scholarly journals A cautionary note on recall vaccination in ex-COVID-19 subjects

Author(s):  
Riccardo Levi ◽  
Elena Azzolini ◽  
Chiara Pozzi ◽  
Leonardo Ubaldi ◽  
Michele Lagioia ◽  
...  

AbstractCurrently approved COVID-19 vaccines based on mRNA or adenovirus require a first jab followed by recall immunization. There is no indication as to whether individuals who have recovered from COVID-19 should be vaccinated, and if so, if they should receive one or two vaccine doses. Here, we tested the antibody response developed after the first dose of the mRNA based vaccine encoding the SARS-CoV-2 full-length spike protein (BNT162b2) in 124 healthcare professionals of which 57 had a previous history of COVID-19 (ExCOVID). Post-vaccine antibodies in ExCOVID individuals increase exponentially within 7-15 days after the first dose compared to naïve subjects (p<0.0001). We developed a multivariate Linear Regression (LR) model with l2 regularization to predict the IgG response for SARS-COV-2 vaccine. We found that the antibody response of ExCOVID patients depends on the IgG pre-vaccine titer and on the symptoms that they developed during the disorder, with anosmia/dysgeusia and gastrointestinal disorders being the most significantly positively correlated in the LR. Thus, one vaccine dose is sufficient to induce a good antibody response in ExCOVID subjects. This poses caution for ExCOVID subjects to receive a second jab both because they may have a overreaction of the inflammatory response and also in light of the current vaccine shortage.

2022 ◽  
Vol 43 (1) ◽  
pp. 40-43 ◽  
Author(s):  
Mitchell M. Pitlick ◽  
Avni Y. Joshi ◽  
Alexei Gonzalez-Estrada ◽  
Sergio E. Chiarella

Background: As the vaccination campaign in response to the coronavirus disease 2019 (COVID-19) pandemic continues, concerns with regard to adverse reactions to the vaccine remain. Although immediate hypersensitivity reactions have received much attention, delayed systemic urticarial reactions after vaccination can occur. Objective: To describe the clinical presentation, vaccine excipient skin testing results, and outcomes of subsequent COVID-19 vaccination in patients who experienced delayed systemic urticarial reactions after messenger RNA (mRNA) COVID-19 vaccination. Methods: This was a retrospective case series of 12 patients referred to the Mayo Clinics in Rochester, Minnesota, and Jacksonville, Florida, between January 19, 2021, and April 30, 2021, for evaluation of delayed systemic urticarial reactions after mRNA COVID-19 vaccination. Demographics, medical and allergic history, reaction details, vaccine excipient skin testing results (when performed), and the outcome after subsequent vaccination were collected for each patient. Results: The mean age of the patients was 52 years, all were white, and 9 (75%) were women. Half of the patients had a history of drug allergy, and one had a history of chronic spontaneous urticaria. Seven patients reacted to the Pfizer-BioNTech vaccine and five reacted to the Moderna vaccine. Seven patients developed symptoms between 8 and 24 hours after vaccination. Nine patients required antihistamines for treatment. The median time to symptom resolution was 4 days. Nine patients underwent allergist-directed COVID-19 vaccine excipient skin testing, all of which were negative. Ten patients chose to receive their next mRNA COVID-19 vaccine dose, and four patients experienced recurrent delayed urticaria. Conclusion: Delayed systemic urticarial reactions after mRNA COVID-19 vaccination were not life-threatening, could be treated with antihistamines, and were not predicted with vaccine excipient skin testing. They were not a contraindication to subsequent vaccination, although patients should be counseled with regard to the possibility of recurrence.


2021 ◽  
Author(s):  
Harmony L. Tyner ◽  
Mark G. Thompson ◽  
Jefferey L. Burgess ◽  
Lauren Grant ◽  
Manjusha Gaglani ◽  
...  

Background: Data on the development of neutralizing antibodies against SARS-CoV-2 after SARS-CoV-2 infection and after vaccination with messenger RNA (mRNA) COVID-19 vaccines are limited. Methods: From a prospective cohort of 3,975 adult essential and frontline workers tested weekly from August, 2020 to March, 2021 for SARS-CoV-2 infection by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) assay irrespective of symptoms, 497 participants had sera drawn after infection (170), vaccination (327), and after both infection and vaccination (50 from the infection population). Serum was collected after infection and each vaccine dose. Serum-neutralizing antibody titers against USA-WA1/2020-spike pseudotype virus were determined by the 50% inhibitory dilution. Geometric mean titers (GMTs) and corresponding fold increases were calculated using t-tests and linear mixed effects models. Results: Among 170 unvaccinated participants with SARS-CoV-2 infection, 158 (93%) developed neutralizing antibodies (nAb) with a GMT of 1,003 (95% CI=766-1,315). Among 139 previously uninfected participants, 138 (99%) developed nAb after mRNA vaccine dose-2 with a GMT of 3,257 (95% CI = 2,596-4,052). GMT was higher among those receiving mRNA-1273 vaccine (GMT =4,698, 95%CI= 3,186-6,926) compared to BNT162b2 vaccine (GMT=2,309, 95%CI=1,825-2,919). Among 32 participants with prior SARS-CoV-2 infection, GMT was 21,655 (95%CI=14,766-31,756) after mRNA vaccine dose-1, without further increase after dose-2. Conclusions: A single dose of mRNA vaccine after SARS-CoV-2 infection resulted in the highest observed nAb response. Two doses of mRNA vaccine in previously uninfected participants resulted in higher nAb to SARS-CoV-2 than after one dose of vaccine or SARS-CoV-2 infection alone. Neutralizing antibody response also differed by mRNA vaccine product.


2021 ◽  
Author(s):  
Rahmat Azhari Kemal ◽  
Dita Kartika Sari ◽  
Ariza Julia Paulina

Several studies have shown that individuals with previous history of SARS-CoV-2 infection had boosted antibody response after single dose of mRNA or adenovirus-vectored vaccines. We wondered whether single dose CoronaVac, a whole-inactivated vaccine, could be considered for COVID-19 survivors in Indonesia. We measured IgG anti-RBD titre among 18 survivors and 37 non-survivors. Among survivors, there were 9 survivors with positive antibody titre (seropositive) before vaccination and 9 seronegative survivors. All respondents received two doses of CoronaVac vaccine at 14-days interval. We found no significant antibody titre difference between non-survivor at 14 or 28 days after second dose as well as seronegative survivor at at 14 days after second dose. Seropositive survivors were rapidly boosted after first dose with higher antibody titer than non-survivors and seronegative survivors after second dose. However, antibody titer did not differ between first and second dose among seropositive survivors. Seropositive COVID-19 survivors could receive single dose of CoronaVac vaccine which could potentially ease the vaccine supply constrain. A long-term follow-up must be conducted to observe difference in antibody response and persistence.


2021 ◽  
Author(s):  
Duaa Al-Sadeq ◽  
Farah Shurrab ◽  
Ahmed Ismail ◽  
Fathima Humaira Amanullah ◽  
Swapna Thomas ◽  
...  

Two mRNA vaccines, Pfizer-BNT162b2 and Moderna-mRNA-1273, were granted the US Food and Drug Administration Emergency Use Authorization for preventing COVID-19. However, little is known about the difference in antibody responses induced by the two mRNA vaccines in naive and individuals with a previous history of infections (PI group). Therefore, we investigated the levels of anti-S-RBD total antibodies (IgM, IgA, and IgG), anti-S-RBD IgG, and anti-S-RBD IgA in these two groups 1-13 (median=6) weeks following administration of two doses of mRNA-1273 or BNT162b2 vaccines. Results showed that in naive-vaccinated group, the mRNA-1327 vaccine induces significantly higher levels of S-RBD total antibodies (3.5-fold; p<0.001), S-RBD IgG (2-fold-p<0.01), and S-IgA (2.1-fold, p<0.001) than the BNT162b2 vaccine. In the PI-vaccinated group, both vaccines produce significantly higher S-RBD total antibodies level than those of the naive-vaccinated group. The PI group produced a higher level of S-RBD IgG than the naive-BNT162b2 (p=0.05) but not more than the naive-mRNA-1273 (p=0.9) group. Interestingly, the PI-vaccinated group produced a comparable level of IgA ratio to the naive-mRNA-1273 group but significantly higher than the naive-BNT162b2 group (1.6-fold, p<0.001). Our results showed that the mRNA-1327 vaccine is more immunogenic and induces a greater antibody response than the BNT162b2 vaccine.


Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1325
Author(s):  
Robert Flisiak ◽  
Małgorzata Pawłowska ◽  
Magdalena Rogalska-Płońska ◽  
Monika Bociąga-Jasik ◽  
Krzysztof Kłos ◽  
...  

The current study aimed to determine to what extent prior COVID-19 infection affects the response of specific antibodies following vaccination. The study involved 173 healthcare professionals who completed the two-dose vaccination course with BNT162b2, including 40 who previously experienced clinical COVID-19. The levels of anti-SARS-CoV-2 S1S2 IgG (anti-S) and, in some cases, anti-SARS-CoV-S-RBD IgG (anti-S-RBD) were determined six months after complete vaccination. A level exceeding the cut-off values for both anti-S and anti-S-RBD was observed in 100% of subjects, but after setting the analysis to 5- and 10-fold cut-off levels, the percentage of subjects meeting this criterion was significantly higher for anti-S-RBD. The 100-fold cut-off level was achieved by only 21% and 16% for anti-S and anti-S-RBD, respectively. Anti-S and anti-S-RBD levels above ten times the positive cut-off were respectively observed in 91% and 100% individuals with a history of COVID-19, while among those without COVID-19, these values were 64% and 90%, respectively. Significantly higher incidence of values above 10 and 100 times the cut-off became apparent among people with a history of COVID-19. In conclusion, vaccination against COVID-19 following infection with the disease provides higher levels of specific antibodies 6 months after vaccination than those of individuals without a history of the disease, which supports the use of a booster dose, particularly for those who have not experienced SARS-CoV-2 infection.


2021 ◽  
Author(s):  
Alessio Mazzoni ◽  
Nicoletta Di Lauria ◽  
Laura Maggi ◽  
Lorenzo Salvati ◽  
Anna Vanni ◽  
...  

AbstractCharacterizing the adaptive immune response to COVID-19 vaccination in individuals who recovered from SARS-CoV-2 infection may define current and future clinical practice. To determine the effect of two doses BNT162b2 mRNA COVID-19 vaccination schedule in individuals who recovered from COVID-19 (ex COVID-19) compared to naïve subjects we evaluated SARS-CoV-2 spike-specific T and B cell responses, as well as specific IgG, IgM and neutralizing antibodies titres in 22 individuals who received BNT162b2 mRNA COVID-19 vaccine, 11 of which had a previous history of SARS-CoV-2 infection. Evaluations were performed before vaccination and then weekly until 7 days post second injection. Data obtained clearly showed that one vaccine dose is sufficient to increase both cellular and humoral immune response in ex COVID-19 subjects without any additional improvement after the second dose. On the contrary, the second dose is mandatory in naïve ones to further enhance the response. These results question whether a second vaccine jab in ex COVID-19 subjects is required and indicate that millions of vaccine doses may be redirected to naïve individuals, thus shortening the time to reach herd immunity.


2007 ◽  
Vol 177 (4S) ◽  
pp. 135-135
Author(s):  
Eiji Kikuchi ◽  
Akira Miyajima ◽  
Ken Nakagawa ◽  
Mototsugu Oya ◽  
Takashi Ohigashi ◽  
...  

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