Age-related heterogeneity in immune responses to SARS-CoV-2 vaccine BNT162b2

Abstract

Vaccines remain the cornerstone for containing the SARS-CoV-2 pandemic. mRNA vaccines provide protection in clinical trials using a two-dose approach, separated by a three-week gap. Here we assessed real world immune responses following vaccination with mRNA-based vaccine BNT162b2. Following the first and second doses of the BNT162b2 vaccine, we measured IFNgamma; T cell responses, both total IgG Spike, IgG Spike RBD and neutralising antibody responses to Spike in sera using a lentiviral pseudotyping system. Median age was 82 amongst 26 participants. Three weeks after the first dose a lower proportion of participants over 80 years old achieved adequate neutralisation titre of >1:4 for 50% neutralisation as compared to those under 80 (8/15 versus 11/11, p<0.05). Mean neutralisation titres in this age group after the first dose were lower than in younger individuals (p<0.05). Following the second dose, neutralising antibody response 50% titres were above 1:4 in all individuals and there was no longer a difference by age grouping. A significant proportion of individuals over 80 appear to require a second dose of vaccine, given in this study at three weeks, to achieve virus neutralisation.

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

“…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.…”

Immunogenicity of the BNT162b2 COVID-19 mRNA vaccine and early clinical outcomes in patients with haematological malignancies in Lithuania: a national prospective cohort study

“…Anti-N IgG antibodies are known to have a shorter half-life than anti-S1 IgG antibodies, therefore individuals who were anti-S1 IgG-positive but anti-N IgG-negative might have had an older exposure to SARS-CoV-2 (preprint). 9 Anti-S1 IgG antibody concentrations were compared between timepoint 1 and timepoint 2 within seropositive and seronegative groups.…”

Safety and immunogenicity of one versus two doses of the COVID-19 vaccine BNT162b2 for patients with cancer: interim analysis of a prospective observational study

“…7,8 Likewise, suboptimal vaccine efficacy has been reported in older and immunocompromised populations. [9][10][11][12] The prospect that patients with cancer might be wholly or partially unprotected by vaccination has implications for their health and for the control of SARS-CoV-2 transmission within their environments, including health-care facilities. 7,13,14 Consequently, we launched the SOAP-02 vaccine study to address the safety and efficacy of the BNT162b2 vaccine in patients with cancer, and to investigate whether or not a boost at day 21 following initial vaccination was beneficial in this patient population.…”