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Understanding “Hybrid Immunity”: Comparison and Predictors of Humoral Immune Responses to Severe Acute Respiratory Syndrome Coronavirus 2 Infection (SARS-CoV-2) and Coronavirus Disease 2019 (COVID-19) Vaccines

2022; Oxford University Press; Volume: 76; Issue: 3 Linguagem: Inglês

10.1093/cid/ciac392

1537-6591

Nusrat J Epsi, Stephanie A Richard, David A Lindholm, Katrin Mende, Anuradha Ganesan, Nikhil Huprikar, Tahaniyat Lalani, Anthony C Fries, Ryan C. Maves, Rhonda E Colombo, Derek Larson, Alfred G. Smith, Wormi Sharon, Carlos J Maldonado, Evan Ewers, Milissa U. Jones, Catherine M Berjohn, Daniel H. Libraty, Margaret Edwards, Caroline English, Julia S Rozman, Rupal Mody, Christopher Colombo, E Samuels, P Nwachukwu, Marana S Tso, I Scher, Celia Byrne, Jennifer A. Rusiecki, Mark P. Simons, David R. Tribble, Christopher C. Broder, Brian K. Agan, Timothy Burgess, Eric D. Laing, Simon Pollett, J Cowden, M Darling, S DeLeon, David A Lindholm, A Markelz, Katrin Mende, S Merritt, T Merritt, Nicola Turner, Trevor Wellington, S Bazan, P K Love, N Dimascio-Johnson, Evan Ewers, Kathleen Gallagher, Derek Larson, A Rutt, Paul W. Blair, Josh Chenoweth, Daniel E. Clark, Susan Chambers, Christopher Colombo, Rhonda E Colombo, Christopher P. Conlon, Katie Everson, P Faestel, T Ferguson, Lisi Gordon, S Grogan, S Lis, C Mount, D Musfeldt, D Odineal, M Perreault, W Robb-McGrath, R Sainato, C Schofield, Clare Skinner, Michael Ashley Stein, M Switzer, M Timlin, Samuel Wood, S Banks, Rebecca M. Carpenter, L Kim, K Kronmann, Tahaniyat Lalani, Teresa Lee, Adrian D. Smith, Richard Smith, R Tant, T Warkentien, Catherine M Berjohn, S Cammarata, N Kirkland, Daniel H. Libraty, Ryan C. Maves, Gregory Utz, S Chi, R Flanagan, Milissa U Jones, Carolina Lucas, Cristian Madar, K Miyasato, Catherine Uyehara, Brian K. Agan, L Andronescu, A Austin, Christopher C. Broder, Timothy Burgess, Celia Byrne, K Chung, J Davies, C English, Nusrat J Epsi, Christopher B. Fox, Mark Fritschlanski, M Grother, A Hadley, Patrick W. Hickey, Eric D. Laing, Charlotte Lanteri, Jeffrey Livezey, Allison M.W. Malloy, R Mohammed, C Morales, P Nwachukwu, Cara Olsen, Edward Parmelee, Simon Pollett, Stephanie A Richard, Julia S Rozman, Jennifer A. Rusiecki, E Samuels, P Nwachukwu, Marana S Tso, Consuelo Romero‐Sánchez, I Scher, Mark P. Simons, Andrew L. Snow, Kalyani Telu, David R. Tribble, L Ulomi, T Chao, Richard R. Chapleau, Muderhwa Zagabe Christian, Anthony C Fries, C Harrington, Victoria A. Hogan, S Huntsberger, K Lanter, E Macias, J Meyer, S Purves, Kerry L. Reynolds, Navid Behzadi Koochani, C Starr, John K. Iskander, I Kamara, Bruce Barton, D Hostler, J Hostler, K Lago, Carlos J Maldonado, J Mehrer, T Hunter, José Enrique Mejía, J Montes, Rupal Mody, R Resendez, P Sandoval, M Wayman, I Barahona, A Baya, Anuradha Ganesan, Nikhil Huprikar, Bryan A. Johnson, Sheila A. Peel,

Influenza Virus Research Studies

Abstract Background Comparison of humoral responses in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinees, those with SARS-CoV-2 infection, or combinations of vaccine/ infection (“hybrid immunity”) may clarify predictors of vaccine immunogenicity. Methods We studied 2660 US Military Health System beneficiaries with a history of SARS-CoV-2 infection-alone (n = 705), vaccination-alone (n = 932), vaccine-after-infection (n = 869), and vaccine-breakthrough-infection (n = 154). Peak anti-spike–immunoglobulin G (IgG) responses through 183 days were compared, with adjustment for vaccine product, demography, and comorbidities. We excluded those with evidence of clinical or subclinical SARS-CoV-2 reinfection from all groups. Results Multivariable regression results indicated that vaccine-after-infection anti-spike–IgG responses were higher than infection-alone (P < .01), regardless of prior infection severity. An increased time between infection and vaccination was associated with greater post-vaccination IgG response (P < .01). Vaccination-alone elicited a greater IgG response but more rapid waning of IgG (P < .01) compared with infection-alone (P < .01). BNT162b2 and mRNA-1273 vaccine-receipt was associated with greater IgG responses compared with JNJ-78436735 vaccine-receipt (P < .01), regardless of infection history. Those with vaccine-after-infection or vaccine-breakthrough-infection had a more durable anti-spike–IgG response compared to infection-alone (P < .01). Conclusions Vaccine-receipt elicited higher anti-spike–IgG responses than infection-alone, although IgG levels waned faster in those vaccinated (compared to infection-alone). Vaccine-after-infection elicits a greater humoral response compared with vaccine or infection alone; and the timing, but not disease severity, of prior infection predicted these post-vaccination IgG responses. While differences between groups were small in magnitude, these results offer insights into vaccine immunogenicity variations that may help inform vaccination timing strategies.