Pre-Existing Comorbidities Diminish the Likelihood of Seropositivity After SARS-CoV-2 Vaccination

Abstract

Background: The impact of chronic health conditions (CHC) on serostatus post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is unknown. Methods: We assessed serostatus post-SARS-CoV-2 vaccination among fully vaccinated participants recruited between April 2021 through August 2021 in 18 years and older residents of Jefferson County, Kentucky, USA. Serostatus was determined by measuring SARS-CoV-2 Spike protein specific immunoglobulin (Ig) G (Spike IgG) antibodies via enzyme-linked immunoassay (ELISA) in peripheral blood samples. Results: Of the 5,178 fully vaccinated participants, 51 were seronegative and 5,127 were seropositive. Chronic kidney disease (CKD) (OR=13.49; 95% CI: 4.88, 37.3; P<0.0001) and autoimmune disease (OR=11.34; 95% CI: 5.21, 24.69; P<0.0001) showed highest association with negative serostatus in fully vaccinated participants. The absence of any CHC was strongly associated with positive serostatus (OR=0.37; 95% CI: 0.19, 0.73; P=0.003). The risk of negative serostatus increased in the presence of two CHCs (OR=2.82; 95% CI: 1.14, 7) to three or more CHCs (OR=4.52; 95% CI: 1.68, 12.14). Similarly, use of 2 or more CHC related medications was significantly associated with seronegative status (OR=6.08; 95%: 2.01, 18.35). Conclusions: Presence of any CHC, especially CKD or autoimmune disease, increased the likelihood of seronegative status among individuals who were fully vaccinated to SAR-CoV-2. This risk increased with a concurrent increase in number of comorbidities, especially with multiple medications. Absence of any CHC was protective and increased the likelihood of a positive serological response post-vaccination. These results will help develop appropriate guidelines for booster doses and targeted vaccination programs.

Effectiveness of Coronavac and ChAdOx1 COVID-19 vaccines against severe illness in Thailand: A retrospective cohort study

“…Partial vaccination with ChAdOx1 nCoV-19 had the lowest protective effects against severe illness. The low protection was mostly likely due to the prioritized targets of ChAdOx1 nCoV-19, which were vulnerable groups; thus, the VE might be reduced by aged and underlying diseases [20,24,25]. By focusing on vulnerable groups that are at risk for severe COVID-19, the VE of one-dose vaccination for preventing severe outcomes in older people and people with pre-existing conditions were 68.3% and 57.8%, respectively, which might not be su cient protection [26].…”

Using SARS-CoV-2 Antibody Testing in COVID-19 Research

“…In fact, individuals with pre-existing chronic health conditions have a multifold higher likelihood of being seronegative (absence of Spike IgG) even after completing full vaccination regimen. 9 Third, seroconversion timeline is not uniform across all individuals. Although public health guidelines recommend a minimum 14-day incubation period after final vaccination dose or infection diagnosis for developing measurable antibody levels, there are multiple reports of individuals seroconverting well after that timeframe.…”