Factors Associated with SARS-CoV-2 Antibody Titer After Sinovac Vaccination Among Health Care Workers

Theresia Santi, Baringin De Samakto, Lina Kamarga, Feronica Kusuma Hidayat, Ferry Hidayat

Abstract


Background: One of the methods to record immunogenicity after vaccination is to measure antibody titer. This study aimed to get the value of antibody titer post Sinovac vaccination and to analyze factors that associate with it. The trend of titer changes within 3 months period and the incidence of COVID-19 were also observed. Methods: A prospective cohort study was conducted in March until May 2021 involving 250 health care workers of Siloam Hospitals Lippo-Cikarang who have completed two doses of Sinovac vaccination. We collected 3 titer data from each participant to observe the trend of changes. The incidence of COVID-19 among post-vaccinated subjects was also calculated. Results: From total of 250 participants, 88 (35.2%) were males and 162 (64.8%) were females. Fourteen days after vaccination, 248 subjects (99.2%) had seroconversion. The median antibody titer amounted to 63.58 U/ml (0.4->250 U/ml). The titer was higher in age group 26-39 years (85.1 U/ml, p=0.003) and in women (78.7 U/ml, p=0.007). Within 3 months period, 162 from 200 participants (81%) who completed 3 titer tests, had antibody titer reduction (p=0.231). In observation, 94 from 245 (38.3%) participants tested positive COVID-19, with only 5 out of 94 (5.3%) participants being hospitalized. Conclusion: The highest median titer was achieved 14 days after Sinovac vaccination (63.58 U/ml). Younger age group and women are associated with higher value. The reduction trend in titer within 3 months is insignificant. Among post-vaccinated infection subjects, the hospitalization rate is low, which shows that Sinovac vaccination still has a protective effect.


Keywords


Sinovac; SARS-CoV-2; COVID-19; antibody; vaccination; health care workers

References


Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33.

World Health Organization. The COVID-19 candidate vaccine landscape. [Internet]. [Cited2021August6].From: https://www.who.int/publications/m/item/draft-landscape-of-COVID-19-candidate-vaccines.

Palacios R, Patino E, Piorelli MD, et al. Double-blind, randomized, placebo-controlled phase III clinical trial to evaluate the efficacy and safety of treating healthcare professionals with the adsorbed COVID-19 (inactivated) vaccine manufactured by Sinovac – PROVISCOV: A structured summary of a study protocol for a randomized controlled trial. Trials. 2020;21:853.

Tanriover MD, Dogonay HL, Akova M, et al. Efficacy and savety of an inactivated whole-virion SARS-CoV2 Vaccine (CoronaVac): interim results of a double-blind randomized, placebo-controlled, phase 3 trial in Turkey. Lancet. 2021;398:213-22.

Bueno SM, Abarca K Gonzales PA, et al. Interim report: safety and immunogenicity of an inactivated against SARS-CoV2 in healthy Chilean adults in a phase 3 clinical trial. [Internet]. MedRxiv [preprint] 2021. [Cited 2021 July 14]. Available from https://doi.org/10.1101/2021.03.31.21254494.

Rusmil K. Summary Final Report A Phase III, Observer-blind, Randomized, Placebo-controlled Study of the Efficacy, Safety and Immunogenicity of SARS-CoV2 inactivated vaccine in Healthy Adults Aged 18-59 Years Old in Indonesia. Interim report. In: Hadinegoro SR. Webinar Imunisasi Booster bagi Tenaga Kesehatan dan Tenaga Medis, July 14, 2021.

Chakraborty S, Mallajosyula V, Tato CM, Tan GS, Wang TT. SARS-CoV-2 vaccines in advanced clinical trials: Where do we stand? Adv Drug Deliv Rev. 2021;172: 314–38.

Zhang Y, Zeng G, Pan H, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect Dis. 2021;21:181-92.

Satuan Tugas Penanganan COVID-19. Badan POM Keluarkan Ijin Penggunaan Darurat (EUA) untuk vaksin COVID-19 produksi Sinovac. 11 Januari 2021.[Internet] [Cited 2021 March 20]. Available from https://covid19.go.id.

Grigoryan L, Pulendran B. The immunology of SARS-CoV-2 infections and vaccines. Semin Immunol. 2020;50:101422. Available from: https://doi.org/10.1016/j.smim.2020.101422.

Lippi G, Sciacovelli L, Trenti T, Plebani M. Kinetics and biological characteristics of humoral response developing after SARS-CoV-2 infection: implications for vaccination. Clin Chem Lab Med. [internet] 2021 [cited 2021 Aug 20]. Available from: https://doi.org/1I0.1515/cclm-2021-0038.

He Q, Mao Q, Zhang J, et al. COVID-19 vaccines: Current understanding on immunogenicity, safety, and further considerations. Front Immunol. 2021;12:669339.

Zimmerman P, Curtis N. Factors that influence immune response to vaccination. Clin Microbiol Rev. [internet] 2019 [Cited 2021 Jul 8]; 32:e00084-18. Available from: https://doi.org/10.1128/CMR.00084-18.

Pellini R, Venuti A, Pimpinelli F, et al. Obesity may hamper SARS-CoV2 vaccine immunogenicity. [Internet]. medRxiv [preprint] 2021 [Cited 2021 Nov 25]. Available from: https://doi.org/10.1101/2021.02.24.21251664. Posted February 26, 2021.

Jabal KA, Ben-Amram H, Beiruti K, et al. Impact of age, ethnicity, sex and prior infection status on immunogenicity following a single dose of the BNT162b2 mRNA COVID-19 vaccine: real-world evidence from healthcare workers, Israel, December 2020 to January 2021. Euro Surveill. 2021;26(6):pii=2100096. Available from: https://doi.org/10.2807/1560-7917.ES.2021.26.6.2100096. Published February 11, 2021.

Klein SL, Flanagan K. Sex differences in immune respons. Nature. [Internet] [Cited 2021, August 12] 2016; 16:626-38. Available from: doi:10.1038/nri.2016.90. Published online 22 Aug 2016.

Taylor D, Kelly K, Kohut ML. Is insomnia a risk factor for decreased influenza vaccine response? Behav Sleep Med. 2017;15(4):270–87. doi:10.1080/15402002.2015.1126596.

Chastin SFM, Abaraougu U, Bourgois JG, et al. Effects of regular physical activity on the immune system, vaccination and risk of community-acquired infectious disease in the general population: Systematic review and meta-analysis. Sports Med. 2021;51(8):1673-86.

Von Elm E, Altman DG, Egger M, et al. The strengthening the eporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Medicine. 2007;4(10)e296.

Roche Diagnostic. Elecsys Roche. Anti-SARS-CoV2-S. [Internet]. [Cited 2021 August17]. Available from: https://diagnostics.roche.com/global/en/products/params/elecsys-anti-sars-cov-2-s.html.

World Health Organization, Expert Committee on Biological Standarization, 2020. Establishment of the WHO International Standard and Reference Panel for anti-SARS-CoV2 antibody. WHO/BS/2020-2403.[Internet]2020. [cited 2021 August 9] Available at: https://www.who.int/publications/m/item/WHO-BS-2020.2403.

Huilier AG, Meyer B, Andrey DO, et al. Antibody persistence in the first 6 months following SARS-CoV-2 infection among hospital workers: a prospective longitudinal study. Clin Microbiol Infect. 2021: 27:784e1-8.

Higgins V, Fabros A, Kulasingam V. Quantitative measurement of Anti-SARS-CoV-2 antibodies: analytical and clinical evaluation. J Clin Microbiol. 2021;59(4):e03149-20.

Wajnberg A, Amanat F, Firpo A, et al. Robust neutralizing antibodies to SARS-CoV-2 infection persist for months. Science. 2020;370:1227–30.

Ni L, Ye F, Cheng M, et al. Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals. Immunity. 2020;52: 971–7.

Crooke SN, Ovsyannikova IG, Polland GA, Kennedy NG. Immunosenescence and human vaccine immune responses. Immun ageing. 2019;16:25. Available from https://doi.org/10.1186/s12979-019-0164-9.

Wu Z, Hu Y, Xu M, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine (CoronaVac) in healthy adults aged 60 years and older: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect Dis. [Internet] 2021 [cited 2021 August 9]; S1473-3099( 20)30987-7. Available from https://doi.org/10.1016.

Annurad E, Shiwaku K, Nogi A. The new BMI criteria for Asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers. J Occup Health. 2003;45:335-43.

Scott Painter SD, Ovsyannikova I, Polland GA. The weight of obesity on the human immune response to vaccination. Vaccine. 2015;33(36):4422–9. doi:10.1016/j.vaccine.2015.06.101.

Liu F, Guo Z, Dong C. Influences of obesity on the immunogenicity of Hepatitis B vaccine. Hum Vaccin Immunother. 2017;3(5):1014–7.

Sheridan PA, J Handy, Karlsson EA. Obesity is associated with impaired immune response to influenza vaccination in humans. Int J Obes. 2012;36:10727.

Pollack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N engl J Med. 2020;383(27):2603-15. Doi:10.1056/NEJMoa2034577.

Baden LR, Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV2 vaccine. N Engl J Med. 2021;384(5):403-16.

Besedovsky L, Lange T, Bojn J. Sleep and immune function. Eur J Physiol. 2012;463:121-37.

Benedict C, Cadernaes J. Could a good night’s sleep improve COVID-19 vaccine efficacy? Lancet. 2021;9:447-8.

Edward KM, Booy R. Effects of exercise on vaccine-induced immune responses. Hum Vaccin Immunother. 2013;9:907–10.

Ozdemir HO, Tosun S, Coskuner SA, Demir S. Assessment of factors affecting inactivated COVID-19 (CoronaVac) vaccine response and antibody response in healthcare professionals. [internet]. ReseachGate [Preprint]. 2021. [cited 2021 Nov 25]: 14 P. Available from: https://doi.org/10.21203/rs.3.rs-506854/v1.

Xia S, Zhang Y, Wang Y, et al. Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine, BBIBP-CorV: a randomized, double-blind, placebo-controlled, phase 1/ 2 trial. Lancet Infect Dis. 2020;21:39-51.

Doria-Rose N, Suthar MS, Makowski M, et al. Antibody persistence through 6 months after the second dose of mRNA-1273 vaccine for COVID-19. N Engl J Med. 2021;384:2259-61.

Ramasamy MN, Minassian AM, Ewer KJ, et al. Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): A single-blind, randomized, controlled, phase 2/ 3 trial. Lancet. 2021;396:1979-93.

Pan H, Wu Q, Zeng G, et al. Immunogenicity and safety of a third dose, and immune persistence of CoronaVac vaccine in healthy adults aged 18-59 years: interim results from a double-blind, randomized, placebo-controlled phase 2 clinical trial. [Internet]. MedRxiv. [Cited 2021, August 9]. Available from https://doi.org/10.1101/2021.07.23.21261026.

Jara A, Undurraga EA, Gonzales C, et al. Inactivated SARS-CoV-2 vaccine effectively prevented Covid 19, including severe disease and death, supporting implementation of mass vaccination campaigns. N Engl J Med. 2021;385:875-884.

Kompas. Sebaran variant Alpha, Beta dan Delta di Indonesia hingga 7 Agustus 2021. [Internet] 2021 August 8; [cited 2021 August 9]. Available from: https://nasional.kompas.com/read/2021/08/09/16390581/sebaran-varian-alpha-beta-dan-delta-di-indonesia-hingga-7-agustus-2021?page=all.


Full Text: PDF

Refbacks

  • There are currently no refbacks.