Immunogenicity of the BNT162b2 vaccine in frail or disabled nursing home residents: COVID‐A study

Abstract

Background/Objectives The safety and immunogenicity of the BNT162b2 coronavirus disease 2019 (COVID‐19) vaccine in older adults with different frailty and disability profiles have not been well determined. Our objective was to analyze immunogenicity of the BNT162b2 mRNA COVID‐19 vaccine in older adults across frailty and disability profiles. Design Multicenter longitudinal cohort study. Setting and participants A total of 134 residents aged ≥65 years with different frailty and disability profiles in five long‐term care facilities (LTCFs) in Albacete, Spain. Intervention and measurements Residents were administered two vaccine doses as per the label, and antibody levels were determined 21.9 days (SD 9.3) after both the first and second dose. Functional variables were assessed using activities of daily living (Barthel Index), and frailty status was determined with the FRAIL instrument. Cognitive status and comorbidity were also evaluated. Results Mean age was 82.9 years (range 65–99), and 71.6% were female. The mean antibody titers in residents with and without previous COVID‐19 infection were 49,878 AU/ml and 15,274 AU/ml, respectively (mean difference 34,604; 95% confidence interval [CI]: 27,699–41,509). No severe adverse reactions were observed, after either vaccine dose. Those with prevaccination COVID‐19 had an increased antibody level after the vaccine (B = 31,337; 95% CI: 22,725–39,950; p < 0.001). Frailty, disability, older age, sex, cognitive impairment, or comorbidities were not associated with different antibody titers. Conclusions The BNT162b2 mRNA COVID‐19 vaccine in older adults is safe and produces immunogenicity, independently of the frailty and disability profiles. Older adults in LTCFs should receive a COVID‐19 vaccine.

Anti-SARS-CoV-2 Receptor-Binding Domain Total Antibodies Response in Seropositive and Seronegative Healthcare Workers Undergoing COVID-19 mRNA BNT162b2 Vaccination

“…It seems now almost indisputable that universal COVID-19 vaccination will be the keystone in all strategies aimed at stopping or limiting the worldwide circulation of SARS-CoV-2. Nonetheless, although the efficacy of most currently licensed vaccines appears considerably high, especially at reducing the risk of clinical deterioration [15], a considerable inter-individual heterogeneity in post-vaccine immune response is being increasingly noted in some specific populations, especially in the elderly [16] and in immunosuppressed patients [17,18]. Unfortunately, low vaccine responders mostly include categories of frail patients, who already have a magnified risk of unfavorable disease progression if contracting SARS-CoV-2 [19].…”

Sero-survey on Long-term Care Facility Residents Reveals Increased Risk of Sub-optimal Antibody Response to BNT162B2: Implications for Breakthrough Prevention

“…Several papers addressed the efficacy of different SARS-CoV-2 vaccines either through Phase II and III of clinical trials [18][19][20] or field investigations [9][10][11]. Few of them detailed data regarding elderly and persons living in nurse facility [12][13][14][15] and outbreaks after the first and second dose were reported [21][22][23]. At present, cohorts <16 years or >80 years who might show reduced vaccine reactiveness are limited.…”

“…Several reports indicate that vaccination of old age is showing to protect from severe disease, and risk of death by conferring a degree of humoral immunity [9][10][11][12][13][14][15].…”

Fundamental and Advanced Therapies, Vaccine Development against SARS-CoV-2

“…However, the efficacy of these human vaccines in these patients is questionable [ 173 ]. The BNT162b2 vaccine was shown to be effective and safe in a study of 134 patients and older adults with various frailty and disability profiles, providing protection regardless of their condition [ 174 ]. On the other hand, several studies have found lower levels of antibodies in patients with multiple myeloma after the first dose of this vaccine than in the vaccine trials [ 175 , 176 ].…”