Comparison of Neutralizing Activity between Vaccinated and Unvaccinated Hospitalized COVID-19 Patients Infected with Delta, Omicron BA.1, or Omicron BA.2 Variant

Author:

Kim Keun Ju1ORCID,Park Seo-Jin2,Yun Seung Gyu1ORCID,Kim Sang Wook1,Nam Myung-Hyun1,Shin Eun Kyong3ORCID,Chang Eun-Ah45,Park Dae Won6,Lee Chang Kyu1,Yoon Young Kyung7,Cho Yunjung1

Affiliation:

1. Department of Laboratory Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea

2. Department of Laboratory Medicine, Ajou University School of Medicine, Suwon 16499, Republic of Korea

3. Department of Sociology, Korea University, Seoul 02841, Republic of Korea

4. Department of Laboratory Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea

5. Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin-si 16954, Republic of Korea

6. Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea

7. Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea

Abstract

Background: Understanding the immune response to evolving viral strains is crucial for evidence-informed public health strategies. The main objective of this study is to assess the influence of vaccination on the neutralizing activity of SARS-CoV-2 delta and omicron infection against various SARS-CoV-2 variants. Methods: A total of 97 laboratory-confirmed COVID-19 cases were included. To assess the influence of vaccination on neutralizing activity, we measured the neutralizing activity of SARS-CoV-2 delta or omicron (BA.1 or BA.2) infection against wild-type (WT), delta, BA.1, and BA.2, with the results stratified based on vaccination status. Results: The neutralizing activity against the WT, delta, and omicron variants (BA.1 and BA.2) was significantly higher in the vaccinated patients than those in the unvaccinated patients. In the unvaccinated individuals infected with the delta variant, the decrease in binding to BA.1 and BA.2 was statistically significant (3.9- and 2.7-fold, respectively) compared to the binding to delta. In contrast, vaccination followed by delta breakthrough infection improved the cross-neutralizing activity against omicron variants, with only 1.3- and 1.2-fold decreases in BA.1 and BA.2, respectively. Vaccination followed by infection improved cross-neutralizing activity against WT, delta, and BA.2 variants in patients infected with the BA.1 variant, compared to that in unvaccinated patients. Conclusions: Vaccination followed by delta or BA.1 infection is associated with improved cross-neutralizing activity against different SARS-CoV-2 variants. The enhanced protection provided by breakthrough infections could have practical implications for optimizing vaccination strategies.

Funder

SK Bioscience Co., Ltd.

Publisher

MDPI AG

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