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One dose of SARS-CoV-2 vaccine exponentially increases antibodies in individuals who have recovered from symptomatic COVID-19
Riccardo Levi, … , Alberto Mantovani, Maria Rescigno
Riccardo Levi, … , Alberto Mantovani, Maria Rescigno
Published May 6, 2021
Citation Information: J Clin Invest. 2021;131(12):e149154. https://doi.org/10.1172/JCI149154.
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Clinical Research and Public Health Immunology Article has an altmetric score of 25

One dose of SARS-CoV-2 vaccine exponentially increases antibodies in individuals who have recovered from symptomatic COVID-19

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Abstract

BACKGROUND The COVID-19 vaccines currently in use require 2 doses to achieve optimal protection. Currently, there is no indication as to whether individuals who have been exposed to SARS-CoV-2 should be vaccinated, or whether they should receive 1 or 2 vaccine doses.METHODS We tested the antibody response developed after administration of the Pfizer/BioNTech vaccine in 124 health care professionals, of whom 57 had a previous history of SARS-CoV-2 exposure with or without symptoms.RESULTS Postvaccine antibodies in SARS-CoV-2–exposed individuals increased exponentially within 5 to 18 days after the first dose compared to naive subjects (P < 0.0001). In a multivariate linear regression (LR) model we showed that the antibody response depended on the IgG prevaccine titer and on the exposure to SARS-CoV-2. In symptomatic SARS-CoV-2–exposed individuals, IgG reached a plateau after the second dose, and those who voluntarily refrained from receiving the second dose (n = 7) retained their antibody response. Gastrointestinal symptoms, muscle pain, and fever markedly positively correlated with increased IgG responses. By contrast, all asymptomatic/paucisymptomatic and unexposed individuals showed an important increase after the second dose.CONCLUSION One vaccine dose is sufficient in symptomatic SARS-CoV-2–exposed subjects to reach a high titer of antibodies, suggesting no need for a second dose, particularly in light of current vaccine shortage.TRIAL REGISTRATION ClinicalTrials.gov NCT04387929.FUNDING Dolce & Gabbana and the Italian Ministry of Health (Ricerca corrente).

Authors

Riccardo Levi, Elena Azzolini, Chiara Pozzi, Leonardo Ubaldi, Michele Lagioia, Alberto Mantovani, Maria Rescigno

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Figure 1

Experimental design.

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Experimental design.
Observational study approved by the international r...
Observational study approved by the international review board of Istituto Clinico Humanitas (ClinicalTrials.gov NCT04387929). Accrual was on a voluntary basis. All participants signed an informed consent and completed a questionnaire indicating a previous history of SARS-CoV-2 exposure and COVID-19–associated symptoms/clinical manifestations (SARS-CoV-2-Exp). This study was conducted at Istituto Clinico Humanitas in which health care and administrative staff were followed for serology before (Pre VAX), after the first dose (Post VAX1), and after the second dose (Post VAX2) of the Pfizer/BioNTech vaccine.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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