Effects of age, sex, serostatus, and underlying comorbidities on humoral response post-SARS-CoV-2 Pfizer-BioNTech mRNA vaccination: a systematic review

Abstract

With the advent of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, several vaccines have been developed to mitigate its spread and prevent adverse consequences of the Coronavirus Disease 2019 (COVID-19). The mRNA technology is an unprecedented vaccine, usually given in two doses to prevent SARS-CoV-2 infections. Despite effectiveness and safety, inter-individual immune response heterogeneity has been observed in recipients of mRNA-based vaccines. As a novel disease, the specific immune response mechanism responsible for warding off COVID-19 remains unclear at this point. However, significant evidence suggests that humoral response plays a crucial role in affording immunoprotection and preventing debilitating sequelae from COVID-19. As such, this paper focused on the possible effects of age, sex, serostatus, and comorbidities on humoral response (i.e. total antibodies, IgG, and/or IgA) of different populations post-mRNA-based Pfizer-BioNTech vaccination. A systematic search of literature was performed through PubMed, Cochrane CENTRAL, Google Scholar, Science Direct, medRxiv, and Research Square. Studies were included if they reported humoral response to COVID-19 mRNA vaccines. A total of 32 studies were identified and reviewed, and the percent differences of means of reported antibody levels were calculated for comparison. Findings revealed that older individuals, male sex, seronegativity, and those with more comorbidities mounted less humoral immune response. Given these findings, several recommendations were proposed regarding the current vaccination practices. These include giving additional doses of vaccination for immunocompromised and elderly populations. Another recommendation is conducting clinical trials in giving a combined scheme of mRNA vaccines, protein vaccines, and vector-based vaccines.

Association of neutralizing breadth against SARS-CoV-2 with inoculation orders of heterologous prime-boost vaccines

“…but not Wuhan-Hu-1 after adjusting for known confounders including age, sex assigned at birth, 17 dosing interval, 18 and interval between second vaccination and sample collection (Table S1). 19 These findings suggested that the inoculation order of heterologous vaccines was associated with vaccine-elicited neutralizing antibodies against variant B.1.617.2 but not the ancestral strain.…”

SARS-CoV-2 Neutralizing Antibodies Kinetics Postvaccination in Cancer Patients under Treatment with Immune Checkpoint Inhibition

“…Furthermore, the two cohorts of patients and volunteers were not optimally matched with regards to both age, sex, and type of COVID-19 vaccine, thereby posing the risk of confounding. It is worthy of note that it has been suggested that male gender relates to lower humoral response to mRNA vaccines [ 39 ]. Nevertheless, we firmly believe that these results represent a real-world scenario advocating for a booster shot in patients with solid neoplastic diseases under systemic treatment, which along with the implementation of protective measures among patients and healthcare providers [ 40 ] could ensure continuity of cancer care during the pandemic [ 41 ].…”

A Preliminary Study about the Role of Reactive Oxygen Species and Inflammatory Process after COVID-19 Vaccination and COVID-19 Disease

“…Additionally, several studies have revealed an age, gender and, seronegativity dependence of antibody response against COVID-19. Additional doses of vaccination are recommended for immunocompromised and elderly populations following a combined scheme of mRNA vaccines [ 51 ]. In our study, we confirmed a gender-dependent correlation antibodies with ROS production, both in post-vaccination and COVID-infected individuals.…”