Background
Emerging data support detectable immune responses for months after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and vaccination, but it is not yet established to what degree and for how long protection against reinfection lasts.
Methods
We investigated SARS‐CoV‐2‐specific humoral and cellular immune responses more than 8 months post‐asymptomatic, mild and severe infection in a cohort of 1884 healthcare workers (HCW) and 51 hospitalized COVID‐19 patients. Possible protection against SARS‐CoV‐2 reinfection was analyzed by a weekly 3‐month polymerase chain reaction (PCR) screening of 252 HCW that had seroconverted 7 months prior to start of screening and 48 HCW that had remained seronegative at multiple time points.
Results
All COVID‐19 patients and 96% (355/370) of HCW who were anti‐spike IgG positive at inclusion remained anti‐spike IgG positive at the 8‐month follow‐up. Circulating SARS‐CoV‐2‐specific memory T cell responses were detected in 88% (45/51) of COVID‐19 patients and in 63% (233/370) of seropositive HCW. The cumulative incidence of PCR‐confirmed SARS‐CoV‐2 infection was 1% (3/252) among anti‐spike IgG positive HCW (0.13 cases per 100 weeks at risk) compared to 23% (11/48) among anti‐spike IgG negative HCW (2.78 cases per 100 weeks at risk), resulting in a protective effect of 95.2% (95% CI 81.9%–99.1%).
Conclusions
The vast majority of anti‐spike IgG positive individuals remain anti‐spike IgG positive for at least 8 months regardless of initial COVID‐19 disease severity. The presence of anti‐spike IgG antibodies is associated with a substantially reduced risk of reinfection up to 9 months following asymptomatic to mild COVID‐19.
Background
Recent reports demonstrate robust serological responses to a single dose of messenger RNA (mRNA) vaccines in individuals previously infected with SARS-CoV-2. Data on immune responses following a single-dose adenovirus-vectored vaccine expressing the SARS-CoV-2 spike protein (ChAdOx1 nCoV-19) in individuals with previous SARS-CoV-2 infection are however limited, and current guidelines recommend a two-dose regimen regardless of preexisting immunity.
Methods
We compared RBD-specific IgG and RBD-ACE2 blocking antibodies against SARS-CoV-2 wild type and variants of concern following two doses of the mRNA vaccine BNT162b2 in SARS-CoV-2 naïve healthcare workers (n=65) and a single dose of the adenovector vaccine ChAdOx1 nCoV-19 in 82 healthcare workers more than (n=45) and less than (n=37) 11 months post mild SARS-CoV-2 infection at time of vaccination.
Findings
The post-vaccine levels of RBD-specific IgG and neutralizing antibodies against the SARS-CoV-2 wild type and variants of concern including Delta lineage 1.617.2 were similar or higher in participants receiving a single dose of ChAdOx1 nCoV-19 vaccine post SARS-CoV-2 infection (both more than and less than 11 months post infection) compared to SARS-CoV-2 naïve participants who received two doses of BNT162b2 vaccine.
Interpretation
Our data support that a single dose ChAdOx1 nCoV-19 vaccine that is administered up to at least 11 months post SARS-CoV-2 infection serves as an effective immune booster. This provides a possible rationale for a single-dose vaccine regimen.
Funding
A full list of funding bodies that contributed to this study can be found in the Acknowledgements section
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