Antibody response after one and two doses of the BNT162b2 vaccine in
nursing home residents: The CONsort-19 study
Abstract
Methods: Twenty-two French nursing homes were included. COVID-19 had
been diagnosed with real-time reverse-transcriptase polymerase chain
reaction (RT-PCR) for SARS-CoV-2. Blood S-protein IgG and nucleocapsid
(N) IgG protein (N-protein IgG) were measured 21-24 days after the first
jab (1,004 residents) and 6 weeks after the second (820 residents).
Results: Among the 735 residents without prior COVID-19, 41.7% remained
seronegative for S-protein IgG after the first jab vs 2.1% of the 270
residents with a previous positive RT-PCR (p<0.001). After the
second jab, only 3% of the 586 residents without prior COVID-19
remained seronegative. However, 26.5% of them had low S-protein IgG
levels (50-1050 UA/mL) vs 6.4% of the 222 residents with prior
COVID-19. Residents with old infection (first wave), or seropositive for
N-protein IgG at the time of vaccination, had the highest S-protein IgG
levels. Residents with a prior COVID-19 infection had higher S-protein
IgG levels after one dose than those without two jabs. Interpretation: A
single vaccine jab is sufficient to reach immunity in residents with
prior COVID-19. Most residents without prior COVID-19 are seropositive
for S-protein IgG after the second jab, but around 30% have low levels
of S-protein IgG. Whether residents with no or low post-vaccine immunity
are at higher risk of symptomatic COVID-19 requires further analysis.