Determinants of Anti-S Immune Response at 9 Months after COVID-19 Vaccination in a Multicentric European Cohort of Healthcare Workers—ORCHESTRA Project
Giulia Collatuzzo,
Vittorio Lodi,
Daniela Feola,
Giuseppe De Palma,
Emanuele Sansone,
Emma Sala,
Christian Janke,
Noemi Castelletti,
Stefano Porru,
Gianluca Spiteri,
Maria Grazia Lourdes Monaco,
Francesca Larese Filon,
Corrado Negro,
Luca Cegolon,
Jana Beresova,
Eleonora Fabianova,
Lucia A. Carrasco-Ribelles,
Pere Toràn-Monserrat,
Marta Maria Rodriguez-Suarez,
Guillermo Fernandez-Tardon,
Shuffield S. Asafo,
Giorgia Ditano,
Mahsa Abedini,
Paolo Boffetta
Affiliations
Giulia Collatuzzo
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Vittorio Lodi
IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
Daniela Feola
IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
Giuseppe De Palma
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
Emanuele Sansone
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
Emma Sala
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
Christian Janke
Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, 80331 Munich, Germany
Noemi Castelletti
Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, 80331 Munich, Germany
Stefano Porru
Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Gianluca Spiteri
Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy
Maria Grazia Lourdes Monaco
Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy
Francesca Larese Filon
Unit of Occupational Medicine, University of Trieste, 34121 Trieste, Italy
Corrado Negro
Unit of Occupational Medicine, University of Trieste, 34121 Trieste, Italy
Luca Cegolon
Unit of Occupational Medicine, University of Trieste, 34121 Trieste, Italy
Jana Beresova
Epidemiology Department, Regional Authority of Public Health, 97401 Banská Bystrica, Slovakia
Eleonora Fabianova
Occupational Health Department, Regional Authority of Public Health, 97401 Banská Bystrica, Slovakia
Lucia A. Carrasco-Ribelles
Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08302 Mataró, Spain
Pere Toràn-Monserrat
Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08302 Mataró, Spain
Marta Maria Rodriguez-Suarez
Health Research Institute of Asturias, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), 33001 Oviedo, Spain
Guillermo Fernandez-Tardon
Health Research Institute of Asturias, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), 33001 Oviedo, Spain
Shuffield S. Asafo
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Giorgia Ditano
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Mahsa Abedini
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Paolo Boffetta
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Background: The persistence of antibody levels after COVID-19 vaccination has public health relevance. We analyzed the determinants of quantitative serology at 9 months after vaccination in a multicenter cohort. Methods: We analyzed data on anti-SARS-CoV-2 spike antibody levels at 9 months from the first dose of vaccinated HCW from eight centers in Italy, Germany, Spain, Romania and Slovakia. Serological levels were log-transformed to account for the skewness of the distribution and normalized by dividing them by center-specific standard errors. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of one standard deviation of log antibody level and the corresponding 95% confidence interval (CI), and combined them in random-effects meta-analyses. Finally, we conducted a trend analysis of 1 to 7 months’ serology within one cohort. Results: We included 20,216 HCW with up to two vaccine doses and showed that high antibody levels were associated with female sex (p = 0.01), age (RR = 0.87, 95% CI = 0.86–0.88 per 10-year increase), 10-day increase in time since last vaccine (RR = 0.97, 95% CI 0.97–0.98), previous infection (3.03, 95% CI = 2.92–3.13), two vaccine doses (RR = 1.22, 95% CI = 1.09–1.36), use of Spikevax (OR = 1.51, 95% CI = 1.39–1.64), Vaxzevria (OR = 0.57, 95% CI = 0.44–0.73) or heterologous vaccination (OR = 1.33, 95% CI = 1.12–1.57), compared to Comirnaty. The trend in the Bologna cohort, based on 3979 measurements, showed a decrease in mean standardized antibody level from 8.17 to 7.06 (1–7 months, p for trend 0.005). Conclusions: Our findings corroborate current knowledge on the determinants of COVID-19 vaccine-induced immunity and declining trend with time.
