Declining Prevalence of SARS-CoV-2 Antibodies among Vaccinated Nursing Home Residents and Staff Six Months after the Primary BNT162b2 Vaccination Campaign in Belgium: A Prospective Cohort Study.
[en] In the SCOPE study, we monitored SARS-CoV-2 antibodies in a national sample of residents and staff from Belgian nursing homes. Here, we report the seroprevalence among infected and infection-naive residents and staff after the primary COVID-19 vaccination campaign. Among 1554 vaccinated nursing home residents and 1082 vaccinated staff from 69 nursing homes in Belgium, we assessed the proportion having SARS-CoV-2 antibodies approximately two (April 2021), four (June 2021), and six months (August 2021) after a two-dose regimen of the BNT162b2 vaccine. We measured the seroprevalence using SARS-CoV-2 antibody rapid tests and collected socio-demographic and COVID-19 medical data using an online questionnaire. Two months after vaccination (baseline), we found a seroprevalence of 91% (95% CI: 89-93) among vaccinated residents and 99% (95% CI: 98-99) among vaccinated staff. Six months after vaccination, the seroprevalence significantly decreased to 68% (95% CI: 64-72) among residents and to 89% (95% CI; 86-91) among staff (p < 0.001). The seroprevalence was more likely to decrease among infection-naive residents, older residents, or residents with a high care dependency level. These findings emphasize the need for close monitoring of nursing home residents, as a substantial part of this population fails to mount a persistent antibody response after BNT162b2 vaccination.
Disciplines :
Immunology & infectious disease
Author, co-author :
Meyers, Eline ; Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
Deschepper, Ellen; Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
Duysburgh, Els ; Department of Epidemiology and Public Health, Sciensano, 1000 Brussels, Belgium
De Rop, Liselore; EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
De Burghgraeve, Tine; EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
Van Ngoc, Pauline ; Université de Liège - ULiège > Soins primaires et santé
Delogne, Simon; Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, 4000 Liège, Belgium
Coen, Anja; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
De Clercq, Nele; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
Buret, Laetitia ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale
Coenen, Samuel ; Department of Family Medicine & Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium
Sutter, An De; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
Scholtes, Béatrice ; Université de Liège - ULiège > Département des sciences cliniques > Médecine générale
Verbakel, Jan Y ; EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium ; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
Cools, Piet ; Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
Heytens, Stefan; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
Declining Prevalence of SARS-CoV-2 Antibodies among Vaccinated Nursing Home Residents and Staff Six Months after the Primary BNT162b2 Vaccination Campaign in Belgium: A Prospective Cohort Study.
This study was funded by the Belgian Institute for Health, Sciensano (SC_045). Sciensano was involved in the design of this study, result interpretation and manuscript review.
Peeters I. Vermeulen M. Bustos Sierra N. Renard F. Van der Heyden J. Scohy A. Braeye T. Bossuyt N. Haarhuis F. Proesmans K. et al. Surveillance van COVID-19 Gerelateerde Mortaliteit in België, Epidemiologie en Methodologie Tijdens 1e en 2e Golf (Maart 2020–14 Februari 2021) Contract No.: D/2021/14.440/55 Sciensano Brussels, Belgium 2021
Control ECDC Overview of the Implementation of COVID-19 Vaccination Strategies and Deployment Plans in the EU/EEA14 June 2021 ECDC Stockholm, Sweden 2021
Polack F.P. Thomas S.J. Kitchin N. Absalon J. Gurtman A. Lockhart S. Perez J.L. Pérez Marc G. Moreira E.D. Zerbini C. et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine N. Engl. J. Med. 2020 383 2603 2615 10.1056/NEJMoa2034577 33301246
Walsh E.E. Frenck R.W. Jr. Falsey A.R. Kitchin N. Absalon J. Gurtman A. Lockhart S. Neuzil K. Mulligan M.J. Bailey R. et al. Safety and Immunogenicity of Two RNA-Based COVID-19 Vaccine Candidates N. Engl. J. Med. 2020 383 2439 2450 10.1056/NEJMoa2027906 33053279
Bewoner Woonzorgcentrum Gemiddeld 87 Jaar Zorg en Ondersteuning voor Ouderen-Statistiek Vlaanderen: Intermutalistisch Agentschap 2022 Available online: https://www.vlaanderen.be/statistiek-vlaanderen/zorg/zorg-en-ondersteuning-voor-ouderen#bronnen (accessed on 26 April 2022)
Akner G. Analysis of multimorbidity in individual elderly nursing home residents. Development of a multimorbidity matrix Arch. Gerontol. Geriatr. 2009 49 413 419 10.1016/j.archger.2008.12.009 19185359
Kwetkat A. Heppner H.J. Comorbidities in the Elderly and Their Possible Influence on Vaccine Response Interdiscip. Top. Gerontol. Geriatr. 2020 43 73 85 32305984
Remarque E.J. de Bruijn I.A. Boersma W.J.A. Masurel N. Ligthart G.J. Altered antibody response to influenza H1N1 vaccine in healthy elderly people as determined by HI, ELISA, and neutralization assay J. Med. Virol. 1998 55 82 87 10.1002/(SICI)1096-9071(199805)55:1<82::AID-JMV13>3.0.CO;2-1
Ridda I. Macintyre C.R. Lindley R. Gao Z. Sullivan J.S. Yuan F.F. Gao Z. Sullivan J.S. Yuan F.F. McIntyre P.B. Immunological responses to pneumococcal vaccine in frail older people Vaccine 2009 27 1628 1636 10.1016/j.vaccine.2008.11.098
Nath K. Viswanathan S. Upham J. Davies J. Towers M. Looke D. Pritchard A. Burel J. Clinical factors associated with the humoral immune response to influenza vaccination in chronic obstructive pulmonary disease Int. J. Chronic Obstr. Pulm. Dis. 2013 9 51 56 10.2147/COPD.S53590
Levin E.G. Lustig Y. Cohen C. Fluss R. Indenbaum V. Amit S. Doolman R. Waning Immune Humoral Response to BNT162b2 COVID-19 Vaccine over 6 Months N. Engl. J. Med. 2021 385 e84 10.1056/NEJMoa2114583
Levin E.G. Lustig Y. Cohen C. Fluss R. Indenbaum V. Amit S. Doolman R. Asraf K. Mendelson E. Ziv A. et al. Spike-antibody waning after second dose of BNT162b2 or ChAdOx1 Lancet 2021 398 385 387
Matsunaga H. Takeuchi H. Oba Y. Fujimi S. Honda T. Tomonaga K. Waning of Anti-SARS-CoV-2 Spike Antibody Levels 100 to 200 Days after the Second Dose of the BNT162b2 Vaccine Vaccines 2022 10 177 10.3390/vaccines10020177
Triest D. Geebelen L. De Pauw R. De Craeye S. Vodolazkaia A. Verbrugghe M. Magerman K. Robben L. Pannus P. Neven K. et al. Performance of five rapid serological tests in mild-diseased subjects using finger prick blood for exposure assessment to SARS-CoV-2 J. Clin. Virol. 2021 142 104897 10.1016/j.jcv.2021.104897 34304089
Wallace M. Shelkey M. Hartford Institute for Geriatric Nursing Katz Index of Independence in Activities of Daily Living (ADL) Urologic Nursing 2007 27 93 94 17390935
Canaday D.H. Carias L. Oyebanji O.A. Keresztesy D. Wilk D. Payne M. Aung H. Denis K.S. Lam E.C. Wilson B. et al. Reduced BNT162b2 Messenger RNA Vaccine Response in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-Naive Nursing Home Residents Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am. 2021 73 2112 2115 10.1093/cid/ciab447
Canaday D.H. Oyebanji O.A. Keresztesy D. Payne M. Wilk D. Carias L. Aung H. Denis K.S. Lam E.C. Rowley C.F. et al. Significant Reduction in Vaccine-Induced Antibody Levels and Neutralization Activity Among Healthcare Workers and Nursing Home Residents 6 Months Following Coronavirus Disease 2019 BNT162b2 mRNA Vaccination Clin. Infect. Dis. 2022 75 884 887 10.1093/cid/ciab963 35174389
Muller L. Andree M. Moskorz W. Drexler I. Walotka L. Grothmann R. Ptok J. Age-dependent Immune Response to the Biontech/Pfizer BNT162b2 Coronavirus Disease 2019 Vaccination Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am. 2021 73 2065 2072 10.1093/cid/ciab381
Witkowski W. Gerlo S. De Smet E. Wejda M. Acar D. Callens S. Heytens S. Padalko E. Vercruysse H. Cools P. et al. Humoral and Cellular Responses to COVID-19 Vaccination Indicate the Need for Post-Vaccination Testing in Frail Population Vaccines 2022 10 260 10.3390/vaccines10020260
Palache A. Beyer W. Sprenger M. Masurel N. de Jonge S. Vardy A. Charpentier B. Noury J. van Beek W. Borst R. et al. Antibody response after influenza immunization with various vaccine doses: A double-blind, placebo-controlled, multi-centre, dose—Response study in elderly nursing-home residents and young volunteers Vaccine 1993 11 3 9 10.1016/0264-410X(93)90333-S
Kovaiou R.D. Herndler-Brandstetter D. Grubeck-Loebenstein B. Age-related changes in immunity: Implications for vaccination in the elderly Expert Rev. Mol. Med. 2007 9 1 17 10.1017/S1462399407000221
Frasca D. Blomberg B.B. B cell function and influenza vaccine responses in healthy aging and disease Curr. Opin. Immunol. 2014 29 112 118 10.1016/j.coi.2014.05.008
Earle K.A. Ambrosino D.M. Fiore-Gartland A. Goldblatt D. Gilbert P.B. Siber G.R. Dull P. Plotkin S.A. Evidence for antibody as a protective correlate for COVID-19 vaccines Vaccine 2021 39 4423 4428 10.1016/j.vaccine.2021.05.063
Khoury D.S. Cromer D. Reynaldi A. Schlub T.E. Wheatley A.K. Juno J.A. Subbarao K. Kent S.J. Triccas J.A. Davenport M.P. Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection Nat. Med. 2021 27 1205 1211 10.1038/s41591-021-01377-8 34002089
Tartof S.Y. Slezak J.M. Fischer H. Hong V. Ackerson B.K. Ranasinghe O.N. Frankland T.B. Ogun O.A. Zamparo J.M. Gray S. et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: A retrospective cohort study Lancet 2021 398 1407 1416 10.1016/S0140-6736(21)02183-8
Sciensano Belgium COVID-19 Epidemiological Situation: Nursing Homes Surveilance 2022 Available online: https://datastudio.google.com/embed/reporting/7e11980c-3350-4ee3-8291-3065cc4e90c2/page/FHD7B (accessed on 6 June 2022)
