Prevalence of Antibodies to SARS-CoV-2 Following Natural Infection and Vaccination in Irish Hospital Healthcare Workers; Changing Epidemiology as the Pandemic Progresses

AbstractBackgroundNatural and vaccine-induced immunity will play a key role in controlling the SARS-CoV-2 pandemic. SARS-CoV-2 variants have the potential to evade natural and vaccine-induced immunity.MethodsIn a longitudinal cohort study of healthcare workers (HCWs) in Oxfordshire, UK, we investigated the protection from symptomatic and asymptomatic PCR-confirmed SARS-CoV-2 infection conferred by vaccination (Pfizer-BioNTech BNT162b2, Oxford-AstraZeneca ChAdOx1 nCOV-19) and prior infection (determined using anti-spike antibody status), using Poisson regression adjusted for age, sex, temporal changes in incidence and role. We estimated protection conferred after one versus two vaccinations and from infections with the B.1.1.7 variant identified using whole genome sequencing.Results13,109 HCWs participated; 8285 received the Pfizer-BioNTech vaccine (1407 two doses) and 2738 the Oxford-AstraZeneca vaccine (49 two doses). Compared to unvaccinated seronegative HCWs, natural immunity and two vaccination doses provided similar protection against symptomatic infection: no HCW vaccinated twice had symptomatic infection, and incidence was 98% lower in seropositive HCWs (adjusted incidence rate ratio 0.02 [95%CI <0.01-0.18]). Two vaccine doses or seropositivity reduced the incidence of any PCR-positive result with or without symptoms by 90% (0.10 [0.02-0.38]) and 85% (0.15 [0.08-0.26]) respectively. Single-dose vaccination reduced the incidence of symptomatic infection by 67% (0.33 [0.21-0.52]) and any PCR-positive result by 64% (0.36 [0.26-0.50]). There was no evidence of differences in immunity induced by natural infection and vaccination for infections with S-gene target failure and B.1.1.7.ConclusionNatural infection resulting in detectable anti-spike antibodies and two vaccine doses both provide robust protection against SARS-CoV-2 infection, including against the B.1.1.7 variant.SummaryNatural infection resulting in detectable anti-spike antibodies and two vaccine doses both provided ≥ 85% protection against symptomatic and asymptomatic SARS-CoV-2 infection in healthcare workers, including against the B.1.1.7 variant. Single dose vaccination reduced symptomatic infection by 67%.

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Influenza vaccine uptake and attitudes of healthcare workers in Ireland

Occupational Medicine ◽

10.1093/occmed/kqz124 ◽

2019 ◽

Cited By ~ 1

Author(s):

V Hogan ◽

M Lenehan ◽

M Hogan ◽

D P Natin

Keyword(s):

Influenza Vaccination ◽

Healthcare Workers ◽

Vaccine Uptake ◽

Hospital Workers ◽

Line Managers ◽

Vaccination Uptake ◽

Flu Vaccination ◽

Irish Hospital ◽

Local Initiatives ◽

Specific Barriers

Abstract Background Influenza vaccination uptake by Irish healthcare workers remains sub-optimal despite local initiatives to increase it. Aims To investigate hospital workers' attitudes to influenza vaccination and how this influenced their decisions about vaccination. Methods A questionnaire survey of Irish hospital workers, measuring uptake of and attitudes to influenza vaccination. Results There were 747 responders, of whom 361 (48%) reported having received influenza vaccination. Attitudes predicting vaccination uptake included a belief that vaccination would protect family members (P < 0.0005, CI 1.191–1.739), a perception of susceptibility to ’flu (P < 0.0005, CI 1.182–1.685), a belief that all healthcare workers should be vaccinated (P < 0.005, CI 1.153–1.783), perceived ease of getting ’flu vaccination at work (P < 0.0005, CI 1.851–2.842) and encouragement by line managers (P < 0.05, CI 1.018–1.400). Attitudes negatively associated with vaccination uptake included fear of needles (P < 0.05, CI 0.663–0.985) and a belief that vaccination would cause illness (P < 0.0005, CI 0.436–0.647). Medical staff were significantly more likely to be vaccinated. Healthcare students were least likely to be vaccinated (P < 0.0005). Conclusion Addressing specific barriers to influenza vaccination in healthcare workers may improve uptake.

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An Epidemiological Cohort Study of SARS-CoV-2 and COVID-19 in German Healthcare Workers – Interim Analysis after Six Months of Follow-up

10.21203/rs.3.rs-688656/v1 ◽

2021 ◽

Author(s):

Stephan Gehring ◽

Omar Okasha ◽

Frank Kowalzik ◽

Tobias Engelmann ◽

Daniel Schreiner ◽

...

Keyword(s):

Healthcare Workers ◽

Natural Infection ◽

Severe Disease ◽

Smartphone Application ◽

Case Definitions ◽

Humoral Immune ◽

Increased Risk ◽

Transmission Period ◽

Incident Cases

Abstract BackgroundHealthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection. We assessed incidence of SARS-CoV-2 infection and COVID-19 before the roll out of COVID-19 vaccines in a cohort of HCWs in Mainz, Germany.MethodsUsing prospective observational cohort design, antibody status was assessed at baseline and every 6 weeks (±2 weeks). Daily self-reported COVID-19 symptoms were collected using a smartphone application. Symptomatic HCWs were tested using RT-PCR. We estimated symptomatic and asymptomatic SARS-CoV-2 infection rates based on two case definitions of varying sensitivity and specificity.Results3664 HCWs were enrolled with a median follow-up of 101 days. The seroprevalence of anti-SARS-CoV-2 antibodies increased from 2.7% at baseline to 3.8%, with the number of seroconversions (65) outweighing seroreversions (26) by end of follow-up. Among HCWs who seroconverted, 12 (~19%) did not report any symptoms. The estimated incidence rate was 4.5 per 1000 person-months, but none the incident cases developed severe disease. Anti-SARS-CoV-2 antibodies fell below diagnostic cut-off value in a third of those positive at baseline and in one incident case.ConclusionsWe observed increasing COVID-19 rates among HCWs during an accelerated community transmission period, with relatively lower rate of asymptomatic infections. Our findings indicate a relatively long-lasting humoral immune response following natural infection.

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Antibodies to SARS-CoV2 detectable for less than 50 days in polymerase chain reaction confirmed COVID-19 patients

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203893 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3378

Author(s):

Nishant Kumar ◽

Shibal Bhartiya ◽

Tarundeep Singh

Keyword(s):

Polymerase Chain Reaction ◽

Healthcare Workers ◽

Health Workers ◽

Natural Infection ◽

Rt Pcr ◽

Chain Reaction ◽

Cross Sectional Survey ◽

Polymerase Chain ◽

Roche Diagnostics ◽

Pcr Test

Background: A seroprevalence study for COVID-19 antibodies was conducted amongst health workers in Mumbai, India, in June 2020.Methods: Healthcare workers (n=801) underwent a cross sectional survey through electrochemiluminescence immunoassay (Roche diagnostics’ Elecsys anti-SARS-CoV-2 assay, Roche diagnostics, Rotkreuz, Switzerland).Results: Of the 801 healthcare workers, 62 who had been previously diagnosed with a real time-polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection, 45 (73.6%) were found to be seronegative during the study. The duration between the positive RT-PCR test and the serological testing ranged from 15 to 49 days for 34 (54.8%), and was >50 days in 28 subjects. Up to 28 days after a positive PCR test, 90% of the subjects were found to be seropositive, but this reduced to less than half over the next two weeks (38.5% between 29 and 42 days).Conclusions: Our findings are in agreement with previous reports that demonstrate a peak antibody formation after 3 weeks, and also an early antibody decay that is almost exponential. This may also have a significant effect on the protection vaccines are able to provide considering that a natural infection has such a transient antibody response.

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Impact of first dose of BNT162b2 vaccine on COVID-19 infection among healthcare workers in an Irish hospital

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-021-02658-4 ◽

2021 ◽

Author(s):

Jennifer Walsh ◽

Mairead Skally ◽

Leah Traynor ◽

Eoghan de Barra ◽

Aoife Ni Dhuthaigh ◽

...

Keyword(s):

Healthcare Workers ◽

Irish Hospital

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Neutralising reactivity against SARS-CoV-2 B.1.617.2 (Delta) variant by vaccination status and pre-exposure

10.21203/rs.3.rs-1131280/v1 ◽

2021 ◽

Author(s):

Enrico Lavezzo ◽

Monia Pacenti ◽

Laura Manuto ◽

Caterina Boldrin ◽

Margherita Cattai ◽

...

Keyword(s):

Antibody Response ◽

Post Infection ◽

Healthcare Workers ◽

Natural Infection ◽

Vaccination Status ◽

Control Groups ◽

Post Exposure ◽

The Third ◽

Antibody Levels

Abstract In February and March 2020, one of the first Italian clusters of SARS-CoV-2 infection was detected in the municipality of Vo’. Positive subjects were followed up at 2 and 9 months post-infection with different immuno-assays and a micro-neutralisation test. Here we report on the results of the third serosurvey conducted in the same population in June 2021, 15 months post-infection, when we tested 61% of the infected individuals (n=76). Antibodies against the spike (S) antigen significantly decreased (P<0.006, Kruskal-Wallis test) among unvaccinated subjects (n=35) and increased (P<0.0001) in vaccinated individuals (n=41), whereas those against the nucleocapsid (N) decreased in the whole cohort. From the comparison with two control groups (naïve Vo’ inhabitants (n=20) and healthcare workers (HCW, n=61)), subjects vaccinated post exposure (hybrid immunity) had higher antibody levels (P<0.0001) than subjects vaccinated when naïve. Two doses of vaccine elicited stronger anti-S antibody response than natural infection (P<0.0001). Finally, the neutralising reactivity of sera against the B.1.617.2 (Delta) was lower than compared to the B.1 strain (median 1:320 versus 1:1280 1/dil, P<0.0001, and 1:640 versus 1:2560 1/dil, P=0.0014, after one or two vaccine doses, respectively), although subjects with hybrid immunity maintained neutralising titres above 1:40 1/dil.

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

10.1101/2021.09.16.21263576 ◽

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.

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Comparative Immunogenicity of BNT162b2 mRNA Vaccine with Natural SARS-CoV-2 Infection

Vaccines ◽

10.3390/vaccines9091017 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1017

Author(s):

Mina Psichogiou ◽

Andreas Karabinis ◽

Garyphallia Poulakou ◽

Anastasia Antoniadou ◽

Anastasia Kotanidou ◽

...

Keyword(s):

Clinical Trials ◽

Side Effects ◽

Healthcare Workers ◽

Natural Infection ◽

Comparative Data ◽

Spike Protein ◽

Clinical Heterogeneity ◽

Prior Infection ◽

High Immunogenicity ◽

Post Onset

BNT162b2 has proven to be highly effective, but there is a paucity of data regarding immunogenicity factors and comparison between response to vaccination and natural infection. This study included 871 vaccinated healthcare workers (HCW) and 181 patients with natural infection. Immunogenicity was assessed by measuring anti-SARS-CoV-2 against the RBD domain of the spike protein (anti-RBD). Samples were collected 1–2 weeks after vaccination or 15–59 days post-onset of symptoms. Post-vaccine anti-RBD concentrations were associated with age, gender, vaccination side-effects (VSE) and prior infection (Pr-CoV). Anti-RBD median levels (95%CI) were lower by 2466 (651–5583), 6228 (3254–9203) and 7651 (4479–10,823) AU/mL in 35–44, 45–54, 55–70 yrs, respectively, compared with the 18–34 yrs group. In females, the median levels were higher by 2823 (859–4787), 5024 (3122–6926) in individuals with VSE, and 9971 (5158–14,783) AU/mL in HCWs with Pr-CoV. The ratio of anti-RBD in vaccinated individuals versus those with natural infection varied from 1.0 to 19.4. The high immunogenicity of BNT162b2 is verified, although its sustainability has yet to be elucidated. The use of comparative data from natural infection serological panels, expressing the clinical heterogeneity of natural infection, may facilitate early decisions for candidate vaccines to be evaluated in clinical trials.

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Serological surveillance of SARS-CoV-2: trends and humoral response in a cohort of public health workers

10.1101/2020.10.21.20216689 ◽

2020 ◽

Author(s):

Ross J Harris ◽

Heather J Whitaker ◽

Nick J Andrews ◽

Felicity Aiano ◽

Zahin Amin-Chowdhury ◽

...

Keyword(s):

Half Life ◽

Healthcare Workers ◽

Health Workers ◽

Natural Infection ◽

Humoral Response ◽

Spike Protein ◽

Positive Test ◽

Public Health Workers ◽

Serological Surveillance ◽

Antibody Levels

AbstractBackgroundThere is considerable debate about the rate of antibody waning after SARS-CoV-2 infection, raising questions around long-term immunity following both natural infection and vaccination. We undertook prospective serosurveillance in a large cohort of healthy adults from the start of the epidemic in England.MethodsThe serosurveillance cohort included office and laboratory-based staff and healthcare workers in 4 sites in England, who were tested monthly for SARS-CoV-2 spike protein and nucleoprotein IgG between 23rd March and 20th August 2020. Antibody levels from 21 days after a positive test were modelled using mixed effects regression models.FindingsIn total, 2247 individuals were recruited and 2014 (90%) had 3-5 monthly antibody tests. Overall, 272 (12.1%) of individuals had at least one positive/equivocal spike protein IgG result, with the highest proportion in a hospital site (22%), 14% in London and 2.1% in a rural area. Results were similar for nucleoprotein IgG. Following a positive result, 39/587 (6.6%) tested negative for nucleoprotein IgG and 52/515 (10.1%) for spike protein IgG. Nucleoprotein IgG declined by 6.4% per week (95% CI, 5.5-7.4%; half-life, 75 [95% CI, 66-89] days) and spike protein IgG by 5.8% (95% CI, 5.1-6.6%; half-life, 83 [95% CI, 73-96] days).ConclusionsOver the study period SARS-CoV-2 seropositivity was 8-10% overall and up to 21% in clinical healthcare workers. In seropositive individuals, nucleoprotein and spike protein IgG antibodies declined with time after infection and 50% are predicted to fall below the positive test threshold after 6 months.FundingPHE

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