Variation in the Humoral Immune Response Induced by the Administration of the BNT162b2 Pfizer/BioNTech Vaccine: A Systematic Review

Abstract

The BNT162b2 Pfizer/BioNTech vaccine was the first emergency approved vaccine during the COVID-19 pandemic. The aim of this systematic review was to examine the variations in the humoral immune response induced by the administration of the BNT162b2 vaccine in patients with previous SARS-CoV-2 infection, the elderly, and those with comorbidities and immunosuppression states. Additionally, we analyzed the effect of generated neutralizing antibodies against the new variants of concern of SARS-CoV-2. Pubmed, Science Direct, Mendeley, and WorldWide Science were searched between 1 January 2020 and October 2021 using the keywords "BNT162b2", "serology", "comorbidity", "immunosuppression", and "variants of concern"dA total of 20 peer-reviewed publications were selected. The analysis showed that those individuals with previous infections have a considerably higher antibody response after the administration of BNT162b2 vaccine in contrast with seronegative individuals. With regard to variation in immune responses, elderly individuals, patients with cancer, or patients who had undergone a kidney transplant, dialysis, or who were pregnant had a lower antibody response in comparison to healthy individuals. Finally, antibodies developed against the S protein produced by the BNT162b2 vaccine, possessed lower neutralizing activity against the alpha, beta, gamma, and delta variants of SARS-CoV-2. In conclusion, patients with immunodeficiencies and comorbidities have a lesser antibody response, about which further studies need to be performed in order to analyze the effectiveness and duration of the humoral immunity associated with vaccination in these specific populations.

Keywords: BNT162b2; COVID-19; SARS-CoV-2; comorbidities; humoral response; immunosuppression; vaccine.

Figure 1

Study identification, PRISMA flowchart.

Figure 2

Immune response mechanism after the administration of BNT162b2 Pfizer/BioNTech vaccine. After its administration, the vaccine, which is composed of lipid nanoparticles with encapsulated mRNA, induced the production of the spike glycoprotein of SARS-CoV-2 in the host cells. After its recognition by the immune system, it generates a specific cellular and humoral immune response. Released antibodies promote ADCC, CDC, opsonization, neutralization, and complement activation (classical pathway). ACE2: angiotensin-converting enzyme 2; APC: antigen presenting cell; MHC-I: major histocompatibility complex type I; MHC-II: major histocompatibility complex type II; Tfh: T follicular cell; HSM: hypersomatic mutation; Th1: T helper 1; ADCC: antibody dependent cellular cytotoxicity and CDC: complement dependent dytotoxicity. Image created with Biorender (https://biorender.com/; accessed on 25 May 2022).