Highlights d Numerous variants of SARS-CoV-2-harboring mutations in spike have arisen globally d mRNA vaccines elicit potent neutralizing activity against homologous pseudovirus d Cross-neutralization of strains with receptor-binding domain (RBD) mutations is poor d Both RBD and non-RBD mutations mediate escape from vaccine-induced humoral immunity
Background Understanding immunogenicity and effectiveness of SARS-CoV-2 vaccines is critical to guide rational use. Methods We compared the immunogenicity of mRNA-1273, BNT-162b2 or Ad26.COV2.S in healthy ambulatory adults in Massachusetts, USA. To correlate immunogenicity with effectiveness of the three vaccines, we performed an inverse-variance meta-analysis of population level effectiveness from public health reports in >40 million individuals. Results A single dose of either mRNA vaccine yielded comparable antibody and neutralization titers to convalescent individuals. Ad26.COV2.S yielded lower antibody concentrations and frequently undetectable neutralization titers. Bulk and cytotoxic T-cell responses were higher in mRNA1273 and BNT162b2 than Ad26.COV2.S recipients. Regardless of vaccine, <50% of vaccinees demonstrated CD8+ T-cell responses. Antibody concentrations and neutralization titers increased comparably after the first dose of either vaccine, and further in recipients of a second dose. Prior infection was associated with high antibody concentrations and neutralization even after a single dose and regardless of vaccine. Neutralization of beta, gamma and delta strains were poorer regardless of vaccine. In meta-analysis, relative to mRNA1273 the effectiveness of BNT162b2 was lower against infection and hospitalization; and Ad26COV2.S was lower against infection, hospitalization and death. Conclusions Variation in the immunogenicity correlates with variable effectiveness of the three FDA EUA vaccines deployed in the USA.
Vaccination elicits immune responses capable of potently neutralizing SARS-CoV-2. However, ongoing surveillance has revealed the emergence of variants harboring mutations in spike, the main target of neutralizing antibodies. To understand the impact of globally circulating variants, we evaluated the neutralization potency of 48 sera from BNT162b2 and mRNA-1273 vaccine recipients against pseudoviruses bearing spike proteins derived from 10 strains of SARS- CoV-2. While multiple strains exhibited vaccine-induced cross-neutralization comparable to wild- type pseudovirus, 5 strains harboring receptor-binding domain mutations, including K417N/T, E484K, and N501Y, were highly resistant to neutralization. Cross-neutralization of B.1.351 variants was weak and comparable to SARS-CoV and bat-derived WIV1-CoV, suggesting that a relatively small number of mutations can mediate potent escape from vaccine responses. While the clinical impact of neutralization resistance remains uncertain, these results highlight the potential for variants to escape from neutralizing humoral immunity and emphasize the need to develop broadly protective interventions against the evolving pandemic.
Background: Understanding variation in immunogenicity may help rationalize use of existing SARS-CoV-2 vaccines. Methods: We compared immune responses in ambulatory adults vaccinated with mRNA-1273 , BNT-162b2 or Ad26.COV2.S in Massachusetts, USA between February and May 2021. Control groups were pre-pandemic controls (n=1220) and individuals without (n=112) or with prior SARS-CoV-2 infection (n=130) sampled in mid-2020. We measured total anti-spike IgG/M/A antibodies (Roche Elecsys Anti-SARS-COV-2 S assay), anti-receptor-binding-domain (RBD) antibodies; neutralization of SARS-CoV-2 pseudovirus; and T-cell responses. Findings In individuals with prior infection, all vaccines were associated with higher antibody concentrations and neutralization than those in convalescent individuals, even after a single dose. In individuals without prior infection, a single dose of either mRNA vaccine yielded comparable concentrations and neutralization to convalescent unvaccinated individuals, and Ad26.COV2.S yielded lower antibody concentrations and neutralization titers. The second dose of either mRNA vaccine boosted responses. At a median of 24 days after vaccination, two of 21 (9.5%) Ad26.COV2.S recipients had a neutralization titer higher than pre-pandemic controls; repeat sampling at a median 66 days after vaccination found most (11/15 (73%) remained negative. Antibody concentrations and neutralization titers increased similarly after the first dose of either vaccine, and even further in recipients of a second dose of vaccine. T-cell responses were higher in mRNA1273 and BNT162b2 than Ad26.COV2.S recipients. Interpretation SARS-CoV-2 vaccines vary significantly in immunogenicity in individuals without prior infection. If confirmed in effectiveness studies, public health policy may need to be tailored to each vaccine, or even individual responses.
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