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SARS-CoV-2 anti-spike antibody levels following second dose of ChAdOx1 nCov-19 or BNT162b2 in residents of long-term care facilities in England (VIVALDI)



Stirrup, Oliver;

Krutikov, Maria;

Tut, Gokhan;

Palmer, Tom;

Bone, David;

Bruton, Rachel;

Fuller, Christopher;

Shallcross, Laura; + view all

Stirrup, Oliver;

Krutikov, Maria;

Tut, Gokhan;

Palmer, Tom;

Bone, David;

Bruton, Rachel;

Fuller, Christopher;

Azmi, Borscha;

Lancaster, Tara;

Sylla, Panagiota;

Kaur, Nayandeep;

Spalkova, Eliska;

Bentley, Christopher;

Amin, Umayr;

Jadir, Azar;

Hulme, Samuel;

Giddings, Rebecca;

Nacer-Laidi, Hadjer;

Baynton, Verity;

Irwin-Singer, Aidan;

Hayward, Andrew;

Moss, Paul;

Copas, Andrew;

Shallcross, Laura;

– view fewer

(2022)

SARS-CoV-2 anti-spike antibody levels following second dose of ChAdOx1 nCov-19 or BNT162b2 in residents of long-term care facilities in England (VIVALDI).

MedRxiv: Cold Spring Harbor, NY, USA.

Abstract

Background: General population studies have shown strong humoral response following SARS-CoV-2 vaccination with subsequent waning of anti-spike antibody levels. Vaccine-induced immune responses are often attenuated in frail and older populations such as Long-Term Care Facility (LTCF) residents but published data are scarce. /

Methods: VIVALDI is a prospective cohort study in England which links serial blood sampling in LTCF staff and residents to routine healthcare records. We measured quantitative titres of SARS-CoV-2 anti-spike antibodies in residents and staff following second vaccination dose with ChAdOx1 nCov-19 (Oxford-AstraZeneca) or BNT162b2 (Pfizer-BioNTech). We investigated differences in peak antibody levels and rates of decline using linear mixed effects models. /

Results: We report on 1317 samples from 402 residents (median age 86 years, IQR 78-91) and 632 staff (50 years, 37-58), ≤280 days from second vaccination dose. Peak antibody titres were 7.9-fold higher after Pfizer-BioNTech vaccine compared to Oxford-AstraZeneca (95%CI 3.6-17.0; P<0.01) but rate of decline was increased, and titres were similar at 6 months. Prior infection was associated with higher peak antibody levels in both Pfizer-BioNTech (2.8-fold, 1.9-4.1; P<0.01) and Oxford-AstraZeneca (4.8-fold, 3.2-7.1; P<0.01) recipients and slower rates of antibody decline. Increasing age was associated with a modest reduction in peak antibody levels for Oxford-AstraZeneca recipients. /

Conclusions: Double-dose vaccination elicits robust and stable antibody responses in older LTCF residents, suggesting comparable levels of vaccine-induced immunity to that in the general population. Antibody levels are higher after Pfizer-BioNTech vaccination but fall more rapidly compared to Oxford-AstraZeneca recipients and are enhanced by prior infection in both groups.

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