Prior COVID-19 Infection and Antibody Response to Single Versus Double Dose mRNA SARS-CoV-2 Vaccination
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Abstract
The double dose regimen for mRNA vaccines against SARS-CoV-2 presents both a hope and a challenge for global efforts to curb the COVID-19 pandemic. With supply chain logistics impacting the rollout of population-scale vaccination programs, increasing attention has turned to the potential efficacy of single versus double dose vaccine administration for select individuals. To this end, we examined response to Pfizer-BioNTech mRNA vaccine in a large cohort of healthcare workers including those with versus without prior COVID-19 infection. For all participants, we quantified circulating levels of SARS-CoV-2 anti-spike (S) protein IgG at baseline prior to vaccine, after vaccine dose 1, and after vaccine dose 2. We observed that the anti-S IgG antibody response following a single vaccine dose in persons who had recovered from confirmed prior COVID-19 infection was similar to the antibody response following two doses of vaccine in persons without prior infection (P≥0.58). Patterns were similar for the post-vaccine symptoms experienced by infection recovered persons following their first dose compared to the symptoms experienced by infection naïve persons following their second dose (P=0.66). These results support the premise that a single dose of mRNA vaccine could provoke in COVID-19 recovered individuals a level of immunity that is comparable to that seen in infection naïve persons following a double dose regimen. Additional studies are needed to validate our findings, which could allow for public health programs to expand the reach of population wide vaccination efforts.
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SciScore for 10.1101/2021.02.23.21252230: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: All participants provided written informed consent; all protocols were approved by the Cedars-Sinai institutional review board.
IRB: All participants provided written informed consent; all protocols were approved by the Cedars-Sinai institutional review board.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable RESULTS A total of N=1089 vaccine recipients provided at least one blood sample for antibody testing, with an average age of 41.8±12.1 years, 60.8% female and 53.4% non-white (Table 1). Table 2: Resources
Antibodies Sentences Resources We determined prior infection status and timing in relation to … SciScore for 10.1101/2021.02.23.21252230: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: All participants provided written informed consent; all protocols were approved by the Cedars-Sinai institutional review board.
IRB: All participants provided written informed consent; all protocols were approved by the Cedars-Sinai institutional review board.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable RESULTS A total of N=1089 vaccine recipients provided at least one blood sample for antibody testing, with an average age of 41.8±12.1 years, 60.8% female and 53.4% non-white (Table 1). Table 2: Resources
Antibodies Sentences Resources We determined prior infection status and timing in relation to first vaccine date, based on concordance of data documented in health records, presence of anti-N IgG antibodies at baseline pre-vaccination testing, and the self-reported survey information collected. anti-N IgGsuggested: 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: We detected the following sentences addressing limitations in the study:Several limitations of our study merit consideration. We examined antibody response within 7 to 21 days following each vaccine dose, and longer-term follow up is likely to provide additionally informative data – particular regarding the putative duration of immunity acquired from receiving a single versus double dose of vaccine administration. Direct measures of neutralizing antibody levels are a part of our ongoing work. Notwithstanding the size of our study cohort, yet largersized samples are needed for sufficient statistical power to examine differences across demographic and clinical subgroups that are known to exhibit variation in antibody response following vaccination.15-17 In summary, we found in diverse cohort of mRNA vaccine recipients that anti-S IgG levels are similar between those with and without prior COVID-19 infection after receiving their first and second doses, respectively. These results offer preliminary evidence in support of a middle ground between public health motivated and immunologically supported vaccine strategies. If validated, an approach that involves providing a single dose of vaccine to persons with a confirmed history of COVID-19 infection along with an on-time complete vaccine schedule for infection naïve persons could assist with maximizing the benefit of a limited vaccine supply.
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.
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