Prof. Akiko Iwasaki Profile picture
Jul 19, 2021 17 tweets 9 min read Read on X
How do the various mutations within the SARS-CoV-2 variants impact vaccine-induced immunity? The amazing @carolilucas @VogelsChantal @InciYildirim11 led this study with with help from others to tackle this question - using 18 CoV-2 variants. (1/n)

medrxiv.org/content/10.110…
The study was designed to measure antibody and T cell immunity from people who were previously infected or not infected with SARS-CoV-2, before and after the 1st and 2nd doses of mRNA vaccines. Amazing effort by @InciYildirim11 @SaadOmer3 (2/n)
Antibodies to the ancestral S1 and RBD were induced in both prev. infected and uninfected vaccinees. S/S1/RBD-specific IgG levels in response to vaccination were significantly higher in the previously infected compared to uninfected, as reported by others. (3/n)
Next, neutralization activity of antibodies induced by the mRNA vaccines was measured through 50% plaque-reduction neutralization (PRNT50). Despite faster and higher NAb responses in previously infected, similar NAb levels were achieved after 2nd dose in both groups. (4/n)
Notice that even though every vaccinated person generated anti-Spike IgG responses, 2 individuals failed to induce neutralizing Abs even after the 2 shots. We don’t know the underlying cause yet. (5/n)
Next we examined CD4 and CD8 T cell responses to spike and nucleocapsid proteins. mRNA vaccines induced robust activation of CD4 T cells in both previously infected and uninfected vaccinees against ancestral and P.1 spike. (6/n)
In contrast, we found reduced CD8 T cell responses to the P.1 variant spike antigen compared to ancestral spike. This may be related to the various mutations in P.1 spike protein. Mutations are discussed below. (7/n)
Note that other studies found no reduction in T cell responses to ancestral vs. VOC spike antigens in vaccinated people. Difference may be due to assays or hosts. (8/n)

Ad26 vaccine: nature.com/articles/s4158…
mRNA vaccines: sciencedirect.com/science/articl…
How well do mRNA vaccine-induced antibodies work against variants? This is where having collaborators like @NathanGrubaugh is so powerful & enabling 💪🏼 He and his team have been surveying and studying every CoV2 variant in the community. (9/n)
We’re so lucky to tag team with @VogelsChantal in the Grubaugh lab who identified & provided 16/18 variants studied here. @carolilucas painstakingly propagated these variants and @VogelsChantal sequenced and validated each isolate. Spectacular team work! (10/n)
In addition to the spike, these variants have accumulated a number of mutations in other viral genes - important for viral transmission and immune evasion by the variants. This thread will only focus on the spike because that is what is used in mRNA vaccines. (11/n)
This 🏳️‍🌈 graph depicts the PRNT50 of antibodies induced in mRNA vaccinees against the ancestral vs. the 18 variants using authentic viral neutralization assays. You can see the various amino acid changes in the Spike correlating with reduction in NAb capacity. (12/n)
A linear mixed model by @jessroth95 revealed that 8 of the 11 key S gene mutations had significant negative effects on neutralization, and that L452R and E484K/Q had the greatest individual effects.(13/n)
ΔH69/V70 & E484K combination was synergistic (decreased neutralization more than the added effects; β=-0.182; p=0.005), L452R & P681R was antagonistic (decreased neutralization less than the added effects; β=0.228; p=0.003), and E484K & N501Y was neither (β=0.060; p=0.248). (14/)
Previously infected people had higher neutralization against variants than the uninfected in response to vaccination. Future vaccine boosters may help to overcome such NAb reduction observed for the variants with the L452R (B.1.617.2) or E484K & N501Y combo (P.1 , B.1.351). (15/)
Our study is a result of heroic efforts of many people, led by @carolilucas @VogelsChantal @InciYildirim11. Special thanks to Yale SARS-CoV-2 Genomic Surveillance Initiative, and the HCW volunteers for donating blood. @SaadOmer3 @NathanGrubaugh & I co-supervised this work. (End)
Adding this awesome thread by @NathanGrubaugh to accompany mine above. Much more deeper dive into the viral genetics, mutation comparison, community spread, and implications on vaccination strategies.

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More from @VirusesImmunity

Apr 22
Preventing infection is the best way to avoid diseases like #PAIS. A new study from our team @tianyangmao, Jooyoung Kim, @marioph13 et al shows that a generic antibiotic neomycin acts on the host immune system in the👃🏽to trigger antiviral resistance. (1/)🧵
pnas.org/doi/10.1073/pn…
This work is inspired by @SmitaGopinath et al who showed that an antibiotic class called aminoglycosides has an unusual antiviral property. Aminoglycosides including neomycin trigger interferon-stimulated genes through a TLR3-dependent mechanism. (2/)
ncbi.nlm.nih.gov/pmc/articles/P…
In our current study, we showed that nasal application of neomycin in mice one day before infection reduces viral load and disease burden after the SARS-COV-2 challenge. @tianyangmao (3/) Image
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Mar 3
Delighted to share our latest work on #longCOVID - sex differences in symptoms and immune signatures. Led by @SilvaJ_C @taka_takehiro @wood_jamie_1 et al. with @LeyingGuan & @PutrinoLab. We find a striking inverse correlation btw testosterone levels and symptom burden👇🏼 (1/)

medrxiv.org/content/10.110…
This work leverages data from our recent Mount Sinai-Yale long COVID "MY-LC" study with the @PutrinoLab. This time, we asked the question, "Are there differences in symptoms and immune signatures of ♀️ vs. ♂️ with LC"? (2/)

nature.com/articles/s4158…
Image
While some symptoms were equally frequent in females and males, many were more frequent in females (e.g., swelling, headaches, muscle pain, cramps) than males. The top distinguishing symptoms of LC status by sex were hair loss in females and sexual dysfunction in males. (3/) Image
Read 16 tweets
Jan 13
In this prospective observational study, we examined changes in symptoms & immune phenotypes in vaccine-naïve people with #LongCovid after COVID-19 vaccination. Due to the timing of the initiation of this study, we were only able to recruit 16 people. However, the insights we gained are intriguing. Led by @connorbgrady, @bornali_27, @silva_JC, @hmkyale et al. (1/)
medrxiv.org/content/10.110…Image
This study was initiated in collaboration with @Survivor_Corps @dianaberrent based on their Facebook poll showing that 40% of respondents with self-reported Long COVID had mild to full symptom resolution after vaccination while 14% reported worsening of their symptoms. (2/)
doi.org/10.1101/2021.0…
In addition, evidence from other patient advocate groups, including @patientled and @longCovidSOS, and from @DanielGriffinMD, was emerging at the time on the impact of COVID vaccines in people with long COVID. (3/)
Read 19 tweets
Sep 25, 2023
So pleased to report that our Mount Sinai-Yale long COVID (MY-LC) paper with @putrinolab & others is now published!! Proud of the hard work of all who contributed. We found biological signatures that can distinguish people with vs. without #longCOVID (1/) nature.com/articles/s4158…
Question being asked: are there circulating cells & immune factors that are distinct in people with #longCOVID (LC) vs. those who recovered from COVID (convalescent control; CC) or those who never had COVID (healthy control; HC)? We studied 268 participants to address this. (2/) Image
Most participants were infected during the first wave in 2020, and studied on average about a year after the infection. Most were not hospitalized at acute phase and ~2/3 were female. We examined plasma factors, blood leukocytes & antibodies to SARS2, other viruses & self (3/) Image
Read 11 tweets
Aug 27, 2023
A short 🧵on a recent study by @MaggieLind2 with @MHitchingsEpi @datcummings Albert Ko et al. Data show that immunity induced by vaccines, prior infection or both (hybrid) protects against SARS-CoV-2 infection when viral exposure is low to moderate (1/)

nature.com/articles/s4146…
Question being asked: What is the risk of becoming *infected* with SARS-CoV-2 after developing immunity following a vaccine, prior infection, or both if exposure to the virus is very high, moderate, or low? They did not study the severity of symptoms. (2/)
How? The authors used the existing database of the Connecticut Department of Correction, where infection data based on high frequency of testing for SARS-CoV-2 on ~9300 residents across 13 facilities were available. (3/)
Read 9 tweets
May 5, 2023
A new study in @SciImmunology led by @AnisBarmada & Jon Klein @YaleIBIO with @lucasite_lab @InciYildirim11 @YalePediatrics teams explored immune signatures of people who developed myocarditis after mRNA vaccines. Here is what we found. 🧵 (1/)
science.org/doi/10.1126/sc…
Myocarditis is a rare adverse event that occurs most frequently in adolescent and young adult males after the second dose of mRNA vaccines. However, the underlying mechanisms remain unclear. (2/)

cdc.gov/vaccines/covid…
We considered three possible immune mechanisms of myocarditis.
1) Autoimmune/molecular mimicry
2) Hypersensitivity/eosinophilic type 2 immunity
3) Cytokine-mediated lymphocyte/macrophage activation
(3/)
Read 19 tweets

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