Abstract

Vaccinating recovered patients previously infected by COVID-19 with mRNA vaccines to boost their immune response against wild-type viruses (WT), we aimed to investigate whether vaccine platform and time of vaccination affect immunogenicity against the SARS-CoV-2 WT and Delta variant (DV). Convalescent patients infected by COVID-19 were recruited and received one booster dose of the BNT162b2 (PC-B) or CoronaVac (PC-C) vaccines, while SARS-CoV-2 naïve subjects received two doses of the BNT162b2 (CN-B) or CoronaVac (CN-C) vaccines. The neutralizing antibody in sera against the WT and DV was determined with live virus neutralization assay (vMN). The vMN geometric mean titre (GMT) against WT in recovered individuals previously infected by COVID-19 reduced significantly from 60.0 (95% confidence interval (CI), 46.5–77.4) to 33.9 (95% CI, 26.3–43.7) at 6 months post recovery. In the PC-B group, the BNT162b2 vaccine enhanced antibody response against WT and DV, with 22.3-fold and 20.4-fold increases, respectively. The PC-C group also showed 1.8-fold and 2.2-fold increases for WT and DV, respectively, after receiving the CoronaVac vaccine. There was a 10.6-fold increase in GMT in the CN-B group and a 1.3-fold increase in the CN-C group against DV after full vaccination. In both the PC-B and PC-C groups, there was no difference between GMT against WT and DV after vaccination. Subjects in the CN-B and CN-C groups showed inferior GMT against DV compared with GMT against WT after vaccination. In this study, one booster shot effectively enhanced the pre-existing neutralizing activity against WT and DV in recovered subjects.

Highlights

  • Since its outbreak in 2019, coronavirus disease 2019 (COVID-19) has become an unprecedented pandemic and has cost millions of lives

  • We aim to evaluate the persistence of antibody level in recovered patients previously infected by COVID-19, the boosting effect on the antibody levels of these patients with different vaccine platforms, whether such vaccinations protect them from Delta variant (DV), and the most appropriate timing for administering the vaccine

  • When evaluating the immunogenicity of vaccination within each group, a booster shot of the BNT162b2 vaccine given to recovered patients previously infected by COVID-19 (PC-B) greatly enhanced the geometric mean titre (GMT) against both wild-type viruses (WT) (GMT fold increase, 22.3) and DV (GMT fold increase, 20.4) (Table 2)

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Summary

Introduction

Since its outbreak in 2019, coronavirus disease 2019 (COVID-19) has become an unprecedented pandemic and has cost millions of lives. Viral culture and imaging techniques are applied in COVID-19 diagnosis [4]. These techniques can help us screen new COVID-19 cases quickly and efficiently to tackle the pandemic, vaccines are still the primary method used to control COVID-19. Vaccines can induce immune response against SARS-CoV-2, which can be elicited by virus infection, to protect the host [6]. After SARS-CoV2 infection, antibody levels in the serum of a recovered patient can persist for at least 3 months [6,7]. With the increasing prevalence of B.1.617.2 (Delta variant, DV) and a possible fading antibody level, risk of re-infection is a big obstacle to the resolution of the pandemic

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