Evaluation of antibody kinetics and durability in health individuals vaccinated with inactivated COVID-19 vaccine (CoronaVac): a cross-sectional and cohort study in Zhejiang, China

  1. Hangjie Zhang
  2. Qianhui Hua
  3. Nani Nani Xu
  4. Xinpei Zhang
  5. Bo Chen
  6. Xijun Ma
  7. Jie Hu
  8. Zhongbing Chen
  9. Pengfei Yu
  10. Huijun Lei
  11. Shenyu Wang
  12. Linling Ding
  13. Jian Fu
  14. Yuting Liao
  15. Juan Yang
  16. Jianmin Jiang  Is a corresponding author
  17. Huakun Lv  Is a corresponding author
  1. Zhejiang Provincial Center for Disease Control and Prevention, China
  2. Ningbo University, China
  3. Xihu District Center for Disease Control and Prevention, China
  4. Shangyu District Center for Disease Control and Prevention, China
  5. Kaihua District Center for Disease Control and Prevention, China
  6. Yuecheng District Center for Disease Control and Prevention, China
  7. Jiaxing Center for Disease Control and Prevention, China
  8. Longyou District Center for Disease Control and Prevention, China
  9. Xiamen University, China

Abstract

Background: Although inactivated COVID-19 vaccines are proven to be safe and effective in the general population, the dynamic response and duration of antibodies after vaccination in the real world should be further assessed.

Methods: We enrolled 1067 volunteers who had been vaccinated with one or two doses of CoronaVac in Zhejiang Province, China. Another 90 healthy adults without previous vaccinations were recruited and vaccinated with three doses of CoronaVac, 28 days and 6 months apart. Serum samples were collected from multiple timepoints and analyzed for specific IgM/IgG and neutralizing antibodies (NAbs) for immunogenicity evaluation. Antibody responses to the Delta and Omicron variants were measured by pseudovirus-based neutralization tests.

Results: Our results revealed that binding antibody IgM peaked 14-28 days after one dose of CoronaVac, while IgG and NAbs peaked approximately 1 month after the second dose then declined slightly over time. Antibody responses had waned by month 6 after vaccination and became undetectable in the majority of individuals at 12 months. Levels of NAbs to live SARS-CoV-2 were correlated with anti-SARS-CoV-2 IgG and NAbs to pseudovirus, but not IgM. Homologous booster around 6 months after primary vaccination activated anamnestic immunity and raised NAbs 25.5-fold. The neutralized fraction subsequently rose to 36.0% for Delta (p=0.03) and 4.3% for Omicron (p=0.004), and the response rate for Omicron rose from 7.9% (7/89) to 17.8% (16/90).

Conclusions: Two doses of CoronaVac vaccine resulted in limited protection over a short duration. The inactivated vaccine booster can reverse the decrease of antibody levels to prime strain, but it does not elicit potent neutralization against Omicron; therefore, the optimization of booster procedures is vital.

Funding: Key Research and Development Program of Zhejiang Province; Key Program of Health Commission of Zhejiang Province/ Science Foundation of National Health Commission; Major Program of Zhejiang Municipal Natural Science Foundation; Explorer Program of Zhejiang Municipal Natural Science Foundation.

Data availability

All data generated or analysed during this study are included in this published article and its supplementary information files, or are available in database Dryad (https://datadryad.org/).

Article and author information

Author details

  1. Hangjie Zhang

    Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-7334-2536
  2. Qianhui Hua

    School of Medicine, Ningbo University, Ningbo, China
    Competing interests
    The authors declare that no competing interests exist.
  3. Nani Nani Xu

    Xihu District Center for Disease Control and Prevention, Hangzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  4. Xinpei Zhang

    Shangyu District Center for Disease Control and Prevention, Shaoxing, China
    Competing interests
    The authors declare that no competing interests exist.
  5. Bo Chen

    Kaihua District Center for Disease Control and Prevention, Quzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  6. Xijun Ma

    Yuecheng District Center for Disease Control and Prevention, Shaoxing, China
    Competing interests
    The authors declare that no competing interests exist.
  7. Jie Hu

    Department of Immunization Program, Jiaxing Center for Disease Control and Prevention, Jiaxing, China
    Competing interests
    The authors declare that no competing interests exist.
  8. Zhongbing Chen

    Longyou District Center for Disease Control and Prevention, Quzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  9. Pengfei Yu

    Department of Immunization Program, Jiaxing Center for Disease Control and Prevention, Jiaxing, China
    Competing interests
    The authors declare that no competing interests exist.
  10. Huijun Lei

    Longyou District Center for Disease Control and Prevention, Quzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  11. Shenyu Wang

    Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  12. Linling Ding

    Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  13. Jian Fu

    Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  14. Yuting Liao

    School of Public Health, Xiamen University, Xiamen, China
    Competing interests
    The authors declare that no competing interests exist.
  15. Juan Yang

    School of Public Health, Xiamen University, Xiamen, China
    Competing interests
    The authors declare that no competing interests exist.
  16. Jianmin Jiang

    Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
    For correspondence
    jmjiang@cdc.zj.cn
    Competing interests
    The authors declare that no competing interests exist.
  17. Huakun Lv

    Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
    For correspondence
    hklv@cdc.zj.cn
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-3420-6942

Funding

Key Research and Development Program of Zhejiang Province, 2021C03200

  • Hangjie Zhang
  • Nani Nani Xu
  • Bo Chen
  • Yuting Liao
  • Juan Yang
  • Jianmin Jiang
  • Huakun Lv

Key Program of Health Commission of Zhejiang Province/ Science Foundation of National Health Commission, WKJ-ZJ-2221

  • Jianmin Jiang
  • Huakun Lv

Major program of Zhejiang Municipal Natural Science Foundation, LD22H190001

  • Hangjie Zhang

Explorer Program of Zhejiang Municipal Natural Science Foundation, LQ23H00001

  • Hangjie Zhang

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: We state that we conformed with the Helsinki Declaration of 1975 (as revised in 2008) concerning Human and Animal Rights, and that we followed out the policy concerning Informed Consent as shown on Springer.com. The study protocol and informed consent form were approved by the Medical Ethics Committee of The Zhejiang Center for Disease Control and Prevention (2021-044-01). Written informed consent was obtained from all study participants.

Copyright

© 2023, Zhang et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

Metrics

  • 802
    views
  • 131
    downloads
  • 5
    citations

Views, downloads and citations are aggregated across all versions of this paper published by eLife.

Download links

A two-part list of links to download the article, or parts of the article, in various formats.

Downloads (link to download the article as PDF)

Open citations (links to open the citations from this article in various online reference manager services)

Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)

  1. Hangjie Zhang
  2. Qianhui Hua
  3. Nani Nani Xu
  4. Xinpei Zhang
  5. Bo Chen
  6. Xijun Ma
  7. Jie Hu
  8. Zhongbing Chen
  9. Pengfei Yu
  10. Huijun Lei
  11. Shenyu Wang
  12. Linling Ding
  13. Jian Fu
  14. Yuting Liao
  15. Juan Yang
  16. Jianmin Jiang
  17. Huakun Lv
(2023)
Evaluation of antibody kinetics and durability in health individuals vaccinated with inactivated COVID-19 vaccine (CoronaVac): a cross-sectional and cohort study in Zhejiang, China
eLife 12:e84056.
https://doi.org/10.7554/eLife.84056

Share this article

https://doi.org/10.7554/eLife.84056

Further reading

    1. Epidemiology and Global Health
    2. Medicine
    3. Microbiology and Infectious Disease
    Edited by Diane M Harper et al.
    Collection

    eLife has published the following articles on SARS-CoV-2 and COVID-19.

    1. Epidemiology and Global Health
    2. Microbiology and Infectious Disease
    Bo Zheng, Bronner P Gonçalves ... Caoyi Xue
    Research Article

    Background:

    In many settings, a large fraction of the population has both been vaccinated against and infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, quantifying the protection provided by post-infection vaccination has become critical for policy. We aimed to estimate the protective effect against SARS-CoV-2 reinfection of an additional vaccine dose after an initial Omicron variant infection.

    Methods:

    We report a retrospective, population-based cohort study performed in Shanghai, China, using electronic databases with information on SARS-CoV-2 infections and vaccination history. We compared reinfection incidence by post-infection vaccination status in individuals initially infected during the April–May 2022 Omicron variant surge in Shanghai and who had been vaccinated before that period. Cox models were fit to estimate adjusted hazard ratios (aHRs).

    Results:

    275,896 individuals were diagnosed with real-time polymerase chain reaction-confirmed SARS-CoV-2 infection in April–May 2022; 199,312/275,896 were included in analyses on the effect of a post-infection vaccine dose. Post-infection vaccination provided protection against reinfection (aHR 0.82; 95% confidence interval 0.79–0.85). For patients who had received one, two, or three vaccine doses before their first infection, hazard ratios for the post-infection vaccination effect were 0.84 (0.76–0.93), 0.87 (0.83–0.90), and 0.96 (0.74–1.23), respectively. Post-infection vaccination within 30 and 90 days before the second Omicron wave provided different degrees of protection (in aHR): 0.51 (0.44–0.58) and 0.67 (0.61–0.74), respectively. Moreover, for all vaccine types, but to different extents, a post-infection dose given to individuals who were fully vaccinated before first infection was protective.

    Conclusions:

    In previously vaccinated and infected individuals, an additional vaccine dose provided protection against Omicron variant reinfection. These observations will inform future policy decisions on COVID-19 vaccination in China and other countries.

    Funding:

    This study was funded the Key Discipline Program of Pudong New Area Health System (PWZxk2022-25), the Development and Application of Intelligent Epidemic Surveillance and AI Analysis System (21002411400), the Shanghai Public Health System Construction (GWVI-11.2-XD08), the Shanghai Health Commission Key Disciplines (GWVI-11.1-02), the Shanghai Health Commission Clinical Research Program (20214Y0020), the Shanghai Natural Science Foundation (22ZR1414600), and the Shanghai Young Health Talents Program (2022YQ076).