Correlates of protection against symptomatic and asymptomatic SARS-CoV-2 infection

Feng, Shuo, Phillips, Daniel J, White, Thomas, Sayal, Homesh, Aley, Parvinder K, Bibi, Sagida, Dold, Christina, Fuskova, Michelle, Gilbert, Sarah C, Hirsch, Ian, Humphries, Holly E, Jepson, Brett, Kelly, Elizabeth J, Plested, Emma, Shoemaker, Kathryn, Thomas, Kelly M, Vekemans, Johan, Villafana, Tonya L, Lambe, Teresa, Pollard, Andrew J, Voysey, Merryn, Collins, Andrea ORCID: https://orcid.org/0000-0002-4094-1572, Ferreira, Daniela ORCID: https://orcid.org/0000-0002-0594-0902 and Hill, Helen (2021) 'Correlates of protection against symptomatic and asymptomatic SARS-CoV-2 infection'. Nature Medicine, Vol 27, Issue 11, pp. 2032-2040.

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Abstract

The global supply of COVID-19 vaccines remains limited. An understanding of the immune response that is predictive of protection could facilitate rapid licensure of new vaccines. Data from a randomized efficacy trial of the ChAdOx1 nCoV-19 (AZD1222) vaccine in the United Kingdom was analyzed to determine the antibody levels associated with protection against SARS-CoV-2. Binding and neutralizing antibodies at 28 days after the second dose were measured in infected and noninfected vaccine recipients. Higher levels of all immune markers were correlated with a reduced risk of symptomatic infection. A vaccine efficacy of 80% against symptomatic infection with majority Alpha (B.1.1.7) variant of SARS-CoV-2 was achieved with 264 (95% CI: 108, 806) binding antibody units (BAU)/ml: and 506 (95% CI: 135, not computed (beyond data range) (NC)) BAU/ml for anti-spike and anti-RBD antibodies, and 26 (95% CI: NC, NC) international unit (IU)/ml and 247 (95% CI: 101, NC) normalized neutralization titers (NF) for pseudovirus and live-virus neutralization, respectively. Immune markers were not correlated with asymptomatic infections at the 5% significance level. These data can be used to bridge to new populations using validated assays, and allow extrapolation of efficacy estimates to new COVID-19 vaccines.

Item Type:	Article
Additional Information:	LSTM authors are part of the Oxford COVID Vaccine Trial Group
Subjects:	QW Microbiology and Immunology > Viruses > QW 160 Viruses (General). Virology WA Public Health > WA 105 Epidemiology WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 505 Viral respiratory tract infections
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1038/s41591-021-01540-1
Depositing User:	Stacy Murtagh
Date Deposited:	03 Dec 2021 16:26
Last Modified:	03 Dec 2021 16:26
URI:	https://archive.lstmed.ac.uk/id/eprint/19546

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