Journal Article

Risk reduction in SARS-CoV-2 infection and reinfection conferred by humoral antibody levels among essential workers during Omicron predominance

Burgess, Jefferey L., Beitel, Shawn C., Philips, Andrew L., Rose, Spencer, Hegmann, Kurt T., Uhrlaub, Jennifer L., Porter, Cynthia, Yoon, Sarang, Dunnigan, Kayan, Britton, Amadea, Newes-Adeyi, Gabriella, Hollister, James, Ellingson, Katherine D., Sprissler, Ryan, Gwynn, Lisa, Zheng, Pearl Q., Fuller, Sammantha, Caban-Martinez, Alberto, Fowlkes, Ashley, Tyner, Harmony L., Lutrick, Karen, Grant, Lauren, Gaglani, Manjusha, Naleway, Allison L., Olsho, Lauren E. W., Yoo, Young M., Schaefer Solle, Natasha, Romine, James K.

2024

Overview

The extent to which semi-quantitative antibody levels confer protection against SARS-CoV-2 infection in populations with heterogenous immune histories is unclear. Two nested case-control studies were designed within the multisite HEROES/RECOVER prospective cohort of frontline workers to study the relationship between antibody levels and protection against first-time post-vaccination infection and reinfection with SARS-CoV-2 from December 2021 to January 2023. All participants submitted weekly nasal swabs for rRT-PCR testing and blood samples quarterly and following infection or vaccination. Cases of first-time post-vaccination infection following a third dose of monovalent (origin strain WA-1) mRNA vaccine (n = 613) and reinfection (n = 350) were 1:1 matched to controls based on timing of blood draw and other potential confounders. Conditional logistic regression models were fit to estimate infection risk reductions associated with 3-fold increases in end titers for receptor binding domain (RBD). In first-time post-vaccination and reinfection study samples, most were female (67%, 57%), non-Hispanic (82%, 68%), and without chronic conditions (65%, 65%). The odds of first-time post-vaccination infection were reduced by 21% (aOR = 0.79, 95% CI = [0.66–0.96]) for each 3-fold increase in RBD end titers. The odds of reinfection associated with a 3-fold increase in RBD end titers were reduced by 23% (aOR = 0.77, 95% CI = [0.65–0.92] for unvaccinated individuals and 58% (aOR = 0.42, 95% CI = [0.22–0.84]) for individuals with three mRNA vaccine doses following their first infection. Frontline workers with higher antibody levels following a third dose of mRNA COVID-19 vaccine were at reduced risk of SARS-CoV-2 during Omicron predominance. Among those with previous infections, the point estimates of risk reduction associated with antibody levels was greater for those with three vaccine doses compared to those who were unvaccinated.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Antibodies / Antibodies, Viral - blood / Antibodies, Viral - immunology / Biology and life sciences / Blood / Case-Control Studies / Chronic conditions / Chronic infection / COVID-19 / COVID-19 - epidemiology / COVID-19 - immunology / COVID-19 - prevention & control / COVID-19 - virology / COVID-19 vaccines / COVID-19 Vaccines - administration & dosage / COVID-19 Vaccines - immunology / Disease control / Disease transmission / Engineering and Technology / Essential workers / Female / Genomes / Health risks / Humans / Immune response / Immunity, Humoral / Infection / Infections / Influenza / Male / Medical research / Medicine and Health Sciences / Medicine, Experimental / Middle Aged / mRNA / mRNA vaccines / Population studies / Prospective Studies / Regression analysis / Regression models / Reinfection - immunology / Reinfection - prevention & control / Reinfection - virology / Research and Analysis Methods / Risk management / RNA / SARS-CoV-2 - immunology / Self report / Severe acute respiratory syndrome coronavirus 2 / Testing / Vaccination / Vaccines / Viral antibodies / Workers