The impact of SARS-CoV-2 vaccines on antibody responses in the general population in the United Kingdom

Wei, J.; Stoesser, N.; Matthews, P. C.; Studley, R.; Bell, I.; Bell, J. I.; Newton, J. N.; Farrar, J.; Diamond, I.; Rourke, E.; Howarth, A.; Marsden, B. D.; Hoosdally, S.; Jones, E. Y.; Stuart, D. I.; Crook, D. W.; Peto, T. E.; Pouwels, K. B.; Eyre, D. W.; Walker, A. S.; team, COVID-19 Infection Survey

Real-world data on antibody response post-vaccination in the general population are limited. 45,965 adults in the UK's national COVID-19 Infection Survey receiving Pfizer-BioNTech or Oxford-AstraZeneca vaccines had 111,360 anti-spike IgG measurements. Without prior infection, seroconversion rates and quantitative antibody levels post single dose were lower in older individuals, especially >60y. Two doses achieved high responses across all ages, particularly increasing seroconversion in older people, to similar levels to those achieved after prior infection followed by a single dose. Antibody levels rose more slowly and to lower levels with Oxford-AstraZeneca vs Pfizer-BioNTech, but waned following a single Pfizer-BioNTech dose. Latent class models identified four responder phenotypes: older people, males, and those having long-term health conditions were more commonly 'low responders'. Where supplies are limited, vaccines should be prioritised for those not previously infected, and second doses to individuals >60y. Further data on the relationship between vaccine-mediated protection and antibody responses are needed.