Poor Antibody Response to BioNTech/Pfizer Coronavirus Disease 2019 Vaccination in Severe Acute Respiratory Syndrome Coronavirus 2–Naive Residents of Nursing Homes
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Abstract
Background
Residents of nursing homes (NHs) are at high risk of coronavirus disease 2019 (COVID-19)–related disease and death and may respond poorly to vaccination because of old age and frequent comorbid conditions.
Methods
Seventy-eight residents and 106 staff members, naive to infection or previously infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2), were recruited in NHs in Belgium before immunization with 2 doses of 30 µg BNT162b2 messenger RNA (mRNA) vaccine at days 0 and 21. Binding antibodies (Abs) to SARS-CoV-2 receptor-binding domain (RBD), spike domains S1 and S2, RBD Ab avidity, and neutralizing Abs against SARS-CoV-2 wild type and B.1.351 were assessed at days 0, 21, 28, and 49.
Results
SARS-CoV-2–naive residents had lower Ab responses to BNT162b2 mRNA vaccination than naive staff. These poor responses involved lower levels of immunoglobulin (Ig) G to all spike domains, lower avidity of RBD IgG, and lower levels of Abs neutralizing the vaccine strain. No naive residents had detectable neutralizing Abs to the B.1.351 variant. In contrast, SARS-CoV-2–infected residents had high responses to mRNA vaccination, with Ab levels comparable to those in infected staff. Cluster analysis revealed that poor vaccine responders included not only naive residents but also naive staff, emphasizing the heterogeneity of responses to mRNA vaccination in the general population.
Conclusions
The poor Ab responses to mRNA vaccination observed in infection-naive NH residents and in some naive staff members suggest suboptimal protection against breakthrough infection, especially with variants of concern. These data support the administration of a third dose of mRNA vaccine to further improve protection of NH residents against COVID-19.
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SciScore for 10.1101/2021.06.08.21258366: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was approved by the Ethics Committee of the Hôpital Erasme, Brussels, Belgium (reference B4062020000134), the Federal Agency for Medicines and Health Products (2021-000401-24), and is registered on ClinicalTrials.gov (NCT04527614). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Cell Line Authentication not detected. Table 2: Resources
Antibodies Sentences Resources SARS-CoV-2 RBD-Specific antibody avidity: Bio-layer interferometry measurements were performed with an Octet HTX instrument (Fortébio) using AR2G biosensors. SARS-CoV-2 RBD-Specificsuggested: NoneExperimental Models: Cell Lines Sentences Resources Sample-viru… SciScore for 10.1101/2021.06.08.21258366: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was approved by the Ethics Committee of the Hôpital Erasme, Brussels, Belgium (reference B4062020000134), the Federal Agency for Medicines and Health Products (2021-000401-24), and is registered on ClinicalTrials.gov (NCT04527614). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Cell Line Authentication not detected. Table 2: Resources
Antibodies Sentences Resources SARS-CoV-2 RBD-Specific antibody avidity: Bio-layer interferometry measurements were performed with an Octet HTX instrument (Fortébio) using AR2G biosensors. SARS-CoV-2 RBD-Specificsuggested: NoneExperimental Models: Cell Lines Sentences Resources Sample-virus mixtures and virus/cell controls were added to Vero cells (18.000 cells/well) in a 96-well plate and incubated for five days (37°C, 7% CO2). Verosuggested: NoneResults 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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04527614 Enrolling by invitation Influence of Prior Infection With COVID-19 on Occurrence of … 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.
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