Quantitative SARS-CoV-2 anti-spike responses to Pfizer-BioNTech and Oxford-AstraZeneca vaccines by previous infection status

David W Eyre; Sheila F Lumley; Jia Wei; Stuart Cox; Tim James; Anita Justice; Gerald Jesuthasan; Denise O'Donnell; Alison Howarth; Stephanie B Hatch; Brian D Marsden; E Yvonne Jones; David I Stuart; Daniel Ebner; Sarah Hoosdally; Derrick W Crook; Tim E A Peto; Timothy M Walker; Nicole E Stoesser; Philippa C Matthews; Koen B Pouwels; A Sarah Walker; Katie Jeffery

doi:10.1016/j.cmi.2021.05.041

Quantitative SARS-CoV-2 anti-spike responses to Pfizer-BioNTech and Oxford-AstraZeneca vaccines by previous infection status

Clin Microbiol Infect. 2021 Oct;27(10):1516.e7-1516.e14. doi: 10.1016/j.cmi.2021.05.041. Epub 2021 Jun 7.

Authors

David W Eyre¹, Sheila F Lumley², Jia Wei³, Stuart Cox⁴, Tim James⁴, Anita Justice⁴, Gerald Jesuthasan⁴, Denise O'Donnell³, Alison Howarth³, Stephanie B Hatch³, Brian D Marsden⁵, E Yvonne Jones³, David I Stuart³, Daniel Ebner⁶, Sarah Hoosdally⁷, Derrick W Crook², Tim E A Peto², Timothy M Walker⁸, Nicole E Stoesser², Philippa C Matthews², Koen B Pouwels⁹, A Sarah Walker⁷, Katie Jeffery⁴

Affiliations

¹ Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford, UK. Electronic address: david.eyre@bdi.ox.ac.uk.
² Oxford University Hospitals NHS Foundation Trust, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Oxford, UK.
³ Nuffield Department of Medicine, University of Oxford, Oxford, UK.
⁴ Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
⁵ Nuffield Department of Medicine, University of Oxford, Oxford, UK; Kennedy Institute of Rheumatology Research, University of Oxford, UK.
⁶ Nuffield Department of Medicine, University of Oxford, Oxford, UK; Target Discovery Institute, University of Oxford, Oxford, UK.
⁷ NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Oxford, UK.
⁸ Nuffield Department of Medicine, University of Oxford, Oxford, UK; Oxford University Clinical Research Unit, Ho Chi Minh City, Viet nam.
⁹ Nuffield Department of Population Health, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford, UK.

Abstract

Objectives: We investigated determinants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike IgG responses in healthcare workers (HCWs) following one or two doses of Pfizer-BioNTech or Oxford-AstraZeneca vaccines.

Methods: HCWs participating in regular SARS-CoV-2 PCR and antibody testing were invited for serological testing prior to first and second vaccination, and 4 weeks post-vaccination if receiving a 12-week dosing interval. Quantitative post-vaccination anti-spike antibody responses were measured using the Abbott SARS-CoV-2 IgG II Quant assay (detection threshold: ≥50 AU/mL). We used multivariable logistic regression to identify predictors of seropositivity and generalized additive models to track antibody responses over time.

Results: 3570/3610 HCWs (98.9%) were seropositive >14 days post first vaccination and prior to second vaccination: 2706/2720 (99.5%) were seropositive after the Pfizer-BioNTech and 864/890 (97.1%) following the Oxford-AstraZeneca vaccines. Previously infected and younger HCWs were more likely to test seropositive post first vaccination, with no evidence of differences by sex or ethnicity. All 470 HCWs tested >14 days after the second vaccination were seropositive. Quantitative antibody responses were higher after previous infection: median (IQR) >21 days post first Pfizer-BioNTech 14 604 (7644-22 291) AU/mL versus 1028 (564-1985) AU/mL without prior infection (p < 0.001). Oxford-AstraZeneca vaccine recipients had lower readings post first dose than Pfizer-BioNTech recipients, with and without previous infection, 10 095 (5354-17 096) and 435 (203-962) AU/mL respectively (both p < 0.001 versus Pfizer-BioNTech). Antibody responses >21 days post second Pfizer vaccination in those not previously infected, 10 058 (6408-15 582) AU/mL, were similar to those after prior infection followed by one vaccine dose.

Conclusions: SARS-CoV-2 vaccination leads to detectable anti-spike antibodies in nearly all adult HCWs. Whether differences in response impact vaccine efficacy needs further study.

Keywords: Antibody; Quantitative anti-spike antibody; SARS-CoV-2; Serology; Vaccine.

MeSH terms

Adult
Antibodies, Viral / blood*
BNT162 Vaccine
COVID-19 / blood
COVID-19 Vaccines / immunology*
ChAdOx1 nCoV-19
Female
Health Personnel
Humans
Immunogenicity, Vaccine
Immunoglobulin G / blood
Male
Middle Aged
SARS-CoV-2 / immunology*
Spike Glycoprotein, Coronavirus / immunology*
Vaccination

Substances

Antibodies, Viral
COVID-19 Vaccines
Immunoglobulin G
Spike Glycoprotein, Coronavirus
spike protein, SARS-CoV-2
ChAdOx1 nCoV-19
BNT162 Vaccine

Abstract

MeSH terms

Substances

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