Age and Smoking Predict Antibody Titres at 3 Months after the Second Dose of the BNT162b2 COVID-19 Vaccine

  1. Yushi Nomura
  2. Michiru Sawahata
  3. Yosikazu Nakamura
  4. Momoko Kurihara
  5. Ryousuke Koike
  6. Otohiro Katsube
  7. Koichi Hagiwara
  8. Seiji Niho
  9. Norihiro Masuda
  10. Takaaki Tanaka
  11. Kumiya Sugiyama

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Abstract

Objective: We aimed to determine antibody (Ab) titres 3 months after the second dose of the BNT162b2 coronavirus disease-2019 (COVID-19) vaccine and to explore clinical variables predicting these titres in Japan. Methods: We enrolled 378 healthcare workers (255 women, 123 men) whose blood samples were collected 91 ± 15 days after the second of two inoculations of the BNT162b2 COVID-19 mRNA vaccine (Pfizer/BioNTech) given 3 weeks apart. Medical histories and demographic characteristics were recorded using a structured self-reported questionnaire. The relationships between Ab titres and these factors were analysed. Results: Median age (interquartile range (IQR)) of the participants was 44 (32–54) years. Median Ab titre (IQR) against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike antigen was 764 (423–1140) U/mL. Older participants had significantly lower Ab titres; median (IQR) Ab titres were 942 (675–1390) and 1095 (741–1613) U/mL in men and women in their 20s, respectively, but 490 (297–571) and 519 (285–761) U/mL in men and women in their 60–70s, respectively. In the age-adjusted analysis, the only risk factors for lower Ab titres were male sex and smoking. However, the sex difference may have arisen from the sex difference in smoking rate. Moreover, Ab titres were significantly lower in current smokers than in ex-smokers. Conclusions: The most important factors associated with low Ab titres were age and smoking habit. In particular, current smoking status caused lower Ab titres, and smoking cessation before vaccination may improve the individual efficacy of the BNT162b2 vaccine.

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  1. Version published to 10.3390/vaccines9091042
  2. ScreenIT

    SciScore for 10.1101/2021.08.06.21261590: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: This study was approved by the Ethics Committee of National Hospital Organization Utsunomiya National Hospital (No. 03-01, April 19, 2021).
    Consent: Written informed consent was obtained from all study participants before enrolment.
    Sex as a biological variableFinally, we enrolled 378 healthcare workers (255 women, 123 men), including the 6 from our preliminary study [18], and their medical histories and demographic characteristics were recorded using a structured self-reported questionnaire.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    To calculate Spearman’s rank correlation coefficient and perform the Mann-Whitney U test, we used Statistical Package for the Social Sciences (SPSS version 25).
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    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:
    Some limitations and possible sources of bias in this study include the following. First, the participants were limited in number and were all healthcare workers vaccinated at a single national hospital in Tochigi prefecture, where the COVID-19 pandemic has been well-controlled since SARS-CoV-2 began spreading around the globe. Therefore, the results obtained in this study might not be generalisable on a wide scale, or even within Japan. Second, several data, including body height and weight, were obtained by means of a standardised structured self-reported questionnaire. We cannot deny the possibility that some data may have been affected by recall bias. Third, the cut-off level of the Ab against the SARS-CoV-2 spike antigen needs to be determined for the different variants of SARS-CoV-2, but this information is currently unavailable. Further studies are needed to confirm our observations. In conclusion, we have reported for the first time real-world Ab titres against the SARS-CoV-2 spike antigen at 3 months after the second dose of the BNT162b2 vaccine, which were much lower than those measured shortly after the second inoculation. We demonstrated that the most important factors associated with low Ab titres were age and smoking habit. In particular, current smoking status causes lower Ab titres, and smoking cessation before vaccination may improve the individual effectiveness of the BNT162b2 vaccine. To establish a more personalised approach to vaccination involving earlie...

    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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  3. Version published to 10.1101/2021.08.06.21261590v1 on medRxiv