Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis
ObjectivesWe sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.DesignThis study is a 10-month longitudinal cohort study of healthcare workers and serially measured a...
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| Published in | BMJ open Vol. 12; no. 5; p. e059994 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
British Medical Journal Publishing Group
24.05.2022
BMJ Publishing Group LTD BMJ Publishing Group |
| Series | Original research |
| Subjects | |
| Online Access | Get full text |
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| Abstract | ObjectivesWe sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.DesignThis study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.SettingA large, multisite academic medical centre in Southern California, USA.ParticipantsA total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.ResultsVaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (−0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.ConclusionsWhile the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the ‘hybrid’ immunity conferred by natural infection combined with vaccination. |
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| AbstractList | We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.
This study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.
A large, multisite academic medical centre in Southern California, USA.
A total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.
Vaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R
=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (-0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.
While the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the 'hybrid' immunity conferred by natural infection combined with vaccination. ObjectivesWe sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.DesignThis study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.SettingA large, multisite academic medical centre in Southern California, USA.ParticipantsA total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.ResultsVaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (−0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.ConclusionsWhile the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the ‘hybrid’ immunity conferred by natural infection combined with vaccination. Objectives We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.Design This study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.Setting A large, multisite academic medical centre in Southern California, USA.Participants A total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.Results Vaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (−0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.Conclusions While the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the ‘hybrid’ immunity conferred by natural infection combined with vaccination. We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.OBJECTIVESWe sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.This study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.DESIGNThis study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.A large, multisite academic medical centre in Southern California, USA.SETTINGA large, multisite academic medical centre in Southern California, USA.A total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.PARTICIPANTSA total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.Vaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (-0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.RESULTSVaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (-0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.While the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the 'hybrid' immunity conferred by natural infection combined with vaccination.CONCLUSIONSWhile the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the 'hybrid' immunity conferred by natural infection combined with vaccination. |
| Author | Jain, Mohit Sobhani, Kimia Van Eyk, Jennifer E Frias, Edwin C Weber, Brittany Cheng, Susan Driver, Matthew Alotaibi, Mona Wynter, Timothy Khuu, Briana Ebinger, Joseph E Prostko, John C Joung, Sandy Nguyen, Trevor-Trung Arditi, Moshe Liu, Yunxian Fert-Bober, Justyna Wu, Min McGovern, Dermot P B Botting, Patrick G Jordan, Stanley C Melmed, Gil Y Claggett, Brian Sun, Nancy Goodridge, Helen S Stewart, James L Sharma, Sonia Kao, Yu Hung Braun, Jonathan G Minissian, Margo B Chen, Peter |
| AuthorAffiliation | 8 La Jolla Institute for Allergy and Immunology , La Jolla , California , USA 6 Transplant Immunology Laboratory and Comprehensive Transplant Center , Cedars-Sinai Medical Center , Los Angeles , California , USA 5 Department of Biomedical Sciences, Research Division of Immunology , Cedars-Sinai Medical Center , Los Angeles , California , USA 7 Department of Medicine, School of Medicine , University of California, San Diego , San Diego , California , USA 9 Advanced Clinical Biosystems Institute, Department of Biomedical Sciences , Cedars-Sinai Medical Center , Los Angeles , California , USA 10 Brawerman Nursing Institute , Cedars-Sinai Medical Center , Los Angeles , California , USA 13 Department of Pathology and Laboratory Medicine , Cedars-Sinai Medical Center , Los Angeles , California , USA 11 Smidt Heart Institute; Department of Pediatrics, Division of Infectious Diseases and Immunology; Infectious and Immunologic Diseases Research Center (IIDRC); Department of Biomedical Sciences , Cedar |
| AuthorAffiliation_xml | – name: 13 Department of Pathology and Laboratory Medicine , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 5 Department of Biomedical Sciences, Research Division of Immunology , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 6 Transplant Immunology Laboratory and Comprehensive Transplant Center , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 12 F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 11 Smidt Heart Institute; Department of Pediatrics, Division of Infectious Diseases and Immunology; Infectious and Immunologic Diseases Research Center (IIDRC); Department of Biomedical Sciences , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 2 Cardiovascular Division , Brigham and Women’s Hospital , Boston , Massachusetts , USA – name: 10 Brawerman Nursing Institute , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 7 Department of Medicine, School of Medicine , University of California, San Diego , San Diego , California , USA – name: 1 Department of Cardiology, Smidt Heart Institute , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 4 Applied Research and Technology , Abbott Laboratories , Abbott Park , Illinois , USA – name: 3 Division of Pulmonary and Critical Care Medicine , University of California San Diego , San Diego , California , USA – name: 9 Advanced Clinical Biosystems Institute, Department of Biomedical Sciences , Cedars-Sinai Medical Center , Los Angeles , California , USA – name: 8 La Jolla Institute for Allergy and Immunology , La Jolla , California , USA |
| Author_xml | – sequence: 1 givenname: Joseph E surname: Ebinger fullname: Ebinger, Joseph E organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 2 givenname: Sandy surname: Joung fullname: Joung, Sandy organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 3 givenname: Yunxian surname: Liu fullname: Liu, Yunxian organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 4 givenname: Min surname: Wu fullname: Wu, Min organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 5 givenname: Brittany surname: Weber fullname: Weber, Brittany organization: Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA – sequence: 6 givenname: Brian surname: Claggett fullname: Claggett, Brian organization: Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA – sequence: 7 givenname: Patrick G surname: Botting fullname: Botting, Patrick G organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 8 givenname: Nancy surname: Sun fullname: Sun, Nancy organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 9 givenname: Matthew surname: Driver fullname: Driver, Matthew organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 10 givenname: Yu Hung surname: Kao fullname: Kao, Yu Hung organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 11 givenname: Briana surname: Khuu fullname: Khuu, Briana organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 12 givenname: Timothy orcidid: 0000-0002-6956-9217 surname: Wynter fullname: Wynter, Timothy organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 13 givenname: Trevor-Trung surname: Nguyen fullname: Nguyen, Trevor-Trung organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 14 givenname: Mona surname: Alotaibi fullname: Alotaibi, Mona organization: Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, California, USA – sequence: 15 givenname: John C surname: Prostko fullname: Prostko, John C organization: Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA – sequence: 16 givenname: Edwin C surname: Frias fullname: Frias, Edwin C organization: Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA – sequence: 17 givenname: James L surname: Stewart fullname: Stewart, James L organization: Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA – sequence: 18 givenname: Helen S surname: Goodridge fullname: Goodridge, Helen S organization: Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 19 givenname: Peter surname: Chen fullname: Chen, Peter organization: Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 20 givenname: Stanley C surname: Jordan fullname: Jordan, Stanley C organization: Transplant Immunology Laboratory and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 21 givenname: Mohit surname: Jain fullname: Jain, Mohit organization: Department of Medicine, School of Medicine, University of California, San Diego, San Diego, California, USA – sequence: 22 givenname: Sonia surname: Sharma fullname: Sharma, Sonia organization: La Jolla Institute for Allergy and Immunology, La Jolla, California, USA – sequence: 23 givenname: Justyna surname: Fert-Bober fullname: Fert-Bober, Justyna organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 24 givenname: Jennifer E surname: Van Eyk fullname: Van Eyk, Jennifer E organization: Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 25 givenname: Margo B surname: Minissian fullname: Minissian, Margo B organization: Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 26 givenname: Moshe surname: Arditi fullname: Arditi, Moshe organization: Smidt Heart Institute; Department of Pediatrics, Division of Infectious Diseases and Immunology; Infectious and Immunologic Diseases Research Center (IIDRC); Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 27 givenname: Gil Y surname: Melmed fullname: Melmed, Gil Y organization: F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 28 givenname: Jonathan G surname: Braun fullname: Braun, Jonathan G organization: Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 29 givenname: Dermot P B surname: McGovern fullname: McGovern, Dermot P B organization: F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 30 givenname: Susan orcidid: 0000-0002-0587-1572 surname: Cheng fullname: Cheng, Susan email: susan.cheng@cshs.org organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA – sequence: 31 givenname: Kimia surname: Sobhani fullname: Sobhani, Kimia organization: Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA |
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| DOI | 10.1136/bmjopen-2021-059994 |
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generates greater immunoglobulin G levels in women compared to men publication-title: J Infect Dis doi: 10.1093/infdis/jiab314 contributor: fullname: Demonbreun – volume: 9 start-page: 999 year: 2021 ident: 2022063010174797000_12.5.e059994.27 article-title: BNT162b2 COVID-19 vaccine and correlates of humoral immune responses and dynamics: a prospective, single-centre, longitudinal cohort study in health-care workers publication-title: Lancet Respir Med doi: 10.1016/S2213-2600(21)00220-4 contributor: fullname: Lustig – volume: 596 start-page: 417 year: 2021 ident: 2022063010174797000_12.5.e059994.24 article-title: Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2 publication-title: Nature doi: 10.1038/s41586-021-03739-1 contributor: fullname: Collier – ident: 2022063010174797000_12.5.e059994.20 doi: 10.3201/eid2609.201840 |
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| Snippet | ObjectivesWe sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of... We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose... Objectives We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of... |
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| SubjectTerms | Academic Medical Centers Adult Age Antibodies Antibodies, Viral Antibody Formation BNT162 Vaccine Cohort analysis Cohort Studies Comorbidity Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 Vaccines Demography Drug dosages Ethnicity Female Health Personnel Humans Hypertension Immunoglobulin G Infections Infectious Diseases Longitudinal Studies Male Medical personnel Middle Aged Prospective Studies Proteins SARS-CoV-2 Serology Severe acute respiratory syndrome coronavirus 2 Vaccination Variables Work environment Workers |
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| Title | Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis |
| URI | https://bmjopen.bmj.com/content/12/5/e059994.full https://www.ncbi.nlm.nih.gov/pubmed/35613792 https://www.proquest.com/docview/2669130339 https://www.proquest.com/docview/2670063180 https://pubmed.ncbi.nlm.nih.gov/PMC9130668 https://doaj.org/article/8780247aa4eb4c398b2d4cf8d46d9331 |
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