Boosting of serum neutralizing activity against the Omicron variant among recovered COVID-19 patients by BNT162b2 and CoronaVac vaccines
Lu Lu,
Lin-Lei Chen,
Ricky Rui-Qi Zhang,
Owen Tak-Yin Tsang,
Jacky Man-Chun Chan,
Anthony Raymond Tam,
Wai-Shing Leung,
Thomas Shiu-Hong Chik,
Daphne Pui-Ling Lau,
Chris Yau-Chung Choi,
Carol Ho-Yan Fong,
Jian-Piao Cai,
Hoi-Wah Tsoi,
Charlotte Yee-Ki Choi,
Xiaojuan Zhang,
Syed Muhammad Umer Abdullah,
Brian Pui-Chun Chan,
Kwok-Hung Chan,
Kwok-Yung Yuen,
Ivan Fan-Ngai Hung,
Kelvin Kai-Wang To
Affiliations
Lu Lu
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Lin-Lei Chen
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Ricky Rui-Qi Zhang
Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Owen Tak-Yin Tsang
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
Jacky Man-Chun Chan
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
Anthony Raymond Tam
Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
Wai-Shing Leung
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
Thomas Shiu-Hong Chik
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
Daphne Pui-Ling Lau
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
Chris Yau-Chung Choi
Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
Carol Ho-Yan Fong
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Jian-Piao Cai
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Hoi-Wah Tsoi
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Charlotte Yee-Ki Choi
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Xiaojuan Zhang
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Syed Muhammad Umer Abdullah
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Brian Pui-Chun Chan
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Kwok-Hung Chan
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
Kwok-Yung Yuen
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
Ivan Fan-Ngai Hung
Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China
Kelvin Kai-Wang To
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China; Corresponding author at: Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Block T, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, China.
Summary: Background: SARS-CoV-2 Omicron variant evades immunity from past infection or vaccination and is associated with a greater risk of reinfection among recovered COVID-19 patients. We assessed the serum neutralizing antibody (NAb) activity against Omicron variant (Omicron NAb) among recovered COVID-19 patients with or without vaccination. Methods: In this prospective cohort study with 135 recovered COVID-19 patients, we determined the serum NAb titers against ancestral virus or variants using a live virus NAb assay. We used the receiver operating characteristic analysis to determine the optimal cutoff for a commercially-available surrogate NAb assay. Findings: Among recovered COVID-19 patients, the serum live virus geometric mean Omicron NAb titer was statistically significantly higher among BNT162b2 recipients compared to non-vaccinated individuals (85.4 vs 5.6,P < 0.0001). The Omicron seropositive rates in live virus NAb test (NAb titer ≥10) were statistically significantly higher among BNT162b2 (90.6% [29/32];P < 0.0001) or CoronaVac (36.7% [11/30]; P = 0.0115) recipients when compared with non-vaccinated individuals (12.3% [9/73]). Subgroup analysis of CoronaVac recipients showed that the Omicron seropositive rates were higher among individuals with two doses than those with one dose (85.7% vs 21.7%; P = 0.0045). For the surrogate NAb assay, a cutoff of 109.1 AU/ml, which is 7.3-fold higher than the manufacturer's recommended cutoff, could achieve a sensitivity and specificity of 89.5% and 89.8%, respectively, in detecting Omicron NAb. Interpretation: Among individuals with prior COVID-19, one dose of BNT162b2 or two doses of CoronaVac could induce detectable serum Omicron NAb. Our result would be particularly important for guiding vaccine policies in countries with COVID-19 vaccine shortage. Funding: Health and Medical Research Fund, Richard and Carol Yu, Michael Tong (see acknowledgments for full list).
