Antibody responses to the BNT162b2 mRNA vaccine in individuals previously infected with SARS-CoV-2

Abstract

In a cohort of BNT162b2 (Pfizer-BioNTech) mRNA vaccine recipients (n = 1,090), we observed that spike-specific IgG antibody levels and ACE2 antibody binding inhibition responses elicited by a single vaccine dose in individuals with prior SARS-CoV-2 infection (n = 35) were similar to those seen after two doses of vaccine in individuals without prior infection (n = 228). Post-vaccine symptoms were more prominent for those with prior infection after the first dose, but symptomology was similar between groups after the second dose.

Fig. 1. IgG(S-RBD) antibody response to mRNA SARS-CoV-2 vaccination in individuals with and without prior SARS-CoV-2 infection.

Box plots display the median values with the interquartile range (lower and upper hinge) and ±1.5-fold the interquartile range from the first and third quartile (lower and upper whiskers). We used two-sided Wilcoxon tests, without adjustment for multiple testing, to perform the following between-group comparisons: (1) infection-naive individuals (n = 903) and those with prior infection (n = 78), both at baseline (P < 0.001); (2) infection-naive individuals (n = 490) and those with prior infection (n = 35), both after dose 1 (P < 0.001); (3) infection-naive individuals (n = 228) and those with prior infection (n = 11), both after dose 2 (P < 0.001); (4) infection-naive individuals (n = 490) after dose 1 and those with prior infection (n = 78), both at baseline (P < 0.001); and (5) infection-naive individuals (n = 228) after dose 2 and those with prior infection (n = 35) after dose 1 (P = 0.92).

Extended Data Fig. 1. Anti-Nucleocapsid Protein IgG Antibody Response to mRNA SARS-CoV-2 Vaccination in Persons With and Without Prior SARS-CoV-2 infection.

Box plots display the median values with the interquartile range (lower and upper hinge) and ±1.5-fold the interquartile range from the first and third quartile (lower and upper whiskers). We used two-sided Wilcoxon tests, without adjustment for multiple testing, to conduct the following between-group comparisons: (1) infection naïve (n = 903) and those with prior infection (n = 78), both at baseline (P < 0.001); (2) infection naïve (n = 490) and those with prior infection (n = 35), both following dose 1 (P < 0.001); (3) infection naïve (n = 228) and those with prior infection (n = 11), both following dose 2 (P < 0.001); (4) infection naïve (n = 490) following dose 1 and those with prior infection (n = 78) at baseline (P < 0.001); and, (5) infection naïve (n = 228) following dose 2 and those with prior infection (n = 35) following dose 1 (P < 0.001).

Extended Data Fig. 2. Anti-Spike Receptor Binding Domain IgG Antibody Response to mRNA SARS-CoV-2 Vaccination in Persons With and Without Prior SARS-CoV-2 infection: Values Above and Below 4160 AU/mL.

Box plots display the median values with the interquartile range (lower and upper hinge) and ±1.5-fold the interquartile range from the first and third quartile (lower and upper whiskers). We used two-sided Chi-Square tests with the Yate’s correction, without adjustment for multiple testing, to conduct the following between-group comparisons: (1) infection naïve (n = 221) following dose 2 and those with prior infection (n = 27) following dose 1 (P < 0.001); and, (2) infection naïve (n = 221) and those with prior infection (n = 11), both following dose 2 (P = 1.00).

Extended Data Fig. 3. ACE2 Antibody Binding Capacity in Persons With and Without Prior SARS-CoV-2 infection: Values Above and Below 50%.

Box plots display the median values with the interquartile range (lower and upper hinge) and ±1.5-fold the interquartile range from the first and third quartile (lower and upper whiskers). Colors denote values above and below the 50% neutralizing threshold. We used two-sided Wilcoxon tests, without adjustment for multiple testing, to conduct the following between-group comparisons: (1) infection naïve (n = 490) and those with prior infection (n = 35), both following dose 1 (P < 0.001); (2) infection naïve (n = 228) and those with prior infection (n = 11), both following dose 2 (P = 1.00); and, (3) infection naïve (n = 228) following dose 2 and those with prior infection (n = 35) following dose 1 (P = 0.52).

Extended Data Fig. 4. Post-Vaccination Symptoms in Persons With and Without Prior SARS-CoV-2 infection.

Bar graphs display the frequency and severity of symptoms reported following each dose of vaccine administered, by prior infection status.