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J Med Virol . Early humoral and cellular responses after bivalent SARS-CoV-2 mRNA-1273.214 vaccination in long-term care and retirement home reside

tetano

Editor, Senior Moderator
J Med Virol


. 2023 Oct;95(10):e29170.
doi: 10.1002/jmv.29170. Early humoral and cellular responses after bivalent SARS-CoV-2 mRNA-1273.214 vaccination in long-term care and retirement home residents in Ontario, Canada: An observational cohort study

Jessica A Breznik[SUP] 1 2 [/SUP], Ahmad Rahim[SUP] 3 [/SUP], Hina Bhakta[SUP] 4 [/SUP], Rumi Clare[SUP] 4 [/SUP], Ali Zhang[SUP] 1 4 [/SUP], Jann Ang[SUP] 1 4 [/SUP], Hannah D Stacey[SUP] 1 4 [/SUP], Li-Min Liu[SUP] 1 2 [/SUP], Allison Kennedy[SUP] 1 2 [/SUP], Lucas Bilaver[SUP] 1 2 [/SUP], Megan Hagerman[SUP] 1 2 [/SUP], Tara Kajaks[SUP] 3 [/SUP], Jonathan L Bramson[SUP] 1 2 [/SUP], Ishac Nazy[SUP] 4 [/SUP], Matthew S Miller[SUP] 1 4 [/SUP], Andrew P Costa[SUP] 3 5 [/SUP], Dawn M E Bowdish[SUP] 1 2 6 [/SUP]; COVID in LTC Investigator Group



Affiliations
Abstract

Immunogenicity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) bivalent mRNA-1273.214 vaccine (Original/Omicron B.1.1.529 [BA.1]) is underreported in vulnerable older adults in congregate care settings. In residents of 26 long-term care and retirement homes in Ontario, Canada, humoral (i.e., serum anti-spike and anti-receptor binding domain [anti-RBD]) IgG and IgA antibodies and live SARS-CoV-2 neutralization) and cellular (i.e., CD4[SUP]+[/SUP] and CD8[SUP]+[/SUP] activation-induced marker spike-specific T cell memory) responses were assessed 7-120 days postvaccination with four monovalent mRNA vaccines (n = 494) or subsequent bivalent mRNA-1273.214 vaccination (fifth vaccine) (n = 557). Within 4 months, anti-spike and anti-RBD antibody levels were similar after monovalent and bivalent vaccination in infection-naïve individuals. Hybrid immunity (i.e., vaccination and natural infection) generally increased humoral responses. After bivalent vaccination, compared to monovalent vaccination, residents with hybrid immunity had elevated anti-spike and anti-RBD IgG and IgA antibodies. Omicron BA.1 antibody-mediated neutralization, and CD8[SUP]+[/SUP] T cell memory responses to the Omicron BA.1 spike protein, were also higher after bivalent vaccination. Humoral and cellular responses were, therefore, noninferior within 4 months of bivalent mRNA-1273.214 vaccination compared to monovalent mRNA vaccination. Waning of humoral but not cellular immunity was particularly evident in individuals without hybrid immunity. Continued monitoring of vaccine-associated and hybrid immunity against emerging Omicron variants of concern is necessary to assess longevity of protection.

Keywords: COVID-19; SARS-CoV-2; bivalent mRNA vaccines; humoral immunity; older adults; vaccine immunogenicity.

 
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