Modelling SARS-CoV-2 Binding Antibody Waning 8 Months after BNT162b2 Vaccination.

Angelos Hatzakis,Nikos Pantazis,Mina Psichogiou,Andreas Karabinis,Vana Sypsa,Sotirios Tsiodras,Sotirios Roussos,Ioanna Pavlopoulou,Antigoni Chaidaroglou,Dimitrios Degiannis,Dimitrios Paraskevis,Konstantinos Petsios

doi:10.3390/vaccines10020285

Abstract

Several lines of evidence suggest that binding SARS-CoV-2 antibodies such as anti-SARS-CoV-2 RBD IgG (anti-RBD) and neutralising antibodies (NA) are correlates of protection against SARS-CoV-2, and the correlation of anti-RBD and NA is very high. The effectiveness (VE) of BNT162b2 in preventing SARS-CoV-2 infection wanes over time, and this reduction is mainly associated with waning immunity, suggesting that the kinetics of antibodies reduction might be of interest to predict VE. In a study of 97 health care workers (HCWs) vaccinated with the BNT162b2 vaccine, we assessed the kinetics of anti-RBD 30–250 days after vaccination using 388 individually matched plasma samples. Anti-RBD levels declined by 85%, 92%, and 95% at the 4th, 6th, and 8th month from the peak, respectively. The kinetics were estimated using the trajectories of anti-RBD by various models. The restricted cubic splines model had a better fit to the observed data. The trajectories of anti-RBD declines were statistically significantly lower for risk factors of severe COVID-19 and the absence of vaccination side effects. Moreover, previous SARS-CoV-2 infection was associated with divergent trajectories consistent with a slower anti-RBD decline over time. These results suggest that anti-RBD may serve as a harbinger for vaccine effectiveness (VE), and it should be explored as a predictor of breakthrough infections and VE.

Highlights

Two years after the beginning of the COVID-19 pandemic and one year into the widespread application of COVID-19, there is extensive data on vaccine efficacy/effectiveness (VE) based on pivotal randomised trials and several ongoing vaccine effectiveness studies around the globe
In the current real-world study, we modelled the decline of anti-spike receptor-binding domain (RBD) SARS-CoV-2 8 months from vaccination or up to 7 months after the second dose of BNT162b2 using various models, and we assessed the waning trajectories according to demographic and clinical characteristics
A brief questionnaire was administered to health care workers (HCWs) concerning information about age, gender, education, position within the hospital, body mass index (BMI), history of risk factors for severe COVID-19 (RFS-CoV), previous COVID-19 (Pr-CoV), and history of self-reported adverse reactions after vaccination (VSEs)

Summary

Introduction

Two years after the beginning of the COVID-19 pandemic and one year into the widespread application of COVID-19, there is extensive data on vaccine efficacy/effectiveness (VE) based on pivotal randomised trials and several ongoing vaccine effectiveness studies around the globe. An analysis including Pfizer/BioNTech BNT162b2, Moderna mRNA-1273, AstraZeneca ChAdOx1-S, and Johnson & Johnson Ad26.COV2.S vaccines concluded that vaccination remains very effective in the prevention of severe disease/hospitalisation, with only an 8.0 percentage point (95% confidence interval (95% CI) 3.6–15.2) reduction in VE between 1 and 6 months from complete vaccination. Among mRNA vaccines, mRNA-1273 was more effective than the BNT162b2 vaccine in all outcomes of SARS-CoV-2 [6] This difference was more pronounced in preventing infection [7]. In the current real-world study, we modelled the decline of anti-spike RBD (antiRBD) SARS-CoV-2 8 months from vaccination or up to 7 months after the second dose of BNT162b2 using various models, and we assessed the waning trajectories according to demographic and clinical characteristics

Vaccination of Health Care Workers

Serological Tests

Statistical Analysis

Model Selection

Results

Conclusions