Reduced BNT162b2 mRNA vaccine response in SARS-CoV-2-naive nursing home residents

 David H. Canaday, Lenore Carias, Oladayo Oyebanji, Debbie Keresztesy, Dennis Wilk, Michael Payne, Htin Aung, Kerri St. Denis, Evan C. Lam, Brigid Wilson, Christopher F. Rowley, Sarah D. Berry, Cheryl M. Cameron, Mark J. Cameron,  

View ORCID ProfileAlejandro Benjamin Balazs, Stefan Gravenstein, Christopher L. King

doi: https://doi.org/10.1101/2021.03.19.21253920

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2021.03.19.21253920v1.full.pdf

Abstract

The SARS-CoV-2 pandemic impact on nursing home (NH) residents prompted their prioritization for early vaccination. To fill the data gap for vaccine immunogenicity in NH residents, we examined antibody levels after BNT162b2 mRNA vaccine to spike, receptor binding domain (RBD) and for virus neutralization in 149 NH residents and 111 health care worker controls. SARS-CoV-2-naive NH residents mount antibody responses with nearly 4-fold lower median neutralization titers and half the anti-spike level compared to SARS-CoV-2-naive healthcare workers. By contrast, SARS-CoV-2-recovered vaccinated NH residents had neutralization, anti-spike and anti-RBD titers similar to SARS-CoV-2-recovered vaccinated healthcare workers. NH residents blunted antibody responses have important implications regarding the quality and durability of protection afforded by neoantigen vaccines. We urgently need better longitudinal evidence on vaccine effectiveness specific to NH resident populations to inform best practices for NH infection control measures, outbreak prevention and potential indication for a vaccine boost.

Competing Interest Statement

SG and DC are recipients of investigator-initiated grants to their universities from Pfizer to study pneumococcal vaccines and Sanofi Pasteur and Seqirus to study influenza vaccines. SG also does consulting for Seqirus, Sanofi, Merck, and Janssen. SG has spoken for Seqirus.

Funding Statement

Support from NIH (AI129709-03S1, 3P01AG027296-11S1, and U01 CA260539-01) and VA.

https://www.medrxiv.org/content/10.1101/2021.03.19.21253920v1