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BNT162b2 Vaccine-Induced Immune Responses and Dynamics Vary Among Age Groups, Sex and Co-Morbidities: A Longitudinal Prospective Cohort Study

25 Pages Posted: 4 Mar 2021

See all articles by Yaniv Lustig

Yaniv Lustig

Chaim Sheba Medical Center - Central Virology Laboratory

Einav Sapir

Sackler Faculty of Medicine, Tel-Aviv University

Gili Regev-Yochay

Tel-Aviv University - Sackler Faculty of Medicine

Carmit Cohen

Chaim Sheba Medical Center - Infection Prevention & Control Unit

Ronen Fluss

Bio-statistical and Bio-mathematical Unit, The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center

Liraz Olmer

Bio-statistical and Bio-mathematical Unit, The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center

victoria Indenbaum

Chaim Sheba Medical Center - Central Virology Laboratory

Michal Mandelboim

Chaim Sheba Medical Center - Central Virology Laboratory

Ram Doolman

Chaim Sheba Medical Center - Laboratory Division

Sharon Amit

Sheba Medical Center - Clinical Microbiology

Ella Mendelson

Sheba Medical Center - Central Virology Laboratory

Arnona Ziv

Chaim Sheba Medical Center - Bio-statistical and Bio-mathematical Unit

Amit Huppert

Sheba Medical Center - Central Virology Laboratory; Chaim Sheba Medical Center - Bio-statistical and Bio-mathematical Unit

Carmit Rubin

Chaim Sheba Medical Center - Bio-statistical and Bio-mathematical Unit

Laurence Freedman

Sheba Medical Center - Gertner Institute for Epidemiology and Health Policy Research

Yitshak Kreiss

Chaim Sheba Medical Center - General Management

More...

Abstract

Background: Concurrent to BNT162b2 vaccine rollout in Israel, we performed a longitudinal prospective cohort study to assess the early antibody response and antibody kinetics after each vaccine dose among health care workers (HCW) of different ages, gender and co-morbidities.   

Methods: Overall 2,607 vaccinated HCW were followed for five weeks after vaccination and Immunoglobulin (Ig)M, IgA, IgG and neutralizing antibodies were measured by Beckman-coulter SARS-CoV-2 RBD IgG, ELISA-RBD and pseudo-virus neutralization assays. Scatter plot and correlation analyses, logistic and linear regression analyses and linear mixed models were used to investigate the longitudinal antibody response.

Findings: The first vaccine dose elicited low IgG and neutralizing antibody response in the majority of HCW which were rapidly induced 10 and 32 folds, respectively following the second vaccine dose. High (r=0.92) correlation was detected between IgG and neutralizing titers. First dose induced IgG response was significantly lower in older (>65, Ratio of means=0.25 95%CI 0.19-0.31) and immunosuppressed (0.21 95%CI 0.14-0.31) individuals. Yet, this was partially abrogated following the second dose. Overall, lower antibody levels were consistently associated with males (0.84 95%CI 0.80-0.89), older age (>65, 0.64 95%CI 0.58-0.71), immunosuppression (0.44 95%CI 0.33-0.58), and other specific comorbidities (diabetes (0.88 95%CI 0.79-0.98), hypertension (0.90 95%CI 0.82-0.98), heart disease (0.86 95%CI 0.75-0.99) and autoimmune diseases (0.82 95%CI 0.73-0.92).

Interpretation: BNT162b2 vaccine induces a strong and rapid antibody response. The significant correlation between IgG antibodies and neutralization titers, suggest that IgG antibodies may serve as a correlate of neutralization. The second vaccine dose is significantly more important for older and immunosuppressed individuals. Antibody responses were reduced in vulnerable populations and therefore they may be more prone to breakthrough infections. 

Declaration of interests: None to declare.

Ethics statement: The protocol and informed consent were approved by the Institutional review 125 board of the Sheba Medical Center. Written informed consent was obtained from all 126 participants.

Funding: MOH and Sheba medical Center, Israel

Suggested Citation

Lustig, Yaniv and Sapir, Einav and Regev-Yochay, Gili and Cohen, Carmit and Fluss, Ronen and Olmer, Liraz and Indenbaum, victoria and Mandelboim, Michal and Doolman, Ram and Amit, Sharon and Mendelson, Ella and Ziv, Arnona and Huppert, Amit and Rubin, Carmit and Freedman, Laurence and Kreiss, Yitshak, BNT162b2 Vaccine-Induced Immune Responses and Dynamics Vary Among Age Groups, Sex and Co-Morbidities: A Longitudinal Prospective Cohort Study. Available at SSRN: https://ssrn.com/abstract=3790408 or http://dx.doi.org/10.2139/ssrn.3790408

Yaniv Lustig (Contact Author)

Chaim Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Einav Sapir

Sackler Faculty of Medicine, Tel-Aviv University ( email )

Tel-Aviv
Israel

Gili Regev-Yochay

Tel-Aviv University - Sackler Faculty of Medicine ( email )

Tel-Aviv
Israel

Carmit Cohen

Chaim Sheba Medical Center - Infection Prevention & Control Unit ( email )

Tel Hashomer
Ramat-Gan
Israel

Ronen Fluss

Bio-statistical and Bio-mathematical Unit, The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center ( email )

Tel Hashomer
Ramat-Gan
Israel

Liraz Olmer

Bio-statistical and Bio-mathematical Unit, The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center ( email )

Tel Hashomer
Ramat-Gan
Israel

Victoria Indenbaum

Chaim Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Michal Mandelboim

Chaim Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Ram Doolman

Chaim Sheba Medical Center - Laboratory Division ( email )

Tel Hashomer
Ramat-Gan
Israel

Sharon Amit

Sheba Medical Center - Clinical Microbiology ( email )

Tel Hashomer
Ramat-Gan
Israel

Ella Mendelson

Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Arnona Ziv

Chaim Sheba Medical Center - Bio-statistical and Bio-mathematical Unit ( email )

Tel Hashomer
Ramat-Gan
Israel

Amit Huppert

Sheba Medical Center - Central Virology Laboratory ( email )

Ramat-Gan
Israel

Chaim Sheba Medical Center - Bio-statistical and Bio-mathematical Unit ( email )

Tel Hashomer
Ramat-Gan
Israel

Carmit Rubin

Chaim Sheba Medical Center - Bio-statistical and Bio-mathematical Unit ( email )

Tel Hashomer
Ramat-Gan
Israel

Laurence Freedman

Sheba Medical Center - Gertner Institute for Epidemiology and Health Policy Research ( email )

Tel Hashomer
Ramat-Gan
Israel

Yitshak Kreiss

Chaim Sheba Medical Center - General Management ( email )

Tel Hashomer
Ramat-Gan
Israel

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