Correlates of protection and viral load trajectories in omicron breakthrough infections in triple vaccinated healthcare workers.


Journal

Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555

Informations de publication

Date de publication:
22 03 2023
Historique:
received: 09 04 2022
accepted: 27 02 2023
entrez: 23 3 2023
pubmed: 24 3 2023
medline: 25 3 2023
Statut: epublish

Résumé

Vaccination offers protection against severe COVID-19 caused by SARS-CoV-2 omicron but is less effective against infection. Characteristics such as serum antibody titer correlation to protection, viral abundance and clearance of omicron infection in vaccinated individuals are scarce. We present a 4-week twice-weekly SARS-CoV-2 qPCR screening in 368 triple vaccinated healthcare workers. Spike-specific IgG levels, neutralization titers and mucosal spike-specific IgA-levels were determined at study start and qPCR-positive participants were sampled repeatedly for two weeks. 81 (cumulative incidence 22%) BA.1, BA.1.1 and BA.2 infections were detected. High serum antibody titers are shown to be protective against infection (p < 0.01), linked to reduced viral load (p < 0.01) and time to viral clearance (p < 0.05). Pre-omicron SARS-CoV-2 infection is independently associated to increased protection against omicron, largely mediated by mucosal spike specific IgA responses (nested models lr test p = 0.02 and 0.008). Only 10% of infected participants remain asymptomatic through the course of their infection. We demonstrate that high levels of vaccine-induced spike-specific WT antibodies are linked to increased protection against infection and to reduced viral load if infected, and suggest that the additional protection offered by pre-omicron SARS-CoV-2 infection largely is mediated by mucosal spike-specific IgA.

Identifiants

pubmed: 36949041
doi: 10.1038/s41467-023-36984-1
pii: 10.1038/s41467-023-36984-1
pmc: PMC10031702
doi:

Substances chimiques

Immunoglobulin A 0
Antibodies, Viral 0
Antibodies, Neutralizing 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1577

Informations de copyright

© 2023. The Author(s).

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Auteurs

Ulrika Marking (U)

Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.

Sebastian Havervall (S)

Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.

Nina Greilert Norin (NG)

Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.

Oscar Bladh (O)

Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.

Wanda Christ (W)

Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.

Max Gordon (M)

Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.

Henry Ng (H)

Department of Medical Cell Biology and SciLifeLab, Uppsala University, Uppsala, Sweden.

Kim Blom (K)

Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.

Mia Phillipson (M)

Department of Medical Cell Biology and SciLifeLab, Uppsala University, Uppsala, Sweden.

Sara Mangsbo (S)

Department of Pharmacy and SciLifeLab, Uppsala University, Uppsala, Sweden.

Jessica J Alm (JJ)

Department of Microbiology, Tumor and Cell Biology & National Pandemic Center, Karolinska Institutet, Solna, Sweden.

Anna Smed-Sörensen (A)

Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Peter Nilsson (P)

Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden.

Sophia Hober (S)

Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden.

Mikael Åberg (M)

Department of Medical Sciences, Clinical Chemistry and SciLifeLab, Uppsala University, Uppsala, Sweden.

Jonas Klingström (J)

Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Charlotte Thålin (C)

Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden. charlotte.thalin@ki.se.

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Classifications MeSH