ABSTRACT
The management of future booster COVID-19 vaccination requires more and detailed data about the longevity of passive, humoral or cellular, immunity. We investigated the humoral immunogenicity of BNT162b2 mRNA vaccine in healthcare workers (HCW) up to 12 months. This study was designed to evaluate the kinetic of antibody response measuring sequential anti-S IgG levels. Participants were voluntary and SARSCoV- 2 naive HCWs of IRCCS Policlinico San Martino Hospital (Genoa, Italy) that they were immunized with two doses of vaccine at December 2020 and a booster dose 9 months later. Blood was sampled prior to vaccine (T0), at 21 days (T1) and 28 days (T2) after the first dose, at 1 (T3), 3 (T4), 6 (T5) and 9 months (T6) after full vaccination, at 1 (T7) and 3 months (T8) after a booster dose. Serological assays were performed at Laboratory Medicine of our hospital using SARS-CoV-2 IgG panel (Bio-Rad, Marnes-la-Coquette, France). It is a multiplex panel of immunoassays intended for the semiquantitative detection of four different IgG antibodies against the receptor-binding domain (RBD), spike 1 (S1), spike 2 (S2) and nucleocapsid (N) structural proteins of SARS-CoV-2. 51 subjects were enrolled among all HCWs and overall, they showed a seroprevalence of 96% (49/51) for RBD and S1 at T1 and 100% (51/51) from T2 to T6. Median values of RBD [100 (51-188) vs 2945 (1693-5364) U/ mL] and S1[79 (30.7-131) vs 1574 (833-3256) U/mL] increased remarkable from T1 to T2. These parameters reduced gradually from T3 to T6 reaching a fold decrease of -20 times (CI 95%: 18-23) and -19 (CI 95%: 17-22) for RBD and S1, respectively. At T7, it was observed an increase of antibody level in comparison to T2 (RBD 4 times, CI 95%: 2,5-6;S1 3 times, CI 95%: 1,5-5). All subjects were negative for anti-N IgG from T0 until to T8. HCWs experienced SARS-CoV-2 infection documented by a molecular or antigen assay for 39,2% (20/51) after a median time of 165 (69-184) days.Naive and healthy people show a protective humoral response with BNT162b2 that it endures up to 12 months with a booster dose at 9th month. Based on the rapid spread of Omicron variants, humoral decrease and booster breakthrough after less of 6 months, an update of vaccine sera booster may be planned for HCWs and patients with failty.
ABSTRACT
Background: The antibody response to coronavirus disease 2019 (COVID-19) vaccination in patients with inflammatory bowel disease (IBD) on biological drugs is still unclear. Aim: To determine the anti-SARS-CoV-2 spike 1 (anti-S1-IgG) response rate and antibody levels following a complete COVID-19 vaccination cycle in patients with IBD on biological treatment. Methods: We assessed antibody response to COVID-19 in consecutive patients with IBD on biological drugs and without prior exposure to COVID-19. Sera were prospectively collected at baseline and at 21 days (T1), 42 days (T2), and 3 months (T3) after the first vaccine dose. Results: Among the 42 patients included in the study, the overall response rate at T3 was 97.6%, with no difference across the various biological drugs. After the first dose (T1), the response rate was higher in patients receiving anti-tumour necrosis factor (TNF) compared to patients treated with other biologics (p = 0.031). Among the responders, the anti-S1 levels were not significantly different among the various biological drugs at all study timepoints. Concomitant corticosteroids and disease activity had no impact on the response rate at all study timepoints. No unexpected side events were observed. Discussion: The antibody response to vaccination against COVID-19 in patients with IBD on biological drugs is optimal, independently of their mechanism of action. Patients treated with anti-TNF seem to have an earlier response to vaccination, while concomitant low-dose corticosteroids and disease activity does not seem to impact response. This information can be used to program vaccination and inform patients. © 2022 by the authors.
ABSTRACT
Introduction: In patients with Multiple Sclerosis (pwMS) disease- modifying therapies (DMTs) are known to affect immune response to antigens and possibly to SARS-CoV2 vaccine. Therefore, post-vaccination serological assessments are needed to evaluate the effect of the vaccine on SARS-CoV-2 antibody response. Objectives and aims: We designed a prospective multicenter cohort study enrolling pwMS who were scheduled for SARSCov- 2 vaccination with mRNA vaccines (BNT162b2, Pfizer/ BioNTech, Inc or mRNA-1273, Moderna Tx, Inc) to evaluate their effect on SARS-CoV-2 antibody response. Methods: A blood collection for the measure of SARS-CoV-2 antibody before the first vaccine dose and 4 weeks after the second dose was planned, with a centralized and blinded serological assessment (electrochemiluminescence immunoassay, ECLIA, Roche Diagnostics). Results: Preliminary data were collected on 780 pwMS (76% BNT162b2 and 24% mRNA-1273) who had pre- and 4-week post-vaccination blood assessments. 87 (11.2%) were untreated, 154 (19.7%) on ocrelizumab, 25 (3.2%) on rituximab, 85 (10.9%) on fingolimod, 25 (3.2%) on cladribine and 404 (51.7%) on other DMTs. 677 patients (86.8%) had detectable post-vaccination SARS-CoV-2 antibodies. At multivariate analysis, the antibody levels of patients on ocrelizumab (178-fold decrease, p<0.001), fingolimod (26-fold decrease, p<0.001) and rituximab (17-fold decrease, p<0.001) were significantly reduced as compared to untreated patients. Vaccination with mRNA-1273 resulted in a systematically 3.5-fold higher antibody level than with the BNT162b2 vaccine (p<0.001). Interpretation: In pwMS, anti-CD20 treatment and fingolimod led to a reduced humoral response to mRNA-based SARS-CoV-2 vaccines. As mRNA-1273 elicits 3.5-higher antibody levels than BNT162b2, this vaccine may be preferentially considered for patients under anti-CD20 treatment or fingolimod. Combining our data with those that will be produced by studying the cellular immune response to vaccines, and including clinical follow-up, will contribute to better define the most appropriate SARS-CoV-2 vaccine strategies in the context of DMTs and MS. At the time of the ECTRIMS presentation data on the full sample (about 2000 subjects) will be presented.