COVID-19 Vaccines; mRNA Vaccine; BNT162 Vaccine; RNA, Messenger; Antibodies, Viral; Humans; Adult; Population Groups; SARS-CoV-2; Breakthrough Infections; Nursing Homes; Immunity; COVID-19/prevention & control; COVID-19; Molecular Medicine; Immunology and Microbiology (all); Veterinary (all); Public Health, Environmental and Occupational Health; Infectious Diseases; General Veterinary; General Immunology and Microbiology
Abstract :
[en] [en] BACKGROUND: Nursing home residents, a frail and old population group, respond poorly to primary mRNA COVID-19 vaccination. A third dose has been shown to boost protection against severe disease and death in this immunosenescent population, but limited data is available on the immune responses it induces.
METHODS: In this observational cohort study, peak humoral and cellular immune responses were compared 28 days after the second and third doses of the BNT162b2 mRNA COVID-19 vaccine in residents and staff members of two Belgian nursing homes. Only individuals without evidence of previous SARS-CoV-2 infection at third dose administration were included in the study. In addition, an extended cohort of residents and staff members was tested for immune responses to a third vaccine dose and was monitored for vaccine breakthrough infections in the following six months. The trial is registered on ClinicalTrials.gov (NCT04527614).
FINDINGS: All included residents (n = 85) and staff members (n = 88) were SARS-CoV-2 infection naïve at third dose administration. Historical blood samples from 28 days post second dose were available from 42 residents and 42 staff members. Magnitude and quality of humoral and cellular immune responses were strongly boosted in residents post third compared to post second dose. Increases were less pronounced in staff members than in residents. At 28 days post third dose, differences between residents and staff had become mostly insignificant. Humoral, but not cellular, responses induced by a third dose were predictive of subsequent incidence of vaccine breakthrough infection in the six months following vaccination.
INTERPRETATION: These data show that a third dose of mRNA COVID-19 vaccine largely closes the gap in humoral and cellular immune response observed after primary vaccination between NH residents and staff members but suggest that further boosting might be needed to achieve optimal protection against variants of concern in this vulnerable population group.
Disciplines :
Immunology & infectious disease
Author, co-author :
Pannus, Pieter ; SD Infectious Diseases in Humans, Sciensano, 642 Engelandstraat, 1180 Ukkel, Belgium, Institute for Medical Immunology and ULB Center for Research in Immunology (U-CRI), Université libre de Bruxelles (ULB), 8 Rue Adrienne Bolland, 6041 Gosselies, Belgium. Electronic address: pieter.pannus@ulb.be
Kemlin, Delphine; Institute for Medical Immunology and ULB Center for Research in Immunology (U-CRI), Université libre de Bruxelles (ULB), 8 Rue Adrienne Bolland, 6041 Gosselies, Belgium
Houben, Sarah ; SD Infectious Diseases in Humans, Sciensano, 642 Engelandstraat, 1180 Ukkel, Belgium
Olislagers, Véronique; Institute for Medical Immunology and ULB Center for Research in Immunology (U-CRI), Université libre de Bruxelles (ULB), 8 Rue Adrienne Bolland, 6041 Gosselies, Belgium
Waegemans, Alexandra; Institute for Medical Immunology and ULB Center for Research in Immunology (U-CRI), Université libre de Bruxelles (ULB), 8 Rue Adrienne Bolland, 6041 Gosselies, Belgium
De Craeye, Stéphane; SD Infectious Diseases in Humans, Sciensano, 642 Engelandstraat, 1180 Ukkel, Belgium
Ariën, Kevin K; Virology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, 155 Nationalestraat, 2000 Antwerp, Belgium, Department of Biomedical Sciences, University of Antwerp, 13 Prinsstraat, 2000 Antwerp, Belgium
Marchant, Arnaud; Institute for Medical Immunology and ULB Center for Research in Immunology (U-CRI), Université libre de Bruxelles (ULB), 8 Rue Adrienne Bolland, 6041 Gosselies, Belgium
Goossens, Maria E ; SD Infectious Diseases in Humans, Sciensano, 642 Engelandstraat, 1180 Ukkel, Belgium
We thank Caroline Rodeghiero, Fabienne Jurion, Elfriede Heerwegh, Giresse Tima, Elisa Brauns, Muriel Nguyen, Séverine Thomas, Vincent Martens, Valérie Acolty, Inès Vu Duc, Maria Lara Escandell, Sandra Coppens, Ann Ceulemans, Koen Bartholomeeusen and Marylène Vandevenne for their technical and logistical help in the laboratory. We thank Martine Delaere, Kristine Massez, Jody Serré, Nathalie Matia Sangrador and Elodie Glinne for their excellent and dedicated work as study nurses. We thank Dr. Piet Maes (Rega Institute, KU Leuven, Belgium) to kindly provide the Omicron BA.5 SARS-CoV-2 isolate. Finally, we thank all residents and staff members of the participating nursing homes for their availability, flexibility, and dedication to the study. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
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