Can individuals with suboptimal antibody responses to conventional antiviral vaccines acquire adequate antibodies from SARS-CoV-2 mRNA vaccination?

  1. Wataru Ogura
  2. Kouki Ohtsuka
  3. Sachiko Matsuura
  4. Takahiro Okuyama
  5. Satsuki Matsushima
  6. Satoko Ymasaki
  7. Hiroyuki Miyagi
  8. Kumiko Sekiguchi
  9. Hiroaki Ohnishi
  10. Takashi Watanabe
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Abstract

Objective

In Japan, healthcare workers (HCWs) are vaccinated against contagious viruses (measles, rubella, chickenpox, mumps, and hepatitis B) to prevent nosocomial infection; however, some do not produce sufficient antibodies (suboptimal responders). Whether suboptimal responders to live attenuated viruses or inactivated viruses vaccines can produce adequate antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines remains to be elucidated.

Methods

In this prospective cohort study, SARS-CoV-2 anti-spike antibodies were measured 11 times, from before the first BNT162b2 vaccination to 5 months after the second vaccination. Antibody titers of suboptimal and normal responders were compared. SARS-CoV-2 neutralizing antibody activity was measured twice in suboptimal responders, 1 week to 1 month, and 5 months after the second vaccination.

Patients

This study included 50 HCWs who received two doses of mRNA BNT162b2 vaccine 3 weeks apart.

Results

After vaccination, the SARS-CoV-2 anti-spike antibody was detectable in the samples from suboptimal and normal responders at each timepoint. The median SARS-CoV-2 anti-spike antibody titer was higher in suboptimal responders than in normal responders 1 week after receiving the second dose of BNT162b2 vaccine (3721.0 vs. 2251.5, P =0.029). Suboptimal responders had SARS-CoV-2 neutralizing antibody activity 1 week to 1 month, and 5 months after the second vaccination, which exceeded the positive threshold 5 months after the second vaccination.

Conclusion

After BNT162b2 vaccination, suboptimal responders acquired adequate SARS-CoV-2 anti-spike and SARS-CoV-2 neutralizing antibodies to prevent SARS-CoV-2. These results suggest that vaccination with mRNA vaccine against SARS-CoV-2 should also be recommended for suboptimal responders to conventional vaccines.

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