Breakthrough infections with SARS-CoV-2 omicron efficiently boost antibodies from previous BNT162b2 vaccinations.

To investigate whether SARS-CoV-2 omicron breakthrough infection in individuals after three doses of wildtype-based BNT162b2 increases antibody levels measured by a commercially available wildtype-based immunoassay. 16 of 21 individuals in a BNT162b2 vaccination cohort (recruited 129 [129-135] days after dose 3) experienced a breakthrough infection (BTI) between March and September 2022. Antibodies to the receptor binding domain (RBP) of the spike protein (Anti-S) were quantified using the wildtype-based Elecsys SARS-CoV-2 S assay (Roche). Antibody responses of triple vaccinated BTI cases were compared to triple vaccinated individuals without breakthrough infection and to 16 matched individuals after primary omicron infection. In the 16 individuals with primary Omicron infection, the anti-S assay returned only very low results (2.25 [0.61-5.80] U/mL). However, in individuals with BTI, Anti-S levels rose from 7,135 [5,870-17,470] U/mL to 21,705 (7,750-46,137.5) U/mL. At the same time, Anti-S concentrations decreased from 9,120 [7,480-13,480] U/mL to 3,830 (2,390-4,220) U/mL in those 5 of 21 vaccinated only. Our data suggest that breakthrough infection with omicron can efficiently boost wild-type antibodies in individuals vaccinated with wild-type BNT162b2.

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© 2023 Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The Department of Laboratory Medicine (Medical University of Vienna) received compensations for advertisement at scientific symposia from Roche and holds a grant for evaluating an in-vitro diagnostic device from Roche outside of the present study. There was no additional funding received for the present work.