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JAMA Netw Open . Serum and Salivary IgG and IgA Response After COVID-19 Messenger RNA Vaccination

tetano

Editor, Senior Moderator
JAMA Netw Open


. 2024 Apr 1;7(4):e248051.
doi: 10.1001/jamanetworkopen.2024.8051. Serum and Salivary IgG and IgA Response After COVID-19 Messenger RNA Vaccination

Guy Gorochov[SUP] 1 [/SUP], Jacques Ropers[SUP] 2 [/SUP], Odile Launay[SUP] 3 [/SUP], Karim Dorgham[SUP] 1 [/SUP], Omaira da Mata-Jardin[SUP] 1 [/SUP], Said Lebbah[SUP] 2 [/SUP], Christine Durier[SUP] 4 [/SUP], Rebecca Bauer[SUP] 4 [/SUP], Anne Radenne[SUP] 5 [/SUP], Corinne Desaint[SUP] 3 [/SUP], Louis-Victorien Vieillard[SUP] 3 [/SUP], Claire Rekacewicz[SUP] 3 [/SUP], Marie Lachatre[SUP] 3 [/SUP], Béatrice Parfait[SUP] 6 [/SUP], Frédéric Batteux[SUP] 7 [/SUP], Philippe Hupé[SUP] 8 9 [/SUP], Läétitia Ninove[SUP] 10 [/SUP], Maeva Lefebvre[SUP] 11 [/SUP], Anne Conrad[SUP] 12 [/SUP], Bertrand Dussol[SUP] 13 [/SUP], Zoha Maakaroun-Vermesse[SUP] 14 [/SUP], Giovanna Melica[SUP] 15 [/SUP], Jean-François Nicolas[SUP] 16 [/SUP], Renaud Verdon[SUP] 17 [/SUP], Jean-Jacques Kiladjian[SUP] 18 [/SUP], Paul Loubet[SUP] 19 [/SUP], Catherine Schmidt-Mutter[SUP] 20 [/SUP], Christian Dualé[SUP] 21 [/SUP], Séverine Ansart[SUP] 22 [/SUP], Elisabeth Botelho-Nevers[SUP] 23 [/SUP], Jean-Daniel Lelièvre[SUP] 24 [/SUP], Xavier de Lamballerie[SUP] 10 [/SUP], Marie-Paule Kieny[SUP] 25 [/SUP], Eric Tartour[SUP] 26 [/SUP], Stéphane Paul[SUP] 27 [/SUP]



Affiliations
Abstract

Importance: There is still considerable controversy in the literature regarding the capacity of intramuscular messenger RNA (mRNA) vaccination to induce a mucosal immune response.
Objective: To compare serum and salivary IgG and IgA levels among mRNA-vaccinated individuals with or without previous SARS-CoV-2 infection.
Design, setting, and participants: In this cohort study, SARS-CoV-2-naive participants and those with previous infection were consecutively included in the CoviCompare P and CoviCompare M mRNA vaccination trials and followed up to day 180 after vaccination with either the BNT162b2 (Pfizer-BioNTech) vaccine or the mRNA-1273 (Moderna) vaccine at the beginning of the COVID-19 vaccination campaign (from February 19 to June 8, 2021) in France. Data were analyzed from October 25, 2022, to July 13, 2023.
Main outcomes and measures: An ultrasensitive digital enzyme-linked immunosorbent assay was used for the comparison of SARS-CoV-2 spike-specific serum and salivary IgG and IgA levels. Spike-specific secretory IgA level was also quantified at selected times.
Results: A total of 427 individuals were included in 3 groups: participants with SARS-CoV-2 prior to vaccination who received 1 single dose of BNT162b2 (Pfizer-BioNTech) (n = 120) and SARS-CoV-2-naive individuals who received 2 doses of mRNA-1273 (Moderna) (n = 172) or 2 doses of BNT162b2 (Pfizer-BioNTech) (n = 135). The median age was 68 (IQR, 39-75) years, and 228 (53.4%) were men. SARS-CoV-2 spike-specific IgG saliva levels increased after 1 or 2 vaccine injections in individuals with previous infection and SARS-CoV-2-naive individuals. After vaccination, SARS-CoV-2-specific saliva IgA levels, normalized with respect to total IgA levels, were significantly higher in participants with previous infection, as compared with the most responsive mRNA-1273 (Moderna) recipients (median normalized levels, 155 × 10-5 vs 37 × 10-5 at day 29; 107 × 10-5 vs 54 × 10-5 at day 57; and 104 × 10-5 vs 70 × 10-5 at day 180 [P < .001]). In contrast, compared with day 1, spike-specific IgA levels in the BNT162b2-vaccinated SARS-CoV-2-naive group increased only at day 57 (36 × 10-5 vs 49 × 10-5 [P = .01]). Bona fide multimeric secretory IgA levels were significantly higher in individuals with previous infection compared with SARS-CoV-2-naive individuals after 2 antigenic stimulations (median optical density, 0.36 [IQR, 0.16-0.63] vs 0.16 [IQR, 0.10-0.22]; P < .001).
Conclusions and relevance: The findings of this cohort study suggest that mRNA vaccination was associated with mucosal immunity in individuals without prior SARS-CoV-2 infection, but at much lower levels than in previously infected individuals. Further studies are needed to determine the association between specific saliva IgA levels and prevention of infection or transmission.


 
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