Immunogenicity of BNT162b2 vaccine booster against SARS-CoV-2 Delta and Omicron variants in nursing home residents: A prospective observational study in older adults aged from 68 to 98 years

Enagnon Kazali Alidjinou; Julie Demaret; Bénédicte Corroyer-Simovic; Julien Labreuche; Anne Goffard; Jacques Trauet; Daniela Lupau; Sophie Miczek; Fanny Vuotto; Arnaud Dendooven; Dominique Huvent-Grelle; Juliette Podvin; Daniel Dreuil; Karine Faure; Dominique Deplanque; Laurence Bocket; Alain Duhamel; Annie Sobaszek; Didier Hober; Michael Hisbergues; Francois Puisieux; Brigitte Autran; Yazdan Yazdanpanah; Myriam Labalette; Guillaume Lefèvre

doi:10.1016/j.lanepe.2022.100385

Immunogenicity of BNT162b2 vaccine booster against SARS-CoV-2 Delta and Omicron variants in nursing home residents: A prospective observational study in older adults aged from 68 to 98 years

Lancet Reg Health Eur. 2022 Jun:17:100385. doi: 10.1016/j.lanepe.2022.100385. Epub 2022 Apr 21.

Authors

Enagnon Kazali Alidjinou¹, Julie Demaret², Bénédicte Corroyer-Simovic³, Julien Labreuche⁴, Anne Goffard^{5

6}, Jacques Trauet², Daniela Lupau², Sophie Miczek⁷, Fanny Vuotto⁸, Arnaud Dendooven², Dominique Huvent-Grelle³, Juliette Podvin³, Daniel Dreuil³, Karine Faure⁸, Dominique Deplanque⁹, Laurence Bocket¹, Alain Duhamel¹⁰, Annie Sobaszek¹¹, Didier Hober¹, Michael Hisbergues¹², Francois Puisieux³, Brigitte Autran^{13

14}, Yazdan Yazdanpanah¹⁵, Myriam Labalette², Guillaume Lefèvre²

Affiliations

¹ Univ Lille, CHU Lille, Laboratoire de Virologie ULR3610, Lille F-59000, France.
² CHU Lille, Institut d'Immunologie, U1286 - INFINITE - Institute for Translational Research in Inflammation Inserm Univ. Lille, F-59000, Lille, France.
³ CHU Lille, Pôle de Gériatrie, Hôpital Gériatrique Les Bateliers, CHU de Lille, Université de Lille, Lille F-59000, France.
⁴ Department of Biostatistics, CHU Lille, Lille F59000, France.
⁵ Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL U1019 - CIIL-Centre d'Infection et d'Immunité de Lille Centre d'Infection et d'Immunité de Lille, Lille F-59000, France.
⁶ Clinical Microbiology Unit, Institut Pasteur de Lille, Lille F-59000, France.
⁷ CHU Lille, Médecine et santé-Travail, CHU Lille, Lille F-59000, France.
⁸ Département de Maladies Infectieuses, CHU Lille, Lille F-59000, France.
⁹ Univ. Lille, Inserm, CHU Lille, CIC 1403 - Clinical Investigation Center, Lille 59000, France.
¹⁰ Université Lille, CHU Lille, EA 2694 - Santé Publique: Épidémiologie et Qualité Des Soins, Université de Lille, Lille, Hauts-de-France, France.
¹¹ CHU Lille, Médecine et santé-travail, Univ. Lille, CHU Lille, ULR 4483, IMPECS, Lille F-59000, France.
¹² CHU Lille, Université Lille, Univ.Lille, Centre de Ressources Biologiques, Lille F-59000, France.
¹³ Sorbonne-Université, Paris, France.
¹⁴ UMR-S Inserm/UPMC 1135, CIMI-Paris (Centre de Recherches Immunité Maladies Infectieuses), Paris, France.
¹⁵ Infectious Diseases Department, INSERM, IAME, Hôpital Bichat - Claude-Bernard, France.

Abstract

Background: The present study aimed to evaluate the persistent immunogenicity offered by a third dose of BNT162b2 against Delta and Omicron variants, in nursing home (NH) residents.

Methods: In this monocenter prospective observational study, anti-spike IgG levels, S1 domain reactive T cell counts, serum neutralizing antibody titers against Delta and Omicron variants were compared before and up to three months after the BNT162b2 booster dose, in NH residents without COVID-19 (COVID-19 naive) or with COVID-19 prior to initial vaccination (COVID-19 recovered).

Findings: 106 NH residents (median [interquartile range] age: 86·5 [81;91] years) were included. The booster dose induced a high increase of anti-spike antibody levels in all subjects (p < 0.0001) and a mild transient increase of specific T cells. Before the booster dose, Delta neutralization was detected in 19% (n = 8/43) and 88% (n = 37/42) of COVID-19 naive and COVID-19 recovered subjects, respectively. Three months after the booster dose, all NH residents developed and maintained a higher Delta neutralization (p < 0·0001). Before the booster dose, Omicron neutralization was detected in 5% (n = 2/43) and 55% (n = 23/42) of COVID-19 naive and COVID-19 recovered subjects, respectively, and three months after, in 84% and 95%, respectively. Neutralizing titers to Omicron were lower than to Delta in both groups with a 35-fold reduction compared to Delta.

Interpretation: The booster dose restores high neutralization titers against Delta in all NH residents, and at a lower level against Omicron in a large majority of participants. Future studies are warranted to assess if repeated BNT162b2 booster doses or new specific vaccines might be considered for protecting such fragile patients against Omicron and/or future SARS-CoV-2 variants.

Funding: French government through the Programme Investissement d'Avenir (I-SITE ULNE/ANR-16-IDEX-0004 ULNE) and the Label of COVID-19 National Research Priority (National Steering Committee on Therapeutic Trials and Other COVID-19 Research, CAPNET).

Keywords: BNT162b2 vaccine; Boost; Delta; Older people; Omicron; SARS-CoV-2; immunogenicity.