Antibody Titers Before and After a Third Dose of the SARS-CoV-2 BNT162b2 Vaccine in Adults Aged ≥60 Years

Eliakim‐Raz, Noa; Leibovici-Weisman, Yaara; Stemmer, Amos; Ness, Asaf; Awwad, Muhammad; Ghantous, Nassem; Stemmer, Salomon M.

doi:10.1001/jama.2021.19885

Cited by 108 publications

(102 citation statements)

References 6 publications

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“…A booster or additional primary dose of COVID-19 vaccine provides a robust immune response ( 3 ) and protects against COVID-19 illness, hospitalization, and death. CDC now recommends that all persons aged ≥18 years receive a COVID-19 booster dose after the minimum recommended interval since primary series completion ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

“…Corresponding author: Hannah E. Fast, hfast@cdc.gov. 1 Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC; 2 CDC COVID-19 Response Team; 3…”

Section: Acknowledgmentsmentioning

confidence: 99%

“…Vaccination against SARS-CoV-2 (the virus that causes COVID-19) is highly effective at preventing hospitalization due to SARS-CoV-2 infection and booster and additional primary dose COVID-19 vaccinations increase protection (1)(2)(3). During August-November 2021, a series of Emergency Use Authorizations and recommendations, including those for an additional primary dose for immunocompromised persons and a booster dose for persons aged ≥18 years, were approved because of reduced immunogenicity in immunocompromised persons, waning vaccine effectiveness over time, and the introduction of the highly transmissible B.1.617.2 (Delta) variant (4,5).…”

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confidence: 99%

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Booster and Additional Primary Dose COVID-19 Vaccinations Among Adults Aged ≥65 Years — United States, August 13, 2021–November 19, 2021

Fast¹,

Zell²,

Murthy³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionmentioning

confidence: 99%

“…Corresponding author: Hannah E. Fast, hfast@cdc.gov. 1 Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC; 2 CDC COVID-19 Response Team; 3…”

Section: Acknowledgmentsmentioning

confidence: 99%

mentioning

confidence: 99%

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Booster and Additional Primary Dose COVID-19 Vaccinations Among Adults Aged ≥65 Years — United States, August 13, 2021–November 19, 2021

Fast¹,

Zell²,

Murthy³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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“…Although there is no cutoff value that defines seroprotection, the anti-spike antibody level may be used as a surrogate marker [ 15 , 23 ] and as a guide for clinical decision making [ 7 ]. The administration of a booster vaccine is associated with an increase of antibody levels in the general population [ 24 ] and in dialysis patients [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Waning Humoral Response 3 to 6 Months after Vaccination with the SARS-COV-2 BNT162b2 mRNA Vaccine in Dialysis Patients

Berar-Yanay

Freiman

Shapira

et al. 2021

JCM

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Background and objectives: The short-term reported antibody response to SARS-COV-2 vaccination in dialysis patients is high, with a seroconversion response rate up to 97%. Data on the long-term durability of this response are scarce. Our objective was to characterize the long-term anti-spike antibody level in dialysis patients. Design, setting, participants, and measurements: In an observational study, we measured SARS-COV-2 anti-spike antibody levels in dialysis patients who completed 2 doses of the BNT162b2 mRNA SAR S-COV-2 vaccine at 1, 3 and 6 months after the second vaccine dose. We compared the response to dialysis patients who were infected with COVD-19 and to a control group of healthcare-employees. Results: One hundred and forty-two dialysis patients who had been vaccinated (ages 64 ± 11.9 years, 61% male), 33 dialysis patients who had COVID-19 infection (ages 54 ± 14.3 years, 55% male) and 104 individuals in the control group (ages 50 ± 12.2 years, 44% male) were included. The response rate in the vaccinated dialysis patients was 94%, 78% and 73% at 1, 3 and 6 months after the second vaccine dose. In the COVID-19 infected dialysis group and in the control group, the response rate remained at 100% over 6 months. The percentage of change in antibody levels between one and 6 months was −66% in the vaccinated dialysis group, −28% in the control group (p < 0.001) and +48% in dialysis patients who had been infected with COVID-19 (p < 0.001). A non-responder status at 6 months was associated with a lower albumin level. No serious adverse events following vaccination were reported. In conclusion: the initially high response rate to the BNT162b2 vaccine in dialysis patients decreases rapidly. Our results indicate that an early booster (3rd) dose, at three months after the second dose, may be advised for this population to preserve the humoral immunity.

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“…48 BNT162b2 antibody studies show high antibody titers (same specific antibodies as above) postvaccination that wane by 2-6 months (more rapidly in immunosuppressed adults), and increase with boosting. [16][17][18][19][20][21][22][23][24] VE studies show high protection against infection with durability for 6 months (90-95%) earlier in the pandemic when Alpha and Beta variants predominated, but with waning to as low as 20% later when Beta and Delta variants predominated; VE against severe disease (hospitalization and death) remained high (>90%) throughout the pandemic. [29][30][31]34 VE against infection, severe infection, and mortality in Israel when Delta predominated was much higher with boosting.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Antibody Response Durability of mRNA-1273, BNT162b2, and Ad26.COV2.S SARS-CoV-2 Vaccines in Healthcare Workers

Brunner

Freilich

Victory

et al. 2022

Preprint

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ImportanceThere is a dearth of comparative immunologic durability data after COVID-19 vaccinations.ObjectiveTo compare antibody responses and vaccine effectiveness 8.4 months post-primary COVID-19 vaccination.DesignSetting and Participants: In this cohort study of 903 healthcare workers who completed surveys about baseline characteristics and COVID-19 vaccine/infection history, 647 had antibody assays completed and were included herein.ExposureCOVID-19 vaccination with mRNA-1273 (n=387); BNT162b2 (n=212); or Ad26.COV2.S (n=10); unvaccinated (n=10); or boosted (n=28).Main Outcomes and MeasuresThe primary outcome was IgG anti-spike titer. Secondary/tertiary outcomes included IgG spike receptor-binding domain competitive antibody blocking ELISA pseudoneutralization against the USA-WA1/2020 strain, and vaccine effectiveness against COVID-19 infection. Antibody levels were compared using ANOVA and multiple linear regression.ResultsMean age was 49.7, 75.3% were female, and mean comorbidities/patient was 0.7. Baseline variables were balanced (p>.05) except for immunosuppression (higher in boosted, p=.047), prior COVID-19 infections (higher with Ad26.COV2.S and unvaccinated, p<.001), and time since primary vaccination (higher with mRNA-1273 and BNT162b2 than Ad26.COV2.S, p<.001).Unadjusted median (IQR) IgG anti-spike titers (AU/mL) were 1539.5 (876.7-2626.7) for mRNA-1273, 751.2 (422.0-1381.5) for BNT162b2, 451.6 (103.0-2396.7) for Ad26.COV2.S, 113.4 (3.7-194.0) for unvaccinated, and 31898.8 (21347.1-45820.1) for boosted (mRNA-1273 vs. BNT162b2, p<.001; mRNA-1273, BNT162b2, or boosted vs. unvaccinated, p<.006; mRNA-1273, BNT162b2, Ad26.COV2.S, or unvaccinated vs. boosted, p<.001; all other comparisons, p>.05). Unadjusted median (IQR) pseudoneutralization percentages were 90.9% (80.1-95.0) for mRNA-1273, 77.2% (59.1-89.9) for BNT162b2, 57.9% (36.6-95.8) for Ad26.COV2.S, 40.1% (21.7-60.6) for unvaccinated, and 96.4% (96.1-96.6) for boosted (mRNA-1273 vs. BNT162b2, p<.001; mRNA-1273, BNT162b2, or boosted vs. unvaccinated, p<.028; mRNA-1273, BNT162b2, Ad26.COV2.S, or unvaccinated vs. boosted, p<.001; all other comparisons, p>.05). Adjusted anti-spike and pseudoneutralization comparisons of mRNA-1273 and BNT162b2 showed similar patterns (p<.001). Vaccine effectiveness was 87-89% for mRNA-1273, BNT162b2, and boosted, and 33% for Ad26.COV2.S; no group differences were statistically significant.Conclusions and RelevanceDurability of antibody responses 8.4 months after COVID-19 primary vaccination was significantly higher with mRNA-1273 than with BNT162b2, however, vaccine effectiveness was equivalent. Antibody responses and vaccine effectiveness were lower but not significantly different for Ad26.COV2.S; given statistical uncertainty in the small Ad26.COV2.S group, clinically important effects cannot be excluded.

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Antibody Titers Before and After a Third Dose of the SARS-CoV-2 BNT162b2 Vaccine in Adults Aged ≥60 Years

Abstract: This study assesses antispike (anti-S) IgG antibody titers before and after a third BNT162b2 dose (booster) in individuals aged 60 years and older in Israel.

Cited by 108 publications

References 6 publications

Booster and Additional Primary Dose COVID-19 Vaccinations Among Adults Aged ≥65 Years — United States, August 13, 2021–November 19, 2021

Booster and Additional Primary Dose COVID-19 Vaccinations Among Adults Aged ≥65 Years — United States, August 13, 2021–November 19, 2021

Waning Humoral Response 3 to 6 Months after Vaccination with the SARS-COV-2 BNT162b2 mRNA Vaccine in Dialysis Patients

Comparison of Antibody Response Durability of mRNA-1273, BNT162b2, and Ad26.COV2.S SARS-CoV-2 Vaccines in Healthcare Workers

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