Antibody Responses and Infection Prevention following the Sixth Vaccination using the BA.1 bivalent COVID-19 vaccine among Healthcare workers during the XBB variant Dominance in Japan

Abstract

The effect of antibodies elicited by bivalent mRNA vaccines (original and omicron BA.1) on preventing coronavirus disease 2019 (COVID-19) onset in the presence of the XBB variant remains unknown. A prospective cohort study conducted at Chiba University Hospital examined healthcare workers who received their sixth vaccination with the Pfizer-BioNTech COVID-19 bivalent mRNA vaccine (original and omicron BA.1). Researchers quantitatively measured serum anti-spike (S) antibody levels. Participants not infected during the 60-day observation period after vaccination had significantly higher S antibody titers than those who were newly infected (27756 U/mL, 95% CI [24988–30831 U/mL] vs. 15321 U/mL, 95% CI [10824–21688 U/mL], p<0.05). The risk of infection decreased by 84% when the S antibody titer exceeded 15500 U/ml. Neutralizing antibody titers against the XBB.1.16 and XBB.1.42 variants were higher in age- and sex-matched noninfected individuals than in newly infected individuals during the post-vaccination observation period. S antibody titers were highly correlated with neutralizing antibody titers. In conclusion, after the sixth COVID-19 vaccination with the bivalent mRNA vaccine (original and omicron BA.1), high S antibody titers correlated with disease prevention, even in the presence of XBB variants.