Correlates of protection for booster doses of the BNT162b2 vaccine

• DOI: 10.1101/2022.07.16.22277626
• Publication Date: 2022-07-17T17:00:12Z
• Authors: Tomer Hertz; Shlomia Levy; Daniel Ostrovsky; Hannah Oppenheimer; Shosh Zismanov; Alona Kuzmina; Lilach M Friedman; Sanja Trifkovic; David Brice; Lin Chun-Yang; Yonat Shemer-Avni; Merav Cohen-Lahav; Doron Amichay; Ayelet Keren-Naus; Olga Voloshin; Gabriel Weber; Ronza Najjar-Debbiny; Bibiana Chazan; Maureen A. McGargill; Richard Webby; Michal Chowers; Lena Novack; Victor Novack; Ran Taube; Lior Nesher; Orly Weinstein
• Keywords: Booster (rocketry); Booster dose

Abstract Variants of concern (VOC) SARS-CoV2 and waning immunity pose a serious global problem. Overall, vaccination prior infection appear to provide significant protection the majority individuals, but some remain susceptible severe disease. Rigorously identifying broad spectrum correlates (COP) is necessary identify these populations. The extent which additional booster doses also poorly understood. To address this need, we conducted multicenter prospective study assessing association between serological profiles risk for SARS-CoV-2 infection, comparing those vaccinated with three four Pfizer BNT162b2 vaccine. Of 608 healthy adults, 365 received 243 doses. During first 90 days followup, 239 (39%) were infected, whom 165/365 (45%) 3 74/243 (30%) We found that fourth dose elicited rise in antibody binding neutralizing titers against multiple variants, reduced symptomatic by 37% [95% I, 15% - 54%]. identified several parameters based on IgG IgA COPs. strongest was levels RBD mutants VOCs, COP three-dose group (HR=6.34, p=0.008) four-dose (HR=8.14, p=0.018). A combination two commercially available ELISA assays associated both groups (HR = 1.84, p 0.002; HR 2.01, 0.025, respectively). Most importantly, subset individuals low after vaccine responded boost dose, still at significantly increased susceptibility when compared who had pre-existing high antibodies. Thus, highly population remains despite apparent responsiveness vaccines. Further, develop specific sensitive COPs show dramatic effect sizes may be utilized most from future exposures.