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Reduced Antibody and Cellular Immune Responses Following Dual COVID-19 Vaccination Within Infection-Naïve Residents of Long-Term Care Facilities

29 Pages Posted: 9 Dec 2021

See all articles by Gokhan Tut

Gokhan Tut

University of Birmingham - Institute of Immunology and Immunotherapy

Tara Lancaster

University of Birmingham - Institute of Immunology and Immunotherapy

Megan S. Butler

University of Birmingham - Institute of Immunology and Immunotherapy

David Bone

University of Birmingham - Institute of Immunology and Immunotherapy

Nayandeep Kaur

University of Birmingham - Institute of Immunology and Immunotherapy

Eliska Spalkova

University of Birmingham - Institute of Immunology and Immunotherapy

Christopher Bentley

University of Birmingham - Institute of Immunology and Immunotherapy

Panagiota Sylla

University of Birmingham - Institute of Immunology and Immunotherapy

Umayr Amin

University of Birmingham - Institute of Immunology and Immunotherapy

Azar Jadir

University of Birmingham - Institute of Immunology and Immunotherapy

Samuel Hulme

University of Birmingham - Institute of Immunology and Immunotherapy

Morenike Ayodele

University of Birmingham - Institute of Immunology and Immunotherapy

Duncan Murray

University of Birmingham - Institute of Immunology and Immunotherapy

David Greenwood

University of Birmingham - Institute of Immunology and Immunotherapy

Wayne Croft

University of Birmingham - Institute of Immunology and Immunotherapy

Elif Tut

University of Birmingham - Institute of Immunology and Immunotherapy

Rachel Bruton

University of Birmingham - Institute of Immunology and Immunotherapy

Maria Krutikov

University College London - Institute for Health Informatics

Rebecca Giddings

University College London - Institute for Health Informatics

Madhumita Shrotri

University College London - Institute for Health Informatics

Borscha Azmi

University College London - Institute for Health Informatics

Chris Fuller

University College London - Institute for Health Informatics

Aidan Irwin-Singer

UK Health Security Agency; Department of Health and Social Care

Andrew C Hayward

Health Data Research UK; University College London - Research Department of Epidemiology & Public Health

Andrew Copas

University College London - Institute for Global Health; University College London - Institute for Health Informatics

Laura Shallcross

University College London - Institute for Health Informatics

Paul Moss

University of Birmingham - Institute of Immunology and Immunotherapy

More...

Abstract

Background: Age and frailty are risk factors for poor clinical outcomes following SARS-CoV-2 infection. As such, COVID-19 vaccination has been prioritised for this group but there is concern that immune responses may be impaired due to immune senescence and co-morbidity.

Methods: We studied antibody and cellular immune responses following COVID-19 vaccination in 202 staff and 286 residents of long-term care facilities (LTCF). Due to the high prevalence of previous infection within this environment 50% and 51% of these two groups respectively had serological evidence of prior natural SARS-CoV-2 infection.

Results: In both staff and residents with previous infection the antibody responses following dual vaccination were strong and equivalent across the age course. In contrast, within infection-naïve donors these responses were reduced by 2.4-fold and 8.1-fold respectively such that values within the resident population were 2.6-fold lower than in staff.  Impaired neutralisation of delta variant spike binding was also apparent within donors without prior infection. Spike-specific T cell responses were also markedly enhanced by prior infection and within infection-naive donors were 52% lower within residents compared to staff. Post-vaccine spike-specific CD4+ T cell responses displayed single or dual production of IFN-γ+ and IL-2+ whilst previous infection primed for an extended functional profile with TNF-ɑ+ and CXCL10 production.

Interpretation: These data reveal suboptimal post-vaccine immune responses within infection-naïve elderly residents of LTCF and indicate the need for further optimization of immune protection through the use of booster vaccination.

Funding Information: UK Government Department of Health and Social Care.

Declaration of Interests: LS reports grants from the Department of Health and Social Care during the conduct of the study and is a member of the Social Care Working Group, which reports to the Scientific Advisory Group for Emergencies. AH is a member of the New and Emerging Respiratory Virus Threats Advisory Group at the Department of Health. All other authors have nothing to declare.

Ethics Approval Statement: Ethical approval for this study was obtained from the South Central - Hampshire B Research Ethics Committee, REC Ref: 20/SC/0238.

Keywords: Long Term Care Facility, Resident, COVID-19, SARS-CoV-2, Vaccination

Suggested Citation

Tut, Gokhan and Lancaster, Tara and Butler, Megan S. and Bone, David and Kaur, Nayandeep and Spalkova, Eliska and Bentley, Christopher and Sylla, Panagiota and Amin, Umayr and Jadir, Azar and Hulme, Samuel and Ayodele, Morenike and Murray, Duncan and Greenwood, David and Croft, Wayne and Tut, Elif and Bruton, Rachel and Krutikov, Maria and Giddings, Rebecca and Shrotri, Madhumita and Azmi, Borscha and Fuller, Chris and Irwin-Singer, Aidan and Hayward, Andrew C and Copas, Andrew and Shallcross, Laura and Moss, Paul, Reduced Antibody and Cellular Immune Responses Following Dual COVID-19 Vaccination Within Infection-Naïve Residents of Long-Term Care Facilities. Available at SSRN: https://ssrn.com/abstract=3979590 or http://dx.doi.org/10.2139/ssrn.3979590

Gokhan Tut

University of Birmingham - Institute of Immunology and Immunotherapy

Birmingham
United Kingdom

Tara Lancaster

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Megan S. Butler

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

David Bone

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Nayandeep Kaur

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Eliska Spalkova

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Christopher Bentley

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Panagiota Sylla

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Umayr Amin

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Azar Jadir

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Samuel Hulme

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Morenike Ayodele

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Duncan Murray

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

David Greenwood

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Wayne Croft

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Elif Tut

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Rachel Bruton

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

Maria Krutikov

University College London - Institute for Health Informatics

Gower Street
London, WC1E 6BT
United Kingdom

Rebecca Giddings

University College London - Institute for Health Informatics

Gower Street
London, WC1E 6BT
United Kingdom

Madhumita Shrotri

University College London - Institute for Health Informatics ( email )

Gower Street
London, WC1E 6BT
United Kingdom

Borscha Azmi

University College London - Institute for Health Informatics

Gower Street
London, WC1E 6BT
United Kingdom

Chris Fuller

University College London - Institute for Health Informatics ( email )

Gower Street
London, WC1E 6BT
United Kingdom

Aidan Irwin-Singer

UK Health Security Agency

London
United Kingdom

Department of Health and Social Care ( email )

United Kingdom

Andrew C Hayward

Health Data Research UK

United Kingdom

University College London - Research Department of Epidemiology & Public Health ( email )

1-19 Torrington Place
London, WC1E 7HB
United Kingdom

Andrew Copas

University College London - Institute for Global Health

United Kingdom

University College London - Institute for Health Informatics

Gower Street
London, WC1E 6BT
United Kingdom

Laura Shallcross

University College London - Institute for Health Informatics ( email )

Gower Street
London, WC1E 6BT
United Kingdom

Paul Moss (Contact Author)

University of Birmingham - Institute of Immunology and Immunotherapy ( email )

Birmingham
United Kingdom

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