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[Preprint]. 2021 Dec 7:2021.12.07.21267179.
doi: 10.1101/2021.12.07.21267179.

Significantly elevated antibody levels and neutralization titers in nursing home residents after SARS-CoV-2 BNT162b2 mRNA booster vaccination

David H Canaday  1   2 , Oladayo A Oyebanji  1 , Elizabeth White  3 , Debbie Keresztesy  1 , Michael Payne  1 , Dennis Wilk  1 , Lenore Carias  1 , Htin Aung  1 , Kerri St Denis  4 , Maegan L Sheehan  4 , Sarah D Berry  5 , Cheryl M Cameron  1 , Mark J Cameron  1 , Brigid M Wilson  2 , Alejandro B Balazs  4 , Christopher L King  1 , Stefan Gravenstein  3   6   7
Affiliations

Significantly elevated antibody levels and neutralization titers in nursing home residents after SARS-CoV-2 BNT162b2 mRNA booster vaccination

David H Canaday et al. medRxiv. .

Update in

Abstract

Nursing home (NH) residents have experienced significant morbidity and mortality to SARS-CoV-2 throughout the pandemic. Vaccines initially curbed NH resident morbidity and mortality, but antibody levels and protection have declined with time since vaccination, prompting introduction of booster vaccination. This study assesses humoral immune response to booster vaccination in 85 NH residents and 44 health care workers (HCW) that we have followed longitudinally since initial SARS-CoV-2 BNT162b2 mRNA vaccination. The findings reveal that booster vaccination significantly increased anti-spike, anti-receptor binding domain, and neutralization titers above the pre-booster levels in almost all NH residents and HCW to significantly higher levels than shortly after the completion of the initial vaccine series. These data support the CDC recommendation to offer vaccine boosters to HCWs and NH residents on an immunological basis. Notably, even the older, more frail and more multi-morbid NH residents have sizable antibody increases with boosting.

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Figures

Figure 1.
Figure 1.. Anti-spike levels over time pre- and post-boost with BNT162b2 mRNA vaccination in healthcare workers (HCWs) and nursing home (NH) residents, with and without history of SARS-CoV-2.
Anti-spike values depicted in the binding arbitrary units/milliliter (BAU/ml) based on the WHO standard. 2 weeks (2W Post-vax) and 6 months (6M Post-vax) post primary vaccination series and Pre-boost (generally 6–8 months after the first two-dose vaccination series) and Post-boost which is 14±3 days after vaccine boost.
Figure 2.
Figure 2.. Neutralization titers over time pre- and post-boost with BNT162b2 mRNA vaccination in HCW and NH residents, with and without history of SARS-CoV-2.
Pseudovirus neutralization (pNT50) values are shown. The upper limit of detection of the assay is 1:8748 and the low limit of detection of the neutralization assay is 1:12.
Figure 3
Figure 3
Anti-Receptor binding domain (RBD) levels over time pre- and post-boost with BNT162b2 mRNA vaccination in HCW and NH residents, with and without history of SARS-CoV-2.
See this image and copyright information in PMC

References

    1. Canaday DH, Oyebanji OA, Keresztesy D, et al. Significant reduction in vaccine-induced antibody levels and neutralization activity among healthcare workers and nursing home residents 6 months following COVID-19 BNT162b2 mRNA vaccination. Clinical Infectious Diseases. 2021. - PMC - PubMed
    1. Eliakim-Raz N, Leibovici-Weisman Y, Stemmer A, et al. Antibody Titers Before and After a Third Dose of the SARS-CoV-2 BNT162b2 Vaccine in Adults Aged >/=60 Years. JAMA. 2021. - PMC - PubMed
    1. Falsey AR, Frenck RW Jr., Walsh EE, et al. SARS-CoV-2 Neutralization with BNT162b2 Vaccine Dose 3. N Engl J Med. 2021;385(17):1627–1629. - PMC - PubMed
    1. Canaday DH, Carias L, Oyebanji OA, et al. Reduced BNT162b2 mRNA vaccine response in SARS-CoV-2-naive nursing home residents. Clin Infect Dis. 2021. - PMC - PubMed
    1. Garcia-Beltran WF, Lam EC, Astudillo MG, et al. COVID-19-neutralizing antibodies predict disease severity and survival. Cell. 2021;184(2):476–488 e411. - PMC - PubMed

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