Cited by 139SARS-CoV-2 and COVID-19 ResearchImmune responses and vaccinationsCOVID-19 Clinical Research Studies

First-dose mRNA vaccination is sufficient to reactivate immunological memory to SARS-CoV-2 in subjects who have recovered from COVID-19

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Mazzoni, Alessio, Di Lauria, Nicoletta, Maggi, Laura, Salvati, Lorenzo, Vanni, Anna, Capone, Manuela, Lamacchia, Giulia, Mantengoli, Elisabetta +14 more·2021·Journal of Clinical Investigation

Published version of a preprint

Abstract

The characterization of the adaptive immune response to COVID-19 vaccination in individuals who recovered from SARS-CoV-2 infection may define current and future clinical practice. To determine the effect of the 2-dose BNT162b2 mRNA COVID-19 vaccination schedule in individuals who recovered from COVID-19 (COVID-19-recovered subjects) compared with naive subjects, we evaluated SARS-CoV-2 Spike-specific T and B cell responses, as well as specific IgA, IgG, IgM, and neutralizing antibodies titers in 22 individuals who received the BNT162b2 mRNA COVID-19 vaccine, 11 of whom had a previous history of SARS-CoV-2 infection. Evaluations were performed before vaccination and then weekly until 7 days after second injection. Data obtained clearly showed that one vaccine dose is sufficient to increase both cellular and humoral immune response in COVID-19-recovered subjects without any additional improvement after the second dose. On the contrary, the second dose proved mandatory in naive subjects to further enhance the immune response. These findings were further confirmed at the serological level in a larger cohort of naive (n = 68) and COVID-19-recovered (n = 29) subjects, tested up to 50 days after vaccination. These results question whether a second vaccine injection in COVID-19-recovered subjects is required, and indicate that millions of vaccine doses may be redirected to naive individuals, thus shortening the time to reach herd immunity.

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  • mRNA vaccines induce robust germinal center responses in humans, resulting in memory B cells specific for full-length spike and RBD.

    “mRNA vaccines induce robust germinal center responses in humans (14, 15), which result in memory B cells that are specific for both the full-length SARS-CoV-2 spike protein and the spike receptor-binding domain (RBD) (16–18).”

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  1. J Clin Invest. 2021;131(12):e149150 https://doi.org/10.1172/JCI149150
  2. Walsh EE, et al. Safety and immunogenicity of two RNA-based Covid-19 vaccine candidates. N Engl J Med. 2020;383(25):2439-2450. · DOI · Paper page

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Authors
Mazzoni, A., Di Lauria, N., Maggi, L., Salvati, L., Vanni, A., Capone, M., Lamacchia, G., Mantengoli, E., Spinicci, M., Zammarchi, L., Kiros, S. T., Rocca, A., Lagi, F., Colao, M. G., Parronchi, P., Scaletti, C., Turco, L., Liotta, F., Rossolini, G. M., Cosmi, L., Bartoloni, A., & Annunziato, F.
Affiliations
  • University of Florence (IT)
  • Azienda Ospedaliero-Universitaria Careggi (IT)
Corresponding author
Annunziato, Francesco
Venue
Journal of Clinical Investigation
Published
2021-06-15
Volume
131
Issue
12
ISSN
  • 0021-9738 (ISSN-L)
  • 1558-8238
OpenAlex
W3133819496
Cited by
139
References
27
Citations by year
2026: 3 · 2025: 9 · 2024: 10 · 2023: 18 · 2022: 53 · 2021: 45
FWCI
9.98
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Florence Research (University of Florence) (submittedVersion, other-oa)
Funders
  • University of Florence (RICTD2122)
  • Ministero dell’Istruzione, dell’Università e della Ricerca (Excellence Departments 2018-2022)
  • Regione Toscana (TagSARS CoV 2)
  • Ministero della Salute (COVID-2020-12371849)
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 vaccination, BNT162b2 mRNA vaccine, SARS-CoV-2, COVID-19 recovery, first-dose vaccination, immunological memory, spike-specific T cells, B cells, neutralizing antibodies, antibody titers, vaccine dose optimization, herd immunity
MeSH terms
COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, Adult, Aged, Antibodies, Viral, Female, Humans, Immunologic Memory, Male, Middle Aged, Immunity, Humoral, Antibodies, Neutralizing

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