Immunity in people who have had COVID-19 and get a vaccine is a fascinating topic. There are really impressive immune responses! I discuss this in Science today, particularly highlighting recent discoveries. 🧵
science.sciencemag.org/content/372/65…
Hybrid vigor can occur when different plant lines are bred together. Something similar happens when natural immunity is combined with vaccine-generated immunity, resulting in 25 to 100 times higher antibody responses, driven by memory B and CD4 T cells.
Conceptualized above as trees of different sizes.
And here's another visualization, a bit more to scale. 😁
The papers highlighted were:
science.sciencemag.org/content/372/65…
science.sciencemag.org/content/372/65…
The published format allowed limited references, and so I am providing a fuller set of references here, as the rest of this thread, since so much work is being done.
“Reported natural immunity protection against any SARS-CoV-2 re-infection ranges from 81-99.8% over 7-8 months (1-3,5) (though a concerning drop was observed in persons > 65 years old in Denmark (4)). Levels of immunity can be placed on a spectrum…”
1. Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers New England Journal of Medicine 2020 dx.doi.org/10.1056/nejmoa…
2. SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy dx.doi.org/10.1016/j.ecli…
3. SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN) dx.doi.org/10.1016/s0140-…
4. Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study The Lancet 2021 dx.doi.org/10.1016/s0140-…
5. Switzerland
academic.oup.com/cid/advance-ar…
Some of this discussed in this thread:
Delta variant (first seen in India) protection:
ft.com/content/e71471…
"A substantial frequency of memory B cells encode antibodies that are capable of binding or neutralizing VOCs, and the quality of those memory B cells increases over time." ref also:
dx.doi.org/10.1126/sciimm…
"The evolution of B cells in response to infection, or vaccination, is powered by immunological microanatomical structures called germinal centers, which are T cell-dependent, instructed by T follicular helper (TFH) CD4+ T cells."
dx.doi.org/10.1016/j.immu…
"Antibodies are clearly involved in protection against SARS-CoV-2 reinfection"
Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection Nature Medicine 2021 dx.doi.org/10.1038/s41591…
T cell recognition of variants (four):
(A) CD8+ T cell responses in COVID-19 convalescent individuals target conserved epitopes from multiple prominent SARS-CoV-2 circulating variants Open Forum Infectious Diseases 2021 dx.doi.org/10.1093/ofid/o…
(B) SARS-CoV-2 variants of concern partially escape humoral but not T-cell responses in COVID-19 convalescent donors and vaccinees. Science Immunology 2021 dx.doi.org/10.1126/sciimm…
(C) Negligible impact of SARS-CoV-2 variants on CD4+ and CD8+ T cell reactivity in COVID-19 exposed donors and vaccinees . bioRxiv 2021 dx.doi.org/10.1101/2021.0…
(D) Comprehensive analysis of T cell immunodominance and immunoprevalence of SARS-CoV-2 epitopes in COVID-19 cases dx.doi.org/10.1016/j.xcrm…
Studies showing 1-dose immunization data in previously infected individuals are now numerous. Some key ones were cited in this excellent letter:
doi.org/10.1016/j.ebio…
“previously infected people in some … vaccine studies included both asymptomatic and symptomatic COVID-19 cases. Enhanced vaccine immune responses were observed in both groups, indicating hybrid immunity magnitude is not directly proportional to previous COVID-19 severity." ref:
Binding and Neutralization Antibody Titers After a Single Vaccine Dose in Health Care Workers Previously Infected With SARS-CoV-2 JAMA 2021
dx.doi.org/10.1001/jama.2…
This article is now freely available. I got Science to fix their glitch.
science.sciencemag.org/content/372/65…
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