COVID-19 vaccine booster dose needed to achieve Omicron-specific neutralisation in nursing home residents
David H. Canaday,
Oladayo A. Oyebanji,
Elizabeth White,
Debbie Keresztesy,
Michael Payne,
Dennis Wilk,
Lenore Carias,
Htin Aung,
Kerri St. Denis,
Maegan L. Sheehan,
Sarah D. Berry,
Cheryl M. Cameron,
Mark J. Cameron,
Brigid M. Wilson,
Alejandro B. Balazs,
Christopher L. King,
Stefan Gravenstein
Affiliations
David H. Canaday
Case Western Reserve University School of Medicine, Cleveland, OH; Geriatric Research, Education and Clinical Center, Cleveland VA; Corresponding author.
Oladayo A. Oyebanji
Case Western Reserve University School of Medicine, Cleveland, OH
Elizabeth White
Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI
Debbie Keresztesy
Case Western Reserve University School of Medicine, Cleveland, OH
Michael Payne
Case Western Reserve University School of Medicine, Cleveland, OH
Dennis Wilk
Case Western Reserve University School of Medicine, Cleveland, OH
Lenore Carias
Case Western Reserve University School of Medicine, Cleveland, OH
Htin Aung
Case Western Reserve University School of Medicine, Cleveland, OH
Kerri St. Denis
Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
Maegan L. Sheehan
Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
Sarah D. Berry
Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA
Cheryl M. Cameron
Case Western Reserve University School of Medicine, Cleveland, OH
Mark J. Cameron
Case Western Reserve University School of Medicine, Cleveland, OH
Brigid M. Wilson
Geriatric Research, Education and Clinical Center, Cleveland VA
Alejandro B. Balazs
Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
Christopher L. King
Case Western Reserve University School of Medicine, Cleveland, OH
Stefan Gravenstein
Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI; Center on Innovation in Long-Term Services and Supports, Providence Veterans Administration Medical Center, Providence, RI; Division of Geriatrics and Palliative Medicine, Alpert Medical School of Brown University, Providence, RI
Summary: Background: Nursing home (NH) residents have borne a disproportionate share of SARS-CoV-2 morbidity and mortality. Vaccines have limited hospitalisation and death from earlier variants in this vulnerable population. With the rise of Omicron and future variants, it is vital to sustain and broaden vaccine-induced protection. We examined the effect of boosting with BNT162b2 mRNA vaccine on humoral immunity and Omicron-specific neutralising activity among NH residents and healthcare workers (HCWs). Methods: We longitudinally enrolled 85 NH residents (median age 77) and 48 HCWs (median age 51), and sampled them after the initial vaccination series; and just before and 2 weeks after booster vaccination. Anti-spike, anti-receptor binding domain (RBD) and neutralisation titres to the original Wuhan strain and neutralisation to the Omicron strain were obtained. Findings: Booster vaccination significantly increased vaccine-specific anti-spike, anti-RBD, and neutralisation levels above the pre-booster levels in NH residents and HCWs, both in those with and without prior SARS-CoV-2 infection. Omicron-specific neutralisation activity was low after the initial 2 dose series with only 28% of NH residents’ and 28% HCWs’ titres above the assay's lower limit of detection. Omicron neutralising activity following the booster lifted 86% of NH residents and 93% of HCWs to the detectable range. Interpretation: With boosting, the vast majority of HCWs and NH residents developed detectable Omicron-specific neutralising activity. These data provide immunologic evidence that strongly supports booster vaccination to broaden neutralising activity and counter waning immunity in the hope it will better protect this vulnerable, high-risk population against the Omicron variant. Funding: NIH AI129709-03S1, U01 CA260539-01, CDC 200-2016-91773, and VA BX005507-01.
