Neutralizing antibody activity against 21 SARS-CoV-2 variants in older adults vaccinated with BNT162b2

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Abstract

SARS-CoV-2 variants may threaten the effectiveness of vaccines and antivirals to mitigate serious COVID-19 disease. This is of most concern in clinically vulnerable groups such as older adults. We analysed 72 sera samples from 37 individuals, aged 70–89 years, vaccinated with two doses of BNT162b2 (Pfizer–BioNTech) 3 weeks apart, for neutralizing antibody responses to wildtype SARS-CoV-2. Between 3 and 20 weeks after the second vaccine dose, neutralizing antibody titres fell 4.9-fold to a median titre of 21.3 (neutralization dose 80%), with 21.6% of individuals having no detectable neutralizing antibodies at the later time point. Next, we examined neutralization of 21 distinct SARS-CoV-2 variant spike proteins with these sera, and confirmed substantial antigenic escape, especially for the Omicron (B.1.1.529, BA.1/BA.2), Beta (B.1.351), Delta (B.1.617.2), Theta (P.3), C.1.2 and B.1.638 spike variants. By combining pseudotype neutralization with specific receptor-binding domain (RBD) enzyme-linked immunosorbent assays, we showed that changes to position 484 in the spike RBD were mainly responsible for SARS-CoV-2 neutralizing antibody escape. Nineteen sera from the same individuals boosted with a third dose of BNT162b2 contained higher neutralizing antibody titres, providing cross-protection against Omicron BA.1 and BA.2. Despite SARS-CoV-2 immunity waning over time in older adults, booster vaccines can elicit broad neutralizing antibodies against a large number of SARS-CoV-2 variants in this clinically vulnerable cohort.

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  1. SciScore for 10.1101/2021.12.23.21268293: (What is this?)

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

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    RandomizationMultidimensional scaling was carried out with 1000 random restart optimisations, to avoid local optima and increase the likelihood of finding the best fit to the measured titres.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    The binding of IgG on the plate surface was detected by using an anti-human IgG horseradish peroxidase antibody conjugate (Sigma-Aldrich, Poole, UK) and 3,3′,5,5′-Tetramethylbenzidine (Europa Bioproducts Ltd, Ely, UK).
    anti-human IgG
    suggested: None
    Nucleoprotein (N) antibodies were measured as a marker of previous SARS-CoV-2 infection (Anti-SARS-CoV-2 total antibody assay, Roche Diagnostics, Basel, Switzerland) and spike (S) protein antibodies were measured as an indication of infection or vaccination (Elecsys Anti-SARS-CoV-2 S total antibody assay, Roche Diagnostics: positive ≥ 0.8 arbitrary units (au)/mL to assess vaccine response).
    Anti-SARS-CoV-2
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    Cells: Human embryonic kidney (HEK) 293T cells were used to generate lentiviral pseudoparticles bearing the SARS-CoV-2 spike.
    HEK
    suggested: None
    293T
    suggested: KCB Cat# KCB 200744YJ, RRID:CVCL_0063)
    HEK293T cells stably expressing human angiotensin converting enzyme 2 (hACE2) under 1µg/mL puromycin (Gibco) selection were used for neutralisation assays [56].
    HEK293T
    suggested: KCB Cat# KCB 200744YJ, RRID:CVCL_0063)
    Recombinant DNA
    SentencesResources
    Briefly, cells were transfected with 900 ng of SARS-CoV-2 spike (see Supplemental Table 1), 600 ng p8.91 (encoding for HIV-1 gag-pol), 600 ng CSFLW
    p8.91
    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:
    One limitation of our study is that for some VOCs, e.g. Beta, almost all the sera dropped below the limit of detection of our assay (ND80 of 10), providing less granularity, complicating comparisons with other studies, and obfuscating correlations with more sensitive Ab-detection assays such as the RBD-ELISA. Elsewhere, our data on Omicron neutralisation following 2 doses of BNT162b2 fits with recently reported findings. Dejnirattisai et al., Cameroni et al., and Garcia-Beltran et al. all showed drops in neutralisation of >30-fold [18-20, 30]. However, it is clear from our data, and that of Garcia-Beltran et al., [20] that boosting with a 3rd dose of BNT162b2 generates a much higher overall titre of neutralising antibodies to D614G (median ND80 ≥3070.9 in the 70-79 age group, Figure 4B) and that these high titres enhance cross-protection against Omicron and mitigate against the significant drops in neutralisation seen after two doses, highlighting the important role of boosters in providing robust long-term immunity to SARS-CoV-2. A smaller pool of antigenicity data is available on the wide range of other variants (VUIs/VUMs) that have emerged since the beginning of the pandemic. Our data highlighted several important antigenically-divergent variants, in particular C.1.2 and B.1.638 (Note: B.1.638 is from a small isolated outbreak; n=13), both initially detected in South Africa [31]; B.1.621 (Mu), first detected in Colombia [32] and P.3 (Theta) – isolated in the Philippines [...

    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.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

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