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Evidence for antibody as a protective correlate for COVID-19 vaccines.

ABSTRACT: A correlate of protection (CoP) is urgently needed to expedite development of additional COVID-19 vaccines to meet unprecedented global demand. To assess whether antibody titers may reasonably predict efficacy and serve as the basis of a CoP, we evaluated the relationship between efficacy and in vitro neutralizing and binding antibodies of 7 vaccines for which sufficient data have been generated. Once calibrated to titers of human convalescent sera reported in each study, a robust correlation was seen between neutralizing titer and efficacy (ρ = 0.79) and binding antibody titer and efficacy (ρ = 0.93), despite geographically diverse study populations subject to different forces of infection and circulating variants, and use of different endpoints, assays, convalescent sera panels and manufacturing platforms. Together with evidence from natural history studies and animal models, these results support the use of post-immunization antibody titers as the basis for establishing a correlate of protection for COVID-19 vaccines.

SUBMITTER: Earle KA

PROVIDER: S-EPMC8142841 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Evidence for antibody as a protective correlate for COVID-19 vaccines.

Earle Kristen A KA Ambrosino Donna M DM Fiore-Gartland Andrew A Goldblatt David D Gilbert Peter B PB Siber George R GR Dull Peter P Plotkin Stanley A SA

Vaccine 20210524 32

A correlate of protection (CoP) is urgently needed to expedite development of additional COVID-19 vaccines to meet unprecedented global demand. To assess whether antibody titers may reasonably predict efficacy and serve as the basis of a CoP, we evaluated the relationship between efficacy and in vitro neutralizing and binding antibodies of 7 vaccines for which sufficient data have been generated. Once calibrated to titers of human convalescent sera reported in each study, a robust correlation wa ...[more]

PMID: 34210573

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Project description:IntroductionHigh levels of immunity to SARS-CoV-2 in the community correlate with protection from COVID-19 illness. Measuring COVID-19 antibody seroprevalence and persistence may elucidate the level and length of protection afforded by vaccination and infection within a population.MethodsWe measured the duration of detectable anti-spike antibodies following COVID-19 vaccination in a multistate, longitudinal cohort study of almost 13,000 adults who completed daily surveys and submitted monthly dried blood spots collected at home.ResultsOverall, anti-spike antibodies persisted up to 284 days of follow-up with seroreversion occurring in only 2.4% of the study population. In adjusted analyses, risk of seroreversion increased with age (adults aged 55-64: adjusted hazard ratio [aHR] 2.19 [95% confidence interval (CI): 1.22, 3.92] and adults aged > 65: aHR 3.59 [95% CI: 2.07, 6.20] compared to adults aged 18-39). Adults with diabetes had a higher risk of seroreversion versus nondiabetics (aHR 1.77 [95% CI: 1.29, 2.44]). Decreased risk of seroreversion was shown for non-Hispanic Black versus non-Hispanic White (aHR 0.32 [95% CI: 0.13, 0.79]); college degree earners versus no college degree (aHR 0.61 [95% CI: 0.46, 0.81]); and those who received Moderna mRNA-1273 vaccine versus Pfizer-BioNTech BNT162b2 (aHR 0.35 [95% CI: 0.26, 0.47]). An interaction between healthcare worker occupation and sex was detected, with seroreversion increased among male, non-healthcare workers.ConclusionWe established that a remote, longitudinal, multi-site study can reliably detect antibody durability following COVID-19 vaccination. The survey platform and measurement of antibody response using at-home collection at convenient intervals allowed us to explore sociodemographic factors and comorbidities and identify predictors of antibody persistence, which has been demonstrated to correlate with protection against disease. Our findings may help inform public health interventions and policies to protect those at highest risk for severe illness and assist in determining the optimal timing of booster doses.Clinical trials registry: NCT04342884.

Project description:BackgroundMore than 200 countries are experiencing the coronavirus disease (COVID-19) pandemic. COVID-19 vaccination strategies have been implemented worldwide, and repeat COVID-19 outbreaks have been seen. The purpose of this study was to investigate the impact of COVID-19 vaccination on the reduction of perceived anxiety and the association between public anxiety and antibody testing intention during the COVID-19 pandemic.MethodsChinese adults aged 18 and over were surveyed using an anonymous online questionnaire in April and May 2021. The questionnaire collected sociodemographic characteristics, vaccination characteristics, perceived anxiety due to COVID-19, and attitudes toward future antibody testing after COVID-19 vaccination. Perceived anxiety was assessed on a visual analog scale (VAS). Multivariate logistic regression analysis was used to determine the factors influencing future antibody detection.ResultsA total of 3,233 people were investigated, 3,209 valid questionnaires were collected, and the response rate was 99.3%. Of the 3,209 respondents, 2,047 were vaccinated, and 1,162 were unvaccinated. There was a significant difference in anxiety levels between vaccinated and unvaccinated respondents (24.9±25.4 vs. 50.0±33.1, respectively). With the local spread of COVID-19 in mainland China, the public anxiety VAS scores increased by 15.4±25.6 (SMD=120%) and 33.8±31.7 (SMD=49%) among vaccinated and unvaccinated respondents, respectively. Of the 2,047 respondents who were vaccinated, 1,626 (79.4%) thought they would accept antibody testing. Those who displayed more anxiety about acquiring COVID-19 disease were more likely to accept COVID-19 antibody testing. If the antibody test results showed protective antibodies, 1,190 (58.1%) were more likely to arrange travel plans in China, while 526 (25.7%) thought they would feel safer traveling abroad.ConclusionCOVID-19 vaccination strategies help reduce public anxiety. However, public anxiety may be elevated as the local transmission of COVID-19 occurs in mainland China, which is usually caused now by imported cases. Those who display more anxiety choose to have antibody testing. Improving the accessibility of COVID-19 antibody tests can help ease public anxiety and enhance the confidence of some people to participate in social activities.

Dataset Information

Evidence for antibody as a protective correlate for COVID-19 vaccines.

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Evidence for antibody as a protective correlate for COVID-19 vaccines.

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