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

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}, John Hural⁴, Nigel Garrett^{14

15

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 Desmond Tutu HIV Centre, University of Cape Town, South Africa.
¹⁵ Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa.
¹⁶ Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

PMID: 40751436
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 et al. J Infect Dis. 2025.

. 2025 Aug 2:jiaf398.

doi: 10.1093/infdis/jiaf398. Online ahead of print.

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 Desmond Tutu HIV Centre, University of Cape Town, South Africa.
¹⁵ Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa.
¹⁶ Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

PMID: 40751436
DOI: 10.1093/infdis/jiaf398

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 PCR-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 1,000 correlated with 96% efficacy in preventing COVID-19. We observed ID50 geometric mean titers >22,000 in both parasitemic and non-parasitemic participants one month after boosting. We conclude that COVID-19 mRNA vaccine antibody responses are unimpaired by concurrent asymptomatic parasitemia.

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

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Update of

Neutralizing Antibody Responses After mRNA COVID-19 Booster Vaccination are Unaffected by Parasitemia in a Malaria-Endemic Setting.
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. medRxiv [Preprint]. 2025 Apr 16:2025.04.12.25325718. doi: 10.1101/2025.04.12.25325718. medRxiv. 2025. Update in: J Infect Dis. 2025 Aug 02:jiaf398. doi: 10.1093/infdis/jiaf398. PMID: 40321290 Free PMC article. Updated. Preprint.

Grants and funding

UM1 AI068614/AI/NIAID NIH HHS/United States

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

Affiliations

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

Authors

Affiliations

Abstract

Update of

Grants and funding