Association of total and neutralizing SARS-CoV-2 spike -receptor binding domain antibodies with epidemiological and clinical characteristics after immunization with the 1st and 2nd doses of the BNT162b2 vaccine

Athanasios Michos; Elizabeth-Barbara Tatsi; Filippos Filippatos; Charilaos Dellis; Dimitra Koukou; Vasiliki Efthymiou; Evangelia Kastrinelli; Aimilia Mantzou; Vasiliki Syriopoulou

doi:10.1016/j.vaccine.2021.07.067

Association of total and neutralizing SARS-CoV-2 spike -receptor binding domain antibodies with epidemiological and clinical characteristics after immunization with the 1^st and 2^nd doses of the BNT162b2 vaccine

Vaccine. 2021 Sep 24;39(40):5963-5967. doi: 10.1016/j.vaccine.2021.07.067. Epub 2021 Jul 24.

Authors

Athanasios Michos¹, Elizabeth-Barbara Tatsi², Filippos Filippatos³, Charilaos Dellis³, Dimitra Koukou³, Vasiliki Efthymiou², Evangelia Kastrinelli³, Aimilia Mantzou³, Vasiliki Syriopoulou³

Affiliations

¹ First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece. Electronic address: amichos@med.uoa.gr.
² University Research Institute of Maternal and Child Health and Precision Medicine, Athens, Greece.
³ First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.

Abstract

Background: Data regarding the association of antibody levels elicited after immunization with the BNT162b2 mRNA COVID-19 vaccine with epidemiological and clinical parameters are limited.

Methods: We prospectively measured the total (TAbs-RBD) and the neutralizing antibodies (NAbs-RBD) against the receptor binding domain (RBD) of SARS-CoV-2 spike protein in a cohort of 268 Healthcare workers before immunization, 20 days after the 1^st dose and 30 days after the 2^nd dose of the BNT162b2 vaccine. A statistical analysis for possible association of antibodies' levels with epidemiological and clinical parameters was performed.

Results: The mean age (±SD) of the participants was 45.45 years (±11.93) (range: 24-70 years) and 211 (79.9%) were females. Statistically significant differences were detected regarding both TAbs-RBD and NAbs-RBD between the first and second doses of the vaccine (P < 0.001). The median (IQR) percentage (%) of NAbs-RBD after the 1^st dose was 51.07% (31.60%) and after the 2^nd dose 95.31% (3.70%) (P < 0.001). The correlation between the TAbs-RBD and NAbs-RBD was after the 1^st dose, Spearman's, rho: 0.861 (P < 0.001) and after the 2^nd dose rho: 0.989 (P < 0.001). Twenty days after the 1^st dose, 56/264 (21.2%) of the participants had low levels of NAbs-RBD, while one month after the 2^nd dose all of them had protective levels of NAbs-RBD. After the 2^nd vaccine dose, a statistically significant negative association of TAbs-RBD was detected for age (P < 0.001), smoking (P = 0.011), and immunosuppressive medications (P < 0.001), while a positive association was detected for BMI (P = 0.004) and systemic adverse events after immunization (P = 0.001).

Conclusion: A significant correlation of TAbs-RBD and NAbs-RBD was detected after both vaccine doses. Older age, smoking, and immunosuppressive medications negatively affected the final antibody level after SARS-CoV-2 immunization. Our findings emphasize the significance of the 2^nd vaccine dose especially in the older age groups.

Keywords: Antibody; BNT162b2; COVID-19; Immunity; SARS-CoV-2; Spike protein.

MeSH terms

Adult
Aged
Antibodies, Neutralizing / immunology
Antibodies, Viral / immunology*
BNT162 Vaccine
COVID-19 Vaccines* / immunology
COVID-19* / prevention & control
Female
Humans
Immunization
Male
Middle Aged
SARS-CoV-2
Spike Glycoprotein, Coronavirus / immunology
Young Adult

Substances

Antibodies, Neutralizing
Antibodies, Viral
COVID-19 Vaccines
Spike Glycoprotein, Coronavirus
spike protein, SARS-CoV-2
BNT162 Vaccine