tetano
Editor, Senior Moderator
Med (N Y)
. 2023 Feb 16;S2666-6340(23)00064-8.
doi: 10.1016/j.medj.2023.02.004. Online ahead of print.
Evolution of long-term vaccine-induced and hybrid immunity in healthcare workers after different COVID-19 vaccine regimens
Shona C Moore[SUP] 1 [/SUP], Barbara Kronsteiner[SUP] 2 [/SUP], Stephanie Longet[SUP] 3 [/SUP], Sandra Adele[SUP] 2 [/SUP], Alexandra S Deeks[SUP] 4 [/SUP], Chang Liu[SUP] 5 [/SUP], Wanwisa Dejnirattisai[SUP] 6 [/SUP], Laura Silva Reyes[SUP] 7 [/SUP], Naomi Meardon[SUP] 8 [/SUP], Sian Faustini[SUP] 9 [/SUP], Saly Al-Taei[SUP] 9 [/SUP], Tom Tipton[SUP] 3 [/SUP], Luisa M Hering[SUP] 1 [/SUP], Adrienn Angyal[SUP] 10 [/SUP], Rebecca Brown[SUP] 10 [/SUP], Alexander R Nicols[SUP] 11 [/SUP], Susan L Dobson[SUP] 1 [/SUP], Piyada Supasa[SUP] 12 [/SUP], Aekkachai Tuekprakhon[SUP] 12 [/SUP], Andrew Cross[SUP] 13 [/SUP], Jessica K Tyerman[SUP] 11 [/SUP], Hailey Hornsby[SUP] 10 [/SUP], Irina Grouneva[SUP] 10 [/SUP], Megan Plowright[SUP] 14 [/SUP], Peijun Zhang[SUP] 10 [/SUP], Thomas A H Newman[SUP] 14 [/SUP], Jeremy M Nell[SUP] 15 [/SUP], Priyanka Abraham[SUP] 2 [/SUP], Mohammad Ali[SUP] 2 [/SUP], Tom Malone[SUP] 16 [/SUP], Isabel Neale[SUP] 2 [/SUP], Eloise Phillips[SUP] 16 [/SUP], Joseph D Wilson[SUP] 17 [/SUP], Sam M Murray[SUP] 16 [/SUP], Martha Zewdie[SUP] 16 [/SUP], Adrian Shields[SUP] 18 [/SUP], Emily C Horner[SUP] 19 [/SUP], Lucy H Booth[SUP] 19 [/SUP], Lizzie Stafford[SUP] 12 [/SUP], Sagida Bibi[SUP] 7 [/SUP], Daniel G Wootton[SUP] 20 [/SUP], Alexander J Mentzer[SUP] 21 [/SUP], Christopher P Conlon[SUP] 22 [/SUP], Katie Jeffery[SUP] 23 [/SUP], Philippa C Matthews[SUP] 24 [/SUP], Andrew J Pollard[SUP] 25 [/SUP], Anthony Brown[SUP] 16 [/SUP], Sarah L Rowland-Jones[SUP] 14 [/SUP], Juthathip Mongkolsapaya[SUP] 5 [/SUP], Rebecca P Payne[SUP] 11 [/SUP], Christina Dold[SUP] 26 [/SUP], Teresa Lambe[SUP] 27 [/SUP], James E D Thaventhiran[SUP] 19 [/SUP], Gavin Screaton[SUP] 5 [/SUP], Eleanor Barnes[SUP] 28 [/SUP], Susan Hopkins[SUP] 29 [/SUP], Victoria Hall[SUP] 30 [/SUP], Christopher J A Duncan[SUP] 31 [/SUP], Alex Richter[SUP] 18 [/SUP], Miles Carroll[SUP] 3 [/SUP], Thushan I de Silva[SUP] 14 [/SUP], Paul Klenerman[SUP] 32 [/SUP], Susanna Dunachie[SUP] 33 [/SUP], Lance Turtle[SUP] 34 [/SUP]; PITCH Consortium
Affiliations
Abstract
Background: Both infection and vaccination, alone or in combination, generate antibody and T cell responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the maintenance of such responses-and hence protection from disease-requires careful characterization. In a large prospective study of UK healthcare workers (HCWs) (Protective Immunity from T Cells in Healthcare Workers [PITCH], within the larger SARS-CoV-2 Immunity and Reinfection Evaluation [SIREN] study), we previously observed that prior infection strongly affected subsequent cellular and humoral immunity induced after long and short dosing intervals of BNT162b2 (Pfizer/BioNTech) vaccination.
Methods: Here, we report longer follow-up of 684 HCWs in this cohort over 6-9 months following two doses of BNT162b2 or AZD1222 (Oxford/AstraZeneca) vaccination and up to 6 months following a subsequent mRNA booster vaccination.
Findings: We make three observations: first, the dynamics of humoral and cellular responses differ; binding and neutralizing antibodies declined, whereas T and memory B cell responses were maintained after the second vaccine dose. Second, vaccine boosting restored immunoglobulin (Ig) G levels; broadened neutralizing activity against variants of concern, including Omicron BA.1, BA.2, and BA.5; and boosted T cell responses above the 6-month level after dose 2. Third, prior infection maintained its impact driving larger and broader T cell responses compared with never-infected people, a feature maintained until 6 months after the third dose.
Conclusions: Broadly cross-reactive T cell responses are well maintained over time-especially in those with combined vaccine and infection-induced immunity ("hybrid" immunity)-and may contribute to continued protection against severe disease.
Funding: Department for Health and Social Care, Medical Research Council.
Keywords: COVID vaccine; COVID-19; SARS-CoV-2; T cells; Translation to population health; antibody; immunity.
. 2023 Feb 16;S2666-6340(23)00064-8.
doi: 10.1016/j.medj.2023.02.004. Online ahead of print.
Evolution of long-term vaccine-induced and hybrid immunity in healthcare workers after different COVID-19 vaccine regimens
Shona C Moore[SUP] 1 [/SUP], Barbara Kronsteiner[SUP] 2 [/SUP], Stephanie Longet[SUP] 3 [/SUP], Sandra Adele[SUP] 2 [/SUP], Alexandra S Deeks[SUP] 4 [/SUP], Chang Liu[SUP] 5 [/SUP], Wanwisa Dejnirattisai[SUP] 6 [/SUP], Laura Silva Reyes[SUP] 7 [/SUP], Naomi Meardon[SUP] 8 [/SUP], Sian Faustini[SUP] 9 [/SUP], Saly Al-Taei[SUP] 9 [/SUP], Tom Tipton[SUP] 3 [/SUP], Luisa M Hering[SUP] 1 [/SUP], Adrienn Angyal[SUP] 10 [/SUP], Rebecca Brown[SUP] 10 [/SUP], Alexander R Nicols[SUP] 11 [/SUP], Susan L Dobson[SUP] 1 [/SUP], Piyada Supasa[SUP] 12 [/SUP], Aekkachai Tuekprakhon[SUP] 12 [/SUP], Andrew Cross[SUP] 13 [/SUP], Jessica K Tyerman[SUP] 11 [/SUP], Hailey Hornsby[SUP] 10 [/SUP], Irina Grouneva[SUP] 10 [/SUP], Megan Plowright[SUP] 14 [/SUP], Peijun Zhang[SUP] 10 [/SUP], Thomas A H Newman[SUP] 14 [/SUP], Jeremy M Nell[SUP] 15 [/SUP], Priyanka Abraham[SUP] 2 [/SUP], Mohammad Ali[SUP] 2 [/SUP], Tom Malone[SUP] 16 [/SUP], Isabel Neale[SUP] 2 [/SUP], Eloise Phillips[SUP] 16 [/SUP], Joseph D Wilson[SUP] 17 [/SUP], Sam M Murray[SUP] 16 [/SUP], Martha Zewdie[SUP] 16 [/SUP], Adrian Shields[SUP] 18 [/SUP], Emily C Horner[SUP] 19 [/SUP], Lucy H Booth[SUP] 19 [/SUP], Lizzie Stafford[SUP] 12 [/SUP], Sagida Bibi[SUP] 7 [/SUP], Daniel G Wootton[SUP] 20 [/SUP], Alexander J Mentzer[SUP] 21 [/SUP], Christopher P Conlon[SUP] 22 [/SUP], Katie Jeffery[SUP] 23 [/SUP], Philippa C Matthews[SUP] 24 [/SUP], Andrew J Pollard[SUP] 25 [/SUP], Anthony Brown[SUP] 16 [/SUP], Sarah L Rowland-Jones[SUP] 14 [/SUP], Juthathip Mongkolsapaya[SUP] 5 [/SUP], Rebecca P Payne[SUP] 11 [/SUP], Christina Dold[SUP] 26 [/SUP], Teresa Lambe[SUP] 27 [/SUP], James E D Thaventhiran[SUP] 19 [/SUP], Gavin Screaton[SUP] 5 [/SUP], Eleanor Barnes[SUP] 28 [/SUP], Susan Hopkins[SUP] 29 [/SUP], Victoria Hall[SUP] 30 [/SUP], Christopher J A Duncan[SUP] 31 [/SUP], Alex Richter[SUP] 18 [/SUP], Miles Carroll[SUP] 3 [/SUP], Thushan I de Silva[SUP] 14 [/SUP], Paul Klenerman[SUP] 32 [/SUP], Susanna Dunachie[SUP] 33 [/SUP], Lance Turtle[SUP] 34 [/SUP]; PITCH Consortium
Affiliations
- PMID: 36863347
- DOI: 10.1016/j.medj.2023.02.004
Abstract
Background: Both infection and vaccination, alone or in combination, generate antibody and T cell responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the maintenance of such responses-and hence protection from disease-requires careful characterization. In a large prospective study of UK healthcare workers (HCWs) (Protective Immunity from T Cells in Healthcare Workers [PITCH], within the larger SARS-CoV-2 Immunity and Reinfection Evaluation [SIREN] study), we previously observed that prior infection strongly affected subsequent cellular and humoral immunity induced after long and short dosing intervals of BNT162b2 (Pfizer/BioNTech) vaccination.
Methods: Here, we report longer follow-up of 684 HCWs in this cohort over 6-9 months following two doses of BNT162b2 or AZD1222 (Oxford/AstraZeneca) vaccination and up to 6 months following a subsequent mRNA booster vaccination.
Findings: We make three observations: first, the dynamics of humoral and cellular responses differ; binding and neutralizing antibodies declined, whereas T and memory B cell responses were maintained after the second vaccine dose. Second, vaccine boosting restored immunoglobulin (Ig) G levels; broadened neutralizing activity against variants of concern, including Omicron BA.1, BA.2, and BA.5; and boosted T cell responses above the 6-month level after dose 2. Third, prior infection maintained its impact driving larger and broader T cell responses compared with never-infected people, a feature maintained until 6 months after the third dose.
Conclusions: Broadly cross-reactive T cell responses are well maintained over time-especially in those with combined vaccine and infection-induced immunity ("hybrid" immunity)-and may contribute to continued protection against severe disease.
Funding: Department for Health and Social Care, Medical Research Council.
Keywords: COVID vaccine; COVID-19; SARS-CoV-2; T cells; Translation to population health; antibody; immunity.