Abstract
Introduction: Inadequate vaccine response is a common concern among healthcare workers at the frontlines of the COVID-19 pandemic. We aimed to investigate if healthcare workers with history of weak immune response to HBV vaccination are more likely to have weak responses against the BioNTech/Pfizer’s BNT162b2 mRNA SARS-CoV-2 vaccine.
Methods: We prospectively tested 954 healthcare workers for the Anti-SARS-CoV-2 spike (S) protein antibody titers prior to the first and second BNT162b2 vaccination doses and after four weeks after the second dose using Roche’s Elecsys® assay. We calculated the percentage of patients who seroconverted after the first and second doses. We estimated the relative risk of non-seroconversion after the first BNT162b2 vaccine (defined as anti-SARS-CoV-2-S titer <15 U/mL) among HBV vaccine non-responders (HBs-Ab titer <10 mIU/mL) and weak responders (≥10 and <100 mIU/mL) compared to normal responders (≥100 mIU/mL).
Results: Among 954 healthcare workers recruited between March 9 and March 24, 2021 at Osaka Medical and Pharmaceutical University, weak and normal HBV vaccine responders had comparable S-protein titers after the first BNT162b2 dose (51.4 [95% confidence interval 25.2-137.0] versus 59.7 [29.8-138.0] U/mL, respectively). HBV vaccine non-responders were more likely than normal responders to not seroconvert after a single dose (age and sex-adjusted relative risk 1.85 95% confidence interval [1.10-3.13]) although nearly all participants seroconverted after the second dose. After limiting the analysis to 382 patients with baseline comorbidity data, the comorbidity-adjusted relative risk of non-seroconversion among HBV vaccine non-responders to normal responders was 1.32 (95% confidence interval [0.59-2.98]).
Discussion: Long term follow-up studies are needed to understand if protective immunity against SARS-CoV-2 wanes faster among those with history of HBV vaccine non-response and when booster doses are warranted for these healthcare workers.
【초록키워드】 SARS-CoV-2, Vaccine, BNT162b2 vaccine, immune response, vaccination, COVID-19 pandemic, Comorbidity, risk, healthcare worker, SARS-CoV-2 vaccine, HBV, BNT162b2, Protein, protective immunity, vaccine response, healthcare, Patient, Antibody titer, age, Responder, university, Roche, booster dose, BNT162b2 mRNA, single dose, S-protein, Analysis, dose, long term, follow-up study, confidence interval, 95% confidence interval, second dose, participant, doses, pharmaceutical, seroconvert, non-responder, defined, tested, recruited, calculated, seroconverted, faster, comparable, responses against, baseline, Inadequate, 【제목키워드】 prospective observational study, Antibody Response, anti-SARS-CoV-2, healthcare worker, SARS-CoV-2 vaccine, HBV, vaccine response, BNT162b2 mRNA,