Antibody Responses after a Single Dose of SARS-CoV-2 mRNA Vaccine

Bradley, Todd; Grundberg, Elin; Selvarangan, Rangaraj; LeMaster, Cas; Fraley, Elizabeth R.; Banerjee, Dithi; Belden, Bradley; Louiselle, Daniel; Nolte, Nick; Biswell, Rebecca; Pastinen, Tomi; Myers, Angela; Schuster, Jennifer E

doi:10.1056/nejmc2102051

Cited by 146 publications

(146 citation statements)

References 3 publications

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“…Our results suggest that mothers with previous infection could get a similar potential protective effect in their milk after a unique dose of the vaccination course. Recently, similar results in serum samples from health care workers have been reported 23 , showing that specific IgG antibodies directed to different SARS-CoV-2 antigens (S1, S2, RBD, and N regions) persisted 3 weeks after a single vaccination 23 .…”

Section: Discussionsupporting

confidence: 62%

Anti-Sars-Cov-2 IgA And IgG In Human Milk After Vaccination Is Dependent On Vaccine Type And Previous Sars-Cov-2 Exposure: A Longitudinal Study

Selma‐Royo

Bäuerl

Mena‐Tudela

et al. 2021

Preprint

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Importance: Limited data are available on COVID-19 vaccine impact in lactating women. Objective: To evaluate the impact of different COVID-19 vaccines on specific anti-SARS-CoV-2 IgA and IgG levels in human milk. Design, Settings and Participants: In this prospective observational study in Spain, 75 lactating women from priority groups receiving vaccination against SARS-CoV-2 were included (January to April 2021). Human milk samples were collected at seven-time points. A group with confirmed SARS-CoV-2 infection (n=19) and a group of women from prepandemic time (n=13) were included. Exposure: mRNA vaccines (BNT162b2 and mRNA-1273) and adenovirus-vectored vaccine (ChAdOx1 nCoV-19). Main Outcome(s) and Measure(s): Presence of IgA and IgG against RBD SARS-CoV-2 in breast milk. Results: Seventy-five vaccinated lactating women [mean age, 34.9±3.7 years] of whom 96% were Caucasic and 92% were health care workers. A total of 417 milk samples were included and vaccine distribution was BioNTech/Pfizer (BNT162b2, n=30), Moderna (mRNA-1273, n=21), and AstraZeneca (ChAdOx1 nCoV-19, n=24). For each vaccine, 7 time points were collected from baseline up to 25 days after the 1st dose and same points were collected for mRNA vaccines 30 days after 2nd dose. A strong reactivity was observed for IgG and IgA after vaccination mainly after the 2nd dose. Presence and the persistence of specific SARS-CoV-2 antibodies in breast milk were dependent on the vaccine-type and, on previous virus exposure. High inter-variability was observed, being relevant for IgA antibodies. IgG levels were significantly higher than those observed in milk from COVID-19 women while IgA levels were lower. Women with previous COVID-19 increased the IgG levels after the 1st dose to a similar level observed in vaccinated women after the 2nd dose. Conclusions and Relevance: Breast milk from vaccinated women contains anti-SARS-CoV-2 IgA and IgG, with highest after the 2nd dose. Levels were dependent on vaccine type and previous exposure to SARS-CoV-2. Previous COVID-19 influenced the vaccine effect after a single dose, which could be especially relevant in the design of vaccination protocols . Further studies are warranted to demonstrate the potential protective role of these antibodies against COVID-19 in infants from vaccinated and infected mothers through breastfeeding.

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Section: Discussionsupporting

confidence: 62%

Anti-Sars-Cov-2 IgA And IgG In Human Milk After Vaccination Is Dependent On Vaccine Type And Previous Sars-Cov-2 Exposure: A Longitudinal Study

Selma‐Royo

Bäuerl

Mena‐Tudela

et al. 2021

Preprint

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“…Nevertheless, as we are showing here, few recent released reports suggest that the levels of the antibodies in previously infected persons trend or are significantly higher than in SARS-CoV-2 naïve persons (16)(17)(18)(19). Those reports and our own results suggest that a single dose may be enough during the first vaccination stages leading to an optimal use of the vaccine availability worldwide.…”

Section: Introductionsupporting

confidence: 71%

“…One limitation of our work is the limited number of subjects followed up after natural infection or after vaccination. However, due to the still limited data available on immune response to SARS-CoV-2 infection, previous reports have made great contribution with a similar number of subjects as on this study (16,18,19,21). Our results contrast with a report describing a short persistence of the Nabs in plasma donors (22) but are in agreement with recent work indicating that neutralizing antibodies may persist longer (1,5,23).…”

Section: Discussionmentioning

confidence: 66%

Function is more reliable than quantity to follow up the humoral response to the Receptor Binding Domain of SARS-CoV-2 Spike protein after natural infection or COVID-19 vaccination

Sariol

Pantoja²,

Serrano-Collazo

et al. 2021

Preprint

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On this work we report that despite of a decline in the total anti-Spike antibodies the neutralizing antibodies remains at a similar level for an average of 98 days in a longitudinal cohort of 59 Hispanic/Latino exposed to SARS-CoV-2. We are also reporting that the percentage of neutralization correlates with the IgG titers and that in the first collected samples, IgG1 was the predominant isotype (62.71%), followed by IgG4 (15.25%), IgG3 (13.56%), and IgG2 (8.47%) during the tested period. The IgA was detectable in 28.81% of subjects. Only 62.71% of all subjects have detectable IgM in the first sample despite of confirmed infection by a molecular method. Our data suggests that 100% that seroconvert make detectable neutralizing antibody responses measured by a surrogate viral neutralization test. We also found that the IgG titers and neutralizing activity were higher after the first dose in 10 vaccinated subjects out of the 59 with prior infection compare to a subgroup of 21 subjects naive to SARS-CoV-2. One dose was enough but two were necessary to reach the maximum percentage of neutralization in subjects with previous natural infection or naive to SARS-CoV-2 respectively. Like the pattern seen after the natural infection, after the second vaccine dose, the total anti-S antibodies and titers declined but not the neutralizing activity which remains at same levels for more than 80 days after the first vaccine dose. That decline, however, was significantly lower in pre-exposed individuals which denotes the contribution of the natural infection priming a more robust immune response to the vaccine. Also, our data indicates that the natural infection induces a more robust humoral immune response than the first vaccine dose in unexposed subjects. However, the difference was significant only when the neutralization was measured but not by assessing the total anti-S antibodies or the IgG titers. This work is an important contribution to understand the natural immune response to the novel coronavirus in a population severely hit by the virus. Also provide an invaluable data by comparing the dynamic of the immune response after the natural infection vs. the vaccination and suggesting that a functional test is a better marker than the presence or not of antibodies. On this context our results are also highly relevant to consider standardizing methods that in addition to serve as a tool to follow up the immune response to the vaccines may also provide a correlate of protection.

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“…Indeed, 98% of our controls developed anti-RBD IgG within 3 weeks of a single dose of this vaccine, irrespective of previous SARS-CoV-2 infection, which is consistent with recent studies. 19,20 Our results suggest that 1 dose of the BNT162b2 vaccine is insuficient to elicit a robust humoral immune response in most patients receiving hemodialysis who have never been previously exposed to SARS-CoV-2, casting doubt on whether a single dose is efective in this population. In contrast to healthy individuals in whom the second dose can probably be safely delayed, 20 the same is likely not true for most patients receiving hemodialysis.…”

Section: Discussionmentioning

confidence: 80%

“…19,20 Our results suggest that 1 dose of the BNT162b2 vaccine is insuficient to elicit a robust humoral immune response in most patients receiving hemodialysis who have never been previously exposed to SARS-CoV-2, casting doubt on whether a single dose is efective in this population. In contrast to healthy individuals in whom the second dose can probably be safely delayed, 20 the same is likely not true for most patients receiving hemodialysis. We do not know if anti-RBD IgG confers immunity against SARS-CoV-2 infection, but it is likely a good surrogate, as anti-RBD IgG correlates strongly with viral neutralization, 21 Fc-mediated efector functions and cellular responses.…”

Section: Discussionmentioning

confidence: 80%

Short-term antibody response after 1 dose of BNT162b2 vaccine in patients receiving hemodialysis

Goupil

Benlarbi

Beaubien‐Souligny

et al. 2021

CMAJ

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BACKGROUND: Patients receiving in-R E S U L T S : O u r s t u d y i n c l u d e d after vaccination.Among those with centre hemodialysis are at high risk of 154 patients receiving hemodialysis previous SARS-CoV-2 infection, median exposure to SARS-CoV-2 and death if (135 without and 19 with previous SARS-anti-RBD IgG levels at 8 weeks in infected. One dose of the BNT162b2 SARS-CoV-2 infection), 40 controls (20 without patients receiving hemodialysis were CoV-2 vaccine is eficacious in the general and 20 with previous SARS-CoV-2 infec-similar to controls at 3 weeks (p = 0.3) population, but responses in patients tion) and convalescent plasma from and to convalescent plasma (p = 0.8). receiving hemodialysis are uncertain. 16 patients. Among those without previous SARS-CoV-2 infection, anti-RBD IgG INTERPRETATION: A single dose of METHODS: We obtained serial plasma was undetectable at 4 weeks in 75 of BNT162b2 vaccine failed to elicit a from patients receiving hemodialysis and 131 (57%, 95% confidence interval [CI] humoral immune response in most health care worker controls before and 47% to 65%) patients receiving hemodipatients receiving hemodialysis without after vaccination with 1 dose of the alysis, compared with 1 of 20 (5%, 95% previous SARS-CoV-2 infection, even BNT162b2 mRNA vaccine, as well as con-CI 1% to 23%) controls (p < 0.001). No after prolonged observation. In those valescent plasma from patients receiving patient with nondetectable levels at with previous SARS-CoV-2 infection, the hemodialysis who survived COVID-19. We 4 weeks developed anti-RBD IgG by antibody response was delayed. We measured anti-receptor binding domain 8 weeks. Results were similar in nonadvise that patients receiving hemodi-(RBD) immunoglobulin G (IgG) levels and immunosuppressed and younger indialysis be prioritized for a second stratified groups by evidence of previous viduals. Three patients receiving hemo-BNT162b2 dose at the recommended SARS-CoV-2 infection. dialysis developed severe COVID-19 3-week interval. Patients with end-stage kidney disease receiving in-this population. Some hemodialysis centres have thus prioricentre hemodialysis have been uniquely vulnerable dur-tized these patients for vaccination. ing the COVID-19 pandemic. For these patients, unlikeTo facilitate wider vaccine distribution during current shortfor most other people, self-isolation to avoid exposure to SARS-ages, 3 the National Advisory Committee on Immunization of Can-CoV-2 is impossible. Most patients receiving hemodialysis must ada has recommended delaying the second dose of the leave their homes 3 times weekly to receive their life-saving BNT162b2 vaccine from 3 to 16 weeks. 4 In a randomized contreatments, ofen in shared spaces for hours at a time. COVID-19 trolled trial (RCT), the clinical efficacy of the BNT162b2 was case fatality rates are 20%-30% for patients receiving hemodireported to be greater than 80% at 3 weeks afer the first dose. 5 alysis -10 times higher than in the general population. 1,2 However, no patients receiving hemodial...

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Antibody Responses after a Single Dose of SARS-CoV-2 mRNA Vaccine

Cited by 146 publications

References 3 publications

Anti-Sars-Cov-2 IgA And IgG In Human Milk After Vaccination Is Dependent On Vaccine Type And Previous Sars-Cov-2 Exposure: A Longitudinal Study

Anti-Sars-Cov-2 IgA And IgG In Human Milk After Vaccination Is Dependent On Vaccine Type And Previous Sars-Cov-2 Exposure: A Longitudinal Study

Function is more reliable than quantity to follow up the humoral response to the Receptor Binding Domain of SARS-CoV-2 Spike protein after natural infection or COVID-19 vaccination

Short-term antibody response after 1 dose of BNT162b2 vaccine in patients receiving hemodialysis

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