Immune responses to inactivated and vector-based vaccines in individuals previously infected with SARS-CoV-2

  1. Nungruthai Suntronwong
  2. Ritthideach Yorsaeng
  3. Chompoonut Auphimai
  4. Thanunrat Thongmee
  5. Preeyaporn Vichaiwattana
  6. Sitthichai Kanokudom
  7. Suvichada Assawakosri
  8. Pornjarim Nilyanimit
  9. Donchida Srimuan
  10. Thaksaporn Thatsanatorn
  11. Natthinee Sudhinaraset
  12. Nasamon Wanlapakorn
  13. Yong Poovorawan

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Abstract

Immunity wanes in individuals previously infected with SARS-CoV-2, and vaccinating those individuals may help reduce reinfection. Herein, reactogenicity and immunogenicity following vaccination with inactivated (CoronaVac) and vector-based (ChAdOx1-S, AZD1222) vaccines were examined in previously infected individuals. Immune response was also compared between short and long intervals between first date of detection and vaccination. Adverse events were mild but were higher with AZD1222 than with CoronaVac. Baseline IgG-specific antibodies and neutralizing activity were significantly higher with shorter than longer intervals. With a single-dose vaccine, IgG and IgA-specific binding antibodies, neutralizing activity, and total interferon-gamma response peaked at 14 days. Immune response was significantly higher in recovered individuals than in infection-naïve individuals. Antibody response was greater with longer than shorter intervals. AZD1222 induced higher antibody and T cell responses than those of CoronaVac. Thus, to achieve immunity, individuals with prior SARS-CoV-2 exposure may require only a single dose of AZD1222 or two doses of CoronaVac to achieve the immune response. These findings supported vaccine strategies in previously infected individuals.

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    SciScore for 10.1101/2022.01.03.22268704: (What is this?)

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

    Table 1: Rigor

    EthicsConsent: Study design and participants: One hundred and seventeen recovered COVID-19 patients who were healthy adults aged ≥18 years and previously infected with SARS-CoV-2 (defined as anti-nucleocapsid positivity (IgG) or a history of positive SARS-CoV-2 detection) were enrolled with written consent.
    IRB: Approvals were received from the Research Ethics Committee of the Faculty of Medicine, Chulalongkorn University (IRB numbers 192/64 and 281/64).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serological testing: In all sera samples, anti-SARS-CoV-2 IgG and IgA immunoglobulin, including anti-nucleocapsid (N) protein IgG, anti-spike1-specific IgA, and anti-spike/receptor-binding domain (RBD)-specific IgG antibodies, were determined.
    anti-SARS-CoV-2 IgG
    suggested: None
    IgA immunoglobulin, including anti-nucleocapsid (N) protein IgG
    suggested: None
    anti-spike1-specific IgA
    suggested: None
    Software and Algorithms
    SentencesResources
    The IgG antibodies against SARS-CoV-2 S1/RBD were quantitatively measured using CE marked SARS-CoV-2 Quant IgG II (Abbott Diagnostics), and antibody level is expressed as BAU/mL, with values ≥7.1 BAU/mL defined as positive.
    Abbott
    suggested: (Abbott, RRID:SCR_010477)
    All statistical analyses were conducted using GraphPad Prism v9.0 (GraphPad, San Diego, CA) and SPSS v23.0 (IBM Corp, Armonk, NY).
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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:
    There were some limitations to the study. First, neutralizing titers were not examined. Laboratory testing was limited, because titers of anti-S1 IgA, neutralizing activity, and total interferon-gamma responses exceeded upper detection limits. Thus, exact levels of immune response after boosting could not be summarized. Moreover, other SARS-CoV-2-particular proteins, such as matrix and nucleocapsid proteins, which induce total interferon-gamma release52, did not stimulate SARS-CoV-2-specific T cells. Last, small sample size was a limitation. Participants were not randomly assigned to receive different types of vaccine, and vaccine groups were assigned on the basis of convenience. Further investigation is warranted to assess the durability of antibody and T-cell responses after vaccination of people with previous SARS-CoV-2 infection, as well as the interplay between natural and vaccine-induced immunity. Notably, some vaccinated participants in this study failed to produce a booster response, particularly a T-cell response; thus, further studies in this population are needed. Longitudinal studies are required to determine persistence of humoral and T-cell responses after vaccination in previously infected individuals. Additionally, whether immunization of those with prior infection affects the level of mucosal IgA should be further investigated. In conclusion, previously infected SARS-CoV-2 individuals developed a more robust immune response after AZD1222 or CoronaVac vaccinat...

    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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  2. Version published to 10.1101/2022.01.03.22268704v1 on medRxiv