Peri-infection titers of neutralizing and binding antibodies as a predictor of COVID-19 breakthrough infections in vaccinated healthcare professionals: importance of the timing
Author:
Gillot Constant1, Bayart Jean-Louis2, Closset Mélanie3, Cabo Julien4ORCID, Maloteau Vincent1, Dogné Jean-Michel1, Douxfils Jonathan15ORCID, Favresse Julien14
Affiliation:
1. Department of Pharmacy , Namur Research Institute for Life Sciences, Namur Thrombosis and Hemostasis Center, University of Namur , Namur , Belgium 2. Department of Laboratory Medicine , Clinique St-Pierre , Ottignies , Belgium 3. Department of Laboratory Medicine , Université catholique de Louvain, CHU UCL Namur , Namur , Belgium 4. Department of Laboratory Medicine , Clinique St-Luc Bouge , Namur , Belgium 5. Research and Development Department , Qualiblood s.a. , Namur , Belgium
Abstract
Abstract
Objectives
The BNT162b2 messenger RNA vaccine is highly effective in reducing COVID‐19 infection, hospitalization and death. However, many subjects developed a breakthrough infection despite a full vaccination scheme. Since the waned efficacy of mRNA vaccines is correlated with the decrease of antibodies occurring over time, we aimed at evaluating whether lower levels of antibodies were associated with an increased risk of breakthrough infection in a cohort of breakthrough subjects that received three vaccine doses.
Methods
Total binding antibodies against the RBD of the S1 subunit (Roche Diagnostics, Machelen, Belgium) and neutralizing antibodies using the Omicron B.1.1.529 variant pseudovirus were measured. Based on individual kinetic curves, the antibody titer of each subject was interpolated just before the breakthrough infection and compared to a matched-control group that did not develop a breakthrough infection.
Results
Lower levels of total binding and neutralizing antibodies were observed compared to the control group (6.900 [95% CI; 5.101–9.470] vs. 11.395 BAU/mL [8.627–15.050] [p=0.0301] and 26.6 [18.0–39.3] vs. 59.5 dilution titer−1 [32.3–110] [p=0.0042], respectively). The difference between breakthrough and control subjects was mostly observed for neutralizing antibodies before three months after the homologous booster administration (46.5 [18.2–119] vs. 381 [285–509] [p=0.0156]). Considering the measurement of total binding antibodies before 3 months, there was no significant difference (p=0.4375).
Conclusions
In conclusion, our results showed that subjects that developed a breakthrough infection had lower levels of neutralizing and total binding antibodies compared to controls. The difference was mostly noticeable considering neutralizing antibodies, especially for infections occurring before 3 months after the booster administration.
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,General Medicine
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