Decreased Antibody Response After Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination in Patients With Down Syndrome

Bianca M M Streng, Marin Bont, Eveline M Delemarre, Rob S Binnendijk, Gaby Smit, Gerco den Hartog, Antonia M W Coppus, Esther de Vries, Michel E Weijerman, Regina Lamberts, Gert de Graaf, Fiona R van der Klis, Gestur Vidarsson, Neele Rave, Louis J Bont, Joanne G Wildenbeest, Bianca M M Streng, Marin Bont, Eveline M Delemarre, Rob S Binnendijk, Gaby Smit, Gerco den Hartog, Antonia M W Coppus, Esther de Vries, Michel E Weijerman, Regina Lamberts, Gert de Graaf, Fiona R van der Klis, Gestur Vidarsson, Neele Rave, Louis J Bont, Joanne G Wildenbeest

Abstract

The risk of a severe course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in adults with Down syndrome is increased, resulting in an up to 10-fold increase in mortality, in particular in those >40 years of age. After primary SARS-CoV-2 vaccination, the higher risks remain. In this prospective observational cohort study, SARS-CoV-2 spike S1-specific antibody responses after routine SARS-CoV-2 vaccination (BNT162b2, messenger RNA [mRNA]-1273, or ChAdOx1) in adults with Down syndrome and healthy controls were compared. Adults with Down syndrome showed lower antibody concentrations after 2 mRNA vaccinations or after 2 ChAdOx1 vaccinations. After 2 mRNA vaccinations, lower antibody concentrations were seen with increasing age.

Clinical trials registration: NCT05145348.

Keywords: COVID-19 vaccination; Down syndrome; SARS-CoV-2; antibody response.

© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Figures

Figure 1.
Figure 1.
Flow diagram of included participants for analysis. *Participants with a positive anti-spike immunoglobulin G concentration at T = 1 or a positive anti-nucleocapsid IgG concentration at T = 2 or T = 3. Abbreviation: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Figure 2.
Figure 2.
Overview of anti-spike (S1) immunoglobulin G (IgG) concentrations (COV19S1) after different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Antibody concentration at T = 1, T = 2, and T = 3 for the Down syndrome (DS) cohort. Each data point represents an individual’s response. The black solid line represents the geometric mean concentration (GMC) and its 95% confidence interval (CI). *COVID+ indicates evidence of past SARS-CoV-2 infection based on a positive anti-S IgG concentration at T = 1 or a positive anti-nucleocapsid IgG concentration at T = 2 or T = 3. A, A significantly lower antibody response is seen in the DS cohort after messenger RNA (mRNA) vaccination in comparison with the healthy control cohort (HC). Participants with evidence of past SARS-CoV-2 infection in the DS cohort show a significant higher antibody response with a GMC of 3583.2 binding antibody units (BAU)/mL (95% CI, 2436.2–5270.1) compared with SARS-CoV-2–naive participants (GMC, 1055.2 BAU/mL [95% CI, 899.4–1251.9]). B, After ChAdOx1 vaccination, a significant lower antibody response is found in the DS cohort compared to HCs. The participants of the DS cohort with evidence of SARS-CoV-2 infection receiving the ChAdOx1 vaccine also show a higher antibody response compared with naive participants (GMC, 1245.3 BAU/mL [95% CI, 791.3–1959.6] vs 343.1 BAU/mL [95% CI, 264.7–444.8]). C, Antibodies at T = 3 (±28 days after second vaccination) after mRNA vaccine per decade. In the DS cohort, a negative correlation between age and antibody concentration was found. D, Antibodies at T = 3 (±28 days after second vaccination) after ChAdOx1 per decade. No correlation between age and antibody concentration was found.

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Source: PubMed

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