Age and vitamin D affect the magnitude of the antibody response to the first dose of the SARS-CoV-2 BNT162b2 vaccine - 07/05/22

Doi : 10.1016/j.retram.2022.103344 
Isabelle Piec a, Laura Cook b, Samir Dervisevic a, c, William D Fraser a, b, Scott Ruetten d, Marvin Berman d, Emma English a, b, , W Garry John a, b,
a Faculty of Medicine and Health, University of East Anglia, Norwich, UK 
b Department of Clinical Biochemistry, Norfolk and Norwich University Hospitals Trust, Norwich, UK 
c Virology Department, Norfolk and Norwich University Hospitals Trust, Norwich, UK 
d Abbott Diagnostics, 100 Abbott Park, Abbott Park, IL 60046, United States 

Corresponding authors.

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Evidence before this study Immunization is the most important strategy to facilitate the end of the global pandemic. Vaccines, authorized for use globally, have shown more than 90% efficacy against SARS-CoV-2 clinical disease in clinical trials. In an effort to ensure maximal coverage by vaccinating as many people as possible with one dose (of the 2-dose vaccines such as the Pfizer/BioNTech) the UK government extended the recommended interval for the second dose from three to twelve weeks. To date, most studies only evaluate the serological response at a single time point post 1st dose or investigate the antibody response up to three weeks. Many studies simply look for the qualitative absence or presence of antibodies with a very limited number investigating the quantitative antibody response over an extended time period. In addition, most studies do not investigate factors which affect the magnitude of antibody response.
Added value of this study This is the first study to quantify antibody concentrations at multiple time points post first dose of the BNT162b2 mRNA (Pfizer-BioNTech) COVID-19 vaccine in Healthcare workers, with no known previous infection, showing positive concentrations of IgG after 8 weeks. Moreover, younger deciles (≤40yr) showed an initial greater antibody production. Levels at week 8 were similar across ages. Vitamin D concentrations ≥50nmol/L improved the antibody response to a dose of SARS-CoV-2 BNT162b2 (Pfizer/BioNTech) vaccine.
Implications of all the available evidence Both younger and older adults retained positive concentrations of antibodies against SARS-CoV-2, 8 weeks after the first dose of vaccine. Booster immunization should be administered following sunshine exposure or after vitamin D supplementation.

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Most approved vaccines utilise a two-dose strategy. To enable larger groups of patients to receive the first dose, the UK government increased the gap between the two doses from three to twelve weeks. Here we report on the immunogenicity of the first dose, including effect of age and vitamin D status on these levels over an 8 week-period.


Blood samples were collected from healthcare workers (HCW) receiving their first BNT162b2 vaccine dose between January and February 2021. Antibody (Ab) production was measured, prior to and weekly for 4 weeks post immunization, and a final measurement was performed at 8 weeks. Serum vitamin D concentrations were also measured at baseline.


Immunization of 97 HCW induced an Ab response that peaked 3•2 weeks post immunization to decrease thereafter. Ab levels remained positive at 8 weeks. IgG peak concentration was negatively associated with age (β=-0•440, p<0.001). Response to immunization was also significantly affected by vitamin D status (p=0•022), on average 29•3% greater peak value in individuals with 25(OH)D>50nmol/L. No other variable showed significant effect.


The first dose of BNT162b2 produced Ab levels that remained positive after 8 weeks. Peak was greater in younger subjects and 25(OH)D>50nmol/L was beneficial. Booster campaigns should take into consideration vitamin D status which is at its highest following a period of sunshine exposure or following oral supplementation (400-1000IU daily).


Abbott Diagnostics Ltd supplied the kits used to quantify the anti-SARS -CoV-2 Spike IgG and technical support as well as provided financial support for sample collections.

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Keywords : SARS-CoV-2, immunization, BNT162b2, Vitamin D, Age


© 2022  Publié par Elsevier Masson SAS.
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Vol 70 - N° 3

Article 103344- juillet 2022 Retour au numéro
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