Robust antibody responses in 70–80-year-olds 3 weeks after the first or second doses of Pfizer/BioNTech COVID-19 vaccine, United Kingdom, January to February 2021

Subbarao, Sathyavani; Warrener, Lenesha; Höschler, Katja; Perry, Keith R.; Shute, Justin; Whitaker, Heather; O’Brien, Michelle; Baawuah, Frances; Moss, Paul; Parry, Helen; Ladhani, Shamez; Ramsay, Mary; Brown, Kevin E.; Amirthalingam, Gayatri

doi:10.2807/1560-7917.es.2021.26.12.2100329

Cited by 41 publications

(40 citation statements)

References 5 publications

(4 reference statements)

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“…Although the evidence on single-dose immunogenicity of BNT162b2 in older adults is mixed, [28][29][30] pooled data from four ChAdOx1 trials, including over 950 participants aged 70 years and older, indicated vaccine effectiveness of 63•9% (95% CI 46-75•9) against all infection at 22-90 days after a single dose, 17 which is in line with our findings. Our estimates of vaccine effectiveness against all infection are not dissimilar to those from phase 3 efficacy testing of the single-dose Ad26.COV2.S vaccine (Janssen), which was 67•9% (95% CI 38•2-82•8) effective against symptomatic COVID-19 at 28 days or more after vaccination in those aged 60 years and older.…”

Section: Chadox1 Bnt162b2supporting

confidence: 88%

Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of long-term care facilities in England (VIVALDI): a prospective cohort study

Shrotri

Krutikov

Palmer³

et al. 2021

The Lancet Infectious Diseases

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156

127

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Background The effectiveness of SARS-CoV-2 vaccines in older adults living in long-term care facilities is uncertain. We investigated the protective effect of the first dose of the Oxford-AstraZeneca non-replicating viral-vectored vaccine (ChAdOx1 nCoV-19; AZD1222) and the Pfizer-BioNTech mRNA-based vaccine (BNT162b2) in residents of long-term care facilities in terms of PCR-confirmed SARS-CoV-2 infection over time since vaccination. Methods The VIVALDI study is a prospective cohort study that commenced recruitment on June 11, 2020, to investigate SARS-CoV-2 transmission, infection outcomes, and immunity in residents and staff in long-term care facilities in England that provide residential or nursing care for adults aged 65 years and older. In this cohort study, we included long-term care facility residents undergoing routine asymptomatic SARS-CoV-2 testing between Dec 8, 2020 (the date the vaccine was first deployed in a long-term care facility), and March 15, 2021, using national testing data linked within the COVID-19 Datastore. Using Cox proportional hazards regression, we estimated the relative hazard of PCR-positive infection at 0-6 days, 7-13 days, 14-20 days, 21-27 days, 28-34 days, 35-48 days, and 49 days and beyond after vaccination, comparing unvaccinated and vaccinated person-time from the same cohort of residents, adjusting for age, sex, previous infection, local SARS-CoV-2 incidence, long-term care facility bed capacity, and clustering by long-term care facility. We also compared mean PCR cycle threshold (Ct) values for positive swabs obtained before and after vaccination. The study is registered with ISRCTN, number 14447421. Findings 10 412 care home residents aged 65 years and older from 310 LTCFs were included in this analysis. The median participant age was 86 years (IQR 80-91), 7247 (69•6%) of 10 412 residents were female, and 1155 residents (11•1%) had evidence of previous SARS-CoV-2 infection. 9160 (88•0%) residents received at least one vaccine dose, of whom 6138 (67•0%) received ChAdOx1 and 3022 (33•0%) received BNT162b2. Between Dec 8, 2020, and March 15, 2021, there were 36 352 PCR results in 670 628 person-days, and 1335 PCR-positive infections (713 in unvaccinated residents and 612 in vaccinated residents) were included. Adjusted hazard ratios (HRs) for PCR-positive infection relative to unvaccinated residents declined from 28 days after the first vaccine dose to 0•44 (95% CI 0•24-0•81) at 28-34 days and 0•38 (0•19-0•77) at 35-48 days. Similar effect sizes were seen for ChAdOx1 (adjusted HR 0•32, 95% CI 0•15-0•66) and BNT162b2 (0•35, 0•17-0•71) vaccines at 35-48 days. Mean PCR Ct values were higher for infections that occurred at least 28 days after vaccination than for those occurring before vaccination (31•3 [SD 8•7] in 107 PCR-positive tests vs 26•6 [6•6] in 552 PCR-positive tests; p<0•0001).Interpretation Single-dose vaccination with BNT162b2 and ChAdOx1 vaccines provides substantial protection against infection in older adults from 4-7 weeks after vaccination and might reduce SARS...

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Section: Chadox1 Bnt162b2supporting

confidence: 88%

Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of long-term care facilities in England (VIVALDI): a prospective cohort study

Shrotri

Krutikov

Palmer³

et al. 2021

The Lancet Infectious Diseases

Self Cite

156

127

View full text Add to dashboard Cite

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“…Overall, older men had a nearly 50% lower anti-SARS-CoV-2 RBD total antibody response compared to young women [11]. Similar evidence was garnered in other studies, whereby lower vaccine immunogenicity was also reported in older people and/or in males [17][18][19][20][21]. Given the increased risk for poor COVID-19 progression and outcomes associated with advanced age and male sex, these groups may be especially vulnerable in the setting of a diminished immune response [22].…”

Section: Why?supporting

confidence: 63%

Anti-SARS-CoV-2 Antibodies Testing in Recipients of COVID-19 Vaccination: Why, When, and How?

2021

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Although universal vaccination is one of the most important healthcare strategies for limiting SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) circulation and averting the huge number of hospitalizations and deaths due to coronavirus disease 2019 (COVID-19), significant inter-individual variability of COVID-19 vaccines’ efficacies has been described, mostly due to heterogeneous immune response in recipients. This opinion paper hence aims to discuss aspects related to the opportunity of monitoring anti-SARS-CoV-2 antibodies before and after COVID-19 vaccination, highlighting the pros and cons of this strategy. In summary, the advantages of anti-SARS-CoV-2 antibodies’ testing in recipients of COVID-19 vaccination encompass an assessment of baseline seroprevalence of SARS-CoV-2 infection in non-vaccinated individuals; early identification of low or non-responders to COVID-19 vaccination; and timely detection of faster decay of anti-SARS-CoV-2 antibody levels. In contrast, potential drawbacks to date include an unproven equivalence between anti-SARS-CoV-2 antibody titer, neutralizing activity, and vaccine efficiency; the lack of cost-effective analyses of different testing strategies; the enormous volume of blood drawings and increase of laboratory workload that would be needed to support universal anti-SARS-CoV-2 antibodies testing. A potential solution entails the identification of cohorts to be prioritized for testing, including those at higher risk of being infected by variants of concern, those at higher risk of unfavorable disease progression, and subjects in whom vaccine immunogenicity may be expectedly lower and/or shorter.

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“…Outside trials, there are limited data on post-vaccine antibody responses in other groups, especially older adults who were underrepresented in the ChAdOx1 trial 5 . A study of 185 individuals aged >70 years showed high seropositivity after one or two BNT162b2 doses 10 . Another study, of 100 individuals aged 80–100 years, showed almost universal high antibody responses 3 weeks after a single dose of BNT162b2, with spike-specific cellular responses in 63% of participants 11 .…”

Section: Mainmentioning

confidence: 99%

Antibody responses to SARS-CoV-2 vaccines in 45,965 adults from the general population of the United Kingdom

et al. 2021

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We report that in a cohort of 45,965 adults, who were receiving either the ChAdOx1 or the BNT162b2 SARS-CoV-2 vaccines, in those who had no prior infection with SARS-CoV-2, seroconversion rates and quantitative antibody levels after a single dose were lower in older individuals, especially in those aged >60 years. Two vaccine doses achieved high responses across all ages. Antibody levels increased more slowly and to lower levels with a single dose of ChAdOx1 compared with a single dose of BNT162b2, but waned following a single dose of BNT162b2 in older individuals. In descriptive latent class models, we identified four responder subgroups, including a ‘low responder’ group that more commonly consisted of people aged >75 years, males and individuals with long-term health conditions. Given our findings, we propose that available vaccines should be prioritized for those not previously infected and that second doses should be prioritized for individuals aged >60 years. Further data are needed to better understand the extent to which quantitative antibody responses are associated with vaccine-mediated protection.

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Robust antibody responses in 70–80-year-olds 3 weeks after the first or second doses of Pfizer/BioNTech COVID-19 vaccine, United Kingdom, January to February 2021

Cited by 41 publications

References 5 publications

Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of long-term care facilities in England (VIVALDI): a prospective cohort study

Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of long-term care facilities in England (VIVALDI): a prospective cohort study

Anti-SARS-CoV-2 Antibodies Testing in Recipients of COVID-19 Vaccination: Why, When, and How?

Antibody responses to SARS-CoV-2 vaccines in 45,965 adults from the general population of the United Kingdom

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