First-dose mRNA vaccination is sufficient to reactivate immunological memory to SARS-CoV-2 in subjects who have recovered from COVID-19

Mazzoni, Alessio; Lauria, Nicoletta Di; Maggi, Laura; Salvati, Lorenzo; Vanni, Anna; Capone, Manuela; Lamacchia, Giulia; Mantengoli, Elisabetta; Spinicci, Michele; Zammarchi, Lorenzo; Kiros, Seble Tekle; Rocca, Arianna; Lagi, Filippo; Colao, Maria Grazia; Parronchi, Paola; Scaletti, Cristina; Turco, Lucia; Liotta, Francesco; Rossolini, Gian María; Cosmi, Lorenzo; Bartoloni, Alessandro; Annunziato, Francesco

doi:10.1172/jci149150

Cited by 126 publications

(152 citation statements)

References 24 publications

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“…These researchers also did not nd any correlation between age and the intensity of the humoral or cellular response. Our observations are consistent also with the results published by Krammer et al[23], Saadat et al [24], Ebinger et al [25], Mazzoni et al [26] and Gobbi et al [27]. Both our study.…”

Section: Discussionsupporting

confidence: 94%

Differences in the concentration of anti-SARS-CoV-2 IgG antibodies post-COVID-19 recovery or post-vaccination

Tretyn

Szczepanek

Skorupa

et al. 2021

Preprint

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At the end of 2020, population-based vaccination programs with new generation mRNA-based vaccines began almost all over the world. The aim of the study was to evaluate the titer of anti-SARS-CoV-2 IgG antibodies against the S1 subunit of the virus’s spike protein as a marker of the humoral response in 477 patients and the concentration of gamma interferon as an indicator of a cellular response in 28 individuals. In our studies, we used serological enzyme-linked immunosorbent assays. IgG was measured in weeks 2 and 3 after the first dose and 1–5 weeks after the second dose of an mRNA vaccine in seropositive and seronegative individuals as well as in symptomatic and asymptomatic convalescents. High levels of antibodies were observed in 98% of our vaccinated cohort, and the presence of protective T cells was confirmed in the blood samples of all participants. The humoral immune response is diversified and is visible as early as 2–3 weeks after the first dose of the mRNA vaccine. The level of protection increased significantly after the second dose, with the increase being much greater in pre-vaccine healthy subjects and less in convalescents. In the second and third weeks after the second dose, the concentration of IgG antibodies was the highest, and in the following weeks, it decreased gradually. Regular serological measurements on eight subjects show that antibody titers are lower four months after vaccination than before the second dose.

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Section: Discussionsupporting

confidence: 94%

Differences in the concentration of anti-SARS-CoV-2 IgG antibodies post-COVID-19 recovery or post-vaccination

Tretyn

Szczepanek

Skorupa

et al. 2021

Preprint

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show abstract

“…A small, in itself anecdotal, subset of previously infected subjects who had experienced florid symptomatology and robust responses to the first dose of vaccine experienced a reduction in antibody titers upon receiving the second dose (7). This observation is supported by the characterization of the kinetics of cellular immunity in Mazzoni and Lauria et al (8).…”

Section: More Doses May Not Always Be Bettermentioning

confidence: 81%

“…And, perhaps aided by a virus that initially seemed unusually meek against vaccine strategies of all colors and flavors, numerous immunogens achieved surprisingly high efficacy against mild COVID-19 symptoms in clinical trials (2,3,4,5,6). However, the universality of the problem and the promiscuousness of respiratory transmission, present two important challenges that two separate studies, by Levi and Azzolini et al and Mazzoni and Lauria et al, in this issue of the JCI address: how to protect everyone as soon as possible and, consequently, also decrease the risk for emergence of resistant variants that could send all our efforts back to zero (7,8).…”

Section: Protecting Everyone Against Covid-19 As Soon As Possiblementioning

confidence: 99%

Mounting evidence for immunizing previously infected subjects with a single dose of SARS-CoV-2 vaccine

Marc¹,

Álvarez-Paggi²,

Polack³

2021

Journal of Clinical Investigation

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Efforts to best protect the world from SARS-CoV-2 as variants emerge and despite limited vaccine supply are ongoing. One strategy that may maximize vaccine coverage and expedite immunization campaigns involves providing single mRNA vaccine doses to individuals with previous COVID-19. In this issue of the JCI two independent studies, Levi and Azzolini et al. and Mazzoni and Lauria et al., explored vaccine responses in individuals previously infected with the virus. Levi, Azzolini and colleagues used multilinear regression models to correlate exposure and symptoms, with antibody response to the vaccine. Mazzoni, Lauria and colleagues characterized B cell and T cell kinetics in whole blood after one and two doses of vaccine in health care workers with and without previous infection. Both studies indicate that one vaccine dose may sufficiently protect individuals who have recovered from COVID-19. Implementing a single dose mRNA vaccine protocol in previously symptomatic individuals may facilitate and expedite immunization campaigns.

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“…The first such caveat is that the equivalence between the anti-SARS-CoV-2 antibody levels and vaccine efficacy is not so straightforward, since the role played by cellular immunity and memory B cells cannot be ascertained only through serological testing [58]. Therefore, although cases of SARS-CoV-2 re-infection due to waiving of humoral immunity, VOCs, or both are increasingly reported [59], more research is urgently needed to define (i) the individual protective threshold level of anti-SARS-CoV-2 antibodies below which the humoral defense against different SARS-CoV-2 variants is more likely to fail [60], (ii) whether the memory B cells primed by previous SARS-CoV-2 infection or COVID-19 vaccination can be rapidly reactivated and will be capable of generating an efficient anti-SARS-CoV-2 antibody level [61,62], and (iii) the role of cell-mediated immunity in protecting from SARS-CoV-2 infection and especially in averting the risk of developing severe or critical forms of the disease. Besides the still uncertain relationship with vaccine efficacy, evidence was also published showing that the different commercially available anti-SARS-CoV-2 immunoassays display variable agreement with neutralization tests [63].…”

Section: Potential Drawbacksmentioning

confidence: 99%

Anti-SARS-CoV-2 Antibodies Testing in Recipients of COVID-19 Vaccination: Why, When, and How?

2021

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Although universal vaccination is one of the most important healthcare strategies for limiting SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) circulation and averting the huge number of hospitalizations and deaths due to coronavirus disease 2019 (COVID-19), significant inter-individual variability of COVID-19 vaccines’ efficacies has been described, mostly due to heterogeneous immune response in recipients. This opinion paper hence aims to discuss aspects related to the opportunity of monitoring anti-SARS-CoV-2 antibodies before and after COVID-19 vaccination, highlighting the pros and cons of this strategy. In summary, the advantages of anti-SARS-CoV-2 antibodies’ testing in recipients of COVID-19 vaccination encompass an assessment of baseline seroprevalence of SARS-CoV-2 infection in non-vaccinated individuals; early identification of low or non-responders to COVID-19 vaccination; and timely detection of faster decay of anti-SARS-CoV-2 antibody levels. In contrast, potential drawbacks to date include an unproven equivalence between anti-SARS-CoV-2 antibody titer, neutralizing activity, and vaccine efficiency; the lack of cost-effective analyses of different testing strategies; the enormous volume of blood drawings and increase of laboratory workload that would be needed to support universal anti-SARS-CoV-2 antibodies testing. A potential solution entails the identification of cohorts to be prioritized for testing, including those at higher risk of being infected by variants of concern, those at higher risk of unfavorable disease progression, and subjects in whom vaccine immunogenicity may be expectedly lower and/or shorter.

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First-dose mRNA vaccination is sufficient to reactivate immunological memory to SARS-CoV-2 in subjects who have recovered from COVID-19

Cited by 126 publications

References 24 publications

Differences in the concentration of anti-SARS-CoV-2 IgG antibodies post-COVID-19 recovery or post-vaccination

Differences in the concentration of anti-SARS-CoV-2 IgG antibodies post-COVID-19 recovery or post-vaccination

Mounting evidence for immunizing previously infected subjects with a single dose of SARS-CoV-2 vaccine

Anti-SARS-CoV-2 Antibodies Testing in Recipients of COVID-19 Vaccination: Why, When, and How?

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