Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes

Crick COVID Immunity Pipeline; Gokhan Tut; Tara Lancaster; Maria Krutikov; Panagiota Sylla; David Bone; Eliska Spalkova; Christopher Bentley; Umayr Amin; Azar Jadir; Samuel Hulme; Nayandeep Kaur; Elif Tut; Rachel Bruton; Mary Y. Wu; Ruth Harvey; Edward J. Carr; Madhumita Shrotri; Verity Baynton; Aidan Irwin-Singer; Rupert Beale; Oliver Stirrup; Borscha Azmi; Christopher Fuller; Andrew J. Copas; Laura Shallcross; Andrew Hayward; Paul A. Moss

doi:10.1038/s43587-022-00328-3

Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes

Crick COVID Immunity Pipeline, Gokhan Tut, Tara Lancaster, Maria Krutikov, Panagiota Sylla, David Bone, Eliska Spalkova, Christopher Bentley, Umayr Amin, Azar Jadir, Samuel Hulme, Nayandeep Kaur, Elif Tut, Rachel Bruton, Mary Y. Wu, Ruth Harvey, Edward J. Carr, Madhumita Shrotri, Verity Baynton, Aidan Irwin-SingerRupert Beale, Oliver Stirrup, Borscha Azmi, Christopher Fuller, Andrew J. Copas, Laura Shallcross, Andrew Hayward, Paul A. Moss

UK Health Security Agency

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Abstract

Third-dose coronavirus disease 2019 vaccines are being deployed widely but their efficacy has not been assessed adequately in vulnerable older people who exhibit suboptimal responses after primary vaccination series. This observational study, which was carried out by the VIVALDI study based in England, looked at spike-specific immune responses in 341 staff and residents in long-term care facilities who received an mRNA vaccine following dual primary series vaccination with BNT162b2 or ChAdOx1. Third-dose vaccination strongly increased antibody responses with preferential relative enhancement in older people and was required to elicit neutralization of Omicron. Cellular immune responses were also enhanced with strong cross-reactive recognition of Omicron. However, antibody titers fell 21–78% within 100 d after vaccine and 27% of participants developed a breakthrough Omicron infection. These findings reveal strong immunogenicity of a third vaccine in one of the most vulnerable population groups and endorse an approach for widespread delivery across this population. Ongoing assessment will be required to determine the stability of immune protection.

Original language	English
Pages (from-to)	93-104
Number of pages	12
Journal	Nature Aging
Volume	3
Issue number	1
DOIs	https://doi.org/10.1038/s43587-022-00328-3
Publication status	Published - 20 Jan 2023

Bibliographical note

Funding Information: The authors would like to thank the staff and residents in the LTCFs that participated in this study, and Mark Marshall at NHS England who pseudonymised the electronic health records. This research was funded in whole, or in part, by the Wellcome Trust [CC2230, CC2087]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This work was supported by the Francis Crick Institute which receives its core funding from Cancer Research UK (CC2230, CC2087), the UK Medical Research Council (CC2230, CC2087), and the Wellcome Trust (CC2230, CC2087); and the Department of Health and Social Care. This report is independent research funded by the Department of Health and Social Care (COVID-19 surveillance studies). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. We thank Prof. Wendy Barclay of Imperial College and the wider Genotype to Phenotype consortium for the Delta strain used in this study, and Max Whiteley and Thushan I de Silva at The University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust for providing source material. We thank Prof. Gavin Screaton of the University of Oxford for the Omicron strain used in this study.

L.S. 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. A.H. is a member of the New and Emerging Respiratory Virus Threats Advisory Group at the Department of Health. The remaining authors declare no competing interests

Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing,
adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To viewa copy of this license, visit http://creativecommons.org/licenses/ by/4.0

Publisher Copyright: © The Author(s) 2023

Citation: Tut, G., Lancaster, T., Krutikov, M. et al. Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes. Nat Aging 3, 93–104 (2023). https://doi.org/10.1038/s43587-022-00328-3

DOI: https://doi.org/10.1038/s43587-022-00328-3

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Cite this

Crick COVID Immunity Pipeline, Tut, G., Lancaster, T., Krutikov, M., Sylla, P., Bone, D., Spalkova, E., Bentley, C., Amin, U., Jadir, A., Hulme, S., Kaur, N., Tut, E., Bruton, R., Wu, M. Y., Harvey, R., Carr, E. J., Shrotri, M., Baynton, V., ... Moss, P. A. (2023). Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes. Nature Aging, 3(1), 93-104. https://doi.org/10.1038/s43587-022-00328-3

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abstract = "Third-dose coronavirus disease 2019 vaccines are being deployed widely but their efficacy has not been assessed adequately in vulnerable older people who exhibit suboptimal responses after primary vaccination series. This observational study, which was carried out by the VIVALDI study based in England, looked at spike-specific immune responses in 341 staff and residents in long-term care facilities who received an mRNA vaccine following dual primary series vaccination with BNT162b2 or ChAdOx1. Third-dose vaccination strongly increased antibody responses with preferential relative enhancement in older people and was required to elicit neutralization of Omicron. Cellular immune responses were also enhanced with strong cross-reactive recognition of Omicron. However, antibody titers fell 21–78% within 100 d after vaccine and 27% of participants developed a breakthrough Omicron infection. These findings reveal strong immunogenicity of a third vaccine in one of the most vulnerable population groups and endorse an approach for widespread delivery across this population. Ongoing assessment will be required to determine the stability of immune protection.",

author = "{Crick COVID Immunity Pipeline} and Gokhan Tut and Tara Lancaster and Maria Krutikov and Panagiota Sylla and David Bone and Eliska Spalkova and Christopher Bentley and Umayr Amin and Azar Jadir and Samuel Hulme and Nayandeep Kaur and Elif Tut and Rachel Bruton and Wu, {Mary Y.} and Ruth Harvey and Carr, {Edward J.} and Madhumita Shrotri and Verity Baynton and Aidan Irwin-Singer and Rupert Beale and Oliver Stirrup and Borscha Azmi and Christopher Fuller and Copas, {Andrew J.} and Laura Shallcross and Andrew Hayward and Moss, {Paul A.}",

note = "Funding Information: The authors would like to thank the staff and residents in the LTCFs that participated in this study, and Mark Marshall at NHS England who pseudonymised the electronic health records. This research was funded in whole, or in part, by the Wellcome Trust [CC2230, CC2087]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This work was supported by the Francis Crick Institute which receives its core funding from Cancer Research UK (CC2230, CC2087), the UK Medical Research Council (CC2230, CC2087), and the Wellcome Trust (CC2230, CC2087); and the Department of Health and Social Care. This report is independent research funded by the Department of Health and Social Care (COVID-19 surveillance studies). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. We thank Prof. Wendy Barclay of Imperial College and the wider Genotype to Phenotype consortium for the Delta strain used in this study, and Max Whiteley and Thushan I de Silva at The University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust for providing source material. We thank Prof. Gavin Screaton of the University of Oxford for the Omicron strain used in this study. L.S. 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. A.H. is a member of the New and Emerging Respiratory Virus Threats Advisory Group at the Department of Health. The remaining authors declare no competing interests Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article{\textquoteright}s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article{\textquoteright}s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To viewa copy of this license, visit http://creativecommons.org/licenses/ by/4.0 Publisher Copyright: {\textcopyright} The Author(s) 2023 Citation: Tut, G., Lancaster, T., Krutikov, M. et al. Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes. Nat Aging 3, 93–104 (2023). https://doi.org/10.1038/s43587-022-00328-3 DOI: https://doi.org/10.1038/s43587-022-00328-3",

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Crick COVID Immunity Pipeline, Tut, G, Lancaster, T, Krutikov, M, Sylla, P, Bone, D, Spalkova, E, Bentley, C, Amin, U, Jadir, A, Hulme, S, Kaur, N, Tut, E, Bruton, R, Wu, MY, Harvey, R, Carr, EJ, Shrotri, M, Baynton, V , Irwin-Singer, A, Beale, R, Stirrup, O, Azmi, B, Fuller, C, Copas, AJ, Shallcross, L, Hayward, A & Moss, PA 2023, 'Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes', Nature Aging, vol. 3, no. 1, pp. 93-104. https://doi.org/10.1038/s43587-022-00328-3

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AU - Crick COVID Immunity Pipeline

AU - Tut, Gokhan

AU - Lancaster, Tara

AU - Krutikov, Maria

AU - Sylla, Panagiota

AU - Bone, David

AU - Spalkova, Eliska

AU - Bentley, Christopher

AU - Amin, Umayr

AU - Jadir, Azar

AU - Hulme, Samuel

AU - Kaur, Nayandeep

AU - Tut, Elif

AU - Bruton, Rachel

AU - Wu, Mary Y.

AU - Harvey, Ruth

AU - Carr, Edward J.

AU - Shrotri, Madhumita

AU - Baynton, Verity

AU - Irwin-Singer, Aidan

AU - Beale, Rupert

AU - Stirrup, Oliver

AU - Azmi, Borscha

AU - Fuller, Christopher

AU - Copas, Andrew J.

AU - Shallcross, Laura

AU - Hayward, Andrew

AU - Moss, Paul A.

N1 - Funding Information: The authors would like to thank the staff and residents in the LTCFs that participated in this study, and Mark Marshall at NHS England who pseudonymised the electronic health records. This research was funded in whole, or in part, by the Wellcome Trust [CC2230, CC2087]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This work was supported by the Francis Crick Institute which receives its core funding from Cancer Research UK (CC2230, CC2087), the UK Medical Research Council (CC2230, CC2087), and the Wellcome Trust (CC2230, CC2087); and the Department of Health and Social Care. This report is independent research funded by the Department of Health and Social Care (COVID-19 surveillance studies). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. We thank Prof. Wendy Barclay of Imperial College and the wider Genotype to Phenotype consortium for the Delta strain used in this study, and Max Whiteley and Thushan I de Silva at The University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust for providing source material. We thank Prof. Gavin Screaton of the University of Oxford for the Omicron strain used in this study. L.S. 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. A.H. is a member of the New and Emerging Respiratory Virus Threats Advisory Group at the Department of Health. The remaining authors declare no competing interests Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To viewa copy of this license, visit http://creativecommons.org/licenses/ by/4.0 Publisher Copyright: © The Author(s) 2023 Citation: Tut, G., Lancaster, T., Krutikov, M. et al. Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes. Nat Aging 3, 93–104 (2023). https://doi.org/10.1038/s43587-022-00328-3 DOI: https://doi.org/10.1038/s43587-022-00328-3

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Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes

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