Neutralization of VOCs including Delta one year post COVID-19 or vaccine

  1. Sebastian Havervall
  2. Ulrika Marking
  3. Max Gordon
  4. Henry Ng
  5. Nina Greilert-Norin
  6. Sarah Lindbo
  7. Kim Blom
  8. Peter Nilsson
  9. Mia Phillipson
  10. Jonas Klingström
  11. Sara Mangsbo
  12. Mikael Åberg
  13. Sophia Hober
  14. Charlotte Thålin

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Abstract

Background

SARS-CoV-2 variants, such as Alpha, Beta, Gamma and Delta, are raising concern about the efficiency of neutralizing antibodies (NAb) induced by wild-type infection or vaccines based on the wild-type spike.

Methods

We determined IgG and NAb against SARS-CoV-2 variants one year following mild wild-type infection (n=104) and two-dose regimens with BNT162b2 (BNT/BNT) (n=67), ChAdOx1 (ChAd/ChAd) (n=82), or heterologous ChAdOx1 followed by BNT162b2 (ChAd/BNT) (n=116).

Findings

Wild type spike IgG and NAb remained detectable in 80% (83/104) of unvaccinated participants one year post mild infection. The neutralizing capacity was similar against wild type (reference), Alpha (0.95 (0.92-0.98) and Delta 1.03 (0.95-1.11) but significantly reduced against Beta (0.54 (0.48-0.60)) and Gamma 0.51 (0.44-0.61). Similarly, BNT/BNT and ChAd/ChAd elicited sustained capacity against Alpha and Delta (1.01 (0.78-1.31) and 0.85 (0.64-1.14)) and (0.96 (0.84-1.09) and 0.82 (0.61-1.10) respectively), with reduced capacity against Beta (0.67 (0.50-0.88) and 0.53 (0.40-0.71)) and Gamma (0.12 (0.06-0.27) and 0.54 (0.37-0.80)). A similar trend was found following ChAd/BNT (0.74 (0.66-0.83) and 0.70 (0.50-0.97) against Alpha and Delta and 0.29 (0.20-0.42) and 0.13 (0.08-0.20) against Beta and Gamma).

Interpretation

Persistent neutralization of the wide-spread Alpha and Delta variants one year after wild-type infection may aid vaccine policy makers in low-resource settings when prioritizing vaccine supply. The reduced capacity of neutralizing Beta and Gamma strains, but not the Alpha and Delta strains following both infection and three different vaccine regimens argues for caution against Beta and Gamma-exclusive mutations in the efforts to optimize next generation SARS-CoV-2 vaccines.

Funding

A full list of funding bodies that contributed to this study can be found in the Acknowledgements section

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2021.08.12.21261951: (What is this?)

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

    Table 1: Rigor

    EthicsConsent: The study was approved by the Swedish Ethical Review Authority (dnr 2020-01653), and written informed consent was obtained from all study participants.
    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:
    Limitations of this study include the observational and single-center design and the large portion of women. Strengths include the long follow-up and different vaccine regimes within the same study protocol along with the baseline sample opportunity against the wild-type and VOC strains. Our findings of long-lasting neutralization of the widely spreading B.1.1.7 (Alpha) and B.1.617.2 (Delta) variants one year after wild type infection may aid vaccine policy makers in low-resource settings when prioritizing limited vaccine supply. Furthermore, the globally reduced capacity of neutralizing B.1.351 (Beta) and P.1 (Gamma) strains, but not the B.1.1.7 (Alpha) and B.1.617.2 (Delta) strains following both infection and three different vaccine regimens argues for caution against B.1.351 (Beta) and P.1 (Gamma)-exclusive spike protein mutations in the efforts to optimize next generation SARS-CoV-2 vaccines.

    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.

    About SciScore

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  2. Version published to 10.1101/2021.08.12.21261951 on medRxiv