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Longitudinal Surveillance of COVID-19 Antibodies in Pediatric Healthcare Workers
Dunia Hatabah1, Sneh Lata Gupta1, Grace Mantus1,2
1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.
Insights
COVID-19 vaccination and infection generate spike-specific antibodies that cross-react with other coronaviruses. Booster shots significantly improve antibody durability compared to the primary vaccine series.
Area of Science:
- Immunology
- Vaccinology
- Infectious Diseases
Background:
- Limited longitudinal data exists on COVID-19 immune responses in healthcare workers (HCWs).
- Understanding immune profiles in vaccinated, unvaccinated, and previously infected individuals is crucial.
Purpose of the Study:
- To investigate the longitudinal impact of COVID-19 vaccination on immunoglobulin G (IgG) antibody titers in pediatric HCWs (pHCWs).
- To assess antibody cross-reactivity with other human coronaviruses.
- To compare immune responses between vaccinated, unvaccinated, infected, and naïve participants.
Main Methods:
- Prospective longitudinal observational cohort study of 642 pediatric HCWs from 2020-2022.
- Measurement of anti-spike IgG antibody titers over time, including post-vaccine and post-booster doses.
- Analysis of cross-reactivity against SARS-CoV-1, MERS-CoV, and seasonal coronaviruses (HCoV-HKU1, HCoV-OC43).
Main Results:
- Vaccinated participants exhibited higher anti-spike IgG titers than unvaccinated individuals (p < 0.0001).
- Previously infected participants required only one vaccine dose for maximum titers, unlike naïve participants needing two.
- Anti-spike titers declined significantly 9 months post-primary series but remained sustained 9 months post-booster.
- Antibodies generated by infection and/or vaccination showed cross-reactivity with other coronaviruses.
Conclusions:
- All vaccinated pediatric HCWs developed anti-spike antibodies.
- COVID-19 infection and vaccination induce cross-reactive antibodies against various coronaviruses.
- Booster vaccination enhances the durability of anti-spike antibody titers.
- Longitudinal immune profiling is essential for refining public health policies and vaccine strategies.
Abstract:
Background: Vaccines against COVID-19 target the spike protein. There is minimal information on longitudinal COVID-19 immune profiling in recovered versus naïve and vaccinated versus non-vaccinated healthcare workers (HCWs). Methods: This is a prospective longitudinal observational cohort of pediatric HCWs (pHCWs) conducted during 2020-2022 at an academic center, exploring the impact of COVID-19 vaccination on immunoglobulin G (IgG) antibody titers over time and cross-reactivity with other coronaviruses, including SARS-CoV-1, MERS-CoV, and seasonal coronaviruses (HCoV-HKU1 and HCoV-OC43). Results: A total of 642 pHCWs initially enrolled, and 337 participants had repeat IgG titers measured post-vaccine and post-booster. Most participants were female, median age range of 31-40 years. Anti-spike was higher in all vaccinated individuals versus non-vaccinated (p < 0.0001) and naïve versus infected (p < 0.0001). A single dose of vaccine was sufficient to attain maximum titers in recovered participants versus naïve who received both doses of vaccine. Anti-spike titers dropped significantly at 9 months after the primary series, whereas sustained anti-spike titers were observed at 9 months post-booster. Conclusions: All vaccinated pHCWs developed antibodies to spike. COVID-19 infection and/or vaccination yielded antibodies that cross-reacted to SARS-CoV-1, MERS-CoV, HCoV-HKU1, and HCoV-OC43. Anti-spike titers were more durable post-booster compared to the primary series. Longitudinal immune profiling of COVID-19 responses provides vital data to shape public health policies, optimize vaccine strategies, and strengthen pandemic preparedness.
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