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

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 3

Symptomatic SARS-CoV-2–exposed subjects show higher increase of anti-Spike 1/2 IgG levels after the first dose of vaccine.

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Symptomatic SARS-CoV-2–exposed subjects show higher increase of anti-Spi...
(A and B) Anti-Spike 1/2 IgG plasma levels in asymptomatics/paucisymptomatics (n = 15) or symptomatics (n = 42) after the first (A) or after the second dose of vaccination (asymptomatics/paucisymptomatics n = 14, symptomatics n = 33) (B). Each dot corresponds to an individual subject. Log scale on Y axis. (C) Before and after plot (asymptomatics/paucisymptomatics n = 14, symptomatics n = 33), showing trends for each individual subject by linked dots. (D and E) Anti-Spike 1/2 IgG plasma levels in symptomatic SARS-CoV-2–exposed individuals (n = 7) at around 12 days (Post Vax1) or around 34 days (Post Vax1 second time point) after the first dose of vaccine (D). Spaghetti plot showing the trends for each individual subject by linked dots (E). Log scale on y axis. The box plots (A, B, and D) show the interquartile range, the horizontal lines show the median values, and the whiskers indicate the minimum-to-maximum range. P values were determined using 2-tailed unpaired Kolmogorov-Smirnov test (A and B) or 2-tailed Wilcoxon matched-pairs signed rank test (symptomatics post VAX1 vs post VAX 2, P < 0.0001; asymptomatics/paucisymptomatics post VAX1 vs post VAX2, P = 0.0001) (C); 1-way ANOVA with Tukey’s post test (D) or 2-tailed paired Student’s t test (E).