Antibody Response 3 Months after 2 Doses of BNT162b2 mRNA COVID-19 Vaccine in Residents of Long-Term Care Facilities

Causa, Roberta; Almagro-Nievas, Diego; Rivera-Izquierdo, Mario; Benítez-Muñoz, Nicolás; López-Hernández, Begoña; García‐García, Fernando; Álvarez-Estévez, Marta; Soto-Pérez, Maria de la O; Bermúdez-Tamayo, Clara

doi:10.1159/000519711

Cited by 10 publications

(13 citation statements)

References 16 publications

(44 reference statements)

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“…Another explanation for the detected differences between previous studies and the data presented here might be the age of the elderly population. Causa et al showed that the age-related decline of IgG titers has been particularly appreciable among individuals aged 80 or more (15). In their study, Muller et al (6) included aged people with a median age of 88 years (80.1-100.5 years), in contrast to our study, in which the average age was lower (70-94 years).…”

Section: Discussioncontrasting

confidence: 54%

Immune Responses Against SARS-CoV-2 WT and Delta Variant in Elderly BNT162b2 Vaccinees

et al. 2022

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BackgroundResidents of nursing homes are one of the most vulnerable groups during the severe acute syndrome coronavirus 2 (SARS-CoV-2) pandemic. The aim of this study was to characterize cellular and humoral immune responses in >70-year-old participants before vaccination, after first and second vaccination with BNT162b2, in contrast to second-dose-vaccinated participants younger than 60 years.MethodsPeripheral blood mononuclear cells of 45 elderly and 40 younger vaccinees were analyzed by IFNγ ELISpot, specific immunoglobulin G antibody titers against SARS-CoV-2 spike protein, and neutralization abilities against SARS-CoV-2 wild-type (WT) and Delta variant (B.1.617.2).ResultsOur results clearly demonstrate a significantly increased T cell response, IgG titers, and neutralization activities against SARS-CoV-2 WT and Delta between first and second vaccination with BNT162b2 in elderly vaccinees, thereby highlighting the importance of the second booster. Interestingly, similar cellular and humoral immune responses against SARS-CoV-2 WT and Delta were found after the second vaccine dose in the young and elderly groups.ConclusionsOur data demonstrate a full picture of cellular and humoral immune responses of BNT162b2-vaccinees in two age cohorts. In all vaccines, SARS-CoV-2 WT-specific antibodies with similar neutralizing activity were detected in all vaccinees. After the second vaccination, neutralization titers against SARS-CoV-2 Delta were impaired in both age groups compared with SARS-CoV-2 WT, thereby emphasizing the need for an additional booster to overcome rising variants of SARS-CoV-2.

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Section: Discussioncontrasting

confidence: 54%

Immune Responses Against SARS-CoV-2 WT and Delta Variant in Elderly BNT162b2 Vaccinees

et al. 2022

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“…Similarly, in fully vaccinated older adults, there are no significant sex differences in antibody titers (Causa et al, 2021;Kontopoulou et al, 2021;Ríos et al, 2021). Among LTCFR who recovered from SARS-CoV-2 infection, however, there is a trend of higher antibody levels in females than males (Canaday et al, 2021).…”

Section: Sex Differences In the Response To Influenza Vaccination In ...mentioning

confidence: 94%

Roadmap for Sex-Responsive Influenza and COVID-19 Vaccine Research in Older Adults

et al. 2022

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Sex differences in the immune system are dynamic throughout the lifespan and contribute to heterogeneity in the risk of infectious diseases and the response to vaccination in older adults. The importance of the intersection between sex and age in immunity to viral respiratory diseases is clearly demonstrated by the increased prevalence and severity of influenza and COVID-19 in older males compared to older females. Despite sex and age biases in the epidemiology and clinical manifestations of disease, these host factors are often ignored in vaccine research. Here, we review sex differences in the immunogenicity, effectiveness, and safety of the influenza and COVID-19 vaccines in older adults and the impact of sex-specific effects of age-related factors, including chronological age, frailty, and the presence of comorbidities. While a female bias in immunity to influenza vaccines has been consistently reported, understanding of sex differences in the response to COVID-19 vaccines in older adults is incomplete due to small sample sizes and failure to disaggregate clinical trial data by both sex and age. For both vaccines, a major gap in the literature is apparent, whereby very few studies investigate sex-specific effects of aging, frailty, or multimorbidity. By providing a roadmap for sex-responsive vaccine research, beyond influenza and COVID-19, we can leverage the heterogeneity in immunity among older adults to provide better protection against vaccine-preventable diseases.

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Section: Discussionmentioning

confidence: 99%

“…In the older adult cohort, receipt of a third vaccine dose largely eliminated disparities caused by sex, age, and frailty in antibody responses, with the exception of ACE2iAb, which remained lower in frail compared to non-frail or pre-frail participants. The effect of age on SARS-CoV-2 vaccine responses has been studied [7-9, 29-33], but the sex differential impact of age has not been reported previously. Furthermore, studies investigating frailty have not found an effect on antibody responses [34-36], but have reported that frailty increases the risk of post-vaccination breakthrough infection [37, 38], suggesting that the immunogenicity studies may have been under-powered to observe an effect of frailty or that lack of consideration of biological sex obscured the effect.…”

Section: Discussionmentioning

confidence: 99%

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Association of frailty, age, and biological sex with SARS-CoV-2 mRNA vaccine-induced immunity in older adults

Shapiro

Park

Aytenfisu

et al. 2022

Preprint

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Background: Male sex and old age are risk factors for severe COVID-19, but the intersection of sex and aging on antibody responses to SARS-CoV-2 vaccines has not been characterized. Methods: Plasma samples were collected from older adults (75-98 years) before and after three doses of SARS-CoV-2 mRNA vaccination, and from younger adults (18-74 years) post-dose two, for comparison. Antibody binding to SARS-CoV-2 antigens (spike protein [S], S-receptor binding domain [S-RBD], and nucleocapsid [N]) and functional activity against S were measured against the vaccine virus and variants of concern (VOC). Results: Vaccination induced greater antibody titers in older females than males, with both age and frailty associated with reduced antibody responses to vaccine antigens in males, but not females. ACE2 binding inhibition declined more than anti-S or anti-S-RBD IgG in the six months following the second dose (28-fold vs. 12- and 11-fold decreases in titer). The third dose restored functional antibody responses and eliminated disparities caused by sex, age, and frailty in older adults. Responses to the VOC were significantly reduced relative to the vaccine virus, with older males having lower titers to the VOC than females. Older adults had lower responses to the vaccine and VOC viruses than younger adults, with disparities being greater in males than females. Conclusion: Older and frail males may be more vulnerable to breakthrough infections due to low antibody responses before receipt of a third vaccine dose. Promoting third dose coverage in older adults, especially males, is crucial to protecting this vulnerable population.

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Antibody Response 3 Months after 2 Doses of BNT162b2 mRNA COVID-19 Vaccine in Residents of Long-Term Care Facilities

Cited by 10 publications

References 16 publications

Immune Responses Against SARS-CoV-2 WT and Delta Variant in Elderly BNT162b2 Vaccinees

Immune Responses Against SARS-CoV-2 WT and Delta Variant in Elderly BNT162b2 Vaccinees

Roadmap for Sex-Responsive Influenza and COVID-19 Vaccine Research in Older Adults

Association of frailty, age, and biological sex with SARS-CoV-2 mRNA vaccine-induced immunity in older adults

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