Anti‐spike IgG antibody kinetics following the second and third doses of BNT162b2 vaccine in nursing home residents

  1. Helene Jeulin
  2. Carlos Labat
  3. Kevin Duarte
  4. Simon Toupance
  5. Gregoire Nadin
  6. Denis Craus
  7. Ioannis Georgiopoulos
  8. Isabelle Gantois
  9. François Goehringer
  10. Athanase Benetos

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Abstract

Background

Duration of post‐vaccination protection against COVID‐19 in nursing home (NH) residents is a critical issue. The objective of this study was to estimate the duration of the IgG(S) response to the mRNA BNT162b2 vaccine in NH residents with (COV‐Yes) or without (COV‐No) history of SARS‐CoV‐2 infection.

Methods

A 574 COV‐Yes and COV‐No NH residents were included in 2 cohorts: Main ( n  = 115, median age 87 years) or Confirmatory ( n  = 459, median age 89 years). IgG(S) quantification was carried out at three different time points following the BNT162b2 vaccine: three (1st) and seven (2nd) months after the 2nd dose, and 1 month after the 3rd dose (3rd quantification) in the Main cohort, and twice (2nd and 3rd) in the Confirmatory cohort. The seroneutralization capacity according to COVID‐19 history was also measured in a subgroup of patients.

Results

Neutralization capacity was strongly correlated with IgG(S) levels ( R 2 :76%) without any difference between COV‐Yes and COV‐No groups for the same levels of IgG(S). After the 2nd dose, duration of the assumed robust protection (IgG(S) >264 BAU/ml) was two‐fold higher in the COV‐Yes vs. COV‐No group: 12.60 (10.69–14.44) versus 5.76 (3.91–8.64) months, with this advantage mainly due to the higher IgG(S) titers after the 2nd dose and secondary to a slower decay over time. After the 3rd dose, duration of robust protection was estimated at 11.87 (9.88–14.87) (COV‐Yes) and 8.95 (6.85–11.04) (COV‐No) months. These results were similar in both cohorts.

Conclusions and Relevance

In old subjects living in NH, history of SARS‐CoV‐2 infection provides a clear advantage in the magnitude and duration of high IgG(S) titers following the 2nd dose. Importantly, the 3rd dose induces a much more pronounced IgG(S) response than the 2nd dose in COV‐No subjects, the effect of which should be able to ensure a prolonged protection against severe forms of COVID‐19 in these subjects.

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  1. Version published to 10.1111/jgs.17837
  2. ScreenIT

    SciScore for 10.1101/2022.02.07.22270557: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: This study was registered in ClinicalTrials.gov (NCT04964024) and received the approval of the Ethics Committee of the Nancy University Hospital (CHRU) (Comite d’Ethique CHRU de Nancy, decision n°326, August 3rd, 2021).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Quantitative results are expressed as Binding Antibody Units (BAU/mL) according to the WHO first International Standard (IS) for anti-SARS-CoV-2 immunoglobulin (NIBSC code 20/136).
    anti-SARS-CoV-2 immunoglobulin
    suggested: None
    Sera positive for anti-SARS-CoV-2 antibodies were diluted from 1/10 to 1/640 and incubated with live-virus suspension for 2 hr.
    anti-SARS-CoV-2
    suggested: None
    Experimental Models: Cell Lines
    SentencesResources
    The SARS-CoV-2 B.1.617.2 (Delta) strain from a positive respiratory sample (Covi-Lor collection, Nancy University Hospital, France) was cultured on Vero E6 cells.
    Vero E6
    suggested: RRID:CVCL_XD71)

    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:
    This study has two main limitations: first, the definition of COV-Yes by PCR and/or IgG(N)+ cannot eliminate that some subjects considered as being COV-No, had indeed a history of previous asymptomatic SARS-Cov-2 infection (7). Second, only exploration of humoral but not cellular immunity was performed, which probably has an important role in the prevention of serious disease forms. Moreover, the emergence of omicron or other variants in the future may modify the duration of protection. In conclusion, in this very old population of NH residents, previous SARS-Cov-2 infection induces a more pronounced IgG(S) response to the BNT162b2 vaccine leading to a longer protection of the 2nd dose and in a lesser degree of the 3rd dose. We anticipate than in NH residents without history of SARS-CoV-2, the 3rd dose of the RNA vaccine, compared to the 2nd dose, will induce a more prolonged protection against severe forms of COVID-19.

    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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  3. Version published to 10.1101/2022.02.07.22270557v1 on medRxiv