Antibody response to SARS‐CoV‐2 vaccination is extremely vivacious in subjects with previous SARS‐CoV‐2 infection

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Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic calls for rapid actions, now principally oriented to a world‐wide vaccination campaign. In this study we verified if, in individuals with a previous SARS‐CoV‐2 infection, a single dose of messenger RNA (mRNA) vaccine would be immunologically equivalent to a full vaccine schedule in naïve individuals. Health care workers (184) with a previous SARS‐CoV‐2 infection were sampled soon before the second dose of vaccine and between 7 and 10 days after the second dose, the last sampling time was applied to SARS‐CoV‐2 naïve individuals, too. Antibodies against SARS‐CoV‐2 were measured using Elecsys Anti‐SARS‐CoV‐2 S immunoassay. The study was powered for non‐inferiority. We used non parametric tests and Pearson correlation test to perform inferential analysis. After a single vaccine injection, the median titer of specific antibodies in individuals with previous coronavirus disease 2019 was 30.527 U/ml (interquartile range [IQR]: 19.992–39.288) and in subjects with previous SARS‐CoV‐2 asymptomatic infection was 19.367.5 U/ml (IQR: 14.688–31.353) ( p  = .032). Both results were far above the median titer in naïve individuals after a full vaccination schedule: 1974.5 U/ml (IQR: 895–3455) ( p  < .0001). Adverse events after vaccine injection were more frequent after the second dose of vaccine (mean: 0.95; 95% confidence interval [CI]: 0.75–1.14 vs. mean: 1.91; 95% CI: 1.63–2.19) ( p  < .0001) and in exposed compared to naïve (mean: 1.63; 95% CI: 1.28–1.98 vs. mean: 2.35; 95% CI: 1.87–2.82) ( p  = .015). In SARS‐CoV‐2 naturally infected individuals a single mRNA vaccine dose seems sufficient to reach immunity. Modifying current dosing schedules would speed‐up vaccination campaigns.

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  1. SciScore for 10.1101/2021.03.09.21253203: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethics: The Provincial Ethical Committee approved the study and all participants gave their informed consent.
    Consent: Ethics: The Provincial Ethical Committee approved the study and all participants gave their informed consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Individuals with a previous COVID-19 symptomatic disease or a SARS-CoV-2 asymptomatic infection were sampled for measuring SARS-CoV-2 antibody responses soon before the second dose of vaccine and between 7 and 10 days after the second dose, the last sampling time was applied to SARS-CoV-2 naïve individuals, too. Antibodies against SARS-CoV-2 in serum samples were measured using Elecsys® Anti-SARS-CoV-2 S immunoassay (Roche Diagnostics GmbH, Sandhofer Strasse 116, D-68305 Mannheim) for the in vitro quantitative determination of antibodies (including IgG) to the SARS-CoV-2 spike (S) protein receptor binding domain (RBD) [5,6], according to the manufacturer’s instructions.
    S) protein receptor binding domain (RBD)
    suggested: None
    As reported by Roche Diagnostics, the specific U/mL units of the Roche Elecsys® Anti-SARS-CoV-2 S test can be considered equivalent to the binding antibody units (BAU)/mL of the first WHO International Standard for anti-SARS-CoV-2 immunoglobulins [7,8].
    anti-SARS-CoV-2
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has some limitations. Being conducted in health care workers, the age of enrolled individuals ranged from 24 to 66 years and we cannot exclude that younger or older subjects could react differently. Furthermore, most of our subjects were Caucasian and we therefore cannot extend our observation to different ethnicities. Finally, we did not observe any non-responder to the vaccine, although this possibility cannot be absolutely excluded. However, in our experience all patients but two with a pre-exposure to SARS-CoV-2 showed antibody titers well above the 1000 IU/ml after a single vaccine dose. That appears reassuring in the light of a differentiated vaccination schedule. In SARS-CoV-2 naturally infected individuals a single mRNA vaccine dose seems sufficient to reach immunity. Modifying currently implemented dosing schedules would speed-up vaccination campaigns and would limit occurrence of adverse events in this sub-group of individuals

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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