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Persistent B cell memory after SARS-CoV-2 vaccination is functional during breakthrough infections.

Sara Terreri1, Eva Piano Mortari1, Maria Rosaria Vinci2

  • 1Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children's Hospital, IRCCS; Viale di San Paolo, 15, 00146 Rome, Italy.

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|February 8, 2022
PubMed
Summary

Waning immunity can lead to breakthrough SARS-CoV-2 infections. However, memory B cells induced by the BNT162b2 vaccine persist and mount a rapid antibody response upon infection, even months after vaccination.

Keywords:
COVID-19SARS-CoV-2breakthrough infectionsmRNA vaccinememory B cellsmucosal immunitysalivary IgAwaning immunity

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Area of Science:

  • Immunology
  • Vaccinology
  • Virology

Background:

  • Breakthrough SARS-CoV-2 infections in vaccinated individuals are often attributed to waning immunity.
  • Serum antibodies are a key indicator of vaccine-induced B cell memory.
  • Memory B cells are crucial for sustained protection against pathogens, even as antibody levels decline.

Purpose of the Study:

  • To investigate the durability and functionality of BNT162b2 mRNA vaccine-induced B cell memory against SARS-CoV-2.
  • To assess B cell memory response at 3, 6, and 9 months post-second dose in healthcare workers (HCWs).

Main Methods:

  • Longitudinal study of HCWs vaccinated with BNT162b2 mRNA vaccine.
  • Measurement of SARS-CoV-2-specific antibodies and memory B cell responses over time.
  • Analysis of B cell memory in HCWs with and without breakthrough infections.

Main Results:

  • SARS-CoV-2-specific antibodies showed a physiological decline over 9 months.
  • Memory B cells persisted and increased up to 9 months post-vaccination.
  • HCWs with breakthrough infections did not exhibit waning immunity; memory B cells rapidly produced antibodies upon infection.
  • A rapid production of serum antibodies and salivary anti-Spike IgA was observed within 3-4 days of infection.

Conclusions:

  • The BNT162b2 mRNA vaccine induces durable and functional memory B cell responses.
  • Memory B cells provide sustained protection against SARS-CoV-2, mitigating severe disease despite antibody decline.
  • Breakthrough infections do not indicate a failure of vaccine-induced memory B cells but rather a dynamic immune response.