Vaccine-induced seroconversion in participants in the North Carolina COVID-19 community Research Partnership

DeAnna J Friedman-Klabanoff, Ashley H Tjaden, Michele Santacatterina, Iqra Munawar, John W Sanders, David M Herrington, Thomas F Wierzba, Andrea A Berry, COVID-19 Community Research Partnership, DeAnna J Friedman-Klabanoff, Ashley H Tjaden, Michele Santacatterina, Iqra Munawar, John W Sanders, David M Herrington, Thomas F Wierzba, Andrea A Berry, COVID-19 Community Research Partnership

Abstract

Well-regulated clinical trials have shown FDA-approved COVID-19 vaccines to be immunogenic and highly efficacious. We evaluated seroconversion rates in adults reporting ≥ 1 dose of an mRNA COVID-19 vaccine in a cohort study of nearly 8000 adults residing in North Carolina to validate immunogenicity using a novel approach: at-home, participant administered point-of-care testing. Overall, 91.4% had documented seroconversion within 75 days of first vaccination (median: 31 days). Participants who were older and male participants were less likely to seroconvert (adults aged 41-65: adjusted hazard ratio [aHR] 0.69 [95% confidence interval (CI): 0.64, 0.73], adults aged 66-95: aHR 0.55 [95% CI: 0.50, 0.60], compared to those 18-40; males: aHR 0.92 [95% CI: 0.87, 0.98], compared to females). Participants with evidence of prior infection were more likely to seroconvert than those without (aHR 1.50 [95% CI: 1.19, 1.88]) and those receiving BNT162b2 were less likely to seroconvert compared to those receiving mRNA-1273 (aHR 0.84 [95% CI: 0.79, 0.90]). Reporting at least one new symptom after first vaccination did not affect time to seroconversion, but participants reporting at least one new symptom after second vaccination were more likely to seroconvert (aHR 1.11 [95% CI: 1.05, 1.17]). This data demonstrates the high community-level immunogenicity of COVID-19 vaccines, albeit with notable differences in older adults, and feasibility of using at-home, participant administered point-of-care testing for community cohort monitoring. Trial registration: ClinicalTrials.gov NCT04342884.

Keywords: COVID-19; COVID-19 vaccines; Cohort study; Community study; SARS-CoV-2; SARS-CoV-2 serology.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2022 Elsevier Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
Participant Inclusion Flow Diagram.
Fig. 2
Fig. 2
A. Overall cumulative incidence of seroconversion in the cohort. Over 90% of participants seroconverted within 75 days of vaccination, with a median time of 31 days. B. Cumulative incidence of seroconversion based on age. Older participant age at the time of vaccination was associated with longer median time to seroconversion: 27 days for participants aged 18 to 40 years, 32 days for participants aged 41 to 65 years, and 35 days for participants 66 to 95 years. C. Cumulative incidence of seroconversion based on sex. Men had a longer median time to seroconversion (33 days) than women (30 days). D. Cumulative incidence of seroconversion based on race/ethnicity. Non-Hispanic White participants had a median time to documented seroconversion of 31 days compared to 28 days for other races/ethnicities. The number at risk, number of events, and number of censoring are listed below each figure and correspond to 0, 15, 30, 45, 60 and 75 days.
Fig. 3
Fig. 3
A). Cumulative incidence of seroconversion based on prior seropositivity. Participants who were seropositive and then seroreverted prior to vaccination had a shorter median time to seroconversion (24 days) than those who were never seropositive prior to vaccination (31 days). B). Cumulative incidence of seroconversion based on vaccine received. Participants receiving Pfizer BNT162b2 took longer to seroconvert (31 days) than those receiving Moderna mRNA-1273 (30 days). C). Cumulative incidence of seroconversion associated with report of a new symptom after first dose. Participants who reported at least one new symptom after their first dose of a COVID-19 mRNA vaccine had a median time to documented seroconversion of 30 days compared to 31 days for those who did not report any new symptom after their first COVID-19 mRNA vaccine. D). Cumulative incidence of seroconversion associated with report of a new symptom after second dose. Participants reporting at least one new symptom after their second dose of a COVID-19 mRNA vaccine had a shorter median time to documented seroconversion (30 days) than those who did not report any new symptoms after their second dose (32 days). The number at risk, number of events, and number of censoring corresponds to 0, 15, 30, 45, 60 and 75 days.

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