Evolution of seroprevalence to SARS-CoV-2 in blood donors in Sarajevo Canton, Federation of Bosnia and Herzegovina: Cross-sectional and longitudinal studies

Influenza Other Respir Viruses. 2023 Aug 22;17(8):e13182. doi: 10.1111/irv.13182. eCollection 2023 Aug.

Abstract

Background: Sarajevo Canton in the Federation of Bosnia and Herzegovina has recorded several waves of high SARS-CoV-2 transmission and has struggled to reach adequate vaccination coverage. We describe the evolution of infection- and vaccine-induced SARS-CoV-2 antibody response and persistence.

Methods: We conducted repeated cross-sectional analyses of blood donors aged 18-65 years in Sarajevo Canton in November-December 2020 and 2021. We analyzed serum samples for anti-nucleocapsid (anti-N) and anti-spike (anti-S) antibodies. To assess immune durability, we conducted longitudinal analyses of seropositive participants at 6 and 12 months.

Results: One thousand fifteen participants were included in Phase 1 (November-December 2020) and 1152 in Phase 2 (November-December 2021). Seroprevalence increased significantly from 19.2% (95% CI: 17.2%-21.4%) in Phase 1 to 91.6% (95% CI: 89.8%-93.1%) in Phase 2. Anti-S IgG titers were significantly higher among vaccinated (58.5%) than unvaccinated infected participants across vaccine products (p < 0.001), though highest among those who received an mRNA vaccine. At 6 months, 78/82 (95.1%) participants maintained anti-spike seropositivity; at 12 months, 58/58 (100.0%) participants were seropositive, and 33 (56.9%) had completed the primary vaccine series within 6 months. Among 11 unvaccinated participants who were not re-infected at 12 months, anti-S IgG declined from median 770.1 (IQR 615.0-1321.7) to 290.8 (IQR 175.7-400.3). Anti-N IgG antibodies waned earlier, from 35.4% seropositive at 6 months to 24.1% at 12 months.

Conclusions: SARS-CoV-2 seroprevalence increased significantly over 12 months from end of 2020 to end of 2021. Although individuals with previous infection may have residual protection, COVID-19 vaccination is vital to strengthening population immunity.

Trial registration: ClinicalTrials.gov NCT05124535.

Keywords: Bosnia and Herzegovina; SARS‐CoV‐2; cross‐sectional study; longitudinal study; seroprevalence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Donors*
  • Bosnia and Herzegovina / epidemiology
  • COVID-19 Vaccines
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Cross-Sectional Studies
  • Humans
  • Immunoglobulin G
  • Longitudinal Studies
  • SARS-CoV-2 / genetics
  • Seroepidemiologic Studies

Substances

  • COVID-19 Vaccines
  • Immunoglobulin G

Associated data

  • ClinicalTrials.gov/NCT05124535