SARS-CoV-2 BNT162b2 vaccine–induced humoral response and reactogenicity in individuals with prior COVID-19 disease

  1. Steven G. Kelsen
  2. Alan S. Braverman
  3. Mark O. Aksoy
  4. Jacob A. Hayman
  5. Puja S. Patel
  6. Charu Rajput
  7. Huaqing Zhao
  8. Susan G. Fisher
  9. Michael R. Ruggieri
  10. Nina T. Gentile

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Abstract

Most individuals with prior COVID-19 disease manifest long-term protective immune responses against reinfection. Accordingly, we tested the hypothesis that humoral immune and reactogenicity responses to a SARS-CoV-2 mRNA vaccine differ in individuals with and without prior COVID-19 disease.

METHODS

Health care workers ( n = 61) with ( n = 30) and without ( n = 31) prior COVID-19 disease received two 30 μg doses of Pfizer BNT162b2 vaccine 3 weeks apart. Serum IgG antibody against the spike receptor-binding domain; serum neutralizing activity; and vaccine reactogenicity were assessed longitudinally every 2 weeks for 56 days after the first injection.

RESULTS

The COVID-19 group manifested more rapid increases in spike IgG antibody and serum neutralizing activity after the first vaccine dose but showed little or no increase after the second dose compared with the infection-naive group. In fact, spike IgG was at its maximum level after the first dose in 36% of the COVID-19 group versus 0% of the infection-naive group. Peak IgG antibody levels were lower but appeared to fall more slowly in the COVID-19 group versus the infection-naive group. Finally, adverse systemic reactions, e.g., fever, headache, and malaise, were more frequent and lasted longer after both the first and second injection in the COVID-19 group than in the infection-naive group.

CONCLUSION

Individuals with prior COVID-19 disease demonstrate a robust, accelerated humoral immune response to the first dose but an attenuated response to the second dose of BNT162b2 vaccine compared with controls. The COVID-19 group also experienced greater reactogenicity. Humoral responses and reactogenicity to BNT162b2 differ qualitatively and quantitatively in individuals with prior COVID-19 disease compared with infection-naive individuals.

FUNDING

This work was supported by Temple University institutional funds.

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  1. Version published to 10.1172/jci.insight.155889
  2. Version published to 10.1101/2021.03.18.21253845v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.03.18.21253845: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by our Institutional Review Board.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    SARS-CoV-2 Antibody: Serum IgG antibody levels against the SARS-CoV-2 Spike receptor binding domain (RBD) were quantified by a two-step immunoassay using the Beckman Coulter, Access® microparticle-based assay system run on a high throughput, Beckman Coulter immunoassay system (UniCel Dxl 800).
    SARS-CoV-2 Antibody: Serum IgG
    suggested: None
    A standard curve constructed using recombinant human anti-SARS-CoV2 IgG1 antibody (clone CR3022, BEI Resources, Manassas, VA) over a range of concentrations was run with each group of samples to allow conversion of RLU to µg/mL.
    anti-SARS-CoV2 IgG1
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    In brief, pseudovirus uptake via ACE2 receptor was assessed using HEK-293T cells overexpressing the ACE2 receptor (BEI Resources, #NR-52511).
    HEK-293T
    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: 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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.03.18.21253845v1 on medRxiv