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Infectious Diseases

Antibody Titers After a Third and Fourth SARS-CoV-2 BNT162b2 Vaccine Dose in Older Adults

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JAMA Network Open

July 21, 2022

Research Letter

Article Information and Disclosures

Noa Eliakim-Raz, MD^1,2;

Amos Stemmer, MD³;

Nassem Ghantous, MD^1,2;

et al

Asaf Ness, MD^1,2;

Muhammad Awwad, MD^1,2;

Yaara Leibovici-Weisman, MD^1,2;

Salomon M. Stemmer, MD^2,4

Author Affiliations

¹Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
²Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
³Department of Oncology, Sheba Medical Center, Tel Hashomer, Israel
⁴Davidoff Center, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel

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At the beginning of the fifth SARS-CoV-2 wave in Israel, with the B.1.1.529 (Omicron) variant, the effectiveness of the third SARS-CoV-2 BNT162b2 vaccine (Pfizer-BioNTech) against Omicron was questioned. During the fifth wave, in January 2022, the Israeli Ministry of Health authorized a fourth BNT162b2 dose for individuals aged 60 years or older (a third dose was authorized for such individuals in July 2021, during the fourth SARS-CoV-2 wave).

This study, which is an extension of a prior study,¹ compared the response to the third and fourth BNT162b2 vaccine doses among individuals aged 60 years or older by evaluating antispike (anti-S) immunoglobulin G (IgG) antibody titers before and after each dose. This population is at high risk of developing severe SARS-CoV-2 disease and was the first to receive authorization for a third and fourth vaccine dose.

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Article Information

Accepted for Publication: May 10, 2022.

Published: July 21, 2022. doi:10.1001/jamanetworkopen.2022.23090

Corresponding Author: Noa Eliakim-Raz, MD, Internal Medicine E, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky St, Petah Tikva, 49100, Israel (noaeliakim@gmail.com).

Author Contributions: Dr S. M. Stemmer had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Eliakim-Raz, S. M. Stemmer.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Eliakim-Raz, Ghantous, Ness, Awwad, S. M. Stemmer.

Critical revision of the manuscript for important intellectual content: Eliakim-Raz, A. Stemmer, Leibovici-Weisman, S. M. Stemmer.

Statistical analysis: A. Stemmer, Ghantous, Ness, Awwad.

Obtained funding: S. M. Stemmer.

Administrative, technical, or material support: All authors.

Supervision: Eliakim-Raz, S. M. Stemmer.

Conflict of Interest Disclosures: Dr S. M. Stemmer reported receiving research grants (to the institution) from CAN-FITE, AstraZeneca, Bioline RX, Bristol Myers Squibb, Halozyme, Clovis Oncology, CTG Pharma, Exelixis, Geicam, Incyte, Lilly, Moderna, Teva Pharmaceuticals, and Roche and owning stocks and options in CTG Pharma, DocBoxMD, Tyrnovo, VYPE, Cytora, and CAN-FITE. No other disclosures were reported.

Additional Contributions: The authors thank Avital Bareket-Samish, PhD, BioInsight Ltd, for medical editing support. She received financial compensation for her contribution.

Additional Information: The data sets generated during this study are available from the corresponding author on request.

References

Eliakim-Raz N , Leibovici-Weisman Y , Stemmer A , et al. Antibody titers before and after a third dose of the SARS-CoV-2 BNT162b2 vaccine in adults aged ≥60 years. JAMA. 2021;326(21):2203-2204. doi:10.1001/jama.2021.19885 PubMed Google Scholar Crossref

Abbott. SARS-CoV-2 immunoassays. Accessed October 1, 2021. https://www.corelaboratory.abbott/int/en/offerings/segments/infectious-disease/sars-cov-2-

R Foundation. The R Project for Statistical Computing. Accessed June 27, 2021. http://www.r-project.org/

Kamar N , Abravanel F , Marion O , et al. Assessment of 4 doses of SARS-CoV-2 messenger RNA–based vaccine in recipients of a solid organ transplant. JAMA Netw Open. 2021;4(11):e2136030. doi:10.1001/jamanetworkopen.2021.36030 PubMed Google Scholar Crossref

Alejo JL , Mitchell J , Chiang TP , et al. Antibody response to a fourth dose of a SARS-CoV-2 vaccine in solid organ transplant recipients: a case series. Transplantation. 2021;105(12):e280-e281. doi:10.1097/TP.0000000000003934 PubMed Google Scholar Crossref

Harvey RA , Rassen JA , Kabelac CA , et al. Association of SARS-CoV-2 seropositive antibody test with risk of future infection. JAMA Intern Med. 2021;181(5):672-679. doi:10.1001/jamainternmed.2021.0366 PubMed Google Scholar Crossref

Antibody Titers After a Third and Fourth SARS-CoV-2 BNT162b2 Vaccine Dose in Older Adults

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