Dynamics of antibody response to BNT162b2 vaccine after six months: a longitudinal prospective study

Naaber, Paul; Tserel, Liina; Kangro, Kadri; Sepp, Epp; Jürjenson, Virge; Adamson, Ainika; Haljasmägi, Liis; Rumm, Anna Pauliina; Maruste, Regina; Kärner, Jaanika; Gerhold, Joachim M.; Planken, Anu; Ustav, Mart; Kisand, Kai; Peterson, Pärt

BACKGROUND: SARS-CoV-2 mRNA vaccines have proven high efficacy, however, limited data exists on the duration of immune responses and their relation to age and side effects. METHODS: We studied the antibody and memory T cell responses after the two-dose BNT162b2 vaccine in 122 volunteers up to 6 months and correlated the findings with age and side effects. FINDINGS: We found a robust antibody response to Spike protein after the second dose. However, the antibody levels declined at 12 weeks and 6 months post-vaccination, indicating a waning of the immune response over time. At 6 months after the second dose, the Spike antibody levels were similar to the levels in persons vaccinated with one dose or in COVID-19 convalescent individuals. The antibodies efficiently blocked ACE2 receptor binding to SARS-CoV-2 Spike protein of five variants of concern at one week but this was decreased at three months. 87% of individuals developed Spike-specific memory T cell responses, which were lower in individuals with increased proportions of immunosenescent CD8(+) TEMRA cells. We found antibody response to correlate negatively with age and positively with the total score of vaccination side effects. INTERPRETATION: The mRNA vaccine induces a strong antibody response to SARS-CoV-2 and five VOCs at 1 week post-vaccination that decreases thereafter. T cell responses, although detectable in the majority, were lower in individuals with higher T cell immunosenescence. The deterioration of vaccine response suggests the need to monitor for the potential booster vaccination.