Severe acute respiratory syndrome coronavirus 2 spike antibody level decline is more pronounced after the second vaccination, but response to the third vaccination is similar in people with type 1 and type 2 diabetes compared with healthy controls: The prospective COVAC‐DM cohort study

Abstract

Up to 1 June 2022, almost 12 billion vaccine doses for coronavirus disease 2019 (COVID-19) were administered worldwide. 1 People with diabetes were more probable to be hospitalized for COVID-19 and were observed to have in-hospital mortality as high as 25%. 2,3 Hence COVID-19 vaccination is not only recommended with priority in people with diabetes, it has also been shown to be effective in people with diabetes. 4,5 Our research group previously showed that humoral immune response 2-3 weeks after the second COVID-19 vaccination is similar in people with type 1 diabetes, type 2 diabetes and healthy controls, 6

Antibody response to inactivated COVID‐19 vaccine in patients with type 2 diabetes mellitus after the booster immunization

“…Meanwhile, Cheng et al revealed decreased titers of anti‐N/S IgG and anti‐RBD IgG in patients with T2DM compared to HCs 22 . In addition, numerous studies also indicated reduced immunogenicity to mRNA or viral vector‐based COVID‐19 vaccines after finishing full‐course immunization 4,5,13 . Therefore, it is necessary for patients with T2DM to acquire a booster vaccination to improve the effectiveness of the vaccine 14 .…”

“…Therefore, it is necessary for patients with T2DM to acquire a booster vaccination to improve the effectiveness of the vaccine 14 . Sourij et al demonstrated a higher antibody response in patients with T2DM inoculated with the third dose of COVID‐19 mRNA vaccine than with the second dose, and response to the third vaccination showed no significant difference between patients with T2DM and HCs 5 . In this study, we also observed enhanced humoral reactivity in patients with T2DM after the booster dose of inactivated vaccine compared to those after receiving the second dose of vaccine, including anti‐SARS‐CoV‐2 total antibodies ( p = 0.002; Figure S1A), anti‐RBD IgG ( p = 0.0025; Figure S1B), and NAb toward WT ( p = 0.0056; Figure S1C).…”

“…22 In addition, numerous studies also indicated reduced immunogenicity to mRNA or viral vector-based COVID-19 vaccines after finishing full-course immunization. 4,5,13 Therefore, it is necessary for patients with T2DM to acquire a booster vaccination to improve the effectiveness of the vaccine. 14 Sourij et al demonstrated a higher antibody response in patients with T2DM inoculated with the third dose of COVID-19 mRNA vaccine than with the second dose, and response to the third vaccination showed no significant difference between patients with T2DM and HCs.…”

“…4 Sourij et al reported that the titers of anti-SARS-CoV-2 spike protein antibody were decreased in patients with T2DM compared with the healthy controls (HCs) after receiving the second dose of BioNTech-Pfizer/ Moderna mRNA-based vaccines. 5 However, Lee et al found that both the levels of anti-receptor-binding domain (RBD) IgG antibody and NAb did not show significant differences between patients with T2DM and HCs after finishing full-course vaccination of BNT162b2 mRNA vaccines. 6 Therefore, the effectiveness of the COVID-19 vaccine in patients with T2DM remains controversial.…”

“…Ali et al observed that patients with T2DM had lower levels of SARS‐CoV‐2 IgG and neutralizing antibodies (NAbs) compared to those without T2DM after receiving two doses of BNT162b2 mRNA vaccines 4 . Sourij et al reported that the titers of anti‐SARS‐CoV‐2 spike protein antibody were decreased in patients with T2DM compared with the healthy controls (HCs) after receiving the second dose of BioNTech‐Pfizer/Moderna mRNA‐based vaccines 5 . However, Lee et al found that both the levels of anti‐receptor‐binding domain (RBD) IgG antibody and NAb did not show significant differences between patients with T2DM and HCs after finishing full‐course vaccination of BNT162b2 mRNA vaccines 6 .…”