Humoral and T Cell Immune Responses against SARS-CoV-2 after Primary and Homologous or Heterologous Booster Vaccinations and Breakthrough Infection: A Longitudinal Cohort Study in Malaysia

Viruses. 2023 Mar 25;15(4):844. doi: 10.3390/v15040844.

Abstract

Vaccine efficacy against SARS-CoV-2 could be compromised by the emergence of SARS-CoV-2 variants and it is important to study how it impacts the booster vaccination regime. We investigated the humoral and T cell responses longitudinally in vaccinated uninfected (n = 25) and post-COVID-19 individuals (n = 8), and those who had received a BNT162b2 booster following complete two-doses regimes of either BNT162b2 (homologous) (n = 14) or ChAdOx1-S (heterologous) (n = 15) vaccines, by means of a SARS-CoV-2 pseudovirus neutralization test and QuantiFERON SARS-CoV-2 assay. Vaccinated post-COVID-19 individuals showed higher neutralizing antibodies with longer durability against SARS-CoV-2 wild type (WT) and Omicron spikes, but demonstrated similar declining T cell responses compared to the uninfected vaccinated. Two doses of BNT162b2 induced higher neutralizing antibodies against WT and T cell responses than ChAdOx1-S for six months. The BNT162b2 booster confers a greater humoral response against WT, but a similar cross-neutralizing antibody against Omicron and T cell responses in the homologous booster group compared to the heterologous booster group. Breakthrough infection in the homologous booster group (n = 11) significantly increased the neutralizing antibody, but T cell responses remained low. Our data may impact government public health policy regarding the administration of mix-and-match vaccines, where both vaccination regimes can be employed should there be shortages of certain vaccines.

Keywords: BNT162b2 vaccine; ChAdOx1-S vaccine; Omicron; SARS-CoV-2; T cell responses; booster; neutralizing antibody.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • BNT162 Vaccine*
  • Breakthrough Infections
  • COVID-19* / prevention & control
  • ChAdOx1 nCoV-19
  • Cohort Studies
  • Humans
  • Longitudinal Studies
  • Malaysia
  • SARS-CoV-2
  • T-Lymphocytes
  • Vaccination

Substances

  • BNT162 Vaccine
  • Antibodies, Neutralizing
  • ChAdOx1 nCoV-19
  • Antibodies, Viral

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

This research was funded by Fundamental Research Grant Scheme FRGS/1/2020/SKK0/UM/02/5 rewarded by Ministry of Higher Education, Malaysia. Universiti Malaya MG004-2022.