A single mRNA vaccine dose in COVID-19 patients boosts neutralizing antibodies against SARS-CoV-2 and variants of concern

Marit J van Gils; Hugo D G van Willigen; Elke Wynberg; Alvin X Han; Karlijn van der Straten; Judith A Burger; Meliawati Poniman; Melissa Oomen; Khadija Tejjani; Joey H Bouhuijs; Anouk Verveen; Romy Lebbink; Maartje Dijkstra; Brent Appelman; A H Ayesha Lavell; Tom G Caniels; Ilja Bontjer; Lonneke A van Vught; Alexander P J Vlaar; Jonne J Sikkens; Marije K Bomers; Colin A Russell; Neeltje A Kootstra; Rogier W Sanders; Maria Prins; Godelieve J de Bree; Menno D de Jong; RECoVERED Study Group

doi:10.1016/j.xcrm.2021.100486

A single mRNA vaccine dose in COVID-19 patients boosts neutralizing antibodies against SARS-CoV-2 and variants of concern

Cell Rep Med. 2021 Dec 14;3(1):100486. doi: 10.1016/j.xcrm.2021.100486. eCollection 2022 Jan 18.

Authors

Marit J van Gils¹, Hugo D G van Willigen¹, Elke Wynberg^{1

2}, Alvin X Han¹, Karlijn van der Straten^{1

3}, Judith A Burger¹, Meliawati Poniman¹, Melissa Oomen¹, Khadija Tejjani¹, Joey H Bouhuijs¹, Anouk Verveen⁴, Romy Lebbink², Maartje Dijkstra^{2

3}, Brent Appelman⁵, A H Ayesha Lavell⁶, Tom G Caniels¹, Ilja Bontjer¹, Lonneke A van Vught^{5

7}, Alexander P J Vlaar⁷, Jonne J Sikkens⁶, Marije K Bomers⁶, Colin A Russell¹, Neeltje A Kootstra⁸, Rogier W Sanders^{1

9}, Maria Prins^{2

3}, Godelieve J de Bree³, Menno D de Jong¹; RECoVERED Study Group

Collaborators

RECoVERED Study Group:
Ivette Agard, Jane Ayal, Anders Boyd, Floor Cavdar, Marianne Craanen, Udi Davidovich, Annemarieke Deuring, Annelies van Dijk, Ertan Ersan, Laura Del Grande, Joost Hartman, Nelleke Koedoot, Tjalling Leenstra, Dominique Loomans, Agata Makowska, Tom du Maine, Ilja de Man, Amy Matser, Lizenka van der Meij, Marleen van Polanen, Maria Oud, Clark Reid, Leeann Storey, Marije de Wit, Marc van Wijk, Joyce van Assem, Joost van den Aardweg, Marijne van Beek, Thyra Blankert, Brigitte Boeser-Nunnink, Eric Moll van Charante, Karel van Dort, Orlane Figaroa, Leah Frenkel, Arginell Girigorie, Jelle van Haga, Agnes Harskamp-Holwerda, Mette Hazenberg, Soemeja Hidad, Nina de Jong, Marcel Jonges, Suzanne Jurriaans, Hans Knoop, Lara Kuijt, Anja Lok, Marga Mangas Ruiz, Irma Maurer, Pythia Nieuwkerk, Ad van Nuenen, Annelou van der Veen, Bas Verkaik, Gerben-Rienk Visser

Affiliations

¹ Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
² Department of Infectious Diseases, Public Health Service of Amsterdam, GGD, Amsterdam, the Netherlands.
³ Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
⁴ Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam School of Public Health, Amsterdam, the Netherlands.
⁵ Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
⁶ Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
⁷ Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
⁸ Department of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
⁹ Department of Microbiology and Immunology, Weill Medical College of Cornell University, New York, NY, USA.

Abstract

The urgent need for, but limited availability of, SARS-CoV-2 vaccines worldwide has led to widespread consideration of dose-sparing strategies. Here, we evaluate the SARS-CoV-2-specific antibody responses following BNT162b2 vaccination in 150 previously SARS-CoV-2-infected individuals from a population-based cohort. One week after first vaccine dose, spike protein antibody levels are 27-fold higher and neutralizing antibody titers 12-fold higher, exceeding titers of fully vaccinated SARS-CoV-2-naive controls, with minimal additional boosting after the second dose. Neutralizing antibody titers against four variants of concern increase after vaccination; however, overall neutralization breadth does not improve. Pre-vaccination neutralizing antibody titers and time since infection have the largest positive effect on titers following vaccination. COVID-19 severity and the presence of comorbidities have no discernible impact on vaccine response. In conclusion, a single dose of BNT162b2 vaccine up to 15 months after SARS-CoV-2 infection offers higher neutralizing antibody titers than 2 vaccine doses in SARS-CoV-2-naive individuals.

Keywords: BNT162b2; COVID-19; SARS-CoV-2; antibody response; mRNA vaccine; neutralization; previous infection; response predictors; variants.

MeSH terms

Adult
Aged
Antibodies, Neutralizing / blood
Antibodies, Neutralizing / immunology*
Antibodies, Viral / blood
Antibodies, Viral / immunology*
BNT162 Vaccine / administration & dosage*
BNT162 Vaccine / immunology*
COVID-19 / blood
COVID-19 / immunology*
COVID-19 / prevention & control*
COVID-19 / virology
Female
Follow-Up Studies
Humans
Immunogenicity, Vaccine / immunology*
Immunoglobulin G / blood
Immunoglobulin G / immunology
Male
Middle Aged
Neutralization Tests
Prospective Studies
SARS-CoV-2 / immunology*
Severity of Illness Index
Spike Glycoprotein, Coronavirus / immunology
Treatment Outcome
Vaccination / methods*

Substances

Antibodies, Neutralizing
Antibodies, Viral
Immunoglobulin G
Spike Glycoprotein, Coronavirus
spike protein, SARS-CoV-2
BNT162 Vaccine

Supplementary concepts

SARS-CoV-2 variants

Abstract

MeSH terms

Substances

Supplementary concepts

Grants and funding