Hybrid adaptive immunity to SARS-CoV-2 protects against breakthrough infection after COVID-19 vaccination in ALSPAC participants.
Baum, H.; Santopaolo, M.; Francis, O.; Milowdowski, E.; Entwistle, K.; Oliver, E.; Hitchings, B.; Diamond, D.; Thomas, A.; Mitchell, R.; Kibble, M.; Gupta, K.; Di Bartolo, N.; Klenerman, P.; Brown, A.; Morales-Aza, B.; Oliver, J.; Berger, I.; Toye, A. M.; Finn, A.; Goenka, A.; Davidson, A. D.; Ring, S.; Molloy, L.; Lewcock, M.; Northstone, K.; Roth, F.; Timpson, N. J.; Wooldridge, L.; Halliday, A.; Rivino, L.
Show abstract
Immunological memory to vaccination and viral infection involves coordinated action of B and T-cells, thus integrated analysis of these two components is critical for understanding their contributions to protection against breakthrough infections (BI). We investigated cellular and humoral immune responses to SARS-CoV-2 infection and/or COVID-19 vaccination in participants from the Avon Longitudinal Study of Parents and Children (ALSPAC). The magnitude of antibody and T-cell responses following the second vaccine dose was associated with protection against BI in participants with a history of SARS-CoV-2 infection (cases), but not in infection-naive controls. Youdens index thresholds for protection against BI were calculated for all immune measures. Anti-Spike IgG (>666.4 BAU/mL) and anti-Nucleocapsid pan Ig (>0.1332 BAU/mL) thresholds combined were 100% specific and 83.3% sensitive for cases without BI over 8-months follow-up. Collectively these results point to the superior protective effect of hybrid immunity and have implications for the design of next-generation COVID-19 vaccines.
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