Antibody responses and correlates of protection in the general population after two doses of the ChAdOx1 or BNT162b2 vaccines

Jia Wei; Koen B Pouwels; Nicole Stoesser; Philippa C Matthews; Ian Diamond; Ruth Studley; Emma Rourke; Duncan Cook; John I Bell; John N Newton; Jeremy Farrar; Alison Howarth; Brian D Marsden; Sarah Hoosdally; E Yvonne Jones; David I Stuart; Derrick W Crook; Tim E A Peto; A Sarah Walker; David W Eyre; COVID-19 Infection Survey team

doi:10.1038/s41591-022-01721-6

Antibody responses and correlates of protection in the general population after two doses of the ChAdOx1 or BNT162b2 vaccines

Nat Med. 2022 May;28(5):1072-1082. doi: 10.1038/s41591-022-01721-6. Epub 2022 Feb 14.

Authors

Jia Wei^#^{1

2}, Koen B Pouwels^#^{3

4}, Nicole Stoesser^{1

3

5

6}, Philippa C Matthews^{1

6}, Ian Diamond⁷, Ruth Studley⁷, Emma Rourke⁷, Duncan Cook⁷, John I Bell⁸, John N Newton⁹, Jeremy Farrar¹⁰, Alison Howarth^{1

6}, Brian D Marsden^{1

11}, Sarah Hoosdally¹, E Yvonne Jones¹, David I Stuart¹, Derrick W Crook^{1

3

5

6}, Tim E A Peto^{1

3

5

6}, A Sarah Walker^{1

2

3

12}, David W Eyre^{13

14

15

16}; COVID-19 Infection Survey team

Collaborators

COVID-19 Infection Survey team:
Tina Thomas, Daniel Ayoubkhani, Russell Black, Antonio Felton, Megan Crees, Joel Jones, Lina Lloyd, Esther Sutherland, Emma Pritchard, Karina-Doris Vihta, George Doherty, James Kavanagh, Kevin K Chau, Stephanie B Hatch, Daniel Ebner, Lucas Martins Ferreira, Thomas Christott, Wanwisa Dejnirattisai, Juthathip Mongkolsapaya, Sarah Cameron, Phoebe Tamblin-Hopper, Magda Wolna, Rachael Brown, Richard Cornall, Gavin Screaton, Katrina Lythgoe, David Bonsall, Tanya Golubchik, Helen Fryer, Stuart Cox, Kevin Paddon, Tim James, Thomas House, Julie Robotham, Paul Birrell, Helena Jordan, Tim Sheppard, Graham Athey, Dan Moody, Leigh Curry, Pamela Brereton, Ian Jarvis, Anna Godsmark, George Morris, Bobby Mallick, Phil Eeles, Jodie Hay, Harper VanSteenhouse, Jessica Lee, Sean White, Tim Evans, Lisa Bloemberg, Katie Allison, Anouska Pandya, Sophie Davis, David I Conway, Margaret MacLeod, Chris Cunningham

Affiliations

¹ Nuffield Department of Medicine, University of Oxford, Oxford, UK.
² Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
³ The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK.
⁴ Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
⁵ The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
⁶ Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
⁷ Office for National Statistics, Newport, UK.
⁸ Office of the Regius Professor of Medicine, University of Oxford, Oxford, UK.
⁹ Health Improvement Directorate, Public Health England, London, UK.
¹⁰ Wellcome Trust, London, UK.
¹¹ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
¹² MRC Clinical Trials Unit at UCL, University College London, London, UK.
¹³ Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK. david.eyre@bdi.ox.ac.uk.
¹⁴ The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK. david.eyre@bdi.ox.ac.uk.
¹⁵ The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK. david.eyre@bdi.ox.ac.uk.
¹⁶ Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK. david.eyre@bdi.ox.ac.uk.

^# Contributed equally.

Abstract

Antibody responses are an important part of immunity after Coronavirus Disease 2019 (COVID-19) vaccination. However, antibody trajectories and the associated duration of protection after a second vaccine dose remain unclear. In this study, we investigated anti-spike IgG antibody responses and correlates of protection after second doses of ChAdOx1 or BNT162b2 vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United Kingdom general population. In 222,493 individuals, we found significant boosting of anti-spike IgG by the second doses of both vaccines in all ages and using different dosing intervals, including the 3-week interval for BNT162b2. After second vaccination, BNT162b2 generated higher peak levels than ChAdOX1. Older individuals and males had lower peak levels with BNT162b2 but not ChAdOx1, whereas declines were similar across ages and sexes with ChAdOX1 or BNT162b2. Prior infection significantly increased antibody peak level and half-life with both vaccines. Anti-spike IgG levels were associated with protection from infection after vaccination and, to an even greater degree, after prior infection. At least 67% protection against infection was estimated to last for 2-3 months after two ChAdOx1 doses, for 5-8 months after two BNT162b2 doses in those without prior infection and for 1-2 years for those unvaccinated after natural infection. A third booster dose might be needed, prioritized to ChAdOx1 recipients and those more clinically vulnerable.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibody Formation
BNT162 Vaccine
COVID-19* / prevention & control
ChAdOx1 nCoV-19
Humans
Immunoglobulin G
Male
SARS-CoV-2*

Substances

Immunoglobulin G
ChAdOx1 nCoV-19
BNT162 Vaccine

Abstract

Publication types

MeSH terms

Substances

Grants and funding