Abstract
Objective: To determine whether severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibody levels after the first dose of vaccine can predict the final antibody response, and whether this is dependent on the vaccine type.Methods: Sixty-nine recipients of BNT162b2 (Pfizer/BioNTech) and 55 recipients of AZD1222 (AstraZeneca), without previous infection or immunosuppressive medication, were included in this study. Antibody levels were quantified 3 weeks after the first dose [directly before boostering in the case of AZD1222 (11 weeks after the first dose)] and 3 weeks after the second dose using the Roche Elecsys SARS-CoV-2 S total antibody assay.Results: Median pre-booster {BNT162b2: 80.6 [interquartile range (IQR) 25.5–167.0] binding antibody units (BAU)/mL; AZD1222: 56.4 (IQR 36.4–104.8) BAU/mL; not significant} and post-booster [BNT162b2: 2092.0 (IQR 1216.3–4431.8) BAU/mL; AZD1222: 957.0 (IQR 684.5–1684.8) BAU/mL; P<0.0001] levels correlated well in the recipients of BNT162b2 (ρ=0.53) but not in the recipients of AZD1222. Moreover, antibody levels after the first dose of BNT162b2 correlated inversely with age (ρ=-0.33, P=0.013), whereas a positive correlation with age was observed after the second dose in recipients of AZD1222 (ρ=0.26, P=0.030).Conclusions: The results of this study suggest that antibody levels quantified by the Roche Elecsys SARS-CoV-2 S assay before the booster shot could infer post-booster responses to BNT162b2, but not to AZ1222. In addition, this study found a vaccine-dependent effect on antibody responses, where age seems to play an ambivalent role.
Highlights
Vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been available for several months (Zaqout et al, 2021)
The extent to which antibody levels after the first dose are suitable to infer the booster response are not clear. It is unclear whether this response depends on the type of vaccine used. This would be likely because vector and mRNA vaccines elicit different immune responses, with vector vaccines including a non-spike-specific response directed against the vector (Federico, 2021)
This article reports differences in the predictability of SARSCoV-2 vaccine post-booster levels measured with a quantitative antibody assay (Roche Elecsys SARS-CoV-2 S) dependent on the vaccine used
Summary
Vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been available for several months (Zaqout et al, 2021). Determination of spike-proteinspecific antibodies after SARS-CoV-2 vaccination, not recommended unrestrictedly (Centers for Disease Control and Prevention, 2021), is commonly performed. The post-vaccination antibody levels, even when measured with standardized commercially available CE-certified quantitative test systems, differ significantly (Kristiansen et al, 2021; Perkmann et al, 2021a). The extent to which antibody levels after the first dose are suitable to infer the booster response are not clear. It is unclear whether this response depends on the type of vaccine used. This would be likely because vector and mRNA vaccines elicit different immune responses, with vector vaccines including a non-spike-specific response directed against the vector (Federico, 2021)
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