Antibody response dynamics to CoronaVac vaccine and booster immunization in adults and the elderly: A long-term, longitudinal prospective study

Gustavo Jardim Volpe; Sandra Coccuzzo Sampaio Vessoni; Lais Braga Soares; Maria Aparecida Alves Leite Dos Santos Almeida; Patrícia Emília Braga; Glenda Renata de Moraes; Natasha Nicos Ferreira; Pedro Manoel Marques Garibaldi; Simone Kashima; Benedito Antônio Lopes Fonseca; Rodrigo Tocantins Calado; Hugo Alberto Brango García; João Italo Dias de França; Marcos Alves de Lima; Pedro Henrique de Mesquita Pacheco; Marcos Carvalho Borges; Dimas Tadeu Covas

doi:10.1016/j.ijregi.2023.04.003

Antibody response dynamics to CoronaVac vaccine and booster immunization in adults and the elderly: A long-term, longitudinal prospective study

IJID Reg. 2023 Jun:7:222-229. doi: 10.1016/j.ijregi.2023.04.003. Epub 2023 Apr 6.

Authors

Gustavo Jardim Volpe¹, Sandra Coccuzzo Sampaio Vessoni², Lais Braga Soares³, Maria Aparecida Alves Leite Dos Santos Almeida³, Patrícia Emília Braga³, Glenda Renata de Moraes⁴, Natasha Nicos Ferreira¹, Pedro Manoel Marques Garibaldi¹, Simone Kashima⁵, Benedito Antônio Lopes Fonseca⁵, Rodrigo Tocantins Calado⁵, Hugo Alberto Brango García⁶, João Italo Dias de França³, Marcos Alves de Lima³, Pedro Henrique de Mesquita Pacheco³, Marcos Carvalho Borges^{1

5}, Dimas Tadeu Covas²

Affiliations

¹ Serrana State Hospital, Serrana, São Paulo, Brazil.
² Instituto Butantan, São Paulo, São Paulo, Brazil.
³ Fundação Butantan, São Paulo, São Paulo, Brazil.
⁴ Health Department, Serrana, São Paulo, Brazil.
⁵ Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
⁶ Departamento de Matemáticas y Estadística, Universidad del Norte, Barranquilla, Colombia.

Abstract

Background: The long-term humoral immune response after vaccination varies between vaccines and is dependent on the accuracy of the antibody test. A better understanding of the vaccine immune response may help to define vaccination strategies against coronavirus disease 2019 (COVID-19).

Objective: To investigate the long-term immunological response to CoronaVac vaccine and determinants of breakthrough COVID-19 infection.

Methods: A long-term, prospective cohort study involving vaccinated adult and elderly subjects was conducted to investigate the presence of anti-RBD-specific immunoglobulin (Ig)G, anti-nucleocapsid IgG and anti-spike trimeric protein IgG. Antibody level dynamics and risk factors associated with breakthrough COVID-19 infection were investigated.

Results: In total, 3902 participants were included in this study. Vaccination with two doses of CoronaVac and a booster dose increased the levels of anti-RBD-specific IgG, anti-nucleocapsid IgG and anti-spike trimeric IgG significantly. In adults, anti-nucleocapsid IgG and anti-spike trimeric IgG levels decreased significantly 7 months after the second dose. In adults and the elderly, the levels of anti-spike trimeric IgG and anti-RBD IgG decreased significantly 4 and 6 months after the booster dose, respectively. Previous exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and anti-spike trimeric IgG titres was independently associated with a lower probability of post-vaccination infection.

Conclusions: A significant increase in antibody levels was found after two doses of CoronaVac and a booster dose. Antibody titres declined significantly 7 months post-vaccination in participants who did not receive a booster dose. Higher levels of antibodies and previous SARS-CoV-2 infection were associated with protection against breakthrough COVID-19.

Keywords: COVID-19; COVID-19 vaccine booster shot; CoronaVac vaccine; Humoral; Immunity.