Comparative analysis of post-vaccination anti-spike IgG antibodies in old Nursing Home Residents and in middle-aged Healthcare workers

The current consensus is that 2 doses of mRNA vaccines against SARS-CoV-2 are needed for people without COVID-19 history, while for those who had suffered COVID-19, a single dose may be enough to achieve high levels of immunization. This consensus has been based on results obtained in middle-aged populations, whereas only few data exist for the oldest and most frail adults such as nursing home residents (NH-Res) that is, the population most vulnerable to develop severe forms of COVID-19. In this study, we studied the anti-SARS-CoV-2 IgG(S) level of NH-Res and healthcare workers (HCWs) with or without a history of COVID-19 infection taking into account the time since immunization (COVID-19 and/or vaccination). 654 subjects were analyzed: 397 NH-Res (median age 88, IQR 82-93 years, 75% women) and 257 Health Care Workers (HCWs, median 46, IQR 38-54 years, 81% women). NH-Res and HCWs were classified in one of the following 3 groups: No-COVID history and 2 vaccine shots (COV-NO/2VACC); Yes-COVID history and 1 (COV-YES/1VACC) or 2 (COV-YES/2VACC) vaccine injections. The time-related decrease in IgG (S) in subjects without COVID-19 history, SARS-COV-2 serology would be negative in HCWs approximately 220 days and in residents 180 days after vaccination. This time-related decrease was much slower in those with history of COVID. NH-Res belonging into the COV-NO/2VACC and the COV-YES/1VACC groups showed lower IgG (S) levels than the same groups of HCWs (for both groups, p<0.0001), whereas in the group COV-YES/2VACC, IgG (S) levels were similar in NH-Res and HCWs (p=0.88). These results remained unchanged after adjustment for age and duration since immunization. Thus, in NH-Res, 2 vaccine shots were associated with a more pronounced immune response, whereas in HCWs, 1 or 2 vaccine shots in patients with COVID-19 history did make any difference. These results indicate significant differences in mRNA vaccination between NH-Res and middle-aged controls, and could contribute to the specification of vaccine policy in this very old, frail population.

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Significant reduction in humoral immunity among healthcare workers and nursing home residents 6 months after COVID-19 BNT162b2 mRNA vaccination

10.1101/2021.08.15.21262067 ◽

2021 ◽

Cited By ~ 1

Author(s):

David H. Canaday ◽

Oladayo A. Oyebanji ◽

Debbie Keresztesy ◽

Michael Payne ◽

Dennis Wilk ◽

...

Keyword(s):

Nursing Home ◽

Humoral Immunity ◽

Healthcare Workers ◽

Limit Of Detection ◽

Nursing Home Residents ◽

Good Health ◽

Neutralization Assay ◽

Vaccine Response ◽

Post Vaccination ◽

Antibody Levels

AbstractHigh COVID-19 mortality among nursing home (NH) residents led to their prioritization for SARS-CoV-2 vaccination; most NH residents received BNT162b2 mRNA vaccination under the Emergency Use Authorization due to first to market and its availability. With NH residents’ poor initial vaccine response, the rise of NH breakthrough infections and outbreaks, characterization of the durability of immunity to inform public health policy on the need for boosting is needed. We report on humoral immunity from 2 weeks to 6-months post-vaccination in 120 NH residents and 92 ambulatory healthcare worker controls with and without pre-vaccination SARS-CoV-2 infection. Anti-spike and anti-receptor binding domain (RBD) IgG, and serum neutralization titers, were assessed using a bead-based ELISA method and pseudovirus neutralization assay. Anti-spike, anti-RBD and neutralization levels dropped more than 84% over 6 months’ time in all groups irrespective of prior SARS-CoV-2 infection. At 6 months post-vaccine, 70% of the infection-naive NH residents had neutralization titers at or below the lower limit of detection compared to 16% at 2 weeks after full vaccination. These data demonstrate a significant reduction in levels of antibody in all groups. In particular, those infection-naive NH residents had lower initial post-vaccination humoral immunity immediately and exhibited the greatest declines 6 months later. Healthcare workers, given their younger age and relative good-health, achieved higher initial antibody levels and better maintained them, yet also experienced significant declines in humoral immunity. Based on the rapid spread of the delta variant and reports of vaccine breakthrough in NH and among younger community populations, boosting NH residents may be warranted.

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Serosurveillance of SARS CoV 2 among the healthcare workers of a tertiary care teaching institution in Central Kerala during the post lockdown phase

10.1101/2021.01.27.21250502 ◽

2021 ◽

Author(s):

Aboobacker Mohamed Rafi ◽

Maglin Monica Lisa Joseph Tomy ◽

Ronnie Thomas ◽

Chithra Valsan ◽

U G Unnikrishnan ◽

...

Keyword(s):

United States ◽

Health Care ◽

Health Care Workers ◽

Healthcare Workers ◽

The United States ◽

P Value ◽

Antibody Testing ◽

Medical College ◽

Care Workers ◽

History Of

AbstractBackgroundKerala was the first state to have the confirmed case of COVID-19 in the country and it was first confirmed in Thrissur district on 30 January2020.Our institute being in the heart of the city had to take adequate measures to mitigate the spread and treat the required patients by keeping its staff safe & Healthy. The hallmark of COVID 19 infection is high infectivity, pre-symptomatic transmission and asymptomatic prevalence which could result in high cumulative numbers of infections, hospitalizations, and deaths. Kerala was the first state to confirm community transmission in July 2020.Health care workers being in the forefront in the war against COVID19 are very prone in acquiring the infection and are possible to be asymptomatic sources for cluster formation. Knowing the development of immunity as shown by the presence of anti COV2 antibodies in the population contributes to the epidemiological understanding of the disease. The intent of the study is to do an antibody testing in our hospital to find the serosurveillance of SARS CoV 2 among the healthcare workers in our hospital.AimTo estimate the seropositivity of SARS CoV 2 among the healthcare workers at Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, six months after revoking the lockdownMethodologyA cross sectional study among the health care workers of the medical college. Multistage Sampling was done with the hospital block as the first stage and departments as the second stage. In the final stage of sampling the test individuals were selected on a first come first served basis after the antibody test availability was declared open and free for all staff. A consent form and a Google form were given to all staff who volunteered for participating in the study. Each consented participant recruited into the investigation completed a questionnaire which covers details regarding demographics, exposure history, Residence & travel. Blood sample was collected and Anti-SARS COV2 IgG antibody testing which targets the Spike Protein 1(SP1) was done using the VITROS chemiluminescence platform (Orthoclinical diagnostics, USA). Sampling & testing ranged over a time frame from September 5th to December 15th, 2020ResultsJubilee Mission Medical College has 2785 working staff at the time of study. A total of 420 staff consented and their samples were tested. 37 staff members tested positive for COVID-19 antibody, yielding an overall prevalence of 8.75% (95% CI, 6.23–11.86). 86.5 % (32/37) of them were having a history of COVID-19 Antigen / RT PCR Positivity. We identified a statistically significant linear trend (p value =0.00001), between seropositivity and the degree of severity of COVID 19. Among the various factors which increase the risk of seroconversion, history of undergoing quarantine (p value < 0.001), contact with a confirmed case (p value = 0.002), contact with a caregiver for COVID 19 (p value =0.001) and history of Upper respiratory symptoms (p value =0.001), were found to be significantly associated with positive serology.ConclusionsThe overall seropositivity in the current study was found to be 8.75% which is comparable to seroprevalence studies conducted in the United States and Wuhan in China. The pattern of seropositivity across the different category of health workers observed in the present study showed a higher prevalence among nurses. This result is also in agreement with a recent published report from united states. Various measures advised by the national and state health authorities were adequately adhered to. Keeping track of the pattern of development of immunity in the community is part of understanding the illness and forecasting the spread. For the tested HCW, it will boost up morale by ending uncertainty. For the hospital administration it will help in decision making about relative focusing of interventions on patients in general and HCWs. By knowing the immunity status of HCWs, the Institution will be able to contribute authentically to the development of intervention strategies and guidelines from time to time, besides following the available guidelines. Being an educational institution, it is obligatory to train all the elements of care delivery to the future generation of health care workers. Getting experienced from a small but relevant sample was expected to facilitate larger community study envisaged in peripheral areas Jubilee served

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Anti-SARS-CoV-2 IgG seroprevalence among non-vaccinated healthcare workers: a study from rural North India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20212586 ◽

2021 ◽

Vol 8 (7) ◽

pp. 3348

Author(s):

Pratibha Mane ◽

Jyoti Sangwan ◽

Kirti Lohan

Keyword(s):

Health Care ◽

Health Care Workers ◽

Healthcare Workers ◽

North India ◽

Igg Antibodies ◽

Rt Pcr ◽

Positive Form ◽

Care Workers ◽

Increased Risk ◽

The World

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease reported in China initially which spread around the world in no time affecting millions of people. It is caused by a new coronavirus (SARS-CoV-2 or 2019 n-CoV). The healthcare workers (HCW) are at increased risk of acquiring the disease as well as antibody response.Methods: 457 health care workers (HCW) were recruited to give blood samples for anti-SARS CoV-2 IgG testing between September to October 2020.Results: Of the 457 participants, IgG antibodies against SARS-CoV-2 were detected in 116 health care workers (25.4%). The anti-SARS-CoV-2 antibodies were detected maximally in HCWs involved in laboratory work. Around 4 % of health care workers were RT-PCR positive form whom IgG were detected in 15 individuals (71.4%) only.Conclusions: The study concludes a higher prevalence among health care workers involved with patient’s samples and laboratory.

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Seroprevalence of Antibodies against SARS COV- 2 among Health Care Workers at Tertiary Care Hospital, Uttarakhand: A Retrospective study

10.21203/rs.3.rs-783686/v1 ◽

2021 ◽

Author(s):

Amit K Saini ◽

Prasan Kumar Panda ◽

Yogesh Arvind Bahurupi ◽

Balram Omar ◽

Akhil T ◽

...

Keyword(s):

Health Care ◽

Retrospective Study ◽

Health Care Workers ◽

Healthcare Workers ◽

Tertiary Care ◽

Care Hospital ◽

Igg Antibodies ◽

Care Institute ◽

Care Workers ◽

Low Prevalence

Abstract Background: The number of confirmed SARS-CoV-2 infections is vastly underestimated. In this context, Seroprevalence surveys are of utmost importance to assess the proportion of the population that has already developed antibodies against the virus and might potentially be protected against subsequent infection. Health care workers face greater risk of developing SARS-CoV-2. Therefore, present retrospective study was undertaken to estimate the prevalence of antibodies against SARS-CoV-2 among healthcare workers at tertiary care institute, Uttarakhand. Material and Methods : Data was gathered from Hospital records of 704 healthcare workers admitted at COVID 19 Unit and attended Covid-OPD of tertiary care institute, Uttarakhand in-between 15th July to 14th Aug 2020. Result: Out of the 704 recruited participants, 14 (1.99%) were seropositive for IgG antibodies against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive RT-PCR) was 4.40%. Conclusion: The present study shows a low prevalence of SARS-CoV-2 IgG antibodies among health care workers. In addition, posting in COVID-19-positive areas was not associated with increased seropositivity. More studies are warranted to assess IgG/IgM antibodies against SARS-CoV-2 among those HCW who are exposed to COVID-19 patients.

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IMPACT OF VACCINATION ON COVID INFECTION IN HEALTH CARE WORKERS IN WESTERN ZONE OF INDIAN RAILWAYS

10.36106/paripex/6501060 ◽

2021 ◽

pp. 31-34

Author(s):

C.S. Anand ◽

Hafeezunissa Rehman ◽

K. Krishna Kumar ◽

Brham Prakash ◽

Subodh Kumar ◽

...

Keyword(s):

Disease Severity ◽

Health Care Workers ◽

Healthcare Workers ◽

Vaccination Campaign ◽

Vaccine Dose ◽

Post Vaccination ◽

Vaccination Programs ◽

Source Of Infection ◽

Care Workers ◽

Western Zone

Healthcare workers (HCWs) are highly exposed to SARS-CoV-2 infection. HCWs are also likely source of infection of their family members .COVID-19 Vaccination programs started during December 2020 in several countries and prioritized healthcare workers (HCWs).The vaccination campaign coincided with the second surge of COVID cases in Western part of India.This study assess the prevalence of COVID19 infection and disease severity in vaccinated HCWs. Prevalence of SARS-CoV-2 cases was 6.3% of vaccinated HCWs. Most infection cases occurred within two weeks of the first vaccine dose. Out of total HCWs 87.4% were mild, 11.1% were moderate, and 1.5% were severe cases.This study stresses on early identification of asymptomatic carriers in vaccinated individuals.Even vaccinated HCWs might spread the infection leading to hospital outbreaks.With the emergence of newer strains of Covid 19 and amid the rising cases of Delta variant across the globe,adequate infection control practices like masking,social distancing,appropriate PPE and hand sanitization and vaccination are mandatory.However,disease severity is milder post vaccination.It is important to distinguish symptoms of side effects post vaccination from COVID infection even in vaccinated HCW in pandemic.

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The Characteristics of Health Care Workers with COVID-19 and Relationship Between COVID-19 Mortality and BCG/Tuberculosis History: a multi-center study

10.1101/2020.10.08.20209403 ◽

2020 ◽

Author(s):

Ş Torun ◽

Ş Özkaya ◽

N Şen ◽

F Kanat ◽

I Karaman ◽

...

Keyword(s):

Health Care ◽

Mortality Rate ◽

Health Care Workers ◽

Healthcare Workers ◽

Normal Population ◽

Bcg Vaccine ◽

Direct Care ◽

Care Workers ◽

History Of ◽

The Relationship

AbstractBackgroundToday, COVID-19 pandemic has brought countries’ health services into sharp focus. Despite the low incidence of cases(1.2%) and high mortality rate(2.4%) among Turkish population, the low mortality rate(0.3%) despite the high incidence(11.5%) declared in healthcare workers drew our group’s attention. Therefore, we aimed to report the characteristics of infected health-care workers and investigate the relationship between BCG vaccine and tuberculosis history with COVID-19 mortality in infected health-care worker population.MethodThis study was conducted in three hospitals to assess the clinical presentations, disease severity and correlation with BCG vaccine and tuberculous history in COVID-19 positive health-care workers by an online questionnaire platform. The relationship between characteristics and tuberculosis history were investigated according to hospitalization status of the patients.ResultTotal of 465 infected healthcare workers included in the study. The rate of history of direct care and contact to tuberculosis patient, presence of previous tuberculosis treatment and BCG scar, presence of radiological infiltrations was significantly higher in hospitalized healthcare workers. The ratio of direct care and direct contact to the patient with tuberculosis, and presence of family history of tuberculosis were statistically significantly higher in patients with radiological infiltrations.ConclusionAlthough COVID-19 risk and incidence are higher among healthcare workers compared to the normal population due to higher virus load, this study brings evidence for the fact that the lower mortality rate seen in infected healthcare workers might be due to healthcare workers’ frequent exposure to tuberculosis bacillus and the mortality-reducing effects of BCG vaccine, despite the higher hospitalization rate and radiological infiltrations due to over-triggered immune system.

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Transition of antibody titers after the SARS-CoV-2 mRNA vaccine in Japanese healthcare workers

10.1101/2021.12.28.21268435 ◽

2021 ◽

Author(s):

Masahiro Kitabatake ◽

Noriko Ouji-Sageshima ◽

Shota Sonobe ◽

Ryutaro Furukawa ◽

Makiko Konda ◽

...

Keyword(s):

Health Care Workers ◽

Messenger Rna ◽

Healthcare Workers ◽

Neutralizing Antibody ◽

Receptor Binding Domain ◽

Post Vaccination ◽

The Third ◽

Care Workers ◽

Antibody Titers ◽

Support Decision Making

AbstractSince February 2021, health care workers in Japan have been preferentially vaccinated with a messenger RNA vaccine (BNT162b2/Pfizer) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While many studies have confirmed that this vaccine is highly effective in reducing hospitalizations and deaths from coronavirus disease 2019 (COVID-19), antibody titers tend to decline at 3 months, leading to a risk of breakthrough infections. Thus, information is needed to support decision making regarding the third vaccination. In this study, we investigated transition of the anti-SARS-CoV-2 receptor-binding domain (RBD) IgG and neutralizing antibody titers of 41 vaccinated Japanese healthcare workers. Samples were collected seven times starting 1 week before vaccination until 6 months post-vaccination. Anti-SARS-CoV-2 RBD IgG levels peaked at 7 days after the booster, then declined over time and decreased to <10% at 6 months after the booster. Workers with low anti-SARS-CoV-2 RBD IgG levels also had low neutralizing antibody titers. These data support the active use of boosters for healthcare workers, especially for those with low anti-SARS-CoV-2 RBD IgG levels.

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Does a lack of vaccine side effects correlate with reduced BNT162b2 mRNA vaccine response among healthcare workers and nursing home residents?

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-01987-9 ◽

2021 ◽

Author(s):

Oladayo A. Oyebanji ◽

Brigid Wilson ◽

Debbie Keresztesy ◽

Lenore Carias ◽

Dennis Wilk ◽

...

Keyword(s):

Nursing Home ◽

Side Effects ◽

Healthcare Workers ◽

Nursing Home Residents ◽

Community Dwelling ◽

Vaccine Response ◽

Term Care ◽

Post Vaccination ◽

Dichotomous Variable ◽

Antibody Levels

Abstract Background The BNT162b2 SARS-CoV-2 mRNA vaccination has mitigated the burden of COVID-19 among residents of long-term care facilities considerably, despite being excluded from the vaccine trials. Data on reactogenicity (vaccine side effects) in this population are limited. Aims To assess reactogenicity among nursing home (NH) residents. To provide a plausible proxy for predicting vaccine response among this population. Methods We enrolled and sampled NH residents and community-dwelling healthcare workers who received the BNT162b2 mRNA vaccine, to assess local or systemic reactogenicity and antibody levels (immunogenicity). Results NH residents reported reactions at a much lower frequency and lesser severity than the community-dwelling healthcare workers. These reactions were mild and transient with all subjects experiencing more local than systemic reactions. Based on our reactogenicity and immunogenicity data, we developed a linear regression model predicting log-transformed anti-spike, anti-receptor-binding domain (RBD), and neutralizing titers, with a dichotomous variable indicating the presence or absence of reported reactions which revealed a statistically significant effect, with estimated shifts in log-transformed titers ranging from 0.32 to 0.37 (all p < 0.01) indicating greater immunogenicity in subjects with one or more reported reactions of varying severity. Discussion With a significantly lower incidence of post-vaccination reactions among NH residents as reported in this study, the BNT162b2 mRNA vaccine appears to be well-tolerated among this vulnerable population. If validated in larger populations, absence of reactogenicity could help guide clinicians in prioritizing vaccine boosters. Conclusions Reactogenicity is significantly mild among nursing home residents and overall, subjects who reported post-vaccination reactions developed higher antibody titers.

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Seroprevalence and Dynamics of anti-SARS-CoV-2 antibody among healthcare workers following ChAdOx1 nCoV-19 vaccination

10.1101/2021.07.20.21260278 ◽

2021 ◽

Author(s):

Soma Sarkar ◽

Shantanab das ◽

Kabita Choudhury ◽

Saibal Mukherjee ◽

Raghunath Chatterjee

Keyword(s):

Health Care Workers ◽

Healthcare Workers ◽

Natural Infection ◽

Neutralizing Antibody ◽

Exposed Group ◽

Detectable Amount ◽

Significant Drop ◽

Post Vaccination ◽

Care Workers ◽

Regular Contact

Abstract Background The serological evaluations of IgG, IgM, and IgA to the SARS-CoV-2 proteins are widely used for the epidemiological assessment of COVID-19. The Health Care Workers (HCWs) are presumably exposed to a higher risk of acquiring the disease owing to their regular contact with the patients. Methods COVID-19 prevalence was investigated by classifying 313 HCWs into four groups based on their degree of exposure and estimating the IgG and total antibody. The serological assessment of the anti-SARS-CoV-2 antibody was conducted 21 days post-vaccination of first or both doses of the ChAdOx1 nCoV-19 vaccine among 174 HCWs. The vaccinated HCWs were followed up for 3 months for SARS-CoV-2 infection. Findings The levels of anti-SARS-CoV-2 IgG were comparable among different groups, but the seroprevalence gradually decreased from the most exposed to the less exposed group. The neutralizing antibody was positively correlated with IgG as well as total antibody. IgG was marginally decreased after 2 months followed by a significant drop after 4-6 months post-infection. However, 80% of the HCWs developed a detectable amount of IgG after the first dose of vaccination, the median titer of which was comparable to the seropositive HCWs after natural infection. Almost 100% of the HCWs developed antibodies after the second dose of vaccine with boosting effect among the seropositive HCWs. Although ~11.5% of the vaccinated HCWs were infected with the SARS-CoV-2, ~94% of them showed mild symptoms and recovered in home isolation without any O2 support. Interpretations The varying level of seroprevalence among the four groups suggested a stratified spread of the disease. One dose of SARS-CoV-2 vaccination was found to be effective in terms of the antibody titer, while the second dose was required to cover the larger population. The effectiveness of the ChAdOx1 nCoV-19 vaccine was noticeable due to the low rate of post-vaccination infection with moderate or severe symptoms.

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Is Covid-19 seroprevalence different in health care workers as per their risk of exposure? A study from a tertiary care hospital in National Capital Region of India

10.1101/2021.02.10.21251543 ◽

2021 ◽

Author(s):

Sushila Kataria ◽

Rashmi Phogat ◽

Pooja Sharma ◽

Vikas Deswal ◽

Sazid Alam ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Healthcare Workers ◽

Tertiary Care ◽

Health Care Facilities ◽

Vaccine Hesitancy ◽

Care Hospital ◽

Care Workers ◽

History Of ◽

Doctors And Nurses

AbstractBackgroundSARS-CoV-2 infection has severely ravaged health systems, economic and social progress globally in 2020. Seroprevalence studies can provide relevant information on the target populations for vaccination. They are relevant not only in the community, but also for critical population subgroups such as nursing homes or health care facilities. They will assist in strategizing the vaccination policy especially since there is limited availability of the vaccine and vaccine hesitancyObjectiveTo evaluate the seroprevalence in Health Care Workers (HCW) at our hospital and to identify parameters which may affect it.MethodologyThe Baseline profiling and seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was assessed among 3258 healthcare workers (HCWs) of Medanta-The Medicity, Gurugram, Haryana, India, as a part of an ongoing cohort study.The fully automated LIAISON® SARS-CoV-2 S1/S2 IgG test using the chemiluminescence immunoassay (CLIA) for the quantitative determination of anti-S1 and anti-S2 specific IgG antibodies to SARS-CoV-2 was used to test serum samples collected before the receipt of the vaccine. Seroprevalence was evaluated as per gender, age, association with previous Covid-19 diagnosis, use of supplements, and role in the hospital and type of exposure.ResultsOf the 3258 participants tested for IgG serology (S1 and S2 proteins) 46.2% (CI 44.4 – 47.9%) were positive (i.e. had an antibody titre more than 15 Au/ml). Higher seroprevalence was seen in the ‘others’ ie non clinical health care workers (including management, research personnel, pharmacists, technicians, general duty staff, housekeeping, security, food and beverage, and facility maintenance teams) (50.2 Au/ml) than that in clinical HCW (ie doctors and nurses)where it was significantly lower (41.4 Au/ml, p= 0.0001). Also, people with history of Covid-19 were found to have significantly higher antibody levels (p = 0.0001). Amongst the healthcare workers, doctors and nurses had higher relative risk of acquiring Covid-19 infection (RR = 1.21; 95% C.I.: 1.12 - 1.31).ConclusionSeroprevalence in healthcare workers at our hospital is high at 46.2%. It is higher in non-clinical HCW than in clinical HCW. The risk of acquiring Covid-19 infection was higher in clinical HCW and thus, this subgroup may benefit most from vaccination. History of Covid-19 may provide double the protection, in particular in those who had it recently.

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