Understanding 'hybrid immunity': comparison and predictors of humoral immune responses to SARS-CoV-2 infection and COVID-19 vaccines release_2bfyftcteva65aoh4xt74e3fmy

by Nusrat Epsi, Stephanie A. Richard, David A. Lindholm, Katrin Mende, Anuradha Ganesan, Nikhil Huprikar, Tahaniyat Lalani, Anthony C. Fries, Ryan Maves, Rhonda E. Colombo, Derek T. Larson, Alfred Smith (+25 others)

Published in Clinical Infectious Diseases by Oxford University Press (OUP).

2022  

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> Comparing humoral responses in SARS-CoV-2 vaccinees, those with SARS-CoV-2 infection, or combinations of vaccine/infection ('hybrid immunity'), may clarify predictors of vaccine immunogenicity. </jats:sec> <jats:sec> <jats:title>Methods</jats:title> We studied 2660 U.S. Military Health System beneficiaries with a history of SARS-CoV-2 infection-alone (n = 705), vaccination-alone (n = 932), vaccine-after-infection (n = 869), and vaccine-breakthrough-infection (n = 154). Peak anti-spike-IgG responses through 183 days were compared, with adjustment for vaccine product, demography, and comorbidities. We excluded those with evidence of clinical or sub-clinical SARS-CoV-2 reinfection from all groups. </jats:sec> <jats:sec> <jats:title>Results</jats:title> Multivariable regression results indicated vaccine-after-infection anti-spike-IgG responses were higher than infection-alone (p &amp;lt; 0.01), regardless of prior infection severity. An increased time between infection and vaccination was associated with a greater post-vaccination IgG response (p &amp;lt; 0.01). Vaccination-alone elicited a greater IgG response, but more rapid waning of IgG (p &amp;lt; 0.01), compared to infection-alone (p &amp;lt; 0.01). BNT162b2 and mRNA-1273 vaccine-receipt was associated with greater IgG responses compared to JNJ-78436735 (p &amp;lt; 0.01), regardless of infection history. Those with vaccine-after-infection or vaccine-breakthrough-infection had a more durable anti-spike-IgG response compared to infection-alone (p &amp;lt; 0.01). </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> Vaccine-receipt elicited higher anti-spike-IgG responses than infection-alone, although IgG levels waned faster in those vaccinated (compared to infection-alone). Vaccine-after-infection elicits a greater humoral response compared to vaccine or infection alone; and the timing, but not disease severity, of prior infection predicted these post-vaccination IgG responses. While differences between groups were small in magnitude, these results offer insights into vaccine immunogenicity variations that may help inform vaccination timing strategies. </jats:sec>
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Type  article-journal
Stage   published
Date   2022-05-24
Language   en ?
DOI  10.1093/cid/ciac392
PubMed  35608504
PMC  PMC9213853
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ISSN-L:  1058-4838
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