Correlates of protection and viral load trajectories in omicron breakthrough infections in triple vaccinated healthcare workersShow others and affiliations
2023 (English)In: Nature Communications, E-ISSN 2041-1723, Vol. 14, no 1, article id 1577Article in journal (Refereed) Published
Abstract [en]
Vaccination offers protection against severe COVID-19 caused by SARS-CoV-2 omicron but is less effective against infection. Characteristics such as serum antibody titer correlation to protection, viral abundance and clearance of omicron infection in vaccinated individuals are scarce. We present a 4-week twice-weekly SARS-CoV-2 qPCR screening in 368 triple vaccinated healthcare workers. Spike-specific IgG levels, neutralization titers and mucosal spike-specific IgA-levels were determined at study start and qPCR-positive participants were sampled repeatedly for two weeks. 81 (cumulative incidence 22%) BA.1, BA.1.1 and BA.2 infections were detected. High serum antibody titers are shown to be protective against infection (p < 0.01), linked to reduced viral load (p < 0.01) and time to viral clearance (p < 0.05). Pre-omicron SARS-CoV-2 infection is independently associated to increased protection against omicron, largely mediated by mucosal spike specific IgA responses (nested models lr test p = 0.02 and 0.008). Only 10% of infected participants remain asymptomatic through the course of their infection. We demonstrate that high levels of vaccine-induced spike-specific WT antibodies are linked to increased protection against infection and to reduced viral load if infected, and suggest that the additional protection offered by pre-omicron SARS-CoV-2 infection largely is mediated by mucosal spike-specific IgA.
Place, publisher, year, edition, pages
Springer Nature , 2023. Vol. 14, no 1, article id 1577
National Category
Immunology in the medical area
Identifiers
URN: urn:nbn:se:kth:diva-330981DOI: 10.1038/s41467-023-36984-1ISI: 001063479500004PubMedID: 36949041Scopus ID: 2-s2.0-85150788168OAI: oai:DiVA.org:kth-330981DiVA, id: diva2:1780032
Note
QC 20230705
2023-07-052023-07-052023-10-17Bibliographically approved