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One shot to shield ‘em all: reCOVIred people may just need one dose of vaccine

People who have recovered from COVID-19 had a robust antibody response after the first mRNA vaccine dose, but little immune benefit after the second dose, according to new research from the Pennsylvania University. The findings, published today in the journal Science Immunology, suggest only a single vaccine dose may be needed to produce a sufficient antibody response. The team found that those who did not have COVID-19–called COVID naïve–did not have a full immune response until after receiving their second vaccine dose, reinforcing the importance of completing the two recommended doses for achieving strong levels of immunity. The study provides more insight on the underlying immunobiology of mRNA vaccines, which could help shape future vaccine strategies. The human immune response to vaccines and infections result in two major outcomes–the production of antibodies that provide rapid immunity and the creation of memory B cells, which assist in long-term immunity.

This study represents one of the first to uncover how memory B cell responses differ after vaccination in people who previously experienced infection, compared to those who have not have COVID-19. The researchers recruited 44 healthy individuals who received either the BioNTech/Pfizer or Moderna vaccine at the University of Pennsylvania Health System. Of this cohort, 11 had a prior COVID-19 infection. Blood samples were collected for deep immune analyses four times prior to and after vaccine doses. The data shows key differences in vaccine immune responses in COVID naïve versus COVID-19 recovered individuals. The findings suggest that only a single vaccine dose in individuals recovered from COVID-19 may be enough to induce a maximal immune response, based on both strong antibody and memory B cell responses. This is likely due to a primary immune response because of their natural infection.  In contrast, it took two vaccine doses to demonstrate considerable antibody and memory B cell responses for those who did not have COVID-19,

This underlies the importance of the two-dose mRNA vaccine schedule to achieve optimal levels of immunity. These findings were also reflected in an analysis of antibodies against the D614G mutation and the B.1.351 South African variant of COVID-19. For those who did not have COVID-19, it took a second dose to get a robust enough immunity level against the mutation and variant, whereas those recovered from COVID-19 had a strong enough antibody response after one dose. The researchers also examined vaccine-induced side effects in relation to immune responses. While seen in a smaller cohort of 32 COVID naïve people, they found that those who experienced systemic side effects after receiving a vaccine dose–such as fever, chills, headache, and fatigue–had stronger post-vaccination serum antibodies, but not memory B cells. Although more data is needed and all subjects developed robust immunity, it is possible that inflammation and side effects early after vaccination could signal stronger immune reactions.

The researchers are continuing larger-scale studies, which are necessary to fully examine the question of a one- or two-dose regimen in COVID-19-recovered individuals and to see how long the vaccine antibodies last. Wherry and his team are continuing to study the vaccine’s effect on virus-specific T cell responses, another element of the body’s immune response. Senior author E. John Wherry, PhD, chair of the department of Systems Pharmacology and Translational Therapeutics and director of the Penn Institute of Immunology in the Perelman School of Medicine, explained: “Previous COVID-19 mRNA vaccine studies on vaccinated individuals have focused on antibodies more than memory B cells. These are a strong predictor of future antibody responses, which is why it’s vital to measure B cell responses to these vaccines. This efforts arte important for understanding long-term protection and the ability to respond to variants. Our results are encouraging for both short- and long-term vaccine efficacy, and this adds to our understanding of the mRNA vaccine immune response through the analysis of memory B cells”.

  • Edited By Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Goel RR, Apostolidis SA et al. Sci Immunol 2021 Apr 15.

Pollet J et al. Hum Vaccin Immunother. 2021 Apr 13:1-11. 

Kalimuddin S, Tham CY et al. Medicine (NY). 2021 Apr 8. 

Dott. Gianfrancesco Cormaci
- Laurea in Medicina e Chirurgia nel 1998 (MD Degree in 1998) - Specialista in Biochimica Clinica nel 2002 (Clinical Biochemistry residency in 2002) - Dottorato in Neurobiologia nel 2006 (Neurobiology PhD in 2006) - Ha soggiornato negli Stati Uniti, Baltimora (MD) come ricercatore alle dipendenze del National Institute on Drug Abuse (NIDA/NIH) e poi alla Johns Hopkins University, dal 2004 al 2008. - Dal 2009 si occupa di Medicina personalizzata. - Guardia medica presso strutture private dal 2010 - Detentore di due brevetti sulla preparazione di prodotti gluten-free a partire da regolare farina di frumento immunologicamente neutralizzata (owner of patents concerning the production of bakery gluten-free products, starting from regular wheat flour). - Responsabile del reparto Ricerca e Sviluppo per la società CoFood s.r.l. (leader of the R&D for the partnership CoFood s.r.l.) - Autore di un libro riguardante la salute e l'alimentazione, con approfondimenti su come questa condizioni tutti i sistemi corporei. - Autore di articoli su informazione medica e salute sui siti web salutesicilia.com, medicomunicare.it e in lingua inglese sul sito www.medicomunicare.com
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