Quantitative SARS-CoV-2 anti-spike responses to Pfizer–BioNTech and Oxford–AstraZeneca vaccines by previous infection status
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Abstract
OBJECTIVES: We investigated determinants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike IgG responses in healthcare workers (HCWs) following one or two doses of Pfizer-BioNTech or Oxford-AstraZeneca vaccines. METHODS: HCWs participating in regular SARS-CoV-2 PCR and antibody testing were invited for serological testing prior to first and second vaccination, and 4 weeks post-vaccination if receiving a 12-week dosing interval. Quantitative post-vaccination anti-spike antibody responses were measured using the Abbott SARS-CoV-2 IgG II Quant assay (detection threshold: ≥50 AU/mL). We used multivariable logistic regression to identify predictors of seropositivity and generalized additive models to track antibody responses over time. RESULTS: 3570/3610 HCWs (98.9%) were seropositive >14 days post first vaccination and prior to second vaccination: 2706/2720 (99.5%) were seropositive after the Pfizer-BioNTech and 864/890 (97.1%) following the Oxford-AstraZeneca vaccines. Previously infected and younger HCWs were more likely to test seropositive post first vaccination, with no evidence of differences by sex or ethnicity. All 470 HCWs tested >14 days after the second vaccination were seropositive. Quantitative antibody responses were higher after previous infection: median (IQR) >21 days post first Pfizer-BioNTech 14 604 (7644-22 291) AU/mL versus 1028 (564-1985) AU/mL without prior infection (p < 0.001). Oxford-AstraZeneca vaccine recipients had lower readings post first dose than Pfizer-BioNTech recipients, with and without previous infection, 10 095 (5354-17 096) and 435 (203-962) AU/mL respectively (both p < 0.001 versus Pfizer-BioNTech). Antibody responses >21 days post second Pfizer vaccination in those not previously infected, 10 058 (6408-15 582) AU/mL, were similar to those after prior infection followed by one vaccine dose. CONCLUSIONS: SARS-CoV-2 vaccination leads to detectable anti-spike antibodies in nearly all adult HCWs. Whether differences in response impact vaccine efficacy needs further study.
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Seroprevalence surveys were corrected for vaccination.
“Seroprevalence surveys were corrected for vaccination, because vaccination generates a positive anti-spike antibody test in most individuals who receive the vaccine.27”
From Estimating global, regional, and national daily and cumulative infections with SARS-CoV-2 through Nov 14, 2021: a statistical analysis (2022) · cites this paper as [27]
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- Authors
- Eyre, D. W., Lumley, S. F., Wei, J., Cox, S., James, T., Justice, A., Jesuthasan, G., O'Donnell, D., Howarth, A., Hatch, S. B., Marsden, B. D., Jones, E. Y., Stuart, D. I., Ebner, D., Hoosdally, S., Crook, D. W., Peto, T. E. A., Walker, T. M., Stoesser, N. E., Matthews, P. C., Pouwels, K. B., Walker, A. S., & Jeffery, K.
- Affiliations
- Public Health England (GB)
- University of Oxford (GB)
- Oxford University Hospitals NHS Trust (GB)
- Corresponding author
- Eyre, David W.
- ORCID
- Venue
- Clinical Microbiology and Infection
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 27
- Issue
- 10
- Pages
- 1516.e7-1516.e14
- ISSN
- 1198-743X (ISSN-L)
- PMC
- PMC8180449
- OpenAlex
- W3170306142
- Cited by
- 131
- References
- 25
- Citations by year
- 2025: 4 · 2024: 13 · 2023: 11 · 2022: 76 · 2021: 27
- FWCI
- 10.06
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Microbiology and Infection (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institute for Health Research
- United Kingdom Department of Health and Social Care
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Keywords
- SARS-CoV-2, COVID-19 vaccines, anti-spike IgG, prior SARS-CoV-2 infection, hybrid immunity, BNT162b2, Oxford-AstraZeneca vaccine, healthcare workers, seropositivity, antibody kinetics, vaccine dosing interval, ChAdOx1 nCoV-19 vaccine, SARS-CoV-2 spike protein
- MeSH terms
- Immunogenicity, Vaccine, COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, ChAdOx1 nCoV-19, Adult, Antibodies, Viral, Female, Health Personnel, Humans, Immunoglobulin G, Male, Middle Aged, Vaccination, Spike Glycoprotein, Coronavirus
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