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Cited by 655SARS-CoV-2 and COVID-19 ResearchImmune responses and vaccinationsT-cell and B-cell Immunology

The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index; 2 of the 14 sources its claims cite were checked for support.

Distinct antibody and memory B cell responses in SARS-CoV-2 naïve and recovered individuals after mRNA vaccination

Open access
Goel, Rishi R., Apostolidis, Sokratis A., Painter, Mark M., Mathew, Divij, Pattekar, Ajinkya, Kuthuru, Oliva, Gouma, Sigrid, Hicks, Philip, Meng, Wenzhao, Rosenfeld, Aaron M., Dysinger, Sarah, Lundgreen, Kendall A., Kuri-Cervantes, Leticia, Adamski, Sharon, Hicks, Amanda, Korte, Scott, Oldridge, Derek A., Baxter, Amy E., Giles, Josephine R., Weirick, Madison E., McAllister, Christopher M., Dougherty, Jeanette, Long, Sherea, D’Andrea, Kurt, Hamilton, Jacob T., Betts, Michael R., Luning Prak, Eline T., Bates, Paul, Hensley, Scott E., Greenplate, Allison R., Wherry, E. John·2021·Science Immunology
DOI 10.1126/sciimmunol.abi6950PMC PMC8158969

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Abstract

Key differences in both antibody and memory B cell responses to mRNA vaccination were identified on the basis of prior SARS-CoV-2 exposure.

Overview

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Written from the paper’s full text.

TL;DR

In a longitudinal cohort of 44 mRNA-vaccinated adults (33 SARS-CoV-2 naïve, 11 recovered), naïve individuals required two doses for optimal antibody and memory B cell responses, including neutralization of B.1.351, whereas recovered individuals were boosted after the first dose with no further increase after the second. Pre-existing memory B cells correlated with recall antibody responses in recovered individuals, and memory B cell induction declined with age.

Key findings

  • SARS-CoV-2 naïve individuals had undetectable baseline anti-spike and anti-RBD IgG; primary vaccination increased antibodies and the booster further enhanced them. After primary immunization, ~50% developed detectable D614G neutralizing antibodies and only 4/25 developed B.1.351 neutralization above limit of detection; post-boost, all participants neutralized D614G and 26/27 neutralized B.1.351.
  • SARS-CoV-2 recovered individuals had detectable baseline anti-spike and anti-RBD IgG, which increased after the first dose but showed no additional increase after the second. Neutralizing titers against D614G and B.1.351 also peaked after the first dose with no further increase post-boost, and anti-RBD IgG levels were similar between naïve and recovered individuals at 1 week post-boost.
  • Memory B cells specific for spike and RBD were minimally detectable at baseline in naïve individuals, increased after primary vaccination, and were further boosted after the second dose, approaching levels in non-vaccinated recovered donors. Recovered individuals had baseline spike-specific memory B cells ranging from ~0.15–0.8% of total memory B cells, expanded after the first dose, and showed no additional boosting after the second.
  • Post-boost antigen-specific memory B cells showed a clear negative correlation with age, though all age groups increased over baseline. Baseline memory B cell frequency strongly correlated with post-primary antibody levels for spike and RBD in recovered individuals, while post-boost antibodies and memory B cells did not correlate in naïve individuals.

Methods

  • Longitudinal cohort of 44 healthy adults (33 SARS-CoV-2 naïve, 11 recovered; prior infection 65–275 days before vaccination) receiving Pfizer BNT162b2 or Moderna mRNA-1273, with samples at baseline, 2 weeks post-primary, day of second dose, and 1 week post-boost.
  • Assays included ELISA for anti-spike and anti-RBD IgG/IgM, VSV pseudovirus neutralization against D614G and B.1.351, flow cytometric antigen-probe detection of spike-, RBD-, and influenza HA-specific memory B cells, and BCR sequencing of sorted spike+ memory B cells from 5 recovered donors.
  • Statistical analyses used Wilcoxon tests with Holm correction, Spearman rank correlations, hierarchical clustering, principal component analysis, and multivariable linear regression controlling for sex and age.

Limitations

  • Stated: the study was small and designed for deep immunological analysis, so it could not directly address protection or true vaccine efficacy; larger clinical studies are needed to examine one versus two doses in recovered individuals. The cohort consisted of individuals not hospitalized during SARS-CoV-2 infection, and identifying recovered individuals by self-report or laboratory tests may be practically challenging.
  • Stated: the timeframe was short, durability and long-term immunological memory remain unknown, and SHM analyses were limited to a small number of individuals and the first few weeks after vaccination. The cohort was not extensively enriched in those over 50 years old and does not directly address elderly vaccinees.
  • Evident: the small sample size limits subgroup analyses, the healthy/no chronic-condition cohort limits generalizability, and some comparisons used unpaired tests because of missing data or samples for some participants.

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Integrity signals

Registry

Crossref · 10.1126/sciimmunol.abi6950

Cites

59 of 59 references verified0 citation errors · 0 not checkable

Statistics

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Figures

Fig. 1 Antibody responses following mRNA vaccination in SARS-CoV-2 naïve and recovered individuals. A) UPenn Immune Health COVID vaccine study design. B) Concentration of anti-spike and anti-RBD IgG antibodies in vaccinated individuals over time. C) Focus reduction neutralization titer 50% (FRNT50) of vaccine-induced sera against pseudotyped virus expressing SARS-CoV-2 D614G (wild-type) or B.1.351 (South African) variant spike protein. D) Paired analysis of neutralization titers against D614G and B.1.351 in vaccine-induced sera at baseline (timepoint 1), pre-boost (timepoint 2), and post-boost (timepoint 4). E) Bivariate analysis of total anti-spike and anti-RBD binding antibodies with pseudovirus neutralization titers against D614G and B.1.351. Associations between total antibody levels and neutralizing ability were calculated using Spearman rank correlation and are shown with linear trend lines. Dotted lines indicate the limit of detection (LOD) for the assay. Statistics were calculated using unpaired Wilcoxon test (comparisons between timepoints and comparisons between naïve and recovered) or paired Wilcoxon test (comparisons between D614G and B.1.351) with Holm correction for multiple comparisons. Blue and red values indicate statistical comparisons within naïve or recovered groups. Black values indicate statistical comparisons between naïve or recovered groups.
Fig. 1 Antibody responses following mRNA vaccination in SARS-CoV-2 naïve and recovered individuals. A) UPenn Immune Health COVID vaccine study design. B) Concentration of anti-spike and anti-RBD IgG antibodies in vaccinated individuals over time. C) Focus reduction neutralization titer 50% (FRNT50) of vaccine-induced sera against pseudotyped virus expressing SARS-CoV-2 D614G (wild-type) or B.1.351 (South African) variant spike protein. D) Paired analysis of neutralization titers against D614G and B.1.351 in vaccine-induced sera at baseline (timepoint 1), pre-boost (timepoint 2), and post-boost (timepoint 4). E) Bivariate analysis of total anti-spike and anti-RBD binding antibodies with pseudovirus neutralization titers against D614G and B.1.351. Associations between total antibody levels and neutralizing ability were calculated using Spearman rank correlation and are shown with linear trend lines. Dotted lines indicate the limit of detection (LOD) for the assay. Statistics were calculated using unpaired Wilcoxon test (comparisons between timepoints and comparisons between naïve and recovered) or paired Wilcoxon test (comparisons between D614G and B.1.351) with Holm correction for multiple comparisons. Blue and red values indicate statistical comparisons within naïve or recovered groups. Black values indicate statistical comparisons between naïve or recovered groups.CC BY · PubMed Central
Fig. 2 Antigen-specific memory B cell responses following mRNA vaccination in SARS-CoV-2 naïve and recovered individuals. A) Gating strategy and representative plots for flow cytometric analysis of SARS-CoV-2-specific B cells. B) Frequency of spike+, spike+/RBD+, and HA+ memory B cells over time in vaccinated individuals. Data are represented as frequency of antigen-specific cells in the total memory B cell compartment. C) Frequency of IgG and IgM isotypes over time in the antigen-specific memory B cell compartments. D) Frequency of RBD+ memory B cells over time in vaccinated individuals, as a percentage of spike+ memory B cells. E) Somatic hypermutation (SHM) status of spike+ memory B cell clones over time in SARS-CoV-2 recovered individuals. Data are represented as percent of VH-gene nucleotides that are mutated. F) SHM of productive spike-binding clones sampled at timepoint 1 which were also found in at least one other timepoint. Clones with fewer than 10 copies in each patient were excluded. G) Clonal evolution of spike-binding memory B cell lineages that were present prior to vaccination in a recovered individual. For representative lineages, numbers refer to mutations compared to the preceding vertical node. Colors indicate timepoint, black dots indicate inferred nodes, and size is proportional to sequence copy number; GL = germline sequence. All panels: Dotted lines indicate the mean at baseline. RD = non-vaccinated, SARS-CoV-2 recovered donors. Statistics were calculated using unpaired Wilcoxon test (comparisons between timepoints and comparisons between naïve and recovered) with Holm correction for multiple comparisons. Blue and red values indicate statistical comparisons within naïve or recovered groups. Black values indicate statistical comparisons between naïve or recovered groups.
Fig. 2 Antigen-specific memory B cell responses following mRNA vaccination in SARS-CoV-2 naïve and recovered individuals. A) Gating strategy and representative plots for flow cytometric analysis of SARS-CoV-2-specific B cells. B) Frequency of spike+, spike+/RBD+, and HA+ memory B cells over time in vaccinated individuals. Data are represented as frequency of antigen-specific cells in the total memory B cell compartment. C) Frequency of IgG and IgM isotypes over time in the antigen-specific memory B cell compartments. D) Frequency of RBD+ memory B cells over time in vaccinated individuals, as a percentage of spike+ memory B cells. E) Somatic hypermutation (SHM) status of spike+ memory B cell clones over time in SARS-CoV-2 recovered individuals. Data are represented as percent of VH-gene nucleotides that are mutated. F) SHM of productive spike-binding clones sampled at timepoint 1 which were also found in at least one other timepoint. Clones with fewer than 10 copies in each patient were excluded. G) Clonal evolution of spike-binding memory B cell lineages that were present prior to vaccination in a recovered individual. For representative lineages, numbers refer to mutations compared to the preceding vertical node. Colors indicate timepoint, black dots indicate inferred nodes, and size is proportional to sequence copy number; GL = germline sequence. All panels: Dotted lines indicate the mean at baseline. RD = non-vaccinated, SARS-CoV-2 recovered donors. Statistics were calculated using unpaired Wilcoxon test (comparisons between timepoints and comparisons between naïve and recovered) with Holm correction for multiple comparisons. Blue and red values indicate statistical comparisons within naïve or recovered groups. Black values indicate statistical comparisons between naïve or recovered groups.CC BY · PubMed Central
Fig. 3 Association of age and side-effects with B cell responses following mRNA vaccination. A, C) Concentration of anti-spike and anti-RBD IgG antibodies over time compared with sex (A) and age (C) in SARS-CoV-2 naïve individuals. Dotted lines indicate the limit of detection for the assay. B, D) Frequency of spike+ and spike+/RBD+ memory B cells over time compared with sex (B) and age (D) in SARS-CoV-2 naïve individuals. Dotted lines indicate the mean frequency of cells at baseline. Pre-boost indicates samples collected at timepoint 2 (~15 days post-primary vaccination). Post-boost indicates samples collected at timepoint 4 (~7 days post-secondary vaccination). Statistics for sex were calculated using Wilcoxon test. Associations with age were calculated using Spearman rank correlation and are shown with linear trend lines. E) Concentration of anti-spike and anti-RBD IgG antibodies and frequency of spike+ and spike+/RBD+ memory B cells at the post-boost timepoint compared with self-reported side effects after the second dose. Reactogenicity was categorized into either no/local symptoms or systemic symptoms. F) Multivariable linear regression between antibody or memory B cell responses and side effects, controlling for sex and age. Data are represented as estimated regression coefficients with a 95% confidence interval.
Fig. 3 Association of age and side-effects with B cell responses following mRNA vaccination. A, C) Concentration of anti-spike and anti-RBD IgG antibodies over time compared with sex (A) and age (C) in SARS-CoV-2 naïve individuals. Dotted lines indicate the limit of detection for the assay. B, D) Frequency of spike+ and spike+/RBD+ memory B cells over time compared with sex (B) and age (D) in SARS-CoV-2 naïve individuals. Dotted lines indicate the mean frequency of cells at baseline. Pre-boost indicates samples collected at timepoint 2 (~15 days post-primary vaccination). Post-boost indicates samples collected at timepoint 4 (~7 days post-secondary vaccination). Statistics for sex were calculated using Wilcoxon test. Associations with age were calculated using Spearman rank correlation and are shown with linear trend lines. E) Concentration of anti-spike and anti-RBD IgG antibodies and frequency of spike+ and spike+/RBD+ memory B cells at the post-boost timepoint compared with self-reported side effects after the second dose. Reactogenicity was categorized into either no/local symptoms or systemic symptoms. F) Multivariable linear regression between antibody or memory B cell responses and side effects, controlling for sex and age. Data are represented as estimated regression coefficients with a 95% confidence interval.CC BY · PubMed Central
Fig. 4 Antigen-specific memory B cells were a distinct measure of vaccine efficacy and correlated to antibody recall responses. A) Heatmap and hierarchical clustering of vaccine-induced antibody and memory B cell responses. B) Principal component analysis and biplot of vaccine-induced antibody and memory B cell responses. C) Association of post-boost (timepoint 4) antibody levels with post-boost (timepoint 4) antigen-specific memory B cell frequencies in SARS-CoV-2 naïve individuals. D) Association of baseline (timepoint 1) antigen-specific memory B cell frequencies with post-primary vaccination (timepoint 2) antibody levels in SARS-CoV-2 recovered individuals. Illustrations in (C) and (D) represent the corresponding immune relationship. Associations between immunological parameters were calculated using Spearman rank correlation and are shown with non-parametric trend lines (Theil-Sen estimator).
Fig. 4 Antigen-specific memory B cells were a distinct measure of vaccine efficacy and correlated to antibody recall responses. A) Heatmap and hierarchical clustering of vaccine-induced antibody and memory B cell responses. B) Principal component analysis and biplot of vaccine-induced antibody and memory B cell responses. C) Association of post-boost (timepoint 4) antibody levels with post-boost (timepoint 4) antigen-specific memory B cell frequencies in SARS-CoV-2 naïve individuals. D) Association of baseline (timepoint 1) antigen-specific memory B cell frequencies with post-primary vaccination (timepoint 2) antibody levels in SARS-CoV-2 recovered individuals. Illustrations in (C) and (D) represent the corresponding immune relationship. Associations between immunological parameters were calculated using Spearman rank correlation and are shown with non-parametric trend lines (Theil-Sen estimator).CC BY · PubMed Central
Fig. 5 Study summary and key findings). A) Cohort design and objectives. Longitudinal samples were collected from SARS-CoV-2 naïve and recovered individuals and measured for both antibodies and memory B cells. B) Distinct patterns of antibody and memory B cell responses to mRNA vaccination in SARS-CoV-2 naïve and recovered individuals. C) Age-associated differences in antibody and memory B cell responses to mRNA vaccination. D) Baseline memory B cells in SARS-CoV-2 recovered individuals contribute to recall responses following mRNA vaccination.
Fig. 5 Study summary and key findings). A) Cohort design and objectives. Longitudinal samples were collected from SARS-CoV-2 naïve and recovered individuals and measured for both antibodies and memory B cells. B) Distinct patterns of antibody and memory B cell responses to mRNA vaccination in SARS-CoV-2 naïve and recovered individuals. C) Age-associated differences in antibody and memory B cell responses to mRNA vaccination. D) Baseline memory B cells in SARS-CoV-2 recovered individuals contribute to recall responses following mRNA vaccination.CC BY · PubMed Central

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Claims the paper makes

52 Own result · 17 Own method · 12 Own interpretation · 6 Not checked yet · 1 Partly supported · accuracy not yet measured

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  • Probably not a substantial claim. 18
  • It may state two separate claims as one. 13
  • The quote only partly states this claim. 1
27 of 27

  • The paper relies on this without support.

    The prior SARS-CoV-2 infection status of recovered individuals is accurately known.

    “Of this cohort, 11 individuals had a prior SARS-CoV-2 infection, ranging from 65 to 275 days prior to vaccination.”
    “Moreover, there may be practical challenges to identifying SARS-CoV-2 recovered individuals based on self-reported infection or laboratory confirmed tests such as RT-PCR or serology.”

  • The authors state this as an assumption.

    Pre-existing spike-binding memory B cell clones present before vaccination in recovered individuals arose during the initial SARS-CoV-2 infection.

    “These clones, which were present before the first vaccine dose, presumably arose during the initial infection with SARS-CoV-2.”

  • The paper relies on this without support.

    The mRNA vaccines BNT162b2 and mRNA-1273 are similar enough to be analyzed together as mRNA vaccines.

    “who received SARS-CoV-2 mRNA vaccines (Pfizer BNT162b2 or Moderna mRNA-1273) at the University of Pennsylvania Health System”
    “Here, we demonstrated that mRNA vaccines to SARS-CoV-2 induced robust antibody and memory B cell responses to full-length spike and the RBD.”

  • The paper relies on this without support.

    The measured antibody and memory B cell responses are relevant to vaccine efficacy or protection.

    “These results are encouraging for both short- and long-term vaccine efficacy and add to our understanding of SARS-CoV-2 mRNA vaccine-induced immune responses in several ways.”
    “The data presented document key differences in immune responses associated with vaccine efficacy in SARS-CoV-2 naïve versus SARS-CoV-2 recovered individuals.”

  • The paper relies on this without support.

    Pfizer BNT162b2 and Moderna mRNA-1273 vaccines can be grouped together as mRNA vaccination for the analyses.

    “All subjects received either Pfizer (BNT162b2) or Moderna (mRNA-1273) mRNA vaccines.”

  • The paper relies on this without support.

    Self-reported health screening accurately identifies participants without chronic health conditions.

    “All participants were otherwise healthy and based on self-reported health screening did not report any history of chronic health conditions.”

  • The paper relies on this without support.

    Memory B cells are important for durability of immune memory and potential recall responses to infection or future booster vaccination.

    “which are important for durability of immune memory and potential recall responses to infection or future booster .”

  • The paper relies on this without support.

    High circulating titers of neutralizing antibodies are common surrogates of protective immunity.

    “Although high circulating titers of neutralizing antibodies are common surrogates of protective immunity”
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  1. R. Levi, E. Azzolini, C. Pozzi, L. Ubaldi, M. Lagioia, A. Mantovani, M. Rescigno, A cautionary note on recall vaccination in ex-COVID-19 subjects. medRxiv 10.1101/2021.02.01.21250923 (2021). · DOI

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Metadata

Authors
Goel, R. R., Apostolidis, S. A., Painter, M. M., Mathew, D., Pattekar, A., Kuthuru, O., Gouma, S., Hicks, P., Meng, W., Rosenfeld, A. M., Dysinger, S., Lundgreen, K. A., Kuri-Cervantes, L., Adamski, S., Hicks, A., Korte, S., Oldridge, D. A., Baxter, A. E., Giles, J. R., Weirick, M. E., McAllister, C. M., Dougherty, J., Long, S., D’Andrea, K., Hamilton, J. T., Betts, M. R., Luning Prak, E. T., Bates, P., Hensley, S. E., Greenplate, A. R., & Wherry, E. J.
Affiliations
  • University of Pennsylvania (US)
  • Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Corresponding author
  • Goel, Rishi R.
  • Apostolidis, Sokratis A.
  • Painter, Mark M.
  • Mathew, Divij
  • Wherry, E. John
ORCID
Venue
Science Immunology
Publisher
American Association for the Advancement of Science (AAAS)
Published
2021-04-02
Volume
6
Issue
58
ISSN
2470-9468 (ISSN-L)
DOI
10.1126/sciimmunol.abi6950
PMC
PMC8158969
OpenAlex
W3155262144
Cited by
655
References
54
Citations by year
2026: 31 · 2025: 55 · 2024: 73 · 2023: 112 · 2022: 230 · 2021: 153
FWCI
44.92
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Science Immunology (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by-nc-nd)
Funders
  • National Institutes of Health (AI105343, AI082630, AI108545, AI155577, AI149680, AI152236, HL143613, T32 AI055400, P30-AI0450080, T32 CA009140, T32 AR076951-01, U19AI082630)
  • University of Pennsvlvania (21st Century Scholar Fund, COVID Research Fund)
  • Cancer Research Institute (Mark Foundation Fellowship)
  • Chen Family Research Fund
  • Parker Institute for Cancer Immunotherapy
  • Paul G. Allen Frontiers Group
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
  • Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
Keywords
SARS-CoV-2, COVID-19 pandemic, mRNA vaccines, memory B cells, antibody response, neutralizing antibodies, prior SARS-CoV-2 infection, recovered patients, B.1.351 variant, spike protein receptor-binding domain, booster vaccination, age-related immune decline, cell-mediated immunity

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