[HTML][HTML] Three exposures to the spike protein of SARS-CoV-2 by either infection or vaccination elicit superior neutralizing immunity to all variants of concern

PR Wratil, M Stern, A Priller, A Willmann, G Almanzar… - Nature medicine, 2022 - nature.com
PR Wratil, M Stern, A Priller, A Willmann, G Almanzar, E Vogel, M Feuerherd, CC Cheng…
Nature medicine, 2022nature.com
Infection-neutralizing antibody responses after severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 vaccination are an
essential component of antiviral immunity. Antibody-mediated protection is challenged by
the emergence of SARS-CoV-2 variants of concern (VoCs) with immune escape properties,
such as omicron (B. 1.1. 529), which is rapidly spreading worldwide. Here we report
neutralizing antibody dynamics in a longitudinal cohort of coronavirus disease 2019 …
Abstract
Infection-neutralizing antibody responses after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 vaccination are an essential component of antiviral immunity. Antibody-mediated protection is challenged by the emergence of SARS-CoV-2 variants of concern (VoCs) with immune escape properties, such as omicron (B.1.1.529), which is rapidly spreading worldwide. Here we report neutralizing antibody dynamics in a longitudinal cohort of coronavirus disease 2019 convalescent and infection-naive individuals vaccinated with mRNA BNT162b2 by quantifying SARS-CoV-2 spike protein antibodies and determining their avidity and neutralization capacity in serum. Using live-virus neutralization assays, we show that a superior infection-neutralizing capacity against all VoCs, including omicron, developed after either two vaccinations in convalescents or a third vaccination or breakthrough infection of twice-vaccinated, naive individuals. These three consecutive spike antigen exposures resulted in an increasing neutralization capacity per anti-spike antibody unit and were paralleled by stepwise increases in antibody avidity. We conclude that an infection-plus-vaccination-induced hybrid immunity or a triple immunization can induce high-quality antibodies with superior neutralization capacity against VoCs, including omicron.
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