Determinants of early antibody responses to COVID-19 mRNA vaccines in a cohort of exposed and naïve healthcare workers

Moncunill, Gemma; Aguilar, Ruth; Ribes, Marta; Ortega, Natalia; Rubio, Rocío; Molina, María José; Vidal, Marta; Barrios, Diana; Mitchell, Robert A.; Jiménez, Alfons; Castellana, Cristina; Rodó, Pau; Méndez, Susana; Llupià, Anna; Puyol, Laura; Rodrigo Melero, Natalia; Carolis, Carlo; Mayor, Alfredo; Izquierdo, Luis; Trilla, Antoni; Vilella, Anna; García-Basteiro, Alberto L.; Dobaño, Carlota

Determinants of early antibody responses to COVID-19 mRNA vaccines in a cohort of exposed and naïve healthcare workers

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dc.contributor.author Moncunill, Gemma
dc.contributor.author Aguilar, Ruth
dc.contributor.author Ribes, Marta
dc.contributor.author Ortega, Natalia
dc.contributor.author Rubio, Rocío
dc.contributor.author Molina, María José
dc.contributor.author Vidal, Marta
dc.contributor.author Barrios, Diana
dc.contributor.author Mitchell, Robert A.
dc.contributor.author Jiménez, Alfons
dc.contributor.author Castellana, Cristina
dc.contributor.author Rodó, Pau
dc.contributor.author Méndez, Susana
dc.contributor.author Llupià, Anna
dc.contributor.author Puyol, Laura
dc.contributor.author Rodrigo Melero, Natalia
dc.contributor.author Carolis, Carlo
dc.contributor.author Mayor, Alfredo
dc.contributor.author Izquierdo, Luis
dc.contributor.author Trilla, Antoni
dc.contributor.author Vilella, Anna
dc.contributor.author García-Basteiro, Alberto L.
dc.contributor.author Dobaño, Carlota
dc.date.accessioned 2022-03-29T06:41:01Z
dc.date.available 2022-03-29T06:41:01Z
dc.date.issued 2022
dc.description.abstract Background: Two doses of mRNA vaccination have shown >94% efficacy at preventing COVID-19 mostly in naïve adults, but it is not clear if the second dose is needed to maximize effectiveness in those previously exposed to SARS-CoV-2 and what other factors affect responsiveness. Methods: We measured IgA, IgG and IgM levels against SARS-CoV-2 spike (S) and nucleocapsid (N) antigens from the wild-type and S from the Alpha, Beta and Gamma variants of concern, after BNT162b2 (Pfizer/BioNTech) or mRNA-1273 (Moderna) vaccination in a cohort of health care workers (N=578). Neutralizing capacity and antibody avidity were evaluated. Data were analyzed in relation to COVID-19 history, comorbidities, vaccine doses, brand and adverse events. Findings: Vaccination induced robust IgA and IgG levels against all S antigens. Neutralization capacity and S IgA and IgG levels were higher in mRNA-1273 vaccinees, previously SARS-CoV-2 exposed, particularly if symptomatic, and in those experiencing systemic adverse effects (p<0·05). A second dose in pre-exposed did not increase antibody levels. Smoking and comorbidities were associated with 43% (95% CI, 19-59) and 45% (95% CI, 63-18) lower neutralization, respectively, and 35% (95% CI, 3-57%) and 55% (95% CI, 33-70%) lower antibody levels, respectively. Among fully vaccinated, 6·3% breakthroughs were detected up to 189 days post-vaccination. Among pre-exposed non-vaccinated, 90% were IgG seropositive more than 300 days post-infection. Interpretation: Our data support administering a single-dose in pre-exposed healthy individuals as primary vaccination. However, heterogeneity of responses suggests that personalized recommendations may be necessary depending on COVID-19 history and life-style. Higher mRNA-1273 immunogenicity would be beneficial for those expected to respond worse to vaccination and in face of variants that escape immunity such as Omicron. Persistence of antibody levels in pre-exposed unvaccinated indicates maintenance of immunity up to one year.
dc.format.mimetype application/pdf
dc.identifier.citation Moncunill G, Aguilar R, Ribes M, Ortega N, Rubio R, Salmerón G, et al. Determinants of early antibody responses to COVID-19 mRNA vaccines in a cohort of exposed and naïve healthcare workers. EBioMedicine. 2022 Jan;75:103805. DOI: 10.1016/j.ebiom.2021.103805
dc.identifier.doi http://dx.doi.org/10.1016/j.ebiom.2021.103805
dc.identifier.issn 2352-3964
dc.identifier.uri http://hdl.handle.net/10230/52787
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof EBioMedicine. 2022 Jan;75:103805
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.keyword Antibody
dc.subject.keyword Avidity
dc.subject.keyword COVID-19
dc.subject.keyword Health care workers
dc.subject.keyword Neutralization
dc.subject.keyword SARS-CoV-2
dc.subject.keyword mRNA vaccines
dc.title Determinants of early antibody responses to COVID-19 mRNA vaccines in a cohort of exposed and naïve healthcare workers
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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Articles (Center for Genomic Regulation (CRG))
Articles (Barcelona Institute for Global Health (ISGlobal) – Campus Mar)