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. 2025 Oct 15;232(4):e565-e570.
doi: 10.1093/infdis/jiaf398.

Plasmodium falciparum Parasitemia Does Not Diminish Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination in HIV-infected Adults

Taraz Samandari  1 , Millicent Achola  2 , Jack N Hutter  2 , Grace Mboya  3 , Walter Otieno  2 , Jia Jin Kee  4 , Yunda Huang  4   5 , John J Aponte  6 , Christian F Ockenhouse  7 , Cynthia K Lee  7 , Laura Polakowski  8 , Margaret Yacovone  8 , Asa Tapley  4   9   10 , Sufia Dadabhai  11 , Nonhlanhla N Mkhize  12   13 , Haajira Kaldine  12   13 , Sinethemba Bhebhe  12   13 , Penny L Moore  12   13 , John Hural  4 , Nigel Garrett  14   15   16 , James G Kublin  4
Affiliations

Plasmodium falciparum Parasitemia Does Not Diminish Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination in HIV-infected Adults

Taraz Samandari et al. J Infect Dis. .

Abstract

mRNA vaccines have emerged as powerful tools for the prevention of infectious diseases, but subclinical malaria may reduce vaccine immunogenicity. We evaluated neutralizing antibody responses in asymptomatic HIV-infected adults with and without polymerase chain reaction-confirmed Plasmodium falciparum who received either monovalent mRNA-1273 or bivalent mRNA-1273.222 (WA-1 and BA.4/5) booster vaccines. In previous studies, a 50% pseudovirus inhibitory dose neutralizing antibody (ID50) titer of 1000 correlated with 96% efficacy in preventing COVID-19. We observed ID50 geometric mean titers >22 000 in both parasitemic and nonparasitemic participants 1 month after boosting. We conclude that COVID-19 mRNA vaccine antibody responses are unimpaired by concurrent asymptomatic parasitemia.

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

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Conflict of interest statement

Potential conflicts of interest . 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. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Anti-D614G Spike neutralization antibody ID50 titers to booster vaccines in asymptomatic Plasmodium falciparum-PCR-negative (n = 221) and -positive (n = 87) participants at Month-0 and Month-1. Box plots are superimposed on each violin plot, providing the median, 2 hinges which correspond to the first and third quartiles and “whiskers,” which extend to 1.5-times the interquartile range on both ends. Red and blue dots represent monovalent mRNA 1273 and bivalent mRNA 1273.222 booster recipients, respectively. Abbreviations: ID50, 50% inhibitory dose; M0, Month-0 when the booster dose was administered; M1, Month-1; neg, negative by PCR; pos, positive by PCR.
Figure 2.
Figure 2.
ID50 geometric mean ratio estimates of neutralizing antibody Month-1 over Month-0—when participants received a booster vaccine—comparing participants with and without asymptomatic Plasmodium falciparum parasitemia and showing adjustments for covariates in univariate analysis. Abbreviations: Adj, adjusted; BMI, body mass index; CD4, CD4+ T cells in cells/mm3 measured at Month 0; CI, confidence intervals; GMRE, geometric mean ratio estimate (a ratio of M1 over M0 of ID50 geometric mean fold-rises in parasitemic over nonparasitemic participants); ID50, 50% inhibitory dilution neutralizing anti-SARS-CoV-2 antibody titer; VL, HIV viral load in copies/mL measured at M0.
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References

    1. Achan J, Serwanga A, Wanzira H, et al. Current malaria infection, previous malaria exposure, and clinical profiles and outcomes of COVID-19 in a setting of high malaria transmission: an exploratory cohort study in Uganda. Lancet Microb 2022; 3:e62–71. - PMC - PubMed
    1. Osei SA, Biney RP, Anning AS, et al. Low incidence of COVID-19 case severity and mortality in Africa; could malaria co-infection provide the missing link? BMC Infect Dis 2022; 22:78. - PMC - PubMed
    1. Zirmenya L, Natukunda A, Nassuuna J, et al. The effect of malaria on responses to unrelated vaccines in animals and humans: a systematic review and meta-analysis. Parasite Immunol 2024; 46:e13067. - PubMed
    1. Polhemus ME, Remich SA, Ogutu BR, et al. Evaluation of RTS,S/AS02A and RTS,S/AS01B in adults in a high malaria transmission area. PLoS One 2009; 4:e6465. - 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; 190:1038–47. - PMC - PubMed

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