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

2021 ◽  
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.

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

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.

scholarly journals Reduced BNT162b2 mRNA vaccine response in SARS-CoV-2-naive nursing home residents

2021 ◽  
Author(s):  
David H. Canaday ◽  
Lenore Carias ◽  
Oladayo A. Oyebanji ◽  
Debbie Keresztesy ◽  
Dennis Wilk ◽  
...  
Keyword(s):  
Nursing Home ◽  
Healthcare Workers ◽  
Nursing Home Residents ◽  
Antibody Responses ◽  
Control Measures ◽  
Vaccine Response ◽  
Infection Control Measures ◽  
Data Gap ◽  
Antibody Levels ◽  
Care Worker

AbstractThe SARS-CoV-2 pandemic impact on nursing home (NH) residents prompted their prioritization for early vaccination. To fill the data gap for vaccine immunogenicity in NH residents, we examined antibody levels after BNT162b2 mRNA vaccine to spike, receptor binding domain (RBD) and for virus neutralization in 149 NH residents and 111 health care worker controls. SARS-CoV-2-naive NH residents mount antibody responses with nearly 4-fold lower median neutralization titers and half the anti-spike level compared to SARS-CoV-2-naive healthcare workers. By contrast, SARS-CoV-2-recovered vaccinated NH residents had neutralization, anti-spike and anti-RBD titers similar to SARS-CoV-2-recovered vaccinated healthcare workers. NH residents’ blunted antibody responses have important implications regarding the quality and durability of protection afforded by neoantigen vaccines. We urgently need better longitudinal evidence on vaccine effectiveness specific to NH resident populations to inform best practices for NH infection control measures, outbreak prevention and potential indication for a vaccine boost.

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

2021 ◽  
Author(s):  
Helene Jeulin ◽  
Denis Craus ◽  
Carlos Labat ◽  
Athanase Benetos
Keyword(s):  
Nursing Home ◽  
Health Care Workers ◽  
Healthcare Workers ◽  
Nursing Home Residents ◽  
Igg Antibodies ◽  
Middle Aged ◽  
Post Vaccination ◽  
Care Workers ◽  
History Of ◽  
Few Data

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.

Covid-19-vaccinatie en antistofbepaling bij bewoners en personeel van 2 Lanakense woonzorgcentra in de lente van 2021

2021 ◽  
Author(s):  
F. BUNTINX ◽  
I. ASNONG ◽  
M. GULIKERS ◽  
G. VAES ◽  
H. DEWITTE ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Vaccination Campaign ◽  
Nursing Home Residents ◽  
Young Female ◽  
Negative Association ◽  
Antibody Testing ◽  
Post Vaccination ◽  
Staff Members ◽  
Antibody Titres

Uptake and results of Covid-19 vaccination during a pandemic in nursing home residents and staff This study involves the participation of residents and staff of 2 Flemish nursing homes in the Covid-19 vaccination program, as well as the subsequent presence and titres of Covid-19 antibodies. With 1 exception, all 259 residents and 94% of the eligible staff members (n = 237) were vaccinated, 16 young female staff members were vaccinated with some delay because of pregnancy and fertility related fears. Post-vaccination SARS-CoV-2 antibody testing was performed in 214 (83%) residents and 201 (85%) staff members. Of these, respectively 98% and 100% had SARS-CoV-2 antibodies. A clear negative association was found between antibody titres and age. Within these nursing homes (and a number of surrounding nursing homes) the vaccination campaign was successful as well as effective.

scholarly journals Reactogenicity Correlates Only Weakly with Humoral Immunogenicity after COVID-19 Vaccination with BNT162b2 mRNA (Comirnaty®)

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1063
Author(s):  
Jürgen Held ◽  
Jan Esse ◽  
Koray Tascilar ◽  
Philipp Steininger ◽  
Kilian Schober ◽  
...  
Keyword(s):  
Linear Regression ◽  
Regression Model ◽  
Linear Regression Model ◽  
Healthcare Workers ◽  
Model Performance ◽  
Neutralization Assay ◽  
Spike Protein ◽  
Igg Antibody ◽  
Boost Vaccination ◽  
Antibody Levels

mRNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), such as BNT162b2 (Comirnaty®), have proven to be highly immunogenic and efficient but also show marked reactogenicity, leading to adverse effects (AEs). Here, we analyzed whether the severity of AEs predicts the antibody response against the SARS-CoV-2 spike protein. Healthcare workers without prior SARS-CoV-2 infection, who received a prime-boost vaccination with BNT162b2, completed a standardized electronic questionnaire on the duration and severity of AEs. Serum specimens were collected two to four weeks after the boost vaccination and tested with the COVID-19 ELISA IgG (Vircell-IgG), the LIAISON® SARS-CoV-2 S1/S2 IgG CLIA (DiaSorin-IgG) and the iFlash-2019-nCoV NAb surrogate neutralization assay (Yhlo-NAb). A penalized linear regression model fitted by machine learning was used to correlate AEs with antibody levels. Eighty subjects were enrolled in the study. Systemic, but not local, AEs occurred more frequently after the boost vaccination. Elevated SARS-CoV-2 IgG antibody levels were measured in 92.5% of subjects with Vircell-IgG and in all subjects with DiaSorin-IgG and Yhlo-NAb. Gender, age and BMI showed no association with the antibody levels or with the AEs. The linear regression model identified headache, malaise and nausea as AEs with the greatest variable importance for higher antibody levels (Vircell-IgG and DiaSorin-IgG). However, the model performance for predicting antibody levels from AEs was very low for Vircell-IgG (squared correlation coefficient r2 = 0.04) and DiaSorin-IgG (r2 = 0.06). AEs did not predict the surrogate neutralization (Yhlo-NAb) results. In conclusion, AEs correlate only weakly with the SARS-CoV-2 spike protein antibody levels after COVID-19 vaccination with BNT162b2 mRNA.

scholarly journals Effect Monitoring and Insights from Vaccination program of Healthcare Workforce from a tertiary level hospital in India against SARS-CoV-2

2021 ◽  
Author(s):  
Rajat Ujjainia ◽  
Akansha Tyagi ◽  
Viren Sardana ◽  
Salwa Naushin ◽  
Nitin Bhatheja ◽  
...  
Keyword(s):  
Antibody Response ◽  
Neutralizing Antibodies ◽  
Healthcare Workers ◽  
Protein S ◽  
Maximum Increase ◽  
Post Vaccination ◽  
Neutralizing Activity ◽  
Effect Monitoring ◽  
Antibody Levels ◽  
Level Hospital

AbstractThe Oxford-Astra Zeneca COVID 19 vaccine (AZD1222 or ChAdOx1) is locally manufactured as Covishield by Serum Institute, Pune, India. In a group of 307 healthcare workers administered Covishield, we report measured antibody response to SARS-CoV-2 directed against the spike protein (S-antigen) at days 0, 7, 14, 28 and 45, with second dose on day 28 for all except 20 subjects who did not receive a second dose. In 129 subjects (42%) who had already developed antibodies to SARS-CoV-2 at day 0 (before immunization), it was observed that antibody response was significantly higher at each time point, with the maximum increase seen between days 0 and 7. The antibody levels and neutralizing activity in these subjects had peaked by day 28 and the second dose did not lead to further increase. Data from 9 subjects who were seropositive at baseline and received only one dose was similar to those who received both doses. In contrast the baseline sero-negative group (n=178) started developing antibody response only after 14 days or later. Administration of the second dose was associated with further increase in antibody levels at day 45 compared to day 28, with marked increase in neutralizing activity. In baseline seronegative subjects, who did not take the vaccine at day 28 (n=11), the antibody levels increased by about 2.5 folds between days 28 and 45, with minimal change in the neutralizing antibodies. In general, vaccination was well tolerated, and there were no group specific differences in post-vaccination symptomatology. Our data suggests that ChAdOx1 is highly immunogenic, particularly so where previous SARS CoV2 antibody-response is established. In such subjects, a single dose may be sufficient but in absence of such determination, both doses are required.

scholarly journals Impact of prior SARS-CoV-2 infection on post-vaccination SARS-CoV-2 spike IgG antibodies in a longitudinal cohort of healthcare workers

2021 ◽  
Author(s):  
Diana Zhong ◽  
Shaoming Xiao ◽  
Amanda K Debes ◽  
Emily R Egbert ◽  
Patrizio Caturegli ◽  
...  
Keyword(s):  
Serum Sample ◽  
Healthcare Workers ◽  
Natural Infection ◽  
Vaccine Dose ◽  
Igg Antibodies ◽  
Linear Regression Models ◽  
Post Vaccination ◽  
Longitudinal Cohort ◽  
Vaccine Type ◽  
Antibody Levels

Waning serum antibodies against SARS-CoV-2 have sparked discussions about long-term immunity and need for vaccine boosters. We examined SARS-CoV-2 spike IgG antibodies in a longitudinal cohort, comparing antibody decay in individuals who received an mRNA SARS-CoV-2 vaccine, with and without prior SARS-CoV-2 infection. We completed a longitudinal cohort of healthcare workers (HWs) between June 2020 and September 2021. HWs were included if they had a serum sample collected after SARS-CoV-2 infection and/or a serum sample collected ≥ 14 days after second dose of an mRNA SARS-CoV-2 vaccine. Linear regression models adjusting for vaccine type, age, and sex were used to compare post-vaccination antibody levels between 1) HWs with and without prior SARS-CoV-2 infection and 2) HWs with prior SARS-CoV-2 infection ≤ 90 days and > 90 days prior to first vaccine. Serum was collected from 98 HWs after SARS-CoV-2 infection and before vaccine, and 1960 HWs ≥ 14 days following second vaccine dose. Serum spike antibody levels were higher after vaccination than after natural infection. Compared to SARS-CoV-2 naïve individuals, those with prior infection maintained higher post-vaccination mean spike IgG values at 1, 3, and 6 months, after adjusting for age, sex, and vaccine type. Individuals with PCR-confirmed infection > 90 days before vaccination had higher post-vaccination antibody levels than individuals infected ≤ 90 days before vaccination. Individuals with three exposures to spike protein maintain the highest antibody levels particularly when first and second exposures were greater than 90 days apart. A booster dose provides a third exposure and may similarly induce a more durable antibody response.

scholarly journals Long Term Humoral Immunity Decline in Hemodialysis Patients Following SARS-CoV-2 Vaccination

2021 ◽  
Author(s):  
Eibhlin Goggins ◽  
Binu Sharma ◽  
Jennie Z. Ma ◽  
Jitendra Gautam ◽  
Brendan Bowman
Keyword(s):  
Humoral Immunity ◽  
Average Rate ◽  
Vaccination Campaign ◽  
Hemodialysis Patients ◽  
Vaccine Response ◽  
Igg Antibody ◽  
Early Results ◽  
Protein Receptor ◽  
Antibody Levels

AbstractDialysis patients are extremely vulnerable to SARS-CoV-2 infection with high rates of hospitalization and mortality rates estimated at 20-30%. In January of 2021, the University of Virginia Dialysis Program initiated a program wide vaccination campaign administering Pfizer BioNTech mRNA SARS-CoV-2 (BNT162b2) vaccine. To characterize the time-dependent decline in humoral immunity, we performed a prospective cohort study measuring serial monthly semi quantitative IgG antibody levels to the SARS-CoV-2 spike protein receptor binding domain in fully vaccinated in-center hemodialysis patients. Measurements were taken beginning at 2 months post full vaccination through 6 months after full vaccination. Early results showed similar seroconversion rates as prior studies with 88% obtaining positive antibody levels. Those with prior infection obtained the highest antibody levels. Over the ensuing months, patient antibody levels declined at an adjusted average rate of 31% per month. At the conclusion of the study, 40% of patients remaining in the cohort possessed either negative or borderline IgG antibody levels. Projecting future antibody levels based on the slopes of antibody level decay suggests 65% of the cohort will progress to borderline or negative antibody levels at 10 months post full vaccination. In summary, we studied long term vaccine response following vaccination with the BNT162b2 mRNA vaccine in hemodialysis patients. Our data adds to the limited pool of data in this patient population and will help to inform the discussion about vaccine booster needs and frequency.

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