Pallett, Scott JC, Heskin, Joseph, Keating, Fergus, Mazzella, Andrea, Taylor, Hannah, Patel, Aatish, Lamb, Georgia, Sturdy, Deborah, Eisler, Natalie, Denny, Sarah et al (show 13 more authors)
(2023)
Hybrid immunity in older adults is associated with reduced SARS-CoV-2 infections following BNT162b2 COVID-19 immunisation.
COMMUNICATIONS MEDICINE, 3 (1).
83-.
Abstract
<h4>Background</h4>Older adults, particularly in long-term care facilities (LTCF), remain at considerable risk from SARS-CoV-2. Data on the protective effect and mechanisms of hybrid immunity are skewed towards young adults precluding targeted vaccination strategies.<h4>Methods</h4>A single-centre longitudinal seroprevalence vaccine response study was conducted with 280 LCTF participants (median 82 yrs, IQR 76-88 yrs; 95.4% male). Screening by SARS-CoV-2 polymerase chain reaction with weekly asymptomatic/symptomatic testing (March 2020-October 2021) and serology pre-/post-two-dose Pfizer-BioNTech BNT162b2 vaccination for (i) anti-nucleocapsid, (ii) quantified anti-receptor binding domain (RBD) antibodies at three time-intervals, (iii) pseudovirus neutralisation, and (iv) inhibition by anti-RBD competitive ELISA were conducted. Neutralisation activity: antibody titre relationship was assessed via beta linear-log regression and RBD antibody-binding inhibition: post-vaccine infection relationship by Wilcoxon rank sum test.<h4>Results</h4>Here we show neutralising antibody titres are 9.2-fold (95% CI 5.8-14.5) higher associated with hybrid immunity (p < 0.00001); +7.5-fold (95% CI 4.6-12.1) with asymptomatic infection; +20.3-fold, 95% (CI 9.7-42.5) with symptomatic infection. A strong association is observed between antibody titre: neutralising activity (p < 0.00001) and rising anti-RBD antibody titre: RBD antibody-binding inhibition (p < 0.001), although 18/169 (10.7%) participants with high anti-RBD titre (>100BAU/ml), show inhibition <75%. Higher RBD antibody-binding inhibition values are associated with hybrid immunity and reduced likelihood of infection (p = 0.003).<h4>Conclusions</h4>Hybrid immunity in older adults was associated with considerably higher antibody titres, neutralisation and inhibition capacity. Instances of high anti-RBD titre with lower inhibition suggests antibody quantity and quality as independent potential correlates of protection, highlighting added value of measuring inhibition over antibody titre alone to inform vaccine strategy.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Biotechnology, Infectious Diseases, Immunization, Vaccine Related, Prevention, Lung, Clinical Research, Infection, 3 Good Health and Well Being |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 29 Sep 2023 09:32 |
| Last Modified: | 15 Mar 2024 19:20 |
| DOI: | 10.1038/s43856-023-00303-y |
| Open Access URL: | https://doi.org/10.1038/s43856-023-00303-y |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3173204 |
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