Slow Waning of Antibodies Following BNT162b2 as a Third Dose in Adults Who Had Previously Received 2 Doses of Inactivated Vaccine

Cowling, Benjamin J.; Cheng, Samuel; Martín-Sánchez, Mario; Au, Niki Y. M.; Chan, Ka‐Kui; Li, John K C; Fung, Lison W C; Luk, Leo L. H.; Tsang, Leo C. H.; Ip, Dennis Kai Ming; Poon, Leo L M; Leung, Gabriel M.; Peiris, J S Malik; Leung, Nancy

doi:10.1093/infdis/jiac380

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…In individuals vaccinated with a primary series of inactivated vaccine, a homologous booster enhances neutralizing antibody responses to BA.1, but to a lesser extent than heterologous mRNA vaccine boosters ( 44 – 47 ). Neutralizing antibody responses to BA.1 and BA.2 after original mRNA vaccine booster dosing have been shown to decline over time, reaching low levels at 4–6 months post-booster ( 48 , 49 ). The rate of neutralizing antibody decay seems to be similar to that of wild-type SARS-CoV-2 ( 48 ).…”

Section: Characteristics Of Omicron B11529 and Sub-lineagesmentioning

confidence: 99%

“…Evidence suggests that hybrid immunity (vaccine-induced immunity in individuals who have also been infected) after a primary series of inactivated vaccine plus single original mRNA vaccine booster may generate higher neutralizing antibody responses to BA.2 than a second booster of either original mRNA or inactivated vaccine in individuals without previous infection ( 49 ).…”

Section: Characteristics Of Omicron B11529 and Sub-lineagesmentioning

confidence: 99%

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SARS-CoV-2 Omicron variants: burden of disease, impact on vaccine effectiveness and need for variant-adapted vaccines

et al. 2023

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The highly transmissible Omicron (B.1.1.529) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in late 2021. Initial Omicron waves were primarily made up of sub-lineages BA.1 and/or BA.2, BA.4, and BA.5 subsequently became dominant in mid-2022, and several descendants of these sub-lineages have since emerged. Omicron infections have generally caused less severe disease on average than those caused by earlier variants of concern in healthy adult populations, at least, in part, due to increased population immunity. Nevertheless, healthcare systems in many countries, particularly those with low population immunity, have been overwhelmed by unprecedented surges in disease prevalence during Omicron waves. Pediatric admissions were also higher during Omicron waves compared with waves of previous variants of concern. All Omicron sub-lineages exhibit partial escape from wild-type (Wuhan-Hu 1) spike-based vaccine-elicited neutralizing antibodies, with sub-lineages with more enhanced immuno-evasive properties emerging over time. Evaluating vaccine effectiveness (VE) against Omicron sub-lineages has become challenging against a complex background of varying vaccine coverage, vaccine platforms, prior infection rates, and hybrid immunity. Original messenger RNA vaccine booster doses substantially improved VE against BA.1 or BA.2 symptomatic disease. However, protection against symptomatic disease waned, with reductions detected from 2 months after booster administration. While original vaccine-elicited CD8+ and CD4+ T-cell responses cross-recognize Omicron sub-lineages, thereby retaining protection against severe outcomes, variant-adapted vaccines are required to expand the breadth of B-cell responses and improve durability of protection. Variant-adapted vaccines were rolled out in late 2022 to increase overall protection against symptomatic and severe infections caused by Omicron sub-lineages and antigenically aligned variants with enhanced immune escape mechanisms.

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Section: Characteristics Of Omicron B11529 and Sub-lineagesmentioning

confidence: 99%

Section: Characteristics Of Omicron B11529 and Sub-lineagesmentioning

confidence: 99%

SARS-CoV-2 Omicron variants: burden of disease, impact on vaccine effectiveness and need for variant-adapted vaccines

et al. 2023

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“…We established a trial to investigate the strength and durability of antibody responses to a heterologous third dose of BNT162b2 (BioNTech/Fosun Pharma/Pfizer) in adults ≥30 years of age who initially received two doses of an inactivated vaccine. We previously reported initial antibody responses to the third dose of BNT162b2 [5] and durability for up to six months [6], and here we report further data up to 12 months after receipt of the third dose and investigate the effect of Omicron infections and fourth doses on antibody levels.…”

Section: Introductionmentioning

confidence: 54%

Durability for 12 months of antibody response to a booster dose of monovalent BNT162b2 in adults who had initially received 2 doses of inactivated vaccine

Shiu,

Cheng,

Martín-Sánchez

et al. 2023

Preprint

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We administered BNT162b2 as a third dose to 314 adults ≥30 years of age who had previously received 2 doses of inactivated vaccine. We collected blood samples before the third dose and again after 1, 6 and 12 months, and found stable levels of antibody responses to the ancestral strain and Omicron BA.2 at 6-12 months after receipt of the BNT162b2 third dose, with increased antibody levels in individuals who also received a fourth vaccine dose or reported a SARS-CoV-2 infection during follow-up.

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“…But even studying neutralization titers takes time; very few longitudinal studies with data against Omicron subvariants other than for BA.1 were available at the time of this review, and increasing immune escape from post-vaccination neutralizing antibody responses resulting in large proportions of participants with undetectable titers makes them difficult to evaluate, especially in infection-naïve cohorts post-primary vaccination. Indeed, available studies for newer sub-variants provide contradictory results with some observing increased rates of waning against Omicron sub-variants compared to the Index variant 22 , 23 , some finding similar rates of waning 18 , 24 , 25 , and others reporting lower rates 26 , 27 . More evidence is needed to determine if waning of post-vaccination neutralizing antibody titers cross-reactive to newer Omicron subvariants differs from those reactive to the Index variant or to Omicron BA.1.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of the factors affecting waning of post-vaccination neutralizing antibody responses against SARS-CoV-2

Jacobsen,

Sitaras,

Katzmarzyk

et al. 2023

npj Vaccines

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Mass COVID-19 vaccination and continued introduction of new SARS-CoV-2 variants increased prevalence of hybrid immunity at various stages of waning protection. We systematically reviewed waning of post-vaccination neutralizing antibody titers in different immunological settings to investigate differences. We searched published and pre-print studies providing post-vaccination neutralizing antibody responses against the Index strain or Omicron BA.1. We used random effects meta-regression to estimate fold-reduction from months 1 to 6 post last dose by primary vs booster regimen and infection-naïve vs hybrid-immune cohorts. Among 26 eligible studies, 65 cohorts (range 3–21 per stratum) were identified. Month-1 titers varied widely across studies within each cohort and by vaccine platform, number of doses and number of prior infections. In infection-naïve cohorts, the Index strain waned 5.1-fold (95%CI: 3.4–7.8; n = 19 cohorts) post-primary regimen and 3.8-fold (95%CI: 2.4–5.9; n = 21) post-booster from months 1 to 6, and against Omicron BA.1 waned 5.9-fold (95%CI: 3.8–9.0; n = 16) post-booster; Omicron BA.1 titers post-primary were too low to assess. In hybrid-immune, post-primary cohorts, titers waned 3.7-fold (95%CI: 1.7–7.9; n = 8) against the Index strain and 5.0-fold (95%CI: 1.1–21.8; n = 6) against Omicron BA.1; post-booster studies of hybrid-immune cohorts were too few (n = 3 cohorts each strain) to assess. Waning was similar across vaccination regimen and prior-infection status strata but was faster for Omicron BA.1 than Index strains, therefore, more recent sub-variants should be monitored. Wide differences in peak titers by vaccine platform and prior infection status mean titers drop to non-protective levels sooner in some instances, which may affect policy.

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Slow Waning of Antibodies Following BNT162b2 as a Third Dose in Adults Who Had Previously Received 2 Doses of Inactivated Vaccine

Cited by 7 publications

References 13 publications

SARS-CoV-2 Omicron variants: burden of disease, impact on vaccine effectiveness and need for variant-adapted vaccines

SARS-CoV-2 Omicron variants: burden of disease, impact on vaccine effectiveness and need for variant-adapted vaccines

Durability for 12 months of antibody response to a booster dose of monovalent BNT162b2 in adults who had initially received 2 doses of inactivated vaccine

Systematic review and meta-analysis of the factors affecting waning of post-vaccination neutralizing antibody responses against SARS-CoV-2

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