SARS-CoV-2 vaccine-induced antibodies protect against Omicron breakthrough infection
Eva Anna Marianne Baerends, Astrid Korning Hvidt, Joanne Reekie, Ole S. Søgaard, Nina Breinholt Stærke, Dorthe Raben, Henrik Nielsen, Kristine Toft Petersen, Maria Ruwald Juhl, Işık Somuncu Johansen, Susan Olaf Lindvig, Lone Wulff Madsen, Lothar Wiese, Lene Surland Knudsen, Mette Brouw Iversen, Thomas Benfield, Kasper Iversen, Sidsel Dahl Andersen, Anna Karina Juhl, Lisa Loksø Dietz, Signe Rode Andreasen, Thea Kølsen Fischer, Christian Erikstrup, Palle Valentiner‐Branth, Jens Lundgren, Lars Østergaard, Martin Tolstrup, Jens Lundgren, Lars Østergaard, Thomas Benfield, L. Krohn-Dehli, D. K. Petersen, Kamille Fogh, E. Højmark, Kasper Iversen, Przemys aw Wyr bek, Vibeke Klastrup, F Larsen, S.H. Rasmussen, Marianne Hoegsbjerg Schleimann, S. Schieber, Nina Breinholt Stærke, A. Søndergaard, Britta Tarp, M. Tousgaard, Y. Yehdego, Jacob Bodilsen, Henrik Nielsen, K.T. Petersen, M. Ruwald, R. K. Thisted, S. F. Caspersen, Mette Brouw Iversen, Lene Surland Knudsen, James L. Meyerhoff, L. G. Sander, Lothar Wiese, Christiane Abildgaard, Inge K. Holden, Nicholas Johansen, Işık Somuncu Johansen, Lykke Larsen, Susan Olaf Lindvig, L.W. Madsen, Anne Øvrehus, N. A. Kruse, H. Lomholdt, Tyra Grove Krause, Palle Valentiner‐Branth, B. Søborg, Thea Kølsen Fischer, Christian Erikstrup, Sisse Rye Ostrowski, Martin Tolstrup, O.S. Søgaard, Dorthe Raben, E. Jylling, Dan Dupont Hougaard, Søren Due Andersen, K. Lykkegaard, Signe Rode Andreasen, Eva Anna Marianne Baerends, Lisa Loksø Dietz, Astrid Korning Hvidt, Anna Karina Juhl, Rikke Olesen, K.K. Andersen, W. Bannister, C. Bjernved, T W Elsing, Frederik Viggo Lautrup Esmann, Mohsen Ghafari, E. Gravholdt, Stine Finne Jakobsen, Marie Louise Jakobsen, Claus Munk Jensen, Tomas Ø. Jensen, D. Kristensen, Lalit Kumar, Charlotte Matthews
Abstract
SARS-CoV-2 Omicron quickly spread globally, also in regions with high vaccination coverage, emphasizing the importance of exploring the immunological requirements for protection against Omicron breakthrough infection. The test-negative matched case-control study (N = 964) characterized Omicron breakthrough infections in triple-vaccinated individuals from the ENFORCE cohort. Within 60 days before a PCR test spike-specific IgG levels were significantly lower in cases compared to controls (GMR [95% CI] for BA.2: 0.83 [0.73-0.95], p = 0.006). Multivariable logistic regression showed significant associations between high antibody levels and lower odds of infection (aOR [95% CI] for BA.2 spike-specific IgG: 0.65 [0.48-0.88], p = 0.006 and BA.2 ACE2-blocking antibodies: 0.46 [0.30-0.69], p = 0.0002). A sex-stratified analysis showed more pronounced associations for females than males. High levels of vaccine-induced antibodies provide partial protection against Omicron breakthrough infections. This is important knowledge to further characterize a threshold for protection against new variants and to estimate the necessity and timing of booster vaccination.