| Autor: |
San Román J; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, 28922 Madrid, Spain.; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain., Candel FJ; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain.; Clinical Microbiology and Infectious Diseases, IdISSC and IML Health Institutes, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain., Sanz JC; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain., López P; Nursing Homes and Long-Term Care Facilities Support Unit, Dirección Asistencial Norte, Gerencia Asistencial Atención Primaria, 28035 Madrid, Spain., Menéndez-Colino R; Service of Geriatrics, Hospital General Universitario La Paz, 28046 Madrid, Spain., Barreiro P; Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, 28922 Madrid, Spain.; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain., Carretero MDM; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain., Pérez-Abeledo M; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain., Viñuela-Prieto JM; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain.; Department of Neurosurgery, Hospital General Universitario La Paz, 28046 Madrid, Spain., Ramos B; Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain., Canora J; Service of Internal Medicine, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28922 Madrid, Spain., Barba R; Service of Internal Medicine, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, 28922 Madrid, Spain., Zapatero-Gaviria A; Vicecounselor of Healthcare and Public Health, Universidad Rey Juan Carlos, 28922 Madrid, Spain., Martínez-Peromingo FJ; Service of Geriatrics, Hospital Universitario Rey Juan Carlos, Universidad Rey Juan Carlos, 28922 Madrid, Spain., On Behalf Of The Investigators Of The SeroVAC Study |
| Abstrakt: |
Background: Most residents and staff in nursing homes have received full vaccination. Factors related to the immune response to vaccination might be related to the risk of future severe COVID-19 and may guide the need for vaccine boosters. Design: Nursing homes that were tested in a point survey in July-October 2020 were again analyzed after a vaccination campaign in June-July 2021. Immune responses according to IgG against nucleocapsid and spike antigens, and CD4 and CD8 interferon-gamma release assay against spike antigens, were evaluated. Results: A total of 1973 subjects were tested (61.7% residents, 48.3% staff), with a mean (SD) follow-up of 46.4 (3.6) weeks between assessments. More than half of residents and more than a third of staff had evidence of COVID-19 before vaccination; 26.9% and 22.7% had seroreversion of IgG-N, and 8.9% and 4.6% had IgG-N seroconversion at second assessment, respectively. Up to 96.8% of residents and 98.1% of workers had positive IgG-S after a mean of 19.9 (2.1) weeks after vaccination. In residents with vs without a history of COVID-19, IgG-S titers were 4.11 (0.54) vs. 2.73 (0.74) logAU/mL (p < 0.001); in workers these titers were 3.89 (0.61) vs. 3.15 (0.64) logAU/mL (p < 0.001). Linear regression analysis showed that younger age (OR: −0.03 per 10 years-older [95% CI, −0.04 to −0.02], p < 0.001) and evidence of COVID-19 (OR: 1.14 [95% CI, 1.08 to 1.20], p < 0.001) are associated with greater IgG-S titers after vaccination. A direct association was found between IgG-S titers and the intensity of IFN-gamma response against spike antigens. Conclusions: Waning of humoral response and reinfection seems to be more frequent in older as compared to younger adults, although cellular responses shortly after vaccination are comparable between these groups. Younger age and prior COVID-19 are related to greater humoral response after vaccination against SARS-CoV-2. |
