tetano
Editor, Senior Moderator
Influenza Other Respir Viruses
. 2026 Aug;20(8):e70300.
doi: 10.1111/irv.70300.
Impact of ABO Blood System on Immunogenicity and Vaccine Efficacy of COVID-19 Booster Vaccination-A Population-Based Study of 3066 Individuals
Daniela Sieghart[SUP] 1 2 [/SUP], Galateja Jordakieva[SUP] 2 3 [/SUP], Caroline Dürrschmid[SUP] 1 2 [/SUP], Claudia A Hana[SUP] 1 2 [/SUP], Lan Vi Tran[SUP] 1 2 [/SUP], Leonhard X Heinz[SUP] 1 2 [/SUP], Helmuth Haslacher[SUP] 4 [/SUP], Markus Zlesak[SUP] 1 2 [/SUP], Valentin Marzoner[SUP] 1 2 [/SUP], Philip Nasztl[SUP] 5 [/SUP], Giulia Piccini[SUP] 6 [/SUP], Alessandro Manenti[SUP] 6 [/SUP], Emanuele Montomoli[SUP] 6 7 [/SUP], Anselm Jorda[SUP] 5 [/SUP], Clemens Fedrizzi[SUP] 5 [/SUP], Timothy Hasenoehrl[SUP] 2 3 [/SUP], Andrej Zdravkovic[SUP] 2 3 [/SUP], Karolina Anderle[SUP] 5 [/SUP], Ursula Wiedermann[SUP] 8 [/SUP], Susanne Drapalik[SUP] 9 [/SUP], Helmut Steinbrecher[SUP] 9 [/SUP], Felix Bergmann[SUP] 5 [/SUP], Christa Firbas[SUP] 5 [/SUP], Barbara Wagner[SUP] 3 [/SUP], Margherita Leonardi[SUP] 6 [/SUP], Giulio Pierleoni[SUP] 6 10 [/SUP], Matilde Ballini[SUP] 6 [/SUP], Linda Benincasa[SUP] 6 [/SUP], Serena Marchi[SUP] 6 7 [/SUP], Claudia Maria Trombetta[SUP] 6 7 [/SUP], Thomas Perkmann[SUP] 4 [/SUP], Richard Crevenna[SUP] 2 3 [/SUP], Markus Zeitlinger[SUP] 5 [/SUP], Michael Bonelli[SUP] 1 2 [/SUP], Daniel Aletaha[SUP] 1 2 [/SUP], Helga Radner[SUP] 1 2 [/SUP]
Affiliations
Background: ABO blood group has been associated with SARS-CoV-2 susceptibility. Little data exist regarding the impact of ABO and Rhesus (Rh[D]) type on breakthrough infections and antibody responses following SARS-CoV-2 booster vaccination.
Methods: This multicenter, population-based cohort study includes individuals ≥ 18 years who received a booster vaccination against SARS-CoV-2. Antibody levels against SARS-CoV-2 receptor binding domain (RBD) and neutralizing antibodies against wild-type (WT) virus and Omicron variant were assessed at baseline, after 4 weeks and after 6 months. At 6 months follow-up, self-reported ABO and Rh(D) type, time to, and severity of breakthrough infections were collected.
Results: In total, 3066 participants (mean age 49 [35-59], 62% female) were included in multivariable regression models, showing no association of anti-RBD and neutralizing antibodies against wild-type and Omicron variant with ABO or Rh(D) 4 weeks after booster vaccination. Time-dependent Cox regression analysis showed significantly lower rates of breakthrough infections in patients with AB (hazard ratio
0.67 [0.50-0.90]; p = 0.008) compared to O, even after adjustment for relevant covariates and a trend for blood group B (HR 0.82 [0.66-1.01]; p = 0.06) compared to O; there were no associations between Rh(D) and breakthrough infection rates or between observed (asymptomatic to moderate) COVID-19 symptom severity and ABO or Rh(D) blood group.
Conclusions: ABO or Rh(D) blood group was not associated with COVID-19 severity or antibody responses following SARS-CoV-2 vaccination. Breakthrough infections were least common in blood groups AB and B. Although our data do not support previously discussed protective effects of anti-A/B/Rh(D) agglutinins, differences in ABO group appear relevant for Omicron transmission.
Keywords: COVID‐19; SARS‐CoV‐2; break‐through infections; mRNA vaccine; omicron type.
. 2026 Aug;20(8):e70300.
doi: 10.1111/irv.70300.
Impact of ABO Blood System on Immunogenicity and Vaccine Efficacy of COVID-19 Booster Vaccination-A Population-Based Study of 3066 Individuals
Daniela Sieghart[SUP] 1 2 [/SUP], Galateja Jordakieva[SUP] 2 3 [/SUP], Caroline Dürrschmid[SUP] 1 2 [/SUP], Claudia A Hana[SUP] 1 2 [/SUP], Lan Vi Tran[SUP] 1 2 [/SUP], Leonhard X Heinz[SUP] 1 2 [/SUP], Helmuth Haslacher[SUP] 4 [/SUP], Markus Zlesak[SUP] 1 2 [/SUP], Valentin Marzoner[SUP] 1 2 [/SUP], Philip Nasztl[SUP] 5 [/SUP], Giulia Piccini[SUP] 6 [/SUP], Alessandro Manenti[SUP] 6 [/SUP], Emanuele Montomoli[SUP] 6 7 [/SUP], Anselm Jorda[SUP] 5 [/SUP], Clemens Fedrizzi[SUP] 5 [/SUP], Timothy Hasenoehrl[SUP] 2 3 [/SUP], Andrej Zdravkovic[SUP] 2 3 [/SUP], Karolina Anderle[SUP] 5 [/SUP], Ursula Wiedermann[SUP] 8 [/SUP], Susanne Drapalik[SUP] 9 [/SUP], Helmut Steinbrecher[SUP] 9 [/SUP], Felix Bergmann[SUP] 5 [/SUP], Christa Firbas[SUP] 5 [/SUP], Barbara Wagner[SUP] 3 [/SUP], Margherita Leonardi[SUP] 6 [/SUP], Giulio Pierleoni[SUP] 6 10 [/SUP], Matilde Ballini[SUP] 6 [/SUP], Linda Benincasa[SUP] 6 [/SUP], Serena Marchi[SUP] 6 7 [/SUP], Claudia Maria Trombetta[SUP] 6 7 [/SUP], Thomas Perkmann[SUP] 4 [/SUP], Richard Crevenna[SUP] 2 3 [/SUP], Markus Zeitlinger[SUP] 5 [/SUP], Michael Bonelli[SUP] 1 2 [/SUP], Daniel Aletaha[SUP] 1 2 [/SUP], Helga Radner[SUP] 1 2 [/SUP]
Affiliations
- PMID: 42524760
- DOI: 10.1111/irv.70300
Background: ABO blood group has been associated with SARS-CoV-2 susceptibility. Little data exist regarding the impact of ABO and Rhesus (Rh[D]) type on breakthrough infections and antibody responses following SARS-CoV-2 booster vaccination.
Methods: This multicenter, population-based cohort study includes individuals ≥ 18 years who received a booster vaccination against SARS-CoV-2. Antibody levels against SARS-CoV-2 receptor binding domain (RBD) and neutralizing antibodies against wild-type (WT) virus and Omicron variant were assessed at baseline, after 4 weeks and after 6 months. At 6 months follow-up, self-reported ABO and Rh(D) type, time to, and severity of breakthrough infections were collected.
Results: In total, 3066 participants (mean age 49 [35-59], 62% female) were included in multivariable regression models, showing no association of anti-RBD and neutralizing antibodies against wild-type and Omicron variant with ABO or Rh(D) 4 weeks after booster vaccination. Time-dependent Cox regression analysis showed significantly lower rates of breakthrough infections in patients with AB (hazard ratio
0.67 [0.50-0.90]; p = 0.008) compared to O, even after adjustment for relevant covariates and a trend for blood group B (HR 0.82 [0.66-1.01]; p = 0.06) compared to O; there were no associations between Rh(D) and breakthrough infection rates or between observed (asymptomatic to moderate) COVID-19 symptom severity and ABO or Rh(D) blood group.
Conclusions: ABO or Rh(D) blood group was not associated with COVID-19 severity or antibody responses following SARS-CoV-2 vaccination. Breakthrough infections were least common in blood groups AB and B. Although our data do not support previously discussed protective effects of anti-A/B/Rh(D) agglutinins, differences in ABO group appear relevant for Omicron transmission.
Keywords: COVID‐19; SARS‐CoV‐2; break‐through infections; mRNA vaccine; omicron type.