SARS-CoV-2 antibodies and breakthrough infections in the Virus Watch cohort

Robert W. Aldridge*, Alexei Yavlinsky, Vincent Nguyen, Max T. Eyre, Madhumita Shrotri, Annalan M.D. Navaratnam, Sarah Beale, Isobel Braithwaite, Thomas Byrne, Jana Kovar, Ellen Fragaszy, Wing Lam Erica Fong, Cyril Geismar, Parth Patel, Alison Rodger, Anne M. Johnson, Andrew Hayward

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

A range of studies globally demonstrate that the effectiveness of SARS-CoV-2 vaccines wane over time, but the total effect of anti-S antibody levels on risk of SARS-CoV-2 infection and whether this varies by vaccine type is not well understood. Here we show that anti-S levels peak three to four weeks following the second dose of vaccine and the geometric mean of the samples is nine fold higher for BNT162b2 than ChAdOx1. Increasing anti-S levels are associated with a reduced risk of SARS-CoV-2 infection (Hazard Ratio 0.85; 95%CIs: 0.79-0.92). We do not find evidence that this antibody relationship with risk of infection varies by second dose vaccine type (BNT162b2 vs. ChAdOx1). In keeping with our anti-S antibody data, we find that people vaccinated with ChAdOx1 had 1.64 times the odds (95% confidence interval 1.45-1.85) of a breakthrough infection compared to BNT162b2. We anticipate our findings to be useful in the estimation of the protective effect of anti-S levels on risk of infection due to Delta. Our findings provide evidence about the relationship between antibody levels and protection for different vaccines and will support decisions on optimising the timing of booster vaccinations and identifying individuals who should be prioritised for booster vaccination, including those who are older, clinically extremely vulnerable, or received ChAdOx1 as their primary course. Our finding that risk of infection by anti-S level does not interact with vaccine type, but that individuals vaccinated with ChAdOx1 were at higher risk of infection, provides additional support for the use of using anti-S levels for estimating vaccine efficacy.

Original languageEnglish
Article number4869
JournalNature Communications
Volume13
Issue number1
DOIs
Publication statusPublished - Dec 2022
Externally publishedYes

Bibliographical note

Funding Information:
The research costs for the study have been supported by the MRC Grant Ref: MC_PC 19070 awarded to UCL on 30 March 2020 and MRC Grant Ref: MR/V028375/1 awarded on 17 August 2020. The study also received $15,000 of Facebook advertising credit to support a pilot social media recruitment campaign on 18th August 2020. This study was supported by the Wellcome Trust through a Wellcome Clinical Research Career Development Fellowship to RWA [206602] and a Clinical Ph.D. Fellowship to AA [206441/Z/17/Z] I.B. is supported by an NIHR Academic Clinical Fellowship. S.B. and T.B. are supported by an MRC doctoral studentship (MR/N013867/1). This work was conducted on behalf of the Virus Watch Collaborative. We would like to acknowledge Nick Kennedy at Royal Devon and Exeter NHS Foundation Trust for the idea of plotting geometric mean data as presented in Figs. 1 , 2.

Funding Information:
The research costs for the study have been supported by the MRC Grant Ref: MC_PC 19070 awarded to UCL on 30 March 2020 and MRC Grant Ref: MR/V028375/1 awarded on 17 August 2020. The study also received $15,000 of Facebook advertising credit to support a pilot social media recruitment campaign on 18th August 2020. This study was supported by the Wellcome Trust through a Wellcome Clinical Research Career Development Fellowship to RWA [206602] and a Clinical Ph.D. Fellowship to AA [206441/Z/17/Z] I.B. is supported by an NIHR Academic Clinical Fellowship. S.B. and T.B. are supported by an MRC doctoral studentship (MR/N013867/1). This work was conducted on behalf of the Virus Watch Collaborative. We would like to acknowledge Nick Kennedy at Royal Devon and Exeter NHS Foundation Trust for the idea of plotting geometric mean data as presented in Figs. , .

Publisher Copyright:
© 2022, The Author(s).

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