Population Antibody Responses Following COVID-19 Vaccination in 212,102 Individuals

Overview

Journal Nat Commun

Specialty Biology

Date 2022 Feb 17

PMID 35173150

Authors

Helen Ward

Matthew Whitaker

Barnaby Flower

Sonja N Tang

Christina Atchison

Ara Darzi

Christl A Donnelly

Alexandra Cann

Peter J Diggle

Deborah Ashby

Steven Riley

Wendy S Barclay

Paul Elliott

Graham S Cooke

Affiliations

Soon will be listed here.

Abstract

Population antibody surveillance helps track immune responses to COVID-19 vaccinations at scale, and identify host factors that may affect antibody production. We analyse data from 212,102 vaccinated individuals within the REACT-2 programme in England, which uses self-administered lateral flow antibody tests in sequential cross-sectional community samples; 71,923 (33.9%) received at least one dose of BNT162b2 vaccine and 139,067 (65.6%) received ChAdOx1. For both vaccines, antibody positivity peaks 4-5 weeks after first dose and then declines. At least 21 days after second dose of BNT162b2, close to 100% of respondents test positive, while for ChAdOx1, this is significantly reduced, particularly in the oldest age groups (72.7% [70.9-74.4] at ages 75 years and above). For both vaccines, antibody positivity decreases with age, and is higher in females and those with previous infection. Antibody positivity is lower in transplant recipients, obese individuals, smokers and those with specific comorbidities. These groups will benefit from additional vaccine doses.

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References

Guerrera G, Picozza M, DOrso S, Placido R, Pirronello M, Verdiani A . BNT162b2 vaccination induces durable SARS-CoV-2-specific T cells with a stem cell memory phenotype. Sci Immunol. 2021; 6(66):eabl5344. DOI: 10.1126/sciimmunol.abl5344. View

Shrotri M, Navaratnam A, Nguyen V, Byrne T, Geismar C, Fragaszy E . Spike-antibody waning after second dose of BNT162b2 or ChAdOx1. Lancet. 2021; 398(10298):385-387. PMC: 8285117. DOI: 10.1016/S0140-6736(21)01642-1. View

Ward H, Atchison C, Whitaker M, Ainslie K, Elliott J, Okell L . SARS-CoV-2 antibody prevalence in England following the first peak of the pandemic. Nat Commun. 2021; 12(1):905. PMC: 7876103. DOI: 10.1038/s41467-021-21237-w. View

Levin E, Lustig Y, Cohen C, Fluss R, Indenbaum V, Amit S . Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months. N Engl J Med. 2021; 385(24):e84. PMC: 8522797. DOI: 10.1056/NEJMoa2114583. View

Wei J, Stoesser N, Matthews P, Ayoubkhani D, Studley R, Bell I . Antibody responses to SARS-CoV-2 vaccines in 45,965 adults from the general population of the United Kingdom. Nat Microbiol. 2021; 6(9):1140-1149. PMC: 8294260. DOI: 10.1038/s41564-021-00947-3. View

Watanabe M, Balena A, Tuccinardi D, Tozzi R, Risi R, Masi D . Central obesity, smoking habit, and hypertension are associated with lower antibody titres in response to COVID-19 mRNA vaccine. Diabetes Metab Res Rev. 2021; 38(1):e3465. PMC: 8209952. DOI: 10.1002/dmrr.3465. View

Planas D, Veyer D, Baidaliuk A, Staropoli I, Guivel-Benhassine F, Rajah M . Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization. Nature. 2021; 596(7871):276-280. DOI: 10.1038/s41586-021-03777-9. View

Khoury D, Cromer D, Reynaldi A, Schlub T, Wheatley A, Juno J . Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection. Nat Med. 2021; 27(7):1205-1211. DOI: 10.1038/s41591-021-01377-8. View

Davies B, Araghi M, Moshe M, Gao H, Bennet K, Jenkins J . Acceptability, Usability, and Performance of Lateral Flow Immunoassay Tests for Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies: REACT-2 Study of Self-Testing in Nonhealthcare Key Workers. Open Forum Infect Dis. 2021; 8(11):ofab496. PMC: 8522420. DOI: 10.1093/ofid/ofab496. View

10.

Voysey M, Clemens S, Madhi S, Weckx L, Folegatti P, Aley P . Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials. Lancet. 2021; 397(10277):881-891. PMC: 7894131. DOI: 10.1016/S0140-6736(21)00432-3. View

11.

Collier D, Ferreira I, Kotagiri P, Datir R, Lim E, Touizer E . Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2. Nature. 2021; 596(7872):417-422. PMC: 8373615. DOI: 10.1038/s41586-021-03739-1. View

12.

Dodd R, Pickles K, Nickel B, Cvejic E, Ayre J, Batcup C . Concerns and motivations about COVID-19 vaccination. Lancet Infect Dis. 2020; 21(2):161-163. PMC: 7832277. DOI: 10.1016/S1473-3099(20)30926-9. View

13.

Poland G, Ovsyannikova I, Kennedy R . Personalized vaccinology: A review. Vaccine. 2017; 36(36):5350-5357. PMC: 5792371. DOI: 10.1016/j.vaccine.2017.07.062. View

14.

Swanson 2nd P, Padilla M, Hoyland W, McGlinchey K, Fields P, Bibi S . AZD1222/ChAdOx1 nCoV-19 vaccination induces a polyfunctional spike protein-specific T1 response with a diverse TCR repertoire. Sci Transl Med. 2021; 13(620):eabj7211. PMC: 9924073. DOI: 10.1126/scitranslmed.abj7211. View

15.

Riley S, Atchison C, Ashby D, Donnelly C, Barclay W, Cooke G . REal-time Assessment of Community Transmission (REACT) of SARS-CoV-2 virus: Study protocol. Wellcome Open Res. 2021; 5:200. PMC: 8095190. DOI: 10.12688/wellcomeopenres.16228.2. View

16.

Muller L, Andree M, Moskorz W, Drexler I, Walotka L, Grothmann R . Age-dependent Immune Response to the Biontech/Pfizer BNT162b2 Coronavirus Disease 2019 Vaccination. Clin Infect Dis. 2021; 73(11):2065-2072. PMC: 8135422. DOI: 10.1093/cid/ciab381. View

17.

Ward H, Cooke G, Atchison C, Whitaker M, Elliott J, Moshe M . Prevalence of antibody positivity to SARS-CoV-2 following the first peak of infection in England: Serial cross-sectional studies of 365,000 adults. Lancet Reg Health Eur. 2021; 4:100098. PMC: 8088780. DOI: 10.1016/j.lanepe.2021.100098. View

18.

Lopez Bernal J, Gower C, Andrews N . Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. Reply. N Engl J Med. 2021; 385(25):e92. DOI: 10.1056/NEJMc2113090. View

19.

Flower B, Brown J, Simmons B, Moshe M, Frise R, Penn R . Clinical and laboratory evaluation of SARS-CoV-2 lateral flow assays for use in a national COVID-19 seroprevalence survey. Thorax. 2020; 75(12):1082-1088. PMC: 7430184. DOI: 10.1136/thoraxjnl-2020-215732. View

20.

Bates T, Leier H, Lyski Z, Goodman J, Curlin M, Messer W . Age-Dependent Neutralization of SARS-CoV-2 and P.1 Variant by Vaccine Immune Serum Samples. JAMA. 2021; . PMC: 8295896. DOI: 10.1001/jama.2021.11656. View