Durability of anti-spike antibodies after vaccination with mRNA SARS-CoV-2 vaccine is longer in subjects with previous infection: could the booster dose be delayed?

Purpose: The long-term effectiveness of BNT162b2/Pfizer vaccine remains undetermined. This observational prospective study was designed to verify durability of antibodies against the viral receptor-binding domain (RBD) spike (S)-protein (RBD S-Protein IgG) after the second-dose administration of the...

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Published in:Infection Vol. 50; no. 6; pp. 1573 - 1578
Main Authors: Stellini, Roberto, Gianello, Renzo, Gomarasca, Walter
Format: research tables/charts Journal Article
Published: Springer Nature Dec2022
Online Access:View this record in EBSCOhost
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      dt: Dec2022
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s15010-022-01816-9
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        atl: Durability of anti-spike antibodies after vaccination with mRNA SARS-CoV-2 vaccine is longer in subjects with previous infection: could the booster dose be delayed?
      aug:
        au:
          Stellini, Roberto
          Gianello, Renzo
          Gomarasca, Walter
        affil: Infectious Diseases Service, Health Care Department, Poliambulanza Foundation Hospital, Via Bissolati, 57-25124, Brescia, Italy
      sug:
        subj:
          RNA, Messenger
          COVID-19 Vaccines Administration and Dosage
          COVID-19 Vaccines Immunology
          Treatment Delay
          Antibodies, Viral Blood
          Health Personnel
          Treatment Outcomes
          Human
          Nonexperimental Studies
          Prospective Studies
          Italy
          Mann-Whitney U Test
          Descriptive Statistics
          Immunoglobulins
          Confidence Intervals
      ab: Purpose: The long-term effectiveness of BNT162b2/Pfizer vaccine remains undetermined. This observational prospective study was designed to verify durability of antibodies against the viral receptor-binding domain (RBD) spike (S)-protein (RBD S-Protein IgG) after the second-dose administration of the vaccine among Health Care Workers (HCWs). Methods: In all HCWs at the Poliambulanza Foundation Hospital Brescia (Italy) were quantified the levels of RBD S-Protein IgG (Abbott Diagnostics) at 45 and 240 days after the second-dose vaccine. Previous infection was defined as antibodies against SARS-CoV-2 nucleocapsid positivity (Abbott Diagnostics) before vaccination. The Mann–Whitney U test was used to compare mean levels of RBD S-Protein IgG among previously infected and uninfected HCWs. Results: The mean level of the RBD S-protein IgG detected 45 days after the second dose of the vaccine was 30,041 AU/mL (95% CI 145–80,000) for the 250 previously infected HCWs and it was significantly higher (p < 0.001) than that observed in the 1121 previously uninfected subject with the mean level of 10,604 AU/mL (95% CI 165–62,241). Similarly, at 240 days in previously infected subjects the antibody titer was of 8145 AU/mL (95% CI 347–80,000) and significantly higher (p < 0.001) than that observed in the 1121 previously uninfected HCWs with a mean antibody level of 1271 AU/mL (95% CI 50–80,000). When comparing the change in mean antibody levels overtime, the previously infected HCWs presented a 72.9% reduction in RBD S-protein IgG while in the previously uninfected HCWs the reduction was 88.0%. In addition, in the HCWs group without previous infection we reported 53 new SARS-CoV-2 infections and they had a mean level of RBD S-protein IgG antibodies of 1039 AU/mL (95% CI 157–4237) at 240 days. No new infections were found in previously SARS-CoV-2 infected subjects. Conclusions: We report that the mean level of post vaccinal RBD S-protein IgG was significantly higher in the previously infected HCWs than in previously uninfected subjects at 45 and 240 days after the second-dose vaccine. Moreover, our data suggest that the risk of a new SARS-CoV-2 infection was higher in the previously uninfected HCWs than in those who had already contracted natural viral infection. The limitations of this study prevent us to draw definitive conclusions on the antibody titers and on the role of a previous SARS-CoV-2 infection in influencing the levels of post-vaccine RBD S-protein IgG. The booster dose of the vaccine could be delayed after the second dose in previously naturally infected subject and it could have an important strategic impact on the organization of the future COVID-19 vaccination campaign.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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