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Publications

Journal Article Research Support, Non-U.S. Gov't Epublish 40 citations

PubMed: 35613792 DOI: 10.1136/bmjopen-2021-059994

Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis.

BMJ Open 12(5):e059994

Authors: Joseph E Ebinger, Sandy Joung, Yunxian Liu, Min Wu, Brittany Weber, Brian Claggett, Patrick G Botting, Nancy Sun, Matthew Driver, Yu Hung Kao, Briana Khuu, Timothy Wynter, Trevor-Trung Nguyen, Mona Alotaibi, John C Prostko, Edwin C Frias, James L Stewart, Helen S Goodridge, Peter Chen, Stanley C Jordan, Mohit Jain, Sonia Sharma, Justyna Fert-Bober, Jennifer E Van Eyk, Margo B Minissian, Moshe Arditi, Gil Y Melmed, Jonathan G Braun, Dermot P B McGovern, Susan Cheng, Kimia Sobhani

Affiliations

  • Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, California, USA.
  • Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA.
  • Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Transplant Immunology Laboratory and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Department of Medicine, School of Medicine, University of California, San Diego, San Diego, California, USA.
  • La Jolla Institute for Allergy and Immunology, La Jolla, California, USA.
  • Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Smidt Heart Institute; Department of Pediatrics, Division of Infectious Diseases and Immunology; Infectious and Immunologic Diseases Research Center (IIDRC); Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Abstract

OBJECTIVES

We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.

DESIGN

This study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.

SETTING

A large, multisite academic medical centre in Southern California, USA.

PARTICIPANTS

A total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.

RESULTS

Vaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (-0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.

CONCLUSIONS

While the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the 'hybrid' immunity conferred by natural infection combined with vaccination.

MeSH

Hypertension, Antibody Formation, Absenteeism, Vaccines, Vaccination, Covid-19, Health Personnel, Sex, Communicable Diseases, Demography, Infections

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