Vaccines (Aug 2023)

Multimorbidity and Serological Response to SARS-CoV-2 Nine Months after 1st Vaccine Dose: European Cohort of Healthcare Workers—Orchestra Project

  • Concepción Violán,
  • Lucía A. Carrasco-Ribelles,
  • Giulia Collatuzzo,
  • Giorgia Ditano,
  • Mahsa Abedini,
  • Christian Janke,
  • Christina Reinkemeyer,
  • Le Thi Thu Giang,
  • Filippo Liviero,
  • Maria Luisa Scapellato,
  • Marcella Mauro,
  • Francesca Rui,
  • Stefano Porru,
  • Gianluca Spiteri,
  • Maria Grazia Lourdes Monaco,
  • Angela Carta,
  • Marina Otelea,
  • Agripina Rascu,
  • Eleonóra Fabiánová,
  • Zuzana Klöslová,
  • Paolo Boffetta,
  • Pere Torán-Monserrat

Journal volume & issue
Vol. 11, no. 8
p. 1340


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Understanding antibody persistence concerning multimorbidity is crucial for vaccination policies. Our goal is to assess the link between multimorbidity and serological response to SARS-CoV-2 nine months post-first vaccine. We analyzed Healthcare Workers (HCWs) from three cohorts from Italy, and one each from Germany, Romania, Slovakia, and Spain. Seven groups of chronic diseases were analyzed. We included 2941 HCWs (78.5% female, 73.4% ≥ 40 years old). Multimorbidity was present in 6.9% of HCWs. The prevalence of each chronic condition ranged between 1.9% (cancer) to 10.3% (allergies). Two regression models were fitted, one considering the chronic conditions groups and the other considering whether HCWs had diseases from ≥2 groups. Multimorbidity was present in 6.9% of HCWs, and higher 9-months post-vaccine anti-S levels were significantly associated with having received three doses of the vaccine (RR = 2.45, CI = 1.92–3.13) and with having a prior COVID-19 infection (RR = 2.30, CI = 2.15–2.46). Conversely, lower levels were associated with higher age (RR = 0.94, CI = 0.91–0.96), more time since the last vaccine dose (RR = 0.95, CI = 0.94–0.96), and multimorbidity (RR = 0.89, CI = 0.80–1.00). Hypertension is significantly associated with lower anti-S levels (RR = 0.87, CI = 0.80–0.95). The serological response to vaccines is more inadequate in individuals with multimorbidity.