B and T cell response to SARS-CoV-2 vaccination in health care professionals with and without previous COVID-19
Andreas Zollner,
Christina Watschinger,
Annika Rössler,
Maria R. Farcet,
Agnes Penner,
Vincent Böhm,
Sophia J. Kiechl,
Gerald Stampfel,
Rainer Hintenberger,
Herbert Tilg,
Robert Koch,
Marlies Antlanger,
Thomas R. Kreil,
Janine Kimpel,
Alexander R. Moschen
Affiliations
Andreas Zollner
Christian Doppler Laboratory for Mucosal Immunology, Johannes Kepler University Linz, Linz, Austria; Department of Medicine, Division of Internal Medicine 1 (Gastroenterology and Hepatology, Endocrinology and Metabolism), Medical University of Innsbruck, Innsbruck, Austria
Christina Watschinger
Christian Doppler Laboratory for Mucosal Immunology, Johannes Kepler University Linz, Linz, Austria; Department of Internal Medicine 2 (Gastroenterology and Hepatology, Endocrinology and Metabolism, Nephrology, Rheumatology), Johannes Kepler University Linz, Linz, Austria
Annika Rössler
Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck Austria
Maria R. Farcet
Global Pathogen Safety, Baxter AG (part of Takeda), Vienna, Austria
Agnes Penner
Department of Internal Medicine 2 (Gastroenterology and Hepatology, Endocrinology and Metabolism, Nephrology, Rheumatology), Johannes Kepler University Linz, Linz, Austria
Vincent Böhm
Department of Internal Medicine 2 (Gastroenterology and Hepatology, Endocrinology and Metabolism, Nephrology, Rheumatology), Johannes Kepler University Linz, Linz, Austria
Sophia J. Kiechl
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria; VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
Gerald Stampfel
Department of Internal Medicine 2 (Gastroenterology and Hepatology, Endocrinology and Metabolism, Nephrology, Rheumatology), Johannes Kepler University Linz, Linz, Austria
Rainer Hintenberger
Department of Internal Medicine 2 (Gastroenterology and Hepatology, Endocrinology and Metabolism, Nephrology, Rheumatology), Johannes Kepler University Linz, Linz, Austria
Herbert Tilg
Department of Medicine, Division of Internal Medicine 1 (Gastroenterology and Hepatology, Endocrinology and Metabolism), Medical University of Innsbruck, Innsbruck, Austria
Robert Koch
Department of Medicine, Division of Internal Medicine 1 (Gastroenterology and Hepatology, Endocrinology and Metabolism), Medical University of Innsbruck, Innsbruck, Austria
Marlies Antlanger
Department of Internal Medicine 2 (Gastroenterology and Hepatology, Endocrinology and Metabolism, Nephrology, Rheumatology), Johannes Kepler University Linz, Linz, Austria
Thomas R. Kreil
Global Pathogen Safety, Baxter AG (part of Takeda), Vienna, Austria
Janine Kimpel
Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck Austria
Alexander R. Moschen
Christian Doppler Laboratory for Mucosal Immunology, Johannes Kepler University Linz, Linz, Austria; Department of Medicine, Division of Internal Medicine 1 (Gastroenterology and Hepatology, Endocrinology and Metabolism), Medical University of Innsbruck, Innsbruck, Austria; Department of Internal Medicine 2 (Gastroenterology and Hepatology, Endocrinology and Metabolism, Nephrology, Rheumatology), Johannes Kepler University Linz, Linz, Austria; Corresponding author at: Department of Internal Medicine, Christian Doppler Laboratory for Mucosal Immunology, Johannes Kepler University Linz, Krankenhausstr. 9, 4211 Linz, Austria.
Summary: Background: In recent months numerous health care professional acquired COVID-19 at the workplace resulting in significant shortages in medical and nursing staff. We investigated how prior COVID-19 affects SARS-CoV-2 vaccination and how such knowledge could facilitate frugal vaccination strategies. Methods: In a cohort of 41 healthcare professionals with (n=14) and without (n=27) previous SARS-CoV-2 infection, we assessed the immune status before, during and after vaccination with BNT162b2. The humoral immune response was assessed by receptor binding domain ELISA and different SARS-CoV-2 neutralisation assays using wildtype and pseudo-typed viruses. T cell immunity against SARS-CoV-2 surface and nucleocapsid peptides were studied using interferon-γ release assays and intracellular flow cytometry. Vaccine-related side effects were captured. Findings: Prior COVID-19 resulted in improved vaccine responses both in the B and T cell compartment. In vaccine recipients with prior COVID-19, the first vaccine dose induced high antibody concentrations comparable to seronegative vaccine recipients after two injections. This translated into more efficient neutralisation of virus particles, even more pronounced than expected from the RBD ELISA results. Furthermore, T cell responses were stronger in convalescents and particularly strong against the SARS-CoV-2 nucleocapsid protein. Interpretation: Herein, we corroborate recent findings suggesting that in convalescents a single vaccine dose is sufficient to boost adequate in vitro neutralisation of SARS-CoV-2 and therefore may be sufficient to induce adequate protection against severe COVID-19. New spike mutated virus variants render the highly conserved nucleocapsid protein – eliciting strong SARS-CoV-2 specific T cell immunity – an interesting additional vaccine target. Funding: Christian Doppler Research Association, Johannes Kepler University Linz
