Pallett, SJC;
Heskin, J;
Keating, F;
Mazzella, A;
Taylor, H;
Patel, A;
Lamb, G;
Sturdy, D;
Eisler, N;
Denny, S;
et al.
Pallett, SJC; Heskin, J; Keating, F; Mazzella, A; Taylor, H; Patel, A; Lamb, G; Sturdy, D; Eisler, N; Denny, S; Charani, E; Randell, P; Mughal, N; Parker, E; de Oliveira, CR; Rayment, M; Jones, R; Tedder, R; McClure, M; Groppelli, E; Davies, GW; O'Shea, MK; Moore, LSP
(2023)
Hybrid immunity in older adults is associated with reduced SARS-CoV-2 infections following BNT162b2 COVID-19 immunisation.
Commun Med (Lond), 3 (1).
p. 83.
ISSN 2730-664X
https://doi.org/10.1038/s43856-023-00303-y
SGUL Authors: Groppelli, Elisabetta Angela
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Abstract
BACKGROUND: Older adults, particularly in long-term care facilities (LTCF), remain at considerable risk from SARS-CoV-2. Data on the protective effect and mechanisms of hybrid immunity are skewed towards young adults precluding targeted vaccination strategies. METHODS: A single-centre longitudinal seroprevalence vaccine response study was conducted with 280 LCTF participants (median 82 yrs, IQR 76-88 yrs; 95.4% male). Screening by SARS-CoV-2 polymerase chain reaction with weekly asymptomatic/symptomatic testing (March 2020-October 2021) and serology pre-/post-two-dose Pfizer-BioNTech BNT162b2 vaccination for (i) anti-nucleocapsid, (ii) quantified anti-receptor binding domain (RBD) antibodies at three time-intervals, (iii) pseudovirus neutralisation, and (iv) inhibition by anti-RBD competitive ELISA were conducted. Neutralisation activity: antibody titre relationship was assessed via beta linear-log regression and RBD antibody-binding inhibition: post-vaccine infection relationship by Wilcoxon rank sum test. RESULTS: Here we show neutralising antibody titres are 9.2-fold (95% CI 5.8-14.5) higher associated with hybrid immunity (p < 0.00001); +7.5-fold (95% CI 4.6-12.1) with asymptomatic infection; +20.3-fold, 95% (CI 9.7-42.5) with symptomatic infection. A strong association is observed between antibody titre: neutralising activity (p < 0.00001) and rising anti-RBD antibody titre: RBD antibody-binding inhibition (p < 0.001), although 18/169 (10.7%) participants with high anti-RBD titre (>100BAU/ml), show inhibition <75%. Higher RBD antibody-binding inhibition values are associated with hybrid immunity and reduced likelihood of infection (p = 0.003). CONCLUSIONS: Hybrid immunity in older adults was associated with considerably higher antibody titres, neutralisation and inhibition capacity. Instances of high anti-RBD titre with lower inhibition suggests antibody quantity and quality as independent potential correlates of protection, highlighting added value of measuring inhibition over antibody titre alone to inform vaccine strategy.
Item Type: | Article | |||||||||
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Additional Information: | Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2023 | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | |||||||||
Journal or Publication Title: | Commun Med (Lond) | |||||||||
ISSN: | 2730-664X | |||||||||
Language: | eng | |||||||||
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Publisher License: | Creative Commons: Attribution 4.0 | |||||||||
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PubMed ID: | 37328651 | |||||||||
Web of Science ID: | WOS:001009108500001 | |||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/115552 | |||||||||
Publisher's version: | https://doi.org/10.1038/s43856-023-00303-y |
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