Comprehensive assessment of humoral response after Pfizer BNT162b2 mRNA Covid-19 vaccination: a three-case series

Clin Chem Lab Med. 2021 Apr 12;59(9):1585-1591. doi: 10.1515/cclm-2021-0339. Print 2021 Aug 26.

Abstract

Objectives: Since universal vaccination is a pillar against coronavirus disease 2019 (COVID-19), monitoring anti-SARS-CoV-2 neutralizing antibodies is essential for deciphering post-vaccination immune response.

Methods: Three healthcare workers received 30 μg BNT162b2 mRNA Covid-19 Pfizer Vaccine, followed by a second identical dose, 21 days afterwards. Venous blood was drawn at baseline and at serial intervals, up to 63 days afterwards, for assessing total immunoglobulins (Ig) anti-RBD (receptor binding domain), anti-S1/S2 and anti-RBD IgG, anti-RBD and anti-N/S1 IgM, and anti-S1 IgA.

Results: All subjects were SARS-CoV-2 seronegative at baseline. Total Ig anti-RBD, anti-S1/S2 and anti-RBD IgG levels increased between 91 and 368 folds until 21 days after the first vaccine dose, then reached a plateau. The levels raised further after the second dose (by ∼30-, ∼8- and ∼8-fold, respectively), peaking at day 35, but then slightly declining and stabilizing ∼50 days after the first vaccine dose. Anti-S1 IgA levels increased between 7 and 11 days after the first dose, slightly declined before the second dose, after which levels augmented by ∼24-fold from baseline. The anti-RBD and anti-N/S1 IgM kinetics were similar to that of anti-S1 IgA, though displaying substantially weaker increases and modest peaks, only 4- to 7-fold higher than baseline. Highly significant inter-correlation was noted between total Ig anti-RBD, anti-S1/S2 and anti-RBD IgG (all r=0.99), whilst other anti-SARS-CoV-2 antibodies displayed lower, though still significant, correlations. Serum spike protein concentration was undetectable at all-time points.

Conclusions: BNT162b2 mRNA vaccination generates a robust humoral immune response, especially involving anti-SARS-Cov-2 IgG and IgA, magnified by the second vaccine dose.

Keywords: COVID-19; antibodies; coronavirus; immune response; vaccine.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Viral / immunology*
  • BNT162 Vaccine
  • COVID-19 / immunology*
  • COVID-19 / prevention & control
  • COVID-19 / virology
  • COVID-19 Vaccines / administration & dosage
  • COVID-19 Vaccines / genetics
  • COVID-19 Vaccines / immunology*
  • Female
  • Humans
  • Immunity / immunology*
  • Male
  • Middle Aged
  • RNA, Messenger / administration & dosage
  • RNA, Messenger / genetics
  • RNA, Messenger / immunology*
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / immunology*
  • Vaccination / methods*

Substances

  • Antibodies, Viral
  • COVID-19 Vaccines
  • RNA, Messenger
  • BNT162 Vaccine