Anti-Spike and Neutralizing Antibodies after Two Doses of COVID-19 Sinopharm/BIBP Vaccine

Abstract

Host response to COVID-19 vaccines is partially evaluated through the estimation of antibody response, specifically the binding anti-spike (anti-S) and the neutralizing antibodies (nAbs) against SARS-CoV-2. Vaccine-induced humoral response affects decisions on the choice of vaccine type, vaccine acceptance, and the need for boosting. Identification of risk factors for poor antibody response helps to stratify individuals who might potentially require booster doses. The primary objective of this cross-sectional study was to investigate the antibody response after receiving two Sinopharm vaccine doses. Factors affecting antibody response were additionally studied. Moreover, a predictive cutoff for anti-S was generated to predict positivity of nAbs. Blood samples were collected from 92 adults and relevant data were recorded. Antibody levels (anti-S and nAbs) against SARS-CoV-2 were tested one month following the second dose of Sinopharm vaccine using two commercial ELISA tests. Among the 92 participants, 88 tested positive for anti-S (95.7%), with a median level of 52.15 RU/mL (equivalent to 166.88 BAU/mL). Fewer participants (67.4%) were positive for nAbs, with a median percentage of inhibition (%IH) of 50.62% (24.05–84.36). A significant positive correlation existed between the titers of both antibodies (correlation coefficient = 0.875, p < 0.001). When the anti-S titer was greater than 40 RU/mL (128 BAU/mL), nAbs were also positive with a sensitivity of 80.6% and a specificity of 90%. Positive nAbs results were associated with a higher anti-S titers (62.1 RU/mL) compared to negative nAbs (mean anti-S titer of 18.6 RU/mL). History of COVID-19 infection was significantly associated with higher titers of anti-S (p = 0.043) and higher IH% of nAbs (p = 0.048). Hypertensive participants were found to have significantly higher median titers of anti-S (101.18 RU/mL) compared with non-hypertensive ones (42.15 RU/mL), p = 0.034. Post-vaccination headache was significantly higher among those with higher anti-S than those with relatively lower titers (98.82 versus 43.69 RU/mL, p = 0.048). It can be concluded that the Sinopharm vaccine produced high levels of binding antibodies but with low neutralizing abilities. Also, levels of anti-S titer greater than 40 RU/mL could adequately predict positivity of nAbs without need for their testing.