Waning immune humoral response to BNT162B2 COVID-19 vaccine over 6 months

Einav G. Levin, Yaniv Lustig, Carmit Cohen, Ronen Fluss, Victoria Indenbaum, Sharon Amit, Ram Doolman, Keren Asraf, Ella Mendelson, Arnona Ziv, Carmit Rubin, Laurence Freedman, Yitshak Kreiss, Gili Regev-Yochay

Research output: Contribution to journalArticlepeer-review

1245 Scopus citations

Abstract

BACKGROUND Despite high vaccine coverage and effectiveness, the incidence of symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been increasing in Israel. Whether the increasing incidence of infection is due to waning immunity after the receipt of two doses of the BNT162b2 vaccine is unclear. METHODS We conducted a 6-month longitudinal prospective study involving vaccinated health care workers who were tested monthly for the presence of anti-spike IgG and neutralizing antibodies. Linear mixed models were used to assess the dynamics of antibody levels and to determine predictors of antibody levels at 6 months. RESULTS The study included 4868 participants, with 3808 being included in the linear mixed-model analyses. The level of IgG antibodies decreased at a consistent rate, whereas the neutralizing antibody level decreased rapidly for the first 3 months with a relatively slow decrease thereafter. Although IgG antibody levels were highly correlated with neutralizing antibody titers (Spearman’s rank correlation between 0.68 and 0.75), the regression relationship between the IgG and neutralizing antibody levels depended on the time since receipt of the second vaccine dose. Six months after receipt of the second dose, neutralizing antibody titers were substantially lower among men than among women (ratio of means, 0.64; 95% confidence interval [CI], 0.55 to 0.75), lower among persons 65 years of age or older than among those 18 to less than 45 years of age (ratio of means, 0.58; 95% CI, 0.48 to 0.70), and lower among participants with immunosuppression than among those without immunosuppression (ratio of means, 0.30; 95% CI, 0.20 to 0.46). CONCLUSIONS Six months after receipt of the second dose of the BNT162b2 vaccine, humoral response was substantially decreased, especially among men, among persons 65 years of age or older, and among persons with immunosuppression.

Original languageEnglish
Article numbere84
JournalNew England Journal of Medicine
Volume385
Issue number24
DOIs
StatePublished - 9 Dec 2021
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine

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