Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis
Objectives We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.Design This study is a 10-month longitudinal cohort study of healthcare workers and serially measured...
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BMJ Publishing Group
2022-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/5/e059994.full |
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| author | Brian Claggett Sonia Sharma Min Wu Peter Chen Gil Y Melmed Nancy Sun Susan Cheng Joseph E Ebinger Matthew Driver Dermot P B McGovern Kimia Sobhani Mohit Jain Sandy Joung Yunxian Liu Brittany Weber Patrick G Botting Yu Hung Kao Briana Khuu Timothy Wynter Trevor-Trung Nguyen Mona Alotaibi John C Prostko Edwin C Frias James L Stewart Helen S Goodridge Stanley C Jordan Justyna Fert-Bober Jennifer E Van Eyk Margo B Minissian Moshe Arditi Jonathan G Braun |
| author_facet | Brian Claggett Sonia Sharma Min Wu Peter Chen Gil Y Melmed Nancy Sun Susan Cheng Joseph E Ebinger Matthew Driver Dermot P B McGovern Kimia Sobhani Mohit Jain Sandy Joung Yunxian Liu Brittany Weber Patrick G Botting Yu Hung Kao Briana Khuu Timothy Wynter Trevor-Trung Nguyen Mona Alotaibi John C Prostko Edwin C Frias James L Stewart Helen S Goodridge Stanley C Jordan Justyna Fert-Bober Jennifer E Van Eyk Margo B Minissian Moshe Arditi Jonathan G Braun |
| author_sort | Brian Claggett |
| collection | DOAJ |
| description | Objectives We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.Design This study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.Setting A large, multisite academic medical centre in Southern California, USA.Participants A total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.Results Vaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (−0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.Conclusions While the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the ‘hybrid’ immunity conferred by natural infection combined with vaccination. |
| first_indexed | 2025-03-19T22:30:45Z |
| format | Article |
| id | doaj.art-8780247aa4eb4c398b2d4cf8d46d9331 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2025-03-19T22:30:45Z |
| publishDate | 2022-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-8780247aa4eb4c398b2d4cf8d46d93312024-10-17T12:50:16ZengBMJ Publishing GroupBMJ Open2044-60552022-05-0112510.1136/bmjopen-2021-059994Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysisBrian Claggett0Sonia Sharma1Min Wu2Peter Chen3Gil Y Melmed4Nancy Sun5Susan Cheng6Joseph E Ebinger7Matthew Driver8Dermot P B McGovern9Kimia Sobhani10Mohit Jain11Sandy Joung12Yunxian Liu13Brittany Weber14Patrick G Botting15Yu Hung Kao16Briana Khuu17Timothy Wynter18Trevor-Trung Nguyen19Mona Alotaibi20John C Prostko21Edwin C Frias22James L Stewart23Helen S Goodridge24Stanley C Jordan25Justyna Fert-Bober26Jennifer E Van Eyk27Margo B Minissian28Moshe Arditi29Jonathan G Braun302 Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA8 La Jolla Institute for Allergy and Immunology, La Jolla, California, USA1The First Hospital of Jilin University, Jilin, ChinaDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA1 F. Widjaja Inflammatory Bowel Disease Institute, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA3 Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA12 F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA13 Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA7 Department of Medicine, School of Medicine, University of California, San Diego, San Diego, California, USASmidt Heart Institute, Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA2 Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA3 Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, California, USA4 Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA4 Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA4 Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA5 Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California, USA6 Transplant Immunology Laboratory and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA1 Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA11 Smidt Heart Institute; Department of Pediatrics, Division of Infectious Diseases and Immunology; Infectious and Immunologic Diseases Research Center (IIDRC); Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA12 F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USAObjectives We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination.Design This study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics.Setting A large, multisite academic medical centre in Southern California, USA.Participants A total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection.Results Vaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (−0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time.Conclusions While the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the ‘hybrid’ immunity conferred by natural infection combined with vaccination.https://bmjopen.bmj.com/content/12/5/e059994.full |
| spellingShingle | Brian Claggett Sonia Sharma Min Wu Peter Chen Gil Y Melmed Nancy Sun Susan Cheng Joseph E Ebinger Matthew Driver Dermot P B McGovern Kimia Sobhani Mohit Jain Sandy Joung Yunxian Liu Brittany Weber Patrick G Botting Yu Hung Kao Briana Khuu Timothy Wynter Trevor-Trung Nguyen Mona Alotaibi John C Prostko Edwin C Frias James L Stewart Helen S Goodridge Stanley C Jordan Justyna Fert-Bober Jennifer E Van Eyk Margo B Minissian Moshe Arditi Jonathan G Braun Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis BMJ Open |
| title | Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis |
| title_full | Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis |
| title_fullStr | Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis |
| title_full_unstemmed | Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis |
| title_short | Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis |
| title_sort | demographic and clinical characteristics associated with variations in antibody response to bnt162b2 covid 19 vaccination among healthcare workers at an academic medical centre a longitudinal cohort analysis |
| url | https://bmjopen.bmj.com/content/12/5/e059994.full |
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