Reduced BNT162b2 Messenger RNA Vaccine Response in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)–Naive Nursing Home Residents

Abstract

After BNT162b2 mRNA vaccination, antibody levels to spike, receptor binding domain (RBD) and virus neutralization were examined in 149 nursing home (NH) residents and 110 health care worker controls. SARS-CoV-2-naive NH residents median post-2nd vaccine dose antibody neutralization titers are ¼ that of SARS-CoV-2-naive healthcare workers.

Does a lack of vaccine side effects correlate with reduced BNT162b2 mRNA vaccine response among healthcare workers and nursing home residents?

“…Differences in reactions to the two doses, overall and within subgroups, were assessed using McNemar's test for paired dichotomous data. To examine the relationship between reactogenicity and antibody levels, we estimated ordinary least squares linear models predicting log-transformed anti-spike, anti-RBD, and neutralizing titers, controlling for NH vs. control, gender, age, prior SARS-CoV-2 infection, and the interaction of prior SARS-CoV-2 infection and age, based on prior findings [24]. We included a dichotomous variable indicating the presence or absence of any reported reactions.…”

“…Stabilized full-length S protein (aa 16-1230, with furin site mutated) and RBD (aa 319-541) were conjugated to magnetic microbeads (Luminex) and Magpix assay system (BioRad, Inc), the mean fluorescent index is recorded after antigen-specific IgG is detected in patient serum/plasma using PE-conjugated Donkey F(ab)2 anti-human IgG, with Fcγ (Jackson Immunological). Relative antibody units were then ascribed from an internal standard control convalescent serum as previously described [24].…”

“…Using estimated linear regression models predicting log-transformed anti-spike, anti-RBD, and neutralizing titers, we examined the relationship between reactogenicity and antibody levels. Based on earlier findings in this cohort [24], we adjusted for age, prior SARS-CoV-2 infection, and their interaction in the model in addition to gender and NH/control. To these variables, we added a dichotomous variable indicating the presence or absence of any reported reactions.…”

Significant reduction in humoral immunity among healthcare workers and nursing home residents 6 months after COVID-19 BNT162b2 mRNA vaccination

“…In the US, most NH residents received BNT162b2 mRNA vaccination both because of its earlier approval under the Emergency Use Authorization (EUA) and availability compared to other candidate SARS-CoV-2 vaccines. Fully vaccinated NH residents produced about ¼ the antibody to this vaccine than healthy younger comparison populations [1,2]. With the rise of breakthrough infections in NH residents and others with immunocompromise, there is a significant need for characterization of the durability of immunity to inform public health policy.…”

“…We report on 2-week and 6-month post-vaccination antibody levels from 120 NH residents (age range 48-100, median 76) and 92 ambulatory healthcare worker controls (age range 26-78, median 48) with and without pre-vaccination SARS-CoV-2 infection. We assessed anti-spike and anti-receptor binding domain (RBD) IgG, and serum neutralization titers, using a bead-based ELISA method and pseudovirus neutralization assay [1,3]. Anti-spike, anti-RBD and neutralization geometric mean levels dropped more than 80% over 6 months' time in all groups (Fig.…”