Long-Term Analyses of SARS-CoV-2 Humoral and T Cell Responses and Breakthrough SARS-CoV-2 Infections after Two Doses of BNT162b2 Followed by mRNA-1273 and Bivalent Omicron-Adapted BNT162b2 Vaccines: A Prospective Study over 2 Years in Non-Immunocompromised Individuals

Long-term analyses of the immune response following SARS-CoV-2 mRNA vaccines are essential to determining its characteristics and providing the basis for vaccination strategies. We conducted a prospective study in a cohort of 268 healthy adults followed for >2 years after two doses of BNT162b2. A...

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Bibliographic Details
Published in:Vaccines (Basel) 2023-12, Vol.11 (12), p.1835
Main Authors: Erice, Alejo, Prieto, Lola, Caballero, Cristina
Format: Article
Language:English
Subjects:
Antibodies
Asymptomatic
bivalent Omicron-adapted vaccine
BNT162b2
COVID-19
Evaluation
Females
Gender
Health aspects
Immune response
Immune system
Immunoassay
Immunomodulation
Infections
Lymphocytes
Lymphocytes T
mRNA
mRNA vaccines
mRNA-1273
SARS-CoV-2
SARS-CoV-2 antibody humoral immune response
SARS-CoV-2 vaccine
Severe acute respiratory syndrome coronavirus 2
T cells
Vaccines
γ-Interferon
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Summary:Long-term analyses of the immune response following SARS-CoV-2 mRNA vaccines are essential to determining its characteristics and providing the basis for vaccination strategies. We conducted a prospective study in a cohort of 268 healthy adults followed for >2 years after two doses of BNT162b2. Antibodies targeting the receptor-binding domain of the S1 subunit of the spike of SARS-CoV-2 (anti-RBD) were measured at eight time points; T cell response was analyzed using an interferon-γ release assay. A total of 248 (93%) subjects received mRNA-1273 on month 9; 93 (35%) received the bivalent Omicron-adapted BNT162b2 vaccine between months 19 and 26. Breakthrough infections occurred in 215 (80%) participants, with frequencies unaffected by the additional vaccines. Anti-RBD declined over the initial 9 months, increased after mRNA-1273, and declined gradually thereafter. In 50 (17%) previously infected subjects, anti-RBD levels were significantly higher up to month 9 ( < 0.05) but subsequently declined below those of uninfected individuals. Anti-RBD titers protective against SARS-CoV-2 could not be defined. Most subjects developed a positive T cell response that remained after 26 months. Waning of protection against SARS-CoV-2 infection occurred over time, resulting in non-severe breakthrough infections in most participants. The evolution of anti-RBD suggests modulation of the immune response through immune imprinting.
ISSN:2076-393X
2076-393X
DOI:10.3390/vaccines11121835