Hybrid immunity in older adults is associated with reduced SARS-CoV-2 infections following BNT162b2 COVID-19 immunisation.

Autor: Pallett SJC; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK.; Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK., Heskin J; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., Keating F; Royal Hospital Chelsea, Royal Hospital Road, London, UK., Mazzella A; Institute for Infection and Immunity, St George's University of London, London, UK., Taylor H; Army Health Branch, Army Headquarters, Andover, UK., Patel A; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., Lamb G; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., Sturdy D; Royal Hospital Chelsea, Royal Hospital Road, London, UK.; Chief Nurse, Adult Social Care, UK Department of Health and Social Care, London, UK., Eisler N; Royal Hospital Chelsea, Royal Hospital Road, London, UK., Denny S; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., Charani E; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., Randell P; North West London Pathology, London, UK., Mughal N; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK.; North West London Pathology, London, UK., Parker E; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK., de Oliveira CR; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK., Rayment M; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., Jones R; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., Tedder R; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK., McClure M; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK., Groppelli E; Institute for Infection and Immunity, St George's University of London, London, UK., Davies GW; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK., O'Shea MK; Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK.; Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK., Moore LSP; Clinical Infection Department, Chelsea and Westminster NHS Foundation Trust, London, UK. luke.moore@nhs.net.; North West London Pathology, London, UK. luke.moore@nhs.net.; Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, London, UK. luke.moore@nhs.net.
Jazyk: angličtina
Zdroj: Communications medicine [Commun Med (Lond)] 2023 Jun 16; Vol. 3 (1), pp. 83. Date of Electronic Publication: 2023 Jun 16.
DOI: 10.1038/s43856-023-00303-y
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
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