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Microbiol Spectr . Short-Lived Antibody-Mediated Saliva Immunity against SARS-CoV-2 after Vaccination

tetano

Editor, Senior Moderator
Microbiol Spectr


. 2023 Mar 6;e0494722.
doi: 10.1128/spectrum.04947-22. Online ahead of print.
Short-Lived Antibody-Mediated Saliva Immunity against SARS-CoV-2 after Vaccination


Johannes Roth Madsen[SUP] 1 [/SUP], Bettina Eide Holm[SUP] 1 [/SUP], Laura Pérez-Alós[SUP] 1 [/SUP], Rafael Bayarri-Olmos[SUP] 1 [/SUP], Anne Rosbjerg[SUP] 1 [/SUP], Kamille Fogh[SUP] 2 3 [/SUP], Mia Marie Pries-Heje[SUP] 4 [/SUP], Dina Leth Møller[SUP] 5 [/SUP], Cecilie Bo Hansen[SUP] 1 [/SUP], Line Dam Heftdal[SUP] 5 6 [/SUP], Rasmus Bo Hasselbalch[SUP] 2 3 [/SUP], Sebastian Rask Hamm[SUP] 5 [/SUP], Ruth Frikke-Schmidt[SUP] 7 8 [/SUP], Linda Hilsted[SUP] 8 [/SUP], Susanne Dam Nielsen[SUP] 5 7 [/SUP], Kasper Karmark Iversen[SUP] 2 3 7 [/SUP], Henning Bundgaard[SUP] 4 7 [/SUP], Peter Garred[SUP] 1 7 [/SUP]



Affiliations

Abstract

Knowledge about the effect of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on immunity reflected in the saliva is sparse. We examined the antibody response in saliva compared to that in serum 2 and 6 months after the first vaccination with the BNT162b2 vaccine. Four hundred fifty-nine health care professionals were included in a prospective observational study measuring antibody levels in saliva and corresponding serum samples at 2 and 6 months after BNT162b2 vaccination. Vaccinated, previously SARS-CoV-2-infected individuals (hybrid immunity) had higher IgG levels in saliva at 2 months than vaccinated, infection-naive individuals (P < 0.001). After 6 months, saliva IgG levels declined in both groups (P < 0.001), with no difference between groups (P = 0.37). Furthermore, serum IgG levels declined from 2 to 6 months in both groups (P < 0.001). IgG antibodies in saliva and serum correlated in individuals with hybrid immunity at 2 and 6 months (ρ = 0.58, P = 0.001, and ρ = 0.53, P = 0.052, respectively). In vaccinated, infection-naive individuals, a correlation was observed at 2 months (ρ = 0.42, P < 0.001) but not after 6 months (ρ = 0.14, P = 0.055). IgA and IgM antibodies were hardly detectable in saliva at any time point, regardless of previous infection. In serum, IgA was detected at 2 months in previously infected individuals. BNT162b2 vaccination induced a detectable IgG anti-SARS-CoV-2 RBD response in saliva at both 2 and 6 months after vaccination, being more prominent in previously infected than infection-naive individuals. However, a significant decrease in salivary IgG was observed after 6 months, suggesting a rapid decline in antibody-mediated saliva immunity against SARS-CoV-2, after both infection and systemic vaccination. IMPORTANCE Knowledge about the persistence of salivary immunity after SARS-CoV-2 vaccination is limited, and information on this topic could prove important for vaccine strategy and development. We hypothesized that salivary immunity would wane rapidly after vaccination. We measured anti-SARS-CoV-2 IgG, IgA, and IgM concentrations in saliva and serum in both previously infected and infection-naive individuals, 2 and 6 months after first vaccination with BNT162b2, in 459 hospital employees from Copenhagen University Hospital. We observed that IgG was the primary salivary antibody 2 months after vaccination in both previously infected and infection-naive individuals, but dropped significantly after 6 months. Neither IgA nor IgM was detectable in saliva at either time point. Findings indicate that salivary immunity against SARS-CoV-2 rapidly declines following vaccination in both previously infected and infection-naive individuals. We believe this study shines a light on the workings of salivary immunity after SARS-CoV-2 infection, which could prove relevant for vaccine development.

Keywords: IgA; IgG; IgM; SARS-CoV-2 vaccination; immunity; saliva.
 
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