SARS-CoV-2 vaccine antibody response and breakthrough infections in patients receiving dialysis

Background: Patients receiving dialysis are a sentinel population for groups at high risk for death and disability from COVID-19. Understanding correlates of protection post-vaccination can inform immunization and mitigation strategies. Methods: Monthly since January 2021, we tested plasma from 4791 patients receiving dialysis for antibodies to the receptor-binding domain (RBD) of SARS-CoV-2 using a high-throughput assay. We qualitatively assessed the proportion without a detectable RBD response and among those with a response, semiquantitative median IgG index values. Using a nested case-control design, we matched each breakthrough case to five controls by age, sex, and vaccination-month to determine whether peak and pre-breakthrough RBD IgG index values were associated with risk for infection post-vaccination. Results: Among 2563 vaccinated patients, the proportion without a detectable RBD response increased from 6.6% [95% CI 5.5-8.1] in 14-30 days post-vaccination to 20.2% [95% CI 17.1-23.8], and median index values declined from 92.7 (95% CI 77.8-107.5) to 3.7 (95% CI 3.1-4.3) after 5 months. Persons with SARS-CoV-2 infection prior-to-vaccination had higher peak index values than persons without prior infection, but values equalized by 5 months (p=0.230). Breakthrough infections occurred in 56 patients, with samples collected a median of 21 days pre-breakthrough. Peak and pre-breakthrough RBD values <23 (equivalent to <506 WHO BAU/mL) were associated with higher odds for breakthrough infection (OR: 3.7 [95% CI 2.0-6.8] and 9.8 [95% CI 2.9-32.8], respectively). Conclusions: The antibody response to SARS-CoV-2 vaccination wanes rapidly, and in persons receiving dialysis, the persisting antibody response is associated with risk for breakthrough infection.

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The importance of time post-vaccination in determining the decrease in vaccine efficacy against SARS-CoV-2 variants of concern

10.1101/2021.06.06.21258429 ◽

2021 ◽

Author(s):

Yinon M. Bar-On ◽

Elad Noor ◽

Noam Gottlieb ◽

Alex Sigal ◽

Ron Milo

Keyword(s):

Vaccine Efficacy ◽

Strong Dependence ◽

Similar Efficacy ◽

Mitigation Strategies ◽

High Efficacy ◽

Breakthrough Infection ◽

Post Vaccination ◽

Open Question ◽

The Impact ◽

Efficacy Studies

With the development of high-efficacy vaccines against SARS-CoV-2, an urgent open question is whether currently available vaccines protect with similar efficacy against infection with SARS-CoV-2 variants of concern (VOC). Recent reports quantifying the extent by which VOC can evade vaccine immunity resulted in a range of estimates for the same VOC, which makes them difficult to interpret. One possible explanation for the discrepancies between different studies is an inconsistency in terms of the time post-vaccination of the sampled population. Here we present a model based on the observed correlation between antibody neutralization levels and vaccine efficacy, which demonstrates the impact of time post-vaccination on the comparison of the vaccine efficacy for VOC versus non-VOC infections. Our model predicts and exemplifies several possible consequences for vaccine efficacy in VOC infections: 1) a delay in the onset of vaccine efficacy against VOC; 2) a transient increase in susceptibility to breakthrough infection with VOC compared to non-VOC as a function of time after vaccination. We review preliminary data indicating that such phenomena are observed in studies of the B.1.1.7 and B.1.351 variants. We find that ignoring the strong dependence on the time post-vaccination can lead to contradictory reports of relative efficacy against VOC versus non-VOC, with implications on mitigation strategies against VOC and the design of vaccine efficacy studies.

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SARS-CoV-2 seropositivity after infection and antibody response to mRNA-based vaccination

10.1101/2021.02.09.21251319 ◽

2021 ◽

Author(s):

Emily J. Ciccone ◽

Deanna R. Zhu ◽

Rawan Ajeen ◽

Evans K. Lodge ◽

Bonnie E. Shook-Sa ◽

...

Keyword(s):

Immune Response ◽

Antibody Response ◽

Specific Antibody ◽

Vaccine Dose ◽

Antibody Responses ◽

Post Vaccination ◽

Prior Infection

AbstractThe effect of SARS-CoV-2 infection on response to mRNA-based SARS-CoV-2 vaccines is not well-described. We assessed longitudinal SARS-CoV-2-specific antibody responses pre- and post-vaccination among individuals with and without prior infection. The antibody response to the first vaccine dose was almost two-fold higher in individuals who were seropositive before vaccination compared to those who were seronegative, suggesting that prior infection primes the immune response to the first dose of mRNA-based vaccine.

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A cohort study of developmental polychlorinated biphenyl (PCB) exposure in relation to post-vaccination antibody response at 6-months of age

Environmental Research ◽

10.1016/j.envres.2010.02.010 ◽

2010 ◽

Vol 110 (4) ◽

pp. 388-395 ◽

Cited By ~ 25

Author(s):

Todd A. Jusko ◽

Anneclaire J. De Roos ◽

Stephen M. Schwartz ◽

B. Paige Lawrence ◽

Lubica Palkovicova ◽

...

Keyword(s):

Cohort Study ◽

Antibody Response ◽

Polychlorinated Biphenyl ◽

Post Vaccination ◽

Pcb Exposure

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COVID19 vaccine type and humoral immune response in patients receiving dialysis

10.1101/2021.08.02.21261516 ◽

2021 ◽

Author(s):

Pablo Garcia ◽

Shuchi Anand ◽

Jialin Han ◽

Maria Montez-Rath ◽

Sumi Sun ◽

...

Keyword(s):

Immune Response ◽

Antibody Index ◽

Igg Antibody ◽

Post Vaccination ◽

Humoral Immune ◽

Vaccination Response ◽

Vaccine Type ◽

Igg Index ◽

Impaired Immune Response ◽

Index Value

Background Patients on dialysis vaccinated with the attenuated adenovirus SARS-CoV-2 vaccine might mount an impaired response to vaccination. Methods We evaluated the humoral vaccination response among 2,099 fully vaccinated patients receiving dialysis. We used commercially available assays (Siemens) to assess prevalence of no response or diminished response to COVID-19 vaccination by vaccine type. We defined no seroconversion as lack of change from negative to positive in total RBD Ig antibody, no detectable response on semiquantitative RBD IgG antibody (index value <1) as no RBD IgG response, and a semiquantitative RBD IgG index value <10 as diminished RBD IgG response Results Of the 2,099 fully vaccinated patients on dialysis, the proportion receiving the mRNA1273, BNT162b2, and Ad26.COV2.S were 62% (n=1316), 20% (n=416) and 18% (n=367), respectively. A third (33.3%) of patients receiving the attenuated adenovirus Ad26.COV2.S vaccine failed to seroconvert and an additional 36% had no detectable or diminished IgG response even 28-60 days post vaccination. Conclusions One in three fully vaccinated patients receiving dialysis had evidence of an impaired immune response to the attenuated adenovirus Ad26.COV2.S vaccine.

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COVID-19 convalescent plasma donors: impact of vaccination on antibody levels, breakthrough infections and reinfection rate.

10.1101/2021.07.13.21260414 ◽

2021 ◽

Author(s):

Massimo La Raja ◽

Monia Pacenti ◽

Ileana Grimaldi ◽

Caterina Boldrin ◽

Margherita Cattai ◽

...

Keyword(s):

Antibody Response ◽

Antibody Level ◽

Natural Infection ◽

Vaccination Campaign ◽

Reinfection Rate ◽

Post Vaccination ◽

Exponential Increase ◽

The One ◽

Antibody Levels ◽

The Impact

From April 2020 through May 2021 in Padova Province 3395 COVID-19 recovered patients were recruited as potential convalescent plasma donors and tested for SARS-CoV-2 antibodies. Since January 2021 COVID-19 vaccination campaign began in Italy, the impact of vaccination on antibody levels and suspect vaccine breakthrough infections in these subjects were investigated. Post-vaccination anti-Sars-Cov-2 antibody level in 54 previously infected subjects had an exponential increase compared to pre-vaccination level regardless of the number of vaccine doses. However after 100 days from vaccination SARS-CoV-2 antibody level tends to decline. Post-vaccination primary infections were detected in 15 cases, with 3 possible breakthrough infections after a full vaccination course. In these cases, antibody response after infection was present but weaker than the one of subjects vaccinated after natural infection. A trend toward stronger antibody response was observed with increasing distance between natural infection and vaccination. Additionally, 2 cases of asymptomatic reinfections are also discussed.

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Live Oral Adenovirus Type 4 and Type 7 Vaccine Induces Durable Antibody Response

Vaccines ◽

10.3390/vaccines8030411 ◽

2020 ◽

Vol 8 (3) ◽

pp. 411 ◽

Cited By ~ 1

Author(s):

Natalie D. Collins ◽

Anima Adhikari ◽

Yu Yang ◽

Robert A. Kuschner ◽

Nicos Karasavvas ◽

...

Keyword(s):

Antibody Response ◽

Geometric Mean ◽

Fold Increase ◽

Adenovirus Type ◽

The United States ◽

Serum Samples ◽

Post Vaccination ◽

Tract Infections ◽

The Military

Human adenoviruses (AdV) are mostly associated with minimal pathology. However, more severe respiratory tract infections and acute respiratory diseases, most often caused by AdV-4 and AdV-7, have been reported. The only licensed vaccine in the United States, live oral AdV-4 and AdV-7 vaccine, is indicated for use in the military, nearly exclusively in recruit populations. The excellent safety profile and prominent antibody response of the vaccine is well established by placebo-controlled clinical trials, while, long-term immunity of vaccination has not been studied. Serum samples collected over 6 years from subjects co-administered live oral AdV-4 and AdV-7 vaccine in 2011 were evaluated to determine the duration of the antibody response. Group geometric mean titers (GMT) at 6 years post vaccination compared to previous years evaluated were not significantly different for either AdV-4 or AdV-7 vaccine components. There were no subjects that demonstrated waning neutralization antibody (NAb) titers against AdV-4 and less than 5% of subjects against AdV-7. Interestingly, there were subjects that had a four-fold increase in NAb titers against either AdV-4 or AdV-7, at various time points post vaccination, suggesting either homotypic or heterotypic re-exposure. This investigation provided strong evidence that the live oral AdV-4 and AdV-7 vaccine induced long-term immunity to protect from AdV-4 and AdV-7 infections.

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Robust SARS-CoV-2 Antibody Responses in Asian COVID-Naïve Subjects 180 Days after Two Doses of BNT162b2 mRNA COVID-19 Vaccine

Vaccines ◽

10.3390/vaccines9111241 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1241

Author(s):

Chin-Shern Lau ◽

Soon Kieng Phua ◽

Ya-Li Liang ◽

Helen May-Lin Oh ◽

Tar-Choon Aw

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Antibody Response ◽

Southeast Asia ◽

Neutralizing Antibodies ◽

Linear Regression Analysis ◽

Antibody Responses ◽

Post Vaccination ◽

Non Linear ◽

Antibody Panel

Background: Subjects with previous COVID-19 have augmented post-vaccination responses. However, the antibody response in COVID-naïve subjects from Southeast Asia is not well known. Methods: 77 COVID-naïve vaccinees were tested with a full antibody panel [spike antibodies (total (T-Ab), IgG, IgM) and neutralizing antibodies (N-Ab)] pre-vaccination, 10 days after dose 1, and 20/40/60/90/120/150/180 days after dose 2. Results: 10 days after dose 1, 67.6% (48/71)/69.0% (49/71) were T-Ab/IgG positive; only 15.5% (11/71)/14.1% (10/71) were N-Ab/IgM positive. While all (100%) subjects had brisk T-Ab, IgG and N-Ab antibody responses 20 days after complete vaccination, only 79.1% (53/67) were IgM positive. At 180 days (n = 8), T-Ab/IgG/N-Ab were still reactive (lowest T-Ab 186 U/mL, IgG 617 AU/mL, N-Ab 0.39 µg/mL), but IgM was negative in all samples. Spike antibody thresholds of T-Ab 74.1 U/mL (r = 0.95) and IgG 916 AU/mL (r = 0.95) corresponded to N-Ab reactivity (>0.3 µg/mL). Non-linear regression analysis showed that N-Ab would decrease to 0.3 µg/mL by 241 days, whereas T-Ab/IgG would need 470/163 days to reach titers of T-Ab/IgG associated with a N-Ab 0.3 µg/mL (76.4 U/mL and 916 AU/mL respectively). Conclusions: The antibody responses of T-Ab, IgG and N-Ab remain high and durable even at 180 days. N-Ab titers are expected to remain reactive up to 241 days post-vaccination.

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Immune Response to anti-HBs Antibodies in Health Workers Following Hepatitis B Vaccination

Medical Laboratory Technology Journal ◽

10.31964/mltj.v7i2.418 ◽

2021 ◽

Vol 7 (2) ◽

pp. 182

Author(s):

Dinna Rakhmina ◽

Wahdah Norsiah ◽

Tini Elyn Herlina ◽

Norhafizah Mulia Sari ◽

Reza Pertiwi ◽

...

Keyword(s):

Immune Response ◽

Hepatitis B ◽

Antibody Response ◽

Health Workers ◽

Hepatitis B Surface Antigen ◽

Strong Association ◽

Hepatitis B Vaccination ◽

Enzyme Linked Immunosorbent Assay ◽

Dose Frequency ◽

Post Vaccination

According to Regulation No. 53 of 2015 of the Minister of Health of the Republic of Indonesia, a high risk of HBV infection in health workers is a problem that requires attention, and vaccination knowledge is critical to reducing these risk factors. Furthermore, because some people do not produce a sufficient antibody-forming (anti-HBs) response to HBsAg, testing for evidence of protective immunity against hepatitis B vaccination is required (Hepatitis B Surface Antigen). The purpose of the study was to determine the mapping of the characteristics of anti-HBs antibodies response after hepatitis B vaccination in health workers in terms of age, gender, ethnicity, smoking habits, obesity, vaccination frequency, last time of vaccination. Sixty vaccinated health workers were used to creating the research sample. Anti-HBs levels/titers in serum were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method, and a questionnaire was used to compile the data for this study. Age, gender, smoking, obesity, and vaccination dose were all used to map the outcomes of the anti-HBs antibody immune response study. Anti-HBs antibody response in health workers was graded as poor in 36 people (60%) and strong in 24 (40%). Regarding ethnic origin, lifestyle, obesity, and vaccination dose (frequency), there was no significant link between post-vaccination anti-HBs antibody response in health workers. In terms of age and gender, there is a strong association between post-vaccination anti-HBs antibody responses in health workers. Low antibody titers should be revaccinated to enhance anti-HBs titers, and health workers who smoke should quit because it reduces the levels of anti-HBs titers produced clinically.

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Viral loads of Delta-variant SARS-CoV2 breakthrough infections following vaccination and booster with the BNT162b2 vaccine

10.1101/2021.08.29.21262798 ◽

2021 ◽

Author(s):

Matan Levine-Tiefenbrun ◽

Idan Yelin ◽

Hillel Alapi ◽

Rachel Katz ◽

Esma Herzel ◽

...

Keyword(s):

Viral Load ◽

Real Life ◽

Load Reduction ◽

Protective Effects ◽

Breakthrough Infection ◽

Life Effectiveness ◽

Post Vaccination ◽

Viral Loads ◽

Booster Vaccine ◽

Viral Load Reduction

The BNT162b2 vaccine showed high real-life effectiveness both at preventing disease and in reducing viral loads of breakthrough infections, but coincidental with the rise of the Delta-variant SARS-CoV2, these protective effects have been decreasing, prompting a third, booster, vaccine inoculation. Here, analyzing viral loads of over 11,000 infections during the current wave in Israel, we find that even though this wave is dominated by the Delta-variant, breakthrough infections in recently vaccinated patients, still within 2 months post their second vaccine inoculation, do have lower viral loads compared to unvaccinated patients, with the extent of viral load reduction similar to pre-Delta breakthrough observations. Yet, this infectiousness protection starts diminishing for patients two months post vaccination and ultimately vanishes for patients 6 months or longer post vaccination. Encouragingly, we find that this diminishing vaccine effectiveness on breakthrough infection viral loads is restored following the booster vaccine. These results suggest that the vaccine is initially effective in reducing infectiousness of breakthrough infections even with the Delta variant, and that while this protectiveness effect declines with time it can be restored, at least temporarily, with a booster vaccine.

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