infections. In infection-naïve cohorts, the Index strain waned 5.1-fold (95%CI: 3.4-7.8; n = 19 cohorts) post-primary regimen and 3.8-fold (95%CI: 2.4-5.9; n = 21) post-booster from months 1 to 6, and against Omicron BA.1 waned 5.9-fold (95%CI: 3.8-9.0; n = 16) post-booster; Omicron BA.1 titers post-primary were too low to assess. In hybrid-immune, post-primary cohorts, titers waned 3.7-fold (95%CI: 1.7-7.9; n = 8) against the Index strain and 5.0-fold (95%CI: 1.1-21.8; n = 6) against Omicron BA.1; post-booster studies of hybrid-immune cohorts were too few (n = 3 cohorts each strain) to assess. Waning was similar across vaccination regimen and prior-infection status strata but was faster for Omicron BA.1 than Index strains, therefore, more recent sub-variants should be monitored. Wide differences in peak titers by vaccine platform and prior infection status mean titers drop to non-protective levels sooner in some instances, which may affect policy.
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Affiliation(s)
- Henning Jacobsen
- Department of Viral Immunology, Helmholtz Center for Infection Research, Braunschweig, Germany.
| | - Ioannis Sitaras
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Melissa M Higdon
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria Deloria Knoll
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Jacobsen H, Katzmarzyk M, Higdon MM, Jiménez VC, Sitaras I, Bar-Zeev N, Knoll MD. Post-Vaccination Neutralization Responses to Omicron Sub-Variants. Vaccines (Basel) 2022; 10:1757. [PMID: 36298622 PMCID: PMC9607453 DOI: 10.3390/vaccines10101757] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND The emergence of the Omicron variant (B.1.1.529), which correlated with dramatic losses in cross-neutralization capacity of post-vaccination sera, raised concerns about the effectiveness of COVID-19 vaccines against infection and disease. Several clinically relevant sub-variants subsequently emerged rapidly. METHODS We evaluated published and pre-print studies reporting sub-variant specific reductions in cross-neutralization compared to the prototype strain of SARS-CoV-2 and between sub-variants. Median fold-reduction across studies was calculated by sub-variant and vaccine platform. RESULTS Among 178 studies with post-vaccination data, after primary vaccination the sub-variant specific fold-reduction in neutralization capacity compared to the prototype antigen varied widely, from median 4.2-fold for BA.3 to 40.1-fold for BA.2.75; in boosted participants fold-reduction was similar for most sub-variants (5.3-fold to 7.0-fold); however, a more pronounced fold-change was observed for sub-variants related to BA.4 and BA.5 (10.4-fold to 14.2-fold). Relative to BA.1, the other Omicron sub-variants had similar neutralization capacity post-primary vaccination (range median 0.8-fold to 1.1-fold) and post-booster (0.9-fold to 1.4-fold) except for BA.4/5-related sub-variants which was higher (2.1-fold to 2.7-fold). Omicron sub-variant-specific responder rates were low post-primary vaccination (range median 28.0% to 65.9%) compared to the prototype (median 100%) but improved post-booster (range median 73.3% to 100%). CONCLUSIONS Fold-reductions in neutralization titers were comparable post-booster except for sub-variants related to BA.4 and BA.5, which had higher fold-reduction. Assessment after primary vaccination was not possible because of overall poor neutralization responses causing extreme heterogeneity. Considering large fold-decreases in neutralization titers relative to the parental strain for all Omicron sub-variants, vaccine effectiveness is very likely to be reduced against all Omicron sub-variants, and probably more so against variants related to BA.4 or BA.5.
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Affiliation(s)
- Henning Jacobsen
- Department of Viral Immunology, Helmholtz Center for Infection Research, 38124 Braunschweig, Germany
| | - Maeva Katzmarzyk
- Department of Viral Immunology, Helmholtz Center for Infection Research, 38124 Braunschweig, Germany
| | - Melissa M. Higdon
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | | | - Ioannis Sitaras
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Naor Bar-Zeev
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Maria Deloria Knoll
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Cable J, Fauci A, Dowling WE, Günther S, Bente DA, Yadav PD, Madoff LC, Wang L, Arora RK, Van Kerkhove M, Chu MC, Jaenisch T, Epstein JH, Frost SDW, Bausch DG, Hensley LE, Bergeron É, Sitaras I, Gunn MD, Geisbert TW, Muñoz‐Fontela C, Krammer F, de Wit E, Nordenfelt P, Saphire EO, Gilbert SC, Corbett KS, Branco LM, Baize S, van Doremalen N, Krieger MA, Clemens SAC, Hesselink R, Hartman D. Lessons from the pandemic: Responding to emerging zoonotic viral diseases-a Keystone Symposia report. Ann N Y Acad Sci 2022; 1518:209-225. [PMID: 36183296 PMCID: PMC9538336 DOI: 10.1111/nyas.14898] [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] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic caught the world largely unprepared, including scientific and policy communities. On April 10-13, 2022, researchers across academia, industry, government, and nonprofit organizations met at the Keystone symposium "Lessons from the Pandemic: Responding to Emerging Zoonotic Viral Diseases" to discuss the successes and challenges of the COVID-19 pandemic and what lessons can be applied moving forward. Speakers focused on experiences not only from the COVID-19 pandemic but also from outbreaks of other pathogens, including the Ebola virus, Lassa virus, and Nipah virus. A general consensus was that investments made during the COVID-19 pandemic in infrastructure, collaborations, laboratory and manufacturing capacity, diagnostics, clinical trial networks, and regulatory enhancements-notably, in low-to-middle income countries-must be maintained and strengthened to enable quick, concerted responses to future threats, especially to zoonotic pathogens.
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Affiliation(s)
| | - Anthony Fauci
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases (NIAID)National Institutes of Health (NIH)BethesdaMarylandUSA
| | | | - Stephan Günther
- Bernhard Nocht Institute for Tropical Medicine and German Center for Infection ResearchHamburgGermany
| | - Dennis A. Bente
- University of Texas Medical BranchGalveston National LaboratoryGalvestonTexasUSA,Division of Biology and Biological EngineeringCalifornia Institute of TechnologyPasadenaCaliforniaUSA
| | - Pragya Dhruv Yadav
- Indian Council of Medical Research‐National Institute of VirologyPuneIndia
| | - Lawrence C. Madoff
- Department of MedicineUniversity of Massachusetts Chan School of MedicineWorcesterMassachusettsUSA
| | | | - Rahul K. Arora
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada,Institute of Biomedical EngineeringUniversity of OxfordOxfordUK
| | | | - May C. Chu
- Colorado School of Public HealthAnschutz Medical CampusAuroraColoradoUSA
| | - Thomas Jaenisch
- Colorado School of Public HealthAnschutz Medical CampusAuroraColoradoUSA
| | | | | | | | - Lisa E. Hensley
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL)MonroviaLiberia,Division of Clinical ResearchNational Institute of Allergy and Infectious DiseasesBethesdaMarylandUSA
| | - Éric Bergeron
- Viral Special Pathogens Branch, Division of High‐Consequence Pathogens and PathologyCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Ioannis Sitaras
- W. Harry Feinstone Department of Molecular Microbiology and ImmunologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Michael D. Gunn
- Department of MedicineDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Thomas W. Geisbert
- University of ManitobaWinnipegManitobaCanada,Galveston National Laboratory and Department of Microbiology and ImmunologyUniversity of Texas Medical BranchGalvestonTexasUSA
| | - César Muñoz‐Fontela
- Bernhard Nocht Institute for Tropical Medicine and German Center for Infection ResearchHamburgGermany
| | - Florian Krammer
- Department of Microbiology and Department of PathologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Emmie de Wit
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious DiseasesNational Institutes of HealthHamiltonMontanaUSA
| | - Pontus Nordenfelt
- Department of Clinical Sciences Lund, Infection Medicine, Faculty of MedicineLund UniversityLundSweden
| | - Erica Ollmann Saphire
- Center for Infectious Disease and Vaccine ResearchLa Jolla Institute for ImmunologyLa JollaCaliforniaUSA
| | - Sarah C. Gilbert
- Pandemic Sciences Institute, Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Kizzmekia S. Corbett
- Department of Immunology and Infectious DiseasesHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | | | - Sylvain Baize
- Unité de Biologie des Infections Virales EmergentesInstitut PasteurLyonFrance,Centre International de Recherche en Infectiologie (CIRI)LyonFrance,INSERM, Ecole Normale Supérieure de LyonUniversité de LyonLyonFrance
| | - Neeltje van Doremalen
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious DiseasesNational Institutes of HealthHamiltonMontanaUSA
| | - Marco A. Krieger
- Laboratory for Applied Science and Technology in Health, Carlos Chagas InstituteOswaldo Cruz Foundation ‐ ParanáCuritibaBrazil,Integrated Translational Program in Chagas Disease from Fiocruz (Fio‐Chagas)Oswaldo Cruz Foundation ‐ Rio de JaneiroRio de JaneiroBrazil
| | - Sue Ann Costa Clemens
- Oxford Vaccine GroupOxford UniversityOxfordUK,Institute for Global HealthUniversity of SienaSienaItaly
| | - Renske Hesselink
- Coalition for Epidemic Preparedness Innovations (CEPI)OsloNorway
| | - Dan Hartman
- Bill & Melinda Gates FoundationSeattleWashingtonUSA
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