SARS-CoV-2 antibody immunity across three continents: the West Africa, West Indies, West London Consortium

BackgroundThe experience of the COVID-19 pandemic has differed across continents. We hypothesized that regional differences in SARS-CoV-2 immunity might explain this observation. We therefore established the WWW Consortium in Ghana, W Africa; Jamaica, W Indies; and W London. Here, we describe the extent to which antibody immunity differs between these geographic locations. MethodsThe WWW Consortium harmonises across the HERITAGE (Accra, Ghana), WINDFall (Kingston, Jamaica) and Legacy (London, UK) studies, establishing sharing frameworks for samples, metadata, and data; related permissions and oversight; and associated physical and cloud infrastructure. With centralised testing, we performed serological assessments across all three locations at two snapshots in 2024 (April 1st - August 18th; August 19th - December 31st) using high-throughput live virus neutralization and anti-nucleocapsid IgG, including n=763 individuals. FindingsWe found that across all sites most participants had detectable neutralising antibody titres against JN.1 and XEC - the predominant variants in 2024. There were site-related differences in immunity: vaccine-included SARS-CoV-2 strains were better neutralised by participants from the Legacy study - Ancestral, BA.5, XBB.1.5 initially, and JN.1 after a homologous booster in autumn 2024. For HERITAGE, neutralisation of both alpha- (HCoV-229E) and beta-coronaviruses (HCoV-OC43) was higher than WINDFall suggesting a cross-coronavirus serological response in West Africa. Finally, antigenic cartography identified two distinct antibody landscapes, with JN.1 and XEC antigenically distant in Legacy, but not in HERITAGE and WINDFall. InterpretationThere is international heterogeneity in SARS-CoV-2 antibody immunity. Global recommendations for vaccine strain selection should incorporate data from diverse populations to ensure accurate, equitable recommendations. FundingThe Wellcome Trust.