The relationship between antibody titers and incident SARS-CoV-2 infection among recipients of a primary vaccine series

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The relationship between antibody titers and incident SARS-CoV-2 infection among recipients of a primary vaccine series
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The relationship between antibody titers and incident SARS-CoV-2 infection among recipients of a primary vaccine series medrxivpreprint Harvard DukeU JohnsHopkins Columbia Yale antibody infection SARSCoV2 vaccine

By Neha MathurFeb 17 2023Reviewed by Danielle Ellis, B.Sc. *Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Background Coronavirus disease 2019 vaccines-induced nAb titers, measured through serologic tests, are a potential correlate of SARS-CoV-2 immunity. However, multiple factors, e.g., age, comorbidities, and medical history, could affect immune response against SARS-CoV-2 post-vaccination. Even otherwise, vaccine-induced nAb titers wane over time after attaining a peak at four weeks, thus, increasing the risk of reinfection.

About the study In the present study, researchers used the FDA-approved TrimericS assay to measure nAbs against the SARS-CoV-2 WA-1 spike protein in players and team staff of the 2021-2022 NBA season. These individuals, aged 18 years or above, volunteered to get their SARS-CoV-2 nAb titer measurements via the TrimericS Assay between September 12, 2021, and December 31, 2021. Also, most of them had completed their primary COVID-19 vaccination series by the time of antibody testing.

A NAb titer of 100 arbitrary units /mL in a serological assay typically correlates with a 50% protection against wild-type SARS-CoV-2 strain. However, on the TrimericS assay, 250 AU/mL denoted a potentially higher risk of SARS-CoV-2 infection. So, the team compared the risk of contracting COVID-19 within 90 days of nAb measurement with the reference group having >800 AU/mL nAb titers overall and stratified by vaccine type.

All the study participants fell into three groups with 800 AU/mL nAb titer levels. Among unboosted individuals, 2,248 had detectable nAb titer values, with an average titer value of 293.5 AU/mL. Among boosted individuals, nAb titers were highest among those who had completed primary vaccination series in the past four months, i.e., >800 AU/mL, and lowest among those who had taken primary two-doses of a COVID-19 vaccine more than seven months before their serologic testing.

Conclusions The study findings suggested that serologic testing could inform patient-level assessments of susceptibility to SARS-CoV-2 infection. These tests, thus, could serve as a valuable guide to inform decision-making on the COVID-19 booster schedules. However, more wide-scale studies are needed to define correlates of SARS-CoV-2 immune protection.

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