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

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

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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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: May 10, 2022.

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

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Eliakim-Raz N et al. JAMA Network Open.

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
1.
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 PubMedGoogle ScholarCrossref
3.
R Foundation. The R Project for Statistical Computing. Accessed June 27, 2021. http://www.r-project.org/
4.
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 PubMedGoogle ScholarCrossref
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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 PubMedGoogle ScholarCrossref
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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 PubMedGoogle ScholarCrossref
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