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Spike-antibody waning after second dose of BNT162b2 or ChAdOx1

Mary Wilson

Well-known member
Published:July 15, 2021

DOI:https://doi.org/10.1016/S0140-6736(21)01642-1

Madhumita Shrotri, Annalan M D Navaratnam, Vincent Nguyen, Thomas Byrne, Cyril Geismar, Ellen Fragaszy, Sarah Beale, Wing Lam Erica Fong, Parth Patel, Jana Kovar, Andrew C Hayward,*Robert W Aldridge, on behalf of the Virus Watch Collaborative

Vaccines based on the spike glycoprotein of SARS-CoV-2 are being rolled out globally to control transmission and limit morbidity and mortality due to COVID-19. Current evidence indicates strong immunogenicity and high short-term efficacy for BNT162b2 (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (Oxford–AstraZeneca).[SUP]1[/SUP][SUP], [/SUP] [SUP]2[/SUP][SUP], [/SUP] [SUP]3[/SUP] Both vaccines are delivered through a prime-boost strategy, and many countries, including the UK, have used dose intervals longer than 3–4 weeks, expecting to maximise first-dose coverage and immunogenicity. With continued high global incidence, and potential for more transmissible SARS-CoV-2 variants, data on longer-term vaccine efficacy and antibody dynamics in infection-naive individuals are essential for clarifying the need for further booster doses.

To identify early indications of waning antibody levels to the spike protein (S-antibody) after complete two-dose vaccination, we did a cross-sectional analysis of fully vaccinated adults (aged ≥18 years) who submitted capillary blood samples for Virus Watch, a longitudinal community cohort study in England and Wales.[SUP]4[/SUP] The study received ethical approval from the Hampstead NHS Health Research Authority Ethics Committee (20/HRA/2320). Sera were tested using Elecsys Anti-SARS-CoV-2 S and N electro-chemiluminescent immunoassays (Roche Diagnostics, Basel, Switzerland); the S assay targets total antibodies to the S1 subunit of the spike protein (range 0·4–25 000 units per mL [U/mL]), whereas the N assay targets total antibodies to the full-length nucleocapsid protein, which we took as a proxy for previous SARS-CoV-2 infection (specificity 99·8% [99·3–100]).[SUP]5[/SUP] Serological results were linked with demographic and clinical information collected at enrolment and with weekly self-reported vaccination status.
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https://www.thelancet.com/action/showPdf?pii=S0140-6736(21)01642-1
 
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