A single mRNA vaccine dose in COVID-19 patients boosts neutralizing antibodies against SARS-CoV-2 and variants of concern

• Published in: Cell reports. Medicine Vol. 3; no. 1; p. 100486
• Main Authors: van Gils, Marit J., van Willigen, Hugo D.G., Wynberg, Elke, Han, Alvin X., van der Straten, Karlijn, Burger, Judith A., Poniman, Meliawati, Oomen, Melissa, Tejjani, Khadija, Bouhuijs, Joey H., Verveen, Anouk, Lebbink, Romy, Dijkstra, Maartje, Appelman, Brent, Lavell, A.H. Ayesha, Caniels, Tom G., Bontjer, Ilja, van Vught, Lonneke A., Vlaar, Alexander P.J., Sikkens, Jonne J., Bomers, Marije K., Russell, Colin A., Kootstra, Neeltje A., Sanders, Rogier W., Prins, Maria, de Bree, Godelieve J., de Jong, Menno D., Agard, Ivette, Ayal, Jane, Boyd, Anders, Cavdar, Floor, Craanen, Marianne, Davidovich, Udi, Deuring, Annemarieke, van Dijk, Annelies, Ersan, Ertan, del Grande, Laura, Hartman, Joost, Koedoot, Nelleke, Leenstra, Tjalling, Loomans, Dominique, Makowska, Agata, du Maine, Tom, de Man, Ilja, Matser, Amy, van der Meij, Lizenka, van Polanen, Marleen, Oud, Maria, Reid, Clark, Storey, Leeann, de Wit, Marije, van Wijk, Marc, van Assem, Joyce, van den Aardweg, Joost, van Beek, Marijne, Blankert, Thyra, Boeser-Nunnink, Brigitte, Moll van Charante, Eric, van Dort, Karel, Figaroa, Orlane, Frenkel, Leah, Girigorie, Arginell, van Haga, Jelle, Harskamp-Holwerda, Agnes, Hazenberg, Mette, Hidad, Soemeja, de Jong, Nina, Jonges, Marcel, Jurriaans, Suzanne, Knoop, Hans, Kuijt, Lara, Lok, Anja, Ruiz, Marga Mangas, Maurer, Irma, Nieuwkerk, Pythia, van Nuenen, Ad, van der Veen, Annelou, Verkaik, Bas, Visser, Gerben-Rienk
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 18-01-2022; Elsevier
• Subjects: Adult; Aged; Antibodies, Neutralizing - blood; Antibodies, Neutralizing - immunology; Antibodies, Viral - blood; Antibodies, Viral - immunology; antibody response; BNT162 Vaccine - administration & dosage; BNT162 Vaccine - immunology; BNT162b2; COVID-19; COVID-19 - blood; COVID-19 - immunology; COVID-19 - prevention & control; COVID-19 - virology; Female; Follow-Up Studies; Humans; Immunogenicity, Vaccine - immunology; Immunoglobulin G - blood; Immunoglobulin G - immunology; Male; Middle Aged; mRNA vaccine; neutralization; Neutralization Tests; previous infection; Prospective Studies; response predictors; SARS-CoV-2; SARS-CoV-2 - immunology; Severity of Illness Index; Spike Glycoprotein, Coronavirus - immunology; Treatment Outcome; Vaccination - methods; variants; COVID-19; previous infection; SARS-CoV-2; BNT162b2; antibody response; neutralization; response predictors; variants; mRNA vaccine
• ISSN: 2666-3791; 2666-3791
• DOI: 10.1016/j.xcrm.2021.100486

The urgent need for, but limited availability of, SARS-CoV-2 vaccines worldwide has led to widespread consideration of dose-sparing strategies. Here, we evaluate the SARS-CoV-2-specific antibody responses following BNT162b2 vaccination in 150 previously SARS-CoV-2-infected individuals from a population-based cohort. One week after first vaccine dose, spike protein antibody levels are 27-fold higher and neutralizing antibody titers 12-fold higher, exceeding titers of fully vaccinated SARS-CoV-2-naive controls, with minimal additional boosting after the second dose. Neutralizing antibody titers against four variants of concern increase after vaccination; however, overall neutralization breadth does not improve. Pre-vaccination neutralizing antibody titers and time since infection have the largest positive effect on titers following vaccination. COVID-19 severity and the presence of comorbidities have no discernible impact on vaccine response. In conclusion, a single dose of BNT162b2 vaccine up to 15 months after SARS-CoV-2 infection offers higher neutralizing antibody titers than 2 vaccine doses in SARS-CoV-2-naive individuals.
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•150 SARS-CoV-2-infected individuals in a population-based prospective cohort study•The antibody titers increase within 1 week after a single dose of BNT162b2•Neutralization titers against the variants of concern show no increase in breadth•Pre-vaccination antibody titers have the largest effect on vaccine response
In a prospective cohort study, van Gils et al. find that a single dose of BNT162b2 mRNA vaccine up to 15 months after SARS-CoV-2 infection provides neutralizing titers exceeding 2 vaccine doses in SARS-CoV-2-naive individuals. This supports wide implementation of a single-dose mRNA vaccine strategy after prior SARS-CoV-2 infection.