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Clin Infect Dis . SARS-CoV-2 infection history and antibody response to three COVID-19 mRNA vaccine doses

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2022 Dec 29;ciac976.
doi: 10.1093/cid/ciac976. Online ahead of print.
SARS-CoV-2 infection history and antibody response to three COVID-19 mRNA vaccine doses


Meghan K Herring[SUP] 1 [/SUP], James K Romine[SUP] 2 [/SUP], Meredith G Wesley[SUP] 1 [/SUP], Katherine D Ellingson[SUP] 2 [/SUP], Sarang K Yoon[SUP] 3 [/SUP], Alberto J Caban-Martinez[SUP] 4 [/SUP], Jennifer Meece[SUP] 5 [/SUP], Manjusha Gaglani[SUP] 6 7 [/SUP], Lauren Grant[SUP] 8 [/SUP], Lauren E W Olsho[SUP] 1 [/SUP], Harmony L Tyner[SUP] 9 [/SUP], Allison L Naleway[SUP] 10 [/SUP], Sana M Khan[SUP] 2 [/SUP], Andrew L Phillips[SUP] 3 [/SUP], Natasha Schaefer Solle[SUP] 4 [/SUP], Spencer Rose[SUP] 6 [/SUP], Josephine Mak[SUP] 8 [/SUP], Sammantha B Fuller[SUP] 1 [/SUP], Angela Hunt[SUP] 9 [/SUP], Jennifer L Kuntz[SUP] 10 [/SUP], Shawn Beitel[SUP] 2 [/SUP], Young M Yoo[SUP] 8 [/SUP], Pearl Q Zheng[SUP] 1 [/SUP], Gayatri Arani[SUP] 2 [/SUP], Julie Mayo Lamberte[SUP] 8 [/SUP], Taylor Edwards[SUP] 11 [/SUP], Mark G Thompson[SUP] 8 [/SUP], Ryan Sprissler[SUP] 11 [/SUP], Natalie J Thornburg[SUP] 8 [/SUP], Ashley A Lowe[SUP] 2 [/SUP], Tamara Pilishvili[SUP] 8 [/SUP], Jennifer L Uhrlaub[SUP] 2 [/SUP], Karen Lutrick[SUP] 12 [/SUP], Jefferey L Burgess[SUP] 2 [/SUP], Ashley L Fowlkes[SUP] 8 [/SUP]



Affiliations

Abstract

Background: Three doses of coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines produce robust antibody responses, but data are limited among individuals previously infected with SARS-CoV-2. From a cohort of health care personnel (75.5%), first responders (4.6%), and other frontline workers (19.8%) in 6 US states, we longitudinally assessed antibody waning after dose-2, and response to dose-3, according to SARS-CoV-2 infection history.
Methods: Participants submitted sera every three months, after SARS-CoV-2 infection, and after each COVID-19 vaccine dose. Sera were tested for antibodies and reported quantitatively as area under the serial dilution curve (AUC). Changes in the AUC values over time were compared as fold-changes using a linear mixed model.
Results: Analysis included 388 participants who received dose-3 by November 2021. Three comparison groups: (1) vaccine only with no known prior SARS-CoV-2 infection (n = 224); (2) infection prior to dose-1 (n = 123); and (3) infection after dose 2 and before dose-3 (n = 41). The interval from dose 2 and dose 3 was approximately 8-months. After dose-3, antibody levels rose 2.5-fold (95%CI = 2.2-3.0) in group 2, and 2.9-fold (95%CI = 2.6-3.3) in group 1. Those infected within 90 days before dose-3 (and median 233 days (IQR = 213-246) after dose-2) did not increase significantly after dose-3.
Conclusions: A third dose of mRNA vaccine typically elicited a robust humoral immune response among those with primary vaccination regardless of SARS-CoV-2 infection >3 months prior to boosting. Those with infection < 3 months prior to boosting did not have a significant increase in antibody concentrations in response to a booster.

Keywords: COVID-19; antibody kinetics; antibody response; booster; mRNA vaccine.
 
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