Antibody-Mediated Immunogenicity Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Following Priming, Boosting, and Hybrid Immunity: Insights From 11 Months of Follow-up of a Healthcare Worker Cohort in Israel, December 2020–October 2021
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Abstract
Background
We determined circulating anti-S severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibody titers in a vaccinated healthcare workers (HCWs) cohort from Northern Israel in the 11 months following primary vaccination according to age, ethnicity, and previous infection status.
Methods
All consenting HCWs were invited to have their IgG levels measured before vaccination and at 6 subsequent timepoints using a quantitative S1/S2 IgG assay. All HCWs with suspected coronavirus disease 2019 (COVID-19) were polymerase chain reaction (PCR) tested. We described trends in circulating IgG geometric mean concentration (GMC) by age, ethnicity, timing of boosting, and previous infection status and compared strata using Kruskall-Wallis tests.
Results
Among 985 vaccinated HCWs, IgG titers between 1 month post 2nd dose to pre-boosting gradually decreased in all age groups. Younger or previously infected individuals had higher initial post-vaccination IgG levels (P < .001 in both cases); differences substantially decreased or disappeared at 7–9 months, before boosting. The proportion of individuals infected prior to initiating vaccination and re-infected after dose 1 was comparable to the proportion of breakthrough infection post-dose 2 in those not previously infected (4.2 vs 4.7%). Pre-infection IgG levels in the 40 participants with breakthrough infection after dose 2 were similar to levels measured at the same timepoint in vaccinated HCWs who remained uninfected (P > .3). Post-dose3 IgG levels were more than 10-fold those 1 month post-dose 2.
Conclusions
Immunity waned in all age groups and previously infected individuals, reversed by boosting. IgG titers decrease and reinfections in individuals with hybrid immunity (infection + vaccination) suggests they may also require further doses. Our study also highlights the difficulty in determining protective IgG levels.
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SciScore for 10.1101/2021.12.15.21267793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was approved by ZMC’s ethics committee (0133–20-ZIV). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources We verified prior infection status among consenting participants by measuring the presence of anti-Nucleocapsid (N) IgG antibodies using a highly sensitive and specific SARS-CoV-2 IgG qualitative assay (Abbott, Abbot Park, US) [17]. anti-Nucleocapsid (N) IgGsuggested: NoneWorkers with detectable anti-N IgG antibodies and/or documented past positive SARS-CoV-2 PCR were considered previously infected. anti-N IgGsuggested: NoneSoftware and Algorithms Sentences Resources We … SciScore for 10.1101/2021.12.15.21267793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was approved by ZMC’s ethics committee (0133–20-ZIV). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources We verified prior infection status among consenting participants by measuring the presence of anti-Nucleocapsid (N) IgG antibodies using a highly sensitive and specific SARS-CoV-2 IgG qualitative assay (Abbott, Abbot Park, US) [17]. anti-Nucleocapsid (N) IgGsuggested: NoneWorkers with detectable anti-N IgG antibodies and/or documented past positive SARS-CoV-2 PCR were considered previously infected. anti-N IgGsuggested: NoneSoftware and Algorithms Sentences Resources We verified prior infection status among consenting participants by measuring the presence of anti-Nucleocapsid (N) IgG antibodies using a highly sensitive and specific SARS-CoV-2 IgG qualitative assay (Abbott, Abbot Park, US) [17]. Abbottsuggested: (Abbott, RRID:SCR_010477)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: 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: 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.
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