A single mRNA vaccine dose in COVID-19 patients boosts neutralizing antibodies against SARS-CoV-2 and variants of concern
Marit J. van Gils, Hugo D.G. van Willigen, Elke Wynberg, Alvin X. Han, Karlijn van der Straten, Judith A. Burger, Meliawati Poniman, Melissa Oomen, Khadija Tejjani, Joey H. Bouhuijs, Anouk Verveen, Romy Lebbink, Maartje Dijkstra, Brent Appelman, A. H. Ayesha Lavell, Tom G. Caniels, Ilja Bontjer, Lonneke A. van Vught, Alexander P. J. Vlaar, Jonne J. Sikkens, Marije K. Bomers, Colin A. Russell, Neeltje A. Kootstra, Rogier W. Sanders, Maria Prins, Godelieve J. de Bree, Menno D. de Jong, Ivette Agard, Jane Ayal, Anders Boyd, Floor Cavdar, Marianne Craanen, Udi Davidovich, Annemarieke Deuring, Annelies van Dijk, Ertan Ersan, L del Grande, Joost Hartman, Nelleke Koedoot, Tjalling Leenstra, Dominique Loomans, Agata Makowska, Tom du Maine, Ilja de Man, Amy Matser, Lizenka van der Meij, Marleen van Polanen, Maria Oud, Clark Reid, Leeann Storey, Marije de Wit, Marc van Wijk, Joyce van Assem, Joost van den Aardweg, Marijne van Beek, Thyra Blankert, Brigitte Boeser‐Nunnink, Eric P. Moll van Charante, Karel van Dort, Orlane Figaroa, Leah Frenkel, A F Girigorie, Jelle van Haga, Agnes Harskamp-Holwerda, Mette D. Hazenberg, Soemeja Hidad, Menno D. de Jong, Marcel Jonges, Suzanne Jurriaans, Hans Knoop, Lara Kuijt, Anja Lok, Marga Mangas Ruiz, Irma Maurer, Pythia T. Nieuwkerk, Ad van Nuenen, Annelou van der Veen, Bas J Verkaik, Gerben-Rienk Visser
Abstract
The urgent need for, but limited availability of, SARS-CoV-2 vaccines worldwide has led to widespread consideration of dose-sparing strategies. Here, we evaluate the SARS-CoV-2-specific antibody responses following BNT162b2 vaccination in 150 previously SARS-CoV-2-infected individuals from a population-based cohort. One week after first vaccine dose, spike protein antibody levels are 27-fold higher and neutralizing antibody titers 12-fold higher, exceeding titers of fully vaccinated SARS-CoV-2-naive controls, with minimal additional boosting after the second dose. Neutralizing antibody titers against four variants of concern increase after vaccination; however, overall neutralization breadth does not improve. Pre-vaccination neutralizing antibody titers and time since infection have the largest positive effect on titers following vaccination. COVID-19 severity and the presence of comorbidities have no discernible impact on vaccine response. In conclusion, a single dose of BNT162b2 vaccine up to 15 months after SARS-CoV-2 infection offers higher neutralizing antibody titers than 2 vaccine doses in SARS-CoV-2-naive individuals.