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[Preprint]. 2025 Apr 16:2025.04.12.25325718.

doi: 10.1101/2025.04.12.25325718.

Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination are Unaffected by Parasitemia in a Malaria-Endemic Setting

Taraz Samandari¹, Millicent Achola², Jack N Hutter², Grace Mboya³, Walter Otieno², Jia Jin Kee⁴, Yunda Huang^{4

5}, John J Aponte⁶, Christian F Ockenhouse⁷, Cynthia K Lee⁷, Laura Polakowski⁸, Margaret Yacovone⁸, Asa Tapley^{4

9

10}, Sufia Dadabhai¹¹, Nonhlanhla N Mkhize^{12

13}, Haajira Kaldine^{12

13}, Sinethemba Bhebhe^{12

13}, Penny L Moore^{12

13

14}, John Hural⁴, Nigel Garrett^{15

14

16}, James G Kublin⁴

Affiliations

¹ COVID-19 Prevention Network, Seattle, USA.
² U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya.
³ Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.
⁴ Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, USA.
⁵ Department of Global Health, University of Washington, Seattle, USA.
⁶ PATH Center for Vaccine Innovation and Access, Geneva, Switzerland.
⁷ PATH Center for Vaccine Innovation and Access, Washington, District of Columbia, USA.
⁸ National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA.
⁹ Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, USA.
¹⁰ Department of Medicine, University of Cape Town, Cape Town, South Africa.
¹¹ Johns Hopkins Bloomberg School of Public Health, Blantyre, Malawi.
¹² National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa.
¹³ SA MRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁴ Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa.
¹⁵ Desmond Tutu HIV Centre, University of Cape Town, South Africa.
¹⁶ Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

PMID: 40321290
PMCID: PMC12047954
DOI: 10.1101/2025.04.12.25325718

Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination are Unaffected by Parasitemia in a Malaria-Endemic Setting

Taraz Samandari et al. medRxiv. 2025.

[Preprint]. 2025 Apr 16:2025.04.12.25325718.

doi: 10.1101/2025.04.12.25325718.

Authors

Affiliations

¹ COVID-19 Prevention Network, Seattle, USA.
² U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya.
³ Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.
⁴ Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, USA.
⁵ Department of Global Health, University of Washington, Seattle, USA.
⁶ PATH Center for Vaccine Innovation and Access, Geneva, Switzerland.
⁷ PATH Center for Vaccine Innovation and Access, Washington, District of Columbia, USA.
⁸ National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA.
⁹ Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, USA.
¹⁰ Department of Medicine, University of Cape Town, Cape Town, South Africa.
¹¹ Johns Hopkins Bloomberg School of Public Health, Blantyre, Malawi.
¹² National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa.
¹³ SA MRC Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁴ Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa.
¹⁵ Desmond Tutu HIV Centre, University of Cape Town, South Africa.
¹⁶ Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

PMID: 40321290
PMCID: PMC12047954
DOI: 10.1101/2025.04.12.25325718

Update in

Plasmodium falciparum Parasitemia Does Not Diminish Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination in HIV-infected Adults.
Samandari T, Achola M, Hutter JN, Mboya G, Otieno W, Kee JJ, Huang Y, Aponte JJ, Ockenhouse CF, Lee CK, Polakowski L, Yacovone M, Tapley A, Dadabhai S, Mkhize NN, Kaldine H, Bhebhe S, Moore PL, Hural J, Garrett N, Kublin JG. Samandari T, et al. J Infect Dis. 2025 Aug 2:jiaf398. doi: 10.1093/infdis/jiaf398. Online ahead of print. J Infect Dis. 2025. PMID: 40751436

Abstract

Subclinical malaria may reduce the immunogenicity of mRNA vaccines. We evaluated neutralizing antibody responses in adults with (n=87) and without (n=221) PCR-confirmed Plasmodium falciparum who received a COVID-19 booster. Similar boosted ID50 geometric mean titers >22,000 in parasitemic and non-parasitemic participants suggests that COVID-19 mRNA vaccine responses are not impaired.

Keywords: HIV; SARS-CoV-2; booster; immunogenicity; mRNA vaccine; malaria; neutralizing antibody.

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Conflict of interest statement

The authors have declared that no conflict of interest exists. Declaration of Interests: Yunda Huang, Grace Mboya, Sufia Dadabhai, Nonhlanhla Mkhize, Haajira Kaldine, Sinethemba Bhebhe and Penny Moore received funding from NIAID/NIH paid to their institutions for salary support. All other authors have nothing to declare.

Figures

**Figure 1.**
A, Violin boxplots of ID50 neutralizing anti-D614G Spike antibody to booster vaccines in asymptomatic Pf-PCR-positive and -negative participants at M0 and M1 (red=monovalent mRNA-1273, blue=bivalent mRNA-1273.222. B, ID50 GMFR, M1 over M0, comparing participants with and without malaria and adjusted for covariates in univariate analysis. Abbreviations: Adj, adjusted; BMI, body mass index; CD4, CD4+ T cells measured at M0; CI, confidence intervals; GMFR, geometric mean fold-rise ratio; ID50, 50% inhibitory dilution neutralizing anti-SARS-CoV-2 antibody titer; M0, Month-0 which was the time of booster receipt; M1, Month-1 after booster receipt; neg, Pf-PCR negative; Pf, *Plasmodium falciparum*; pos, Pf-PCR positive; VL, HIV viral load measured at M0.

See this image and copyright information in PMC

References

1. Matarazzo L, Bettencourt PJG. mRNA vaccines: a new opportunity for malaria, tuberculosis and HIV. Front Immunol 2023; 14:1172691. - PMC - PubMed
1. Illingworth J, Butler NS, Roetynck S, et al. Chronic Exposure to Plasmodium falciparum Is Associated with Phenotypic Evidence of B and T Cell Exhaustion. J Immunol 2013; 190: 1038–1047. - PMC - PubMed
1. Garrett N, Tapley A, Hudson A, et al. Hybrid versus vaccine immunity of mRNA-1273 among people living with HIV in East and Southern Africa: a prospective cohort analysis from the multicentre CoVPN 3008 study. eClin Med 2025; 80:103054. - PMC - PubMed
1. Kamau E, Tolbert LS, Kortepeter L, et al. Development of a Highly Sensitive Genus-Specific Quantitative Reverse Transcriptase Real-Time PCR Assay for Detection and Quantitation of Plasmodium by Amplifying RNA and DNA of the 18S rRNA Genes. J Clin Micro 2011. 49(8): 2946–2953. - PMC - PubMed
1. Bewley KR, Coombes NS, Gagnon L, et al. Quantification of SARS-CoV-2 neutralizing antibody by wild-type plaque reduction neutralization, microneutralization and pseudotyped virus neutralization assays. Nat Protoc. 2021;16(6):3114–3140. doi: 10.1038/s41596-021-00536-y - DOI - PubMed

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This is a preprint.

Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination are Unaffected by Parasitemia in a Malaria-Endemic Setting

Affiliations

Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination are Unaffected by Parasitemia in a Malaria-Endemic Setting

Authors

Affiliations

Update in

Abstract

Conflict of interest statement

Figures

References

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