Comparative analysis of post-vaccination anti-spike IgG antibodies in old Nursing Home Residents and in middle-aged Healthcare workers

  1. H. Jeulin
  2. D. Craus
  3. C. Labat
  4. A. Benetos

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Abstract

The current consensus is that 2 doses of mRNA vaccines against SARS-CoV-2 are needed for people without COVID-19 history, while for those who had suffered COVID-19, a single dose may be enough to achieve high levels of immunization. This consensus has been based on results obtained in middle-aged populations, whereas only few data exist for the oldest and most frail adults such as nursing home residents (NH-Res) that is, the population most vulnerable to develop severe forms of COVID-19.

In this study, we studied the anti-SARS-CoV-2 IgG(S) level of NH-Res and healthcare workers (HCWs) with or without a history of COVID-19 infection taking into account the time since immunization (COVID-19 and/or vaccination). 654 subjects were analyzed: 397 NH-Res (median age 88, IQR 82-93 years, 75% women) and 257 Health Care Workers (HCWs, median 46, IQR 38-54 years, 81% women). NH-Res and HCWs were classified in one of the following 3 groups: No-COVID history and 2 vaccine shots (COV-NO/2VACC); Yes-COVID history and 1 (COV-YES/1VACC) or 2 (COV-YES/2VACC) vaccine injections.

The time-related decrease in IgG (S) in subjects without COVID-19 history, SARS-COV-2 serology would be negative in HCWs approximately 220 days and in residents 180 days after vaccination. This time-related decrease was much slower in those with history of COVID. NH-Res belonging into the COV-NO/2VACC and the COV-YES/1VACC groups showed lower IgG (S) levels than the same groups of HCWs (for both groups, p<0.0001), whereas in the group COV-YES/2VACC, IgG (S) levels were similar in NH-Res and HCWs (p=0.88). These results remained unchanged after adjustment for age and duration since immunization. Thus, in NH-Res, 2 vaccine shots were associated with a more pronounced immune response, whereas in HCWs, 1 or 2 vaccine shots in patients with COVID-19 history did make any difference. These results indicate significant differences in mRNA vaccination between NH-Res and middle-aged controls, and could contribute to the specification of vaccine policy in this very old, frail population.

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  1. ScreenIT

    SciScore for 10.1101/2021.08.03.21261014: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: The Ethics Committee of the Nancy CHRU hospital made the statement that this research has been carried out in accordance to current French and European ethical standards as well as The Code of Ethics of the World Medical Association (Comité d’Ethique CHRU de Nancy, decision n° 326, August 3, 2021).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    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:
    However, it is important to define a vaccine strategy in order to obtain sufficient neutralizing antibodies level in order to guarantee a long term sufficient immunization One major limitation of our study is its cross-sectional character and therefore results have to be interpreted with a lot of precaution.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04964024Not yet recruitingSaRS-Cov-2 Antibodies Following Exposure to Coronavirus Dise…

    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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  2. Version published to 10.1101/2021.08.03.21261014v1 on medRxiv