TY - JOUR
T1 - Impact of age and comorbidities on SARS-CoV-2 vaccine-induced T cell immunity
AU - Dietz, Lisa Loksø
AU - Juhl, Anna Karina
AU - Søgaard, Ole Schmeltz
AU - Reekie, Joanne
AU - Nielsen, Henrik
AU - Johansen, Isik Somuncu
AU - Benfield, Thomas
AU - Wiese, Lothar
AU - Stærke, Nina Breinholt
AU - Jensen, Tomas Østergaard
AU - Jakobsen, Stine Finne
AU - Olesen, Rikke
AU - Iversen, Kasper
AU - Fogh, Kamille
AU - Bodilsen, Jacob
AU - Petersen, Kristine Toft
AU - Larsen, Lykke
AU - Madsen, Lone Wulff
AU - Lindvig, Susan Olaf
AU - Holden, Inge Kristine
AU - Raben, Dorthe
AU - Andersen, Sidsel Dahl
AU - Hvidt, Astrid Korning
AU - Andreasen, Signe Rode
AU - Baerends, Eva Anna Marianne
AU - Lundgren, Jens
AU - Østergaard, Lars
AU - Tolstrup, Martin
AU - ENFORCE Study Group
N1 - © 2023. The Author(s).
PY - 2023/4/24
Y1 - 2023/4/24
N2 - BACKGROUND: Older age and chronic disease are important risk factors for developing severe COVID-19. At population level, vaccine-induced immunity substantially reduces the risk of severe COVID-19 disease and hospitalization. However, the relative impact of humoral and cellular immunity on protection from breakthrough infection and severe disease is not fully understood.METHODS: In a study cohort of 655 primarily older study participants (median of 63 years (IQR: 51-72)), we determined serum levels of Spike IgG antibodies using a Multiantigen Serological Assay and quantified the frequency of SARS-CoV-2 Spike-specific CD4 + and CD8 + T cells using activation induced marker assay. This enabled characterization of suboptimal vaccine-induced cellular immunity. The risk factors of being a cellular hypo responder were assessed using logistic regression. Further follow-up of study participants allowed for an evaluation of the impact of T cell immunity on breakthrough infections.RESULTS: We show reduced serological immunity and frequency of CD4 + Spike-specific T cells in the oldest age group (≥75 years) and higher Charlson Comorbidity Index (CCI) categories. Male sex, age group ≥75 years, and CCI > 0 is associated with an increased likelihood of being a cellular hypo-responder while vaccine type is a significant risk factor. Assessing breakthrough infections, no protective effect of T cell immunity is identified.CONCLUSIONS: SARS-CoV-2 Spike-specific immune responses in both the cellular and serological compartment of the adaptive immune system increase with each vaccine dose and are progressively lower with older age and higher prevalence of comorbidities. The findings contribute to the understanding of the vaccine response in individuals with increased risk of severe COVID-19 disease and hospitalization.
AB - BACKGROUND: Older age and chronic disease are important risk factors for developing severe COVID-19. At population level, vaccine-induced immunity substantially reduces the risk of severe COVID-19 disease and hospitalization. However, the relative impact of humoral and cellular immunity on protection from breakthrough infection and severe disease is not fully understood.METHODS: In a study cohort of 655 primarily older study participants (median of 63 years (IQR: 51-72)), we determined serum levels of Spike IgG antibodies using a Multiantigen Serological Assay and quantified the frequency of SARS-CoV-2 Spike-specific CD4 + and CD8 + T cells using activation induced marker assay. This enabled characterization of suboptimal vaccine-induced cellular immunity. The risk factors of being a cellular hypo responder were assessed using logistic regression. Further follow-up of study participants allowed for an evaluation of the impact of T cell immunity on breakthrough infections.RESULTS: We show reduced serological immunity and frequency of CD4 + Spike-specific T cells in the oldest age group (≥75 years) and higher Charlson Comorbidity Index (CCI) categories. Male sex, age group ≥75 years, and CCI > 0 is associated with an increased likelihood of being a cellular hypo-responder while vaccine type is a significant risk factor. Assessing breakthrough infections, no protective effect of T cell immunity is identified.CONCLUSIONS: SARS-CoV-2 Spike-specific immune responses in both the cellular and serological compartment of the adaptive immune system increase with each vaccine dose and are progressively lower with older age and higher prevalence of comorbidities. The findings contribute to the understanding of the vaccine response in individuals with increased risk of severe COVID-19 disease and hospitalization.
U2 - 10.1038/s43856-023-00277-x
DO - 10.1038/s43856-023-00277-x
M3 - Journal article
C2 - 37095240
SN - 2730-664X
VL - 3
JO - Communications Medicine
JF - Communications Medicine
M1 - 58
ER -