COVID-19: Seroprevalence and Vaccine Responses in UK Dental Care Professionals

  1. A.M. Shields
  2. S.E. Faustini
  3. C.A. Kristunas
  4. A.M. Cook
  5. C. Backhouse
  6. L. Dunbar
  7. D. Ebanks
  8. B. Emmanuel
  9. E. Crouch
  10. A. Kröger
  11. J. Hirschfeld
  12. P. Sharma
  13. R. Jaffery
  14. S. Nowak
  15. S. Gee
  16. M.T. Drayson
  17. A.G. Richter
  18. T. Dietrich
  19. I.L.C. Chapple

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Abstract

Dental care professionals (DCPs) are thought to be at enhanced risk of occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, robust data to support this from large-scale seroepidemiological studies are lacking. We report a longitudinal seroprevalence analysis of antibodies to SARS-CoV-2 spike glycoprotein, with baseline sampling prior to large-scale practice reopening in July 2020 and follow-up postimplementation of new public health guidance on infection prevention control (IPC) and enhanced personal protective equipment (PPE). In total, 1,507 West Midlands DCPs were recruited into this study in June 2020. Baseline seroprevalence was determined using a combined IgGAM enzyme-linked immunosorbent assay and the cohort followed longitudinally for 6 mo until January/February 2021 through the second wave of the coronavirus disease 2019 pandemic in the United Kingdom and vaccination commencement. Baseline seroprevalence was 16.3%, compared to estimates in the regional population of 6% to 7%. Seropositivity was retained in over 70% of participants at 3- and 6-mo follow-up and conferred a 75% reduced risk of infection. Nonwhite ethnicity and living in areas of greater deprivation were associated with increased baseline seroprevalence. During follow-up, no polymerase chain reaction–proven infections occurred in individuals with a baseline anti–SARS-CoV-2 IgG level greater than 147.6 IU/ml with respect to the World Health Organization international standard 20-136. After vaccination, antibody responses were more rapid and of higher magnitude in those individuals who were seropositive at baseline. Natural infection with SARS-CoV-2 prior to enhanced PPE was significantly higher in DCPs than the regional population. Natural infection leads to a serological response that remains detectable in over 70% of individuals 6 mo after initial sampling and 9 mo from the peak of the first wave of the pandemic. This response is associated with protection from future infection. Even if serological responses wane, a single dose of the Pfizer-BioNTech 162b vaccine is associated with an antibody response indicative of immunological memory.

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  1. Version published to 10.1177/00220345211020270
  2. ScreenIT

    SciScore for 10.1101/2021.02.24.21252368: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: A total of 1,716 individuals registered their interest, of which 1,535 attended the first study visit and provided informed written consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    To assess the response of individual immunoglobulin isotypes, the above protocol was modified to employ polyclonal sheep-anti-human HRP-conjugated polyclonal antibodies against IgG (1:16,000) and IgA (1:2000) as secondary antibodies.
    HRP-conjugated polyclonal antibodies against IgG
    suggested: (GeneTex Cat# GTX29106, RRID:AB_369669)
    IgA
    suggested: None
    In reference to the NIBSC standard, the minimum level of anti-SARS-CoV-2 IgG antibodies in baseline samples associated with protection for 6 months was inferred, based on the original dilution of samples.
    anti-SARS-CoV-2 IgG
    suggested: None
    Software and Algorithms
    SentencesResources
    Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Birmingham [9].
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    Statistical analysis Data was analysed in Stata 16 (StataCorp. 2019. Stata Statistical Software:
    StataCorp
    suggested: (Stata, RRID:SCR_012763)
    StataCorp LLC.) and Graph Pad Prism 9.0 (GraphPad Prism Software, San Diego, California)
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)

    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.

  3. Version published to 10.1101/2021.02.24.21252368v1 on medRxiv