Poor Antibody Response to BioNTech/Pfizer Coronavirus Disease 2019 Vaccination in Severe Acute Respiratory Syndrome Coronavirus 2–Naive Residents of Nursing Homes

Pannus, Pieter; Neven, Kristof Y.; Craeye, Stéphane De; Heyndríckx, Leo; Kerckhove, Sara Vande; Georges, Daphnée; Míchiels, Johan; Francotte, Antoine; Bulcke, Marc Van den; Zrein, Maan; Gucht, Steven Van; Schmickler, Marie Noëlle; Verbrugghe, Mathieu; Matagne, André; Thomas, Isabelle; Dierick, Katelijne; Weiner, Joshua A.; Ackerman, Margaret E.; Goriely, Stanislas; Goossens, Maria E.; Ariën, Kevin K.; Desombere, Isabelle; Marchant, Arnaud

doi:10.1093/cid/ciab998

Cited by 29 publications

(24 citation statements)

References 53 publications

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“…The live-virus VN assay employed to evaluate neutralizing antibody titers in this population is a strength of this study, being the most specific and sensitive serological assay capable of evaluating and detecting functional neutralizing antibodies. However, GMTs found in our study were lower than those found in healthy subjects by a previous study using the same VN methodology, while they are similar to those observed in nursing home residents with a higher median age than our study population [ 43 ]. This evidence underlines a possible vulnerability of prison populations, even in the absence of chronic diseases, probably due to other concomitant conditions extremely common in this population, such as stress related to living in congregate settings, substance abuse, tobacco use, and alcohol abuse, that may have contributed to a lower immune response [ 44 ].…”

Section: Discussionsupporting

confidence: 80%

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

Stufano

Buonvino²,

Trombetta

et al. 2022

Vaccines

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Background. The recent spread of the highly mutated SARS-CoV-2 Omicron variant (B.1.1.529) has raised concerns about protection against COVID-19 in congregate settings such as prisons, characterized by a high risk of transmission and possible difficulties in obtaining adequate vaccination coverage. The present study aims to investigate the spread of an outbreak of COVID-19 in an Italian correctional facility during the dominant circulation of the Omicron BA.1 variant, and also considers BNT162b2 mRNA vaccination coverage among inmates. A COVID-19 screening campaign by RT-PCR was performed on 515 detainees from 4–30 January 2022, in response to an outbreak that began in the correctional facility. Furthermore, 101 serum samples collected from healthy inmates 21 days after having received the second dose of the BNT162b2 vaccine were tested for neutralizing antibodies against both the wild-type SARS-CoV-2 strain and the Omicron BA.1 variant. The global attack rate during the study period was 43.6% (RR 0.8), progressively reducing from unvaccinated inmates (62.7%, RR 1.8) to those who had one dose (52.3%, RR 1.5), two doses (full cycle) (45.0%, RR 1.3), and the third dose (booster) vaccinated group (31.4%, RR 0.7). The percentage of SARS-CoV-2 positive subjects among unvaccinated inmates was significantly higher than in the other groups (p < 0.001), while no significant difference was observed between inmates with one or two vaccine doses. Only two of the positive inmates were hospitalized for COVID-19. The geometric mean titer of neutralizing antibodies in the tested sub-group after two doses of vaccine was lower than in previous studies against the wild-type virus, and showed a complete lack of neutralization against the Omicron variant in 92.1% of individuals. The findings support the need to prioritize vaccination in correctional facilities, as a public health measure to increase the protection of inmates and consequently of prison workers and the community against COVID-19, in coordination with the other prevention strategies.

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Section: Discussionsupporting

confidence: 80%

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

Stufano

Buonvino²,

Trombetta

et al. 2022

Vaccines

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“…In residents without previous COVID-19 infection, Blain et al [ 4 ] found only 3% of seronegative elderly residents 6 weeks after the second dose of the vaccine. The authors also confirmed that the highest levels of anti-RBD antibodies were found in individuals who had COVID-19 prior to vaccination (as can be clearly seen also in our results as well as in those by Pannus et al [ 25 ]) and, in effect, recommended that only a single dose of a vaccine should be applied to participants with COVID-19 history. Kontopoulou et al [ 26 ] also reported a 99% seropositivity in elderly individuals 3 weeks after vaccination.…”

Section: Discussionsupporting

confidence: 92%

Immune Response 5–7 Months after Vaccination against SARS-CoV-2 in Elderly Nursing Home Residents in the Czech Republic: Comparison of Three Vaccines

Martínek

Tomášková

Janošek

et al. 2022

Viruses

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Background and Aims: Elderly nursing home residents are especially prone to a severe course of SARS-CoV-2 infection. In this study, we aimed to investigate the complex immune response after vaccination depending on the convalescence status and vaccine. Methods: Sampling took place in September–October 2021. IgG antibodies against spike protein and nucleocapsid protein, the titer of virus neutralization antibodies against delta and (on a subset of patients) omicron, and cellular immunity (interferon-gamma release assay) were tested in nursing home residents vaccinated with Pfizer, Moderna (both 30–31 weeks after the completion of vaccination), or AstraZeneca (23 weeks) vaccines. The prevalence with 95% confidence intervals (CI) was evaluated in Stata version 17. Results: 95.2% (95% CI: 92.5–97.1%) of the 375 participants had positive results of anti-S IgG, 92.8% (95% CI: 89.7–95.2%) were positive in virus neutralization assay against delta, and 89.0% (95% CI: 84.5–92.5%) in the interferon-gamma-releasing assay detecting cellular immunity. Results of the virus neutralization assay against omicron correlated with those against delta but the neutralization capacity was reduced by about half. As expected, the worst results were found for the AstraZeneca vaccine, although the vaccination-to-test period was the shortest for this vaccine. All immune parameters were significantly higher in convalescent residents than in naive residents after vaccination. No case of COVID-19 occurred during the vaccination-to-test period. Conclusions: A high immune response, especially among vaccinated convalescents (i.e., residents with hybrid immunity), was found in elderly nursing home residents 5–7 months after vaccination against SARS-CoV-2. In view of this, it appears that such residents are much better protected from COVID-19 than those who are only vaccinated and the matter of individual approach to the booster dose in such individuals should be further discussed.

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“…Antibody responses to S2 are increased in some individuals following SARS-CoV-2 infection and plasma S2 Ab response are associated with survival after coronavirus disease 2019 (COVID-19) infection [ 11 ]. However, the development of S2-specific Abs following SARS-CoV-2 natural infection or standard vaccination is limited compared to those specific for S1 [ 12 , 13 ]. While most S1 Abs are neutralizing, only a small fraction of S2 Abs are neutralizing [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Potent universal beta-coronavirus therapeutic activity mediated by direct respiratory administration of a Spike S2 domain-specific human neutralizing monoclonal antibody

et al. 2022

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Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) marks the third novel β-coronavirus to cause significant human mortality in the last two decades. Although vaccines are available, too few have been administered worldwide to keep the virus in check and to prevent mutations leading to immune escape. To determine if antibodies could be identified with universal coronavirus activity, plasma from convalescent subjects was screened for IgG against a stabilized pre-fusion SARS-CoV-2 spike S2 domain, which is highly conserved between human β-coronavirus. From these subjects, several S2-specific human monoclonal antibodies (hmAbs) were developed that neutralized SARS-CoV-2 with recognition of all variants of concern (VoC) tested (Beta, Gamma, Delta, Epsilon, and Omicron). The hmAb 1249A8 emerged as the most potent and broad hmAb, able to recognize all human β-coronavirus and neutralize SARS-CoV and MERS-CoV. 1249A8 demonstrated significant prophylactic activity in K18 hACE2 mice infected with SARS-CoV-2 lineage A and lineage B Beta, and Omicron VoC. 1249A8 delivered as a single 4 mg/kg intranasal (i.n.) dose to hamsters 12 hours following infection with SARS-CoV-2 Delta protected them from weight loss, with therapeutic activity further enhanced when combined with 1213H7, an S1-specific neutralizing hmAb. As little as 2 mg/kg of 1249A8 i.n. dose 12 hours following infection with SARS-CoV Urbani strain, protected hamsters from weight loss and significantly reduced upper and lower respiratory viral burden. These results indicate in vivo cooperativity between S1 and S2 specific neutralizing hmAbs and that potent universal coronavirus neutralizing mAbs with therapeutic potential can be induced in humans and can guide universal coronavirus vaccine development.

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Poor Antibody Response to BioNTech/Pfizer Coronavirus Disease 2019 Vaccination in Severe Acute Respiratory Syndrome Coronavirus 2–Naive Residents of Nursing Homes

Cited by 29 publications

References 53 publications

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

Immune Response 5–7 Months after Vaccination against SARS-CoV-2 in Elderly Nursing Home Residents in the Czech Republic: Comparison of Three Vaccines

Potent universal beta-coronavirus therapeutic activity mediated by direct respiratory administration of a Spike S2 domain-specific human neutralizing monoclonal antibody

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