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Antibody correlates of protection against Delta infection after vaccination: A nested case-control within the UK-based SIREN study

Atti, Ana; Insalata, Ferdinando; Carr, Edward J; Otter, Ashley D; Foulkes, Sarah; Wu, Mary Y; Crick COVID Immunity Pipeline, .; ... SIREN Study Group, .; + view all (2023) Antibody correlates of protection against Delta infection after vaccination: A nested case-control within the UK-based SIREN study. Journal of Infection 10.1016/j.jinf.2023.07.007. (In press). Green open access

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Abstract

Objectives: To investigate serological correlates of protection against SARS-CoV-2 B.1.617.2 (Delta) infection after two vaccinations.// Methods: We performed a case-control study, where cases were Delta infections after the second vaccine dose and controls were vaccinated, never infected participants, matched by age, gender and region. Sera were tested for anti-SARS-CoV-2 Spike antibody levels (anti-S) and neutralising antibody titres (nAbT), using live virus microneutralisation against Ancestral, Delta and Omicron (BA.1, B.1.1.529). We modelled the decay of anti-S and nAbT for both groups, inferring levels at matched calendar times since the second vaccination. We assessed differences in inferred antibody titres between groups and used conditional logistic regression to explore the relationship between titres and odds of infection.// Results: In total, 130 sequence-confirmed Delta cases and 318 controls were included. Anti-S and Ancestral nAbT decayed similarly between groups, but faster in cases for Delta nAbT (p = 0.02) and Omicron nAbT (p = 0.002). At seven days before infection, controls had higher anti-S levels (p < 0.0001) and nAbT (p < 0.0001; all variants) at matched calendar time. A two-fold increase in anti-S levels was associated with a 29% ([95% CI 14–42%]; p = 0.001) reduction in odds of Delta infection. Delta nAbT>40 were associated with reduced odds of Delta infection (89%, [69–96%]; p < 0.0001), with additional benefits for titres >100 (p = 0.009) and >400 (p = 0.007).// Conclusions: We have identified correlates of protection against SARS-CoV-2 Delta, with potential implications for vaccine deployment, development, and public health response.

Type: Article
Title: Antibody correlates of protection against Delta infection after vaccination: A nested case-control within the UK-based SIREN study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jinf.2023.07.007
Publisher version: https://doi.org/10.1016/j.jinf.2023.07.007
Language: English
Additional information: © The Author(s), 2023. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
Keywords: SARS-CoV-2Neutralising AntibodiesSARS-CoV-2 serology, Immunity, Vaccination
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10177289
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