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Booster Vaccination Strongly Enhances SARS-CoV-2-Specific Antibody and Cellular Responses in Elderly Residents of Care Homes

20 Pages Posted: 20 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

Maria Krutikov

University College London - Institute for Health Informatics

Panagiota Sylla

University of Birmingham - Institute of Immunology and Immunotherapy

David Bone

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

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

Nayandeep Kaur

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

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

Verity Baynton

UK Health Security Agency

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

Third dose ‘booster’ COVID-19 vaccines can increase SARS-CoV-2 specific immune responses and are being deployed widely to control the impact of omicron variant infection. However, the efficacy of booster vaccines has not been assessed in the most vulnerable demographic groups such as the elderly and frail. This is important as elderly residents in care facilities who have not had a prior natural SARS-CoV-2 infection exhibit suboptimal antibody and cellular responses following dual vaccination. We studied immune responses in 134 staff and residents in long term care facilities (LTCF) who had received an mRNA booster vaccine following initial dual homologous vaccination with either Pfizer mRNA or ChAdOx1 vaccine. Booster vaccination strongly increased antibody responses irrespective of prior infection status. Amongst staff and residents with serological evidence of prior infection these were 4.1-fold and 3.2-fold higher than following dual vaccination. Furthermore, these were increased by 6.4-fold and 12.3-fold within infection-naïve donors such that elderly donors achieved a similar antibody level to younger staff. Cellular immune responses were boosted only in older donors and achieved equivalence across the life course. The immunogenicity of the mRNA booster vaccine was equivalent in donors who had received either mRNA or adenovirus baseline vaccination. As such, booster vaccination can overcome the negative influence of age on immune responses to dual COVID-19 vaccination in the LTCF setting. These findings reveal strong immunogenicity after the 3rd booster vaccine dose in one of the most vulnerable clinical groups and endorse an approach for rapid delivery across this population.

Clinical Trial Registration Details: The VIVALDI study (ISRCTN14447421).

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 no interests to declare.

Ethics Approval Statement: All participants provided written informed consent for blood sample collection or if residents lacked the capacity to consent, a personal or nominated consultee was identified to act on their behalf. Ethical approval for this study was obtained from the South Central - Hampshire B Research Ethics Committee, REC Ref: 20/SC/0238.

Keywords: SARS-CoV-2, COVID-19, Vaccination, Booster, Care home, Long Term Care Facility (LTCF), Elderly

Suggested Citation

Tut, Gokhan and Lancaster, Tara and Krutikov, Maria and Sylla, Panagiota and Bone, David and Spalkova, Eliska and Bentley, Christopher and Amin, Umayr and Jadir, Azar and Hulme, Samuel and Kaur, Nayandeep and Tut, Elif and Bruton, Rachel and Giddings, Rebecca and Shrotri, Madhumita and Azmi, Borscha and Fuller, Chris and Baynton, Verity and Irwin-Singer, Aidan and Hayward, Andrew C and Copas, Andrew and Shallcross, Laura and Moss, Paul, Booster Vaccination Strongly Enhances SARS-CoV-2-Specific Antibody and Cellular Responses in Elderly Residents of Care Homes. Available at SSRN: https://ssrn.com/abstract=3990239 or http://dx.doi.org/10.2139/ssrn.3990239

Gokhan Tut (Contact Author)

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

Maria Krutikov

University College London - Institute for Health Informatics

Gower Street
London, WC1E 6BT
United Kingdom

Panagiota Sylla

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

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

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

Nayandeep Kaur

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

Birmingham
United Kingdom

Elif Tut

University of Birmingham - Institute of Immunology and Immunotherapy

Birmingham
United Kingdom

Rachel Bruton

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

Birmingham
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

Verity Baynton

UK Health Security Agency ( email )

London
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

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

Birmingham
United Kingdom

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