Thread by @MonicaGandhi9

B CELLS ADAPT THEIR ANTIBODIES TO THE VARIANTS: This is article that showed antibodies & T cells durable (x 8 months) from 1-shot J&J but note: [We] "observed expansion of neutralizing antibody breadth against variants over time..." specifically delta
nejm.org/doi/full/10.10…

beta, gamma. "which suggests maturation of B-cell responses even without further boosting". This is not 1st paper that shows this. Natural immunity or vax generates B cells that go into memory and then they produce antibodies directed against variant they see (ADAPTIVE immunity)

So, I know people have asked about "variant specific boosters" or wanting to boost antibodies with original vax repeatedly, but original vax has mRNA or DNA in it that codes for the L ancestral SARS-CoV-2 strain, not the variants. Your immune system adapts if see virus again to

produce antibodies tailored to that variant. What are other papers? Here are some. This one from OHSU showing the memory B cells generated by the vaccines make antibodies directed towards the variant they are exposed to if variant seen
medrxiv.org/content/10.110…

And this paper shows that natural infection allows for ongoing evolution of neutralizing antibodies produced by memory B cells which are adaptive (also looked at hybrid immunity but vax didn't improve adaptation of in-breath antibodies)
biorxiv.org/content/10.110…

And this paper shows memory B cells keep increasing after mRNA vaccination 3 and 6 months after vaccination and they are able to cross-bind to different variants of concerns to produce adaptive antibodies against them (delta, etc.). Pretty cool
biorxiv.org/content/10.110…

The basis for a booster recommendation after 1 shot J&J is not on the immunologic research above but on finding that protection against severe disease (hospitalization) is not as robust (71%) as Pfizer (88%) and Moderna (93%)
cdc.gov/mmwr/volumes/7…

So please remember that it is not that adaptive immunity from B cells doesn't work & that they and T cells aren't there, the reason boosters got discussed for non-65 year olds, non-immunocompromised is due to so much circulating virus

https://twitter.com/monicagandhi9/status/1438873395144249347?ref_src=twsrc%5Etfw&lang=ca

Here is that preprint going on to full publication to show you how B cells adapt their antibodies to variants if they see the virus in the future. Delta? Okay, says B cells, I will make delta-specific antibodies.
science.org/doi/10.1126/sc…

This is not even speaking of T cells which you know are working to protect you against severe disease (and the T cells help these memory B cells produce antibodies)

IgA and IgG tweets-Antibodies produced by vaccine or infection. Naturally wane in nose and "mucosa" (respiratory tract) - susceptible to mild respiratory infection if circulating virus around you. T cells protect from severe disease; B cells take 3-5 days to make new antibodies

Hereafter will merge T and B cell threads, but thought you would be excited to see this paper. People have been concerned that B cells and T cells may go to lower levels in blood but that is not where they hang out long-term: go to lymph nodes and other biorxiv.org/content/10.110…

structures (bone marrow, lymphoid tissues, etc.) - "germinal centers". Paper shows memory B cells from vax not only in lymph nodes, but mature into LONG-LIVED memory plasma cells-to produce antibodies in future (memory B cells can activate 9 decades later)
nature.com/articles/natur…

Important article to add to this B cells thread on adapting to variants. Authors took individuals with recovered COVID (different disease severities), looked at B cells: short-lived plasma cells transiently secrete antibodies & die but long-lived B cells
academic.oup.com/jid/advance-ar…

traffic to the bone marrow/lymph nodes & and secrete antibodies (ADAPTED towards variants) for months to years’ post-infection if they see the virus again. Serologic studies like ones Pfizer/Moderna will do against Omicron don't capture that B cells will expand, and differentiate

into a NEW population of antibody secreting cells on repeat infection (with a variant or not). This important study showed that 1) memory B cells specific against the receptor binding protein of SARS-CoV-2 (not different in variants) develop even if initial infection asymptomatic

and doesn't mount antibodies ("seronegative") but diagnosed on PCR test; 2) Memory B cells stable, last to at least 1 year post-infection; 3) In contrast to plasma antibodies, the antibodies these B cells are programmed to secrete recognize ancestral AND variants of concern (RBD)

This is why Dr. Fauci and others not concerned that we will need an Omicron-specific booster because we have ADAPTIVE immunity - that is what the adaptive part means! B cells can adapt to variants
medpagetoday.com/infectiousdise…