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Antibody Responses After mRNA-Based COVID-19 Vaccination in Residential Older Adults: Implications for Reopening.
Nace, David A; Kip, Kevin E; Mellors, John W; Peck Palmer, Octavia M; Shurin, Michael R; Mulvey, Katie; Crandall, Melissa; Sobolewski, Michele D; Enick, P Nathan; McCormick, Kevin D; Jacobs, Jana L; Kane, April L; Lukanski, Amy; Kip, Paula L; Wells, Alan.
  • Nace DA; Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: naceda@upmc.edu.
  • Kip KE; Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Mellors JW; Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  • Peck Palmer OM; Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
  • Shurin MR; Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
  • Mulvey K; Clinical Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Crandall M; Clinical Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Sobolewski MD; Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  • Enick PN; Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  • McCormick KD; Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  • Jacobs JL; Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  • Kane AL; Senior Services, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Lukanski A; Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Kip PL; Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Wells A; Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA; Clinical Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
J Am Med Dir Assoc ; 22(8): 1593-1598, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1267723
Semantic information from SemMedBD (by NLM)
1. Antibody Formation PROCESS_OF Elderly (population group)
Subject
Antibody Formation
Predicate
PROCESS_OF
Object
Elderly (population group)
2. COVID-19 Vaccines ADMINISTERED_TO Community
Subject
COVID-19 Vaccines
Predicate
ADMINISTERED_TO
Object
Community
3. RN ADMINISTERED_TO C0001792
Subject
RN
Predicate
ADMINISTERED_TO
Object
C0001792
4. Adaptive Immunity AFFECTS Elderly (population group)
Subject
Adaptive Immunity
Predicate
AFFECTS
Object
Elderly (population group)
5. Nursing Homes LOCATION_OF Study
Subject
Nursing Homes
Predicate
LOCATION_OF
Object
Study
6. Antibody Formation PROCESS_OF Elderly (population group)
Subject
Antibody Formation
Predicate
PROCESS_OF
Object
Elderly (population group)
7. COVID-19 Vaccines ADMINISTERED_TO Community
Subject
COVID-19 Vaccines
Predicate
ADMINISTERED_TO
Object
Community
8. RNA, Messenger ADMINISTERED_TO Elderly (population group)
Subject
RNA, Messenger
Predicate
ADMINISTERED_TO
Object
Elderly (population group)
9. Adaptive Immunity AFFECTS Elderly (population group)
Subject
Adaptive Immunity
Predicate
AFFECTS
Object
Elderly (population group)
10. Nursing Homes LOCATION_OF Study
Subject
Nursing Homes
Predicate
LOCATION_OF
Object
Study
ABSTRACT

OBJECTIVE:

COVID-19 disproportionately impacts residents in long-term care facilities. Our objective was to quantify the presence and magnitude of antibody response in vaccinated, older adult residents at assisted living, personal care, and independent living communities.

DESIGN:

A cross-sectional quality improvement study was conducted March 15 - April 1, 2021 in the greater Pittsburgh region. SETTING AND POPULATION Participants were older adult residents at assisted living, personal care, and independent living communities, who received mRNA-based COVID-19 vaccine. Conditions that impair immune responses were exclusionary criteria.

METHODS:

Sera were collected to measure IgG anti-SARS-CoV-2 antibody level with reflex to total anti-SARS-CoV-2 immunoglobulin levels, and blinded evaluation of SARS-CoV-2 pseudovirus neutralization titers. Descriptive statistics, Pearson correlation coefficients, and multiple linear regression analysis evaluated relationships between factors potentially associated with antibody levels. Spearman correlations were calculated between antibody levels and neutralization titers.

RESULTS:

All participants (N = 70) had received two rounds of vaccination and were found to have antibodies with wide variation in relative levels. Antibody levels trended lower in males, advanced age, current use of steroids, and longer length of time from vaccination. Pseudovirus neutralization titer levels were strongly correlated (P < .001) with Beckman Coulter antibody levels [D614 G NT50, rs = 0.91; B.1.1.7 (UK) NT50, rs = 0.91]. CONCLUSIONS AND IMPLICATIONS Higher functioning, healthier, residential older adults mounted detectable antibody responses when vaccinated with mRNA-based COVID-19 vaccines. Data suggests some degree of immunity is present during the immediate period following vaccination. However, protective effects remain to be determined in larger studies as clinical protection is afforded by ongoing adaptive immunity, which is known to be decreased in older adults. This study provides important preliminary results on level of population risk in older adult residents at assisted living, personal care, and independent living communities to inform reopening strategies, but are not likely to be translatable for residents in nursing homes.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Aged / Humans / Male Language: English Journal: J Am Med Dir Assoc Journal subject: History of Medicine / Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Aged / Humans / Male Language: English Journal: J Am Med Dir Assoc Journal subject: History of Medicine / Medicine Year: 2021 Document Type: Article