Durability and breadth of neutralisation following multiple antigen exposures to SARS-CoV-2 infection and/or COVID-19 vaccination

Alexander P. Underwood, Christina Sølund, Carlota Fernandez-Antunez, Signe Lysemose Villadsen, Lotte S. Mikkelsen, Ulrik Fahnøe, Signe Bollerup, Anni Assing Winckelmann, Uffe Vest Schneider, Alekxander Binderup, Greta Vizgirda, Anna Louise Sørensen, Caroline Nørløv Vinten, Magnus Illum Dalegaard, Santseharay Ramirez, Nina Weis, Jens Bukh*

*Corresponding author for this work

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Abstract

Background: Given the importance of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the prevention of severe coronavirus disease 2019 (COVID-19), detailed long-term analyses of neutralising antibody responses are required to inform immunisation strategies. Methods: In this study, longitudinal neutralising antibody titres to an ancestral SARS-CoV-2 isolate and cross-neutralisation to delta and omicron isolates were analysed in individuals previously infected with SARS-CoV-2, vaccinated against COVID-19, or a complex mix thereof with up to two years of follow-up. Findings: Both infection-induced and vaccine-induced neutralising responses against SARS-CoV-2 appeared to follow similar decay patterns. Following vaccination in previously infected individuals, neutralising antibody responses were more durable than prior to vaccination. Further, this study shows that vaccination after infection, as well as booster vaccination, increases the cross-neutralising potential to both delta and omicron SARS-CoV-2 variants. Interpretation: Taken together, these results suggest that neither type of antigen exposure is superior for neutralising antibody durability. However, these results support vaccination to increase the durability and cross-neutralisation potential of neutralising responses, thereby enhancing protection against severe COVID-19. Funding: This work was supported by grants from The Capital Region of Denmark's Research Foundation, the Novo Nordisk Foundation, the Independent Research Fund Denmark, the Candys Foundation, and the Danish Agency for Science and Higher Education.

Original languageEnglish
Article number104475
JournalEBioMedicine
Volume89
ISSN2352-3964
DOIs
Publication statusPublished - 2023

Bibliographical note

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Keywords

  • COVID-19
  • Cross-neutralisation
  • Delta
  • Longitudinal
  • Neutralising antibody
  • Omicron
  • SARS-CoV-2
  • Virus isolate

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