Factors influencing neutralizing antibody titers elicited by coronavirus disease 2019 vaccines

The World Health Organization has highlighted the importance of an international standard (IS) for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) neutralizing antibody titer detection to calibrate diagnostic techniques. We applied an IS to calibrate neutralizing antibody titers (NTs) (inter-national units/mL) in response to coronavirus disease 2019 (COVID-19) vaccination. Moreover, the as-sociation between different factors and neutralizing antibodies was analyzed. A total of 1667 serum samples were collected from participants receiving different COVID-19 vaccines. Antibody titers were determined by a microneutralization assay using live viruses in a biosafety level 3 (BSL-3) laboratory and a commercial serological MeDiPro kit. The titer determined using the MeDiPro kit was highly correlated with the NT determined using live viruses and calibrated using IS. Fever and antipyretic analgesic treatment were related to neutralizing antibody responses in ChAdOx1-S and BNT162b2 vaccinations. Individuals with diabetes showed a low NT elicited by MVC-COV1901. Individuals with hypertension receiving the BNT162b2 vaccine had lower NTs than those without hypertension. Our study provided the international unit (IU) values of NTs in vaccinated individuals for the development of vaccines and implementation of non-inferiority trials. Correlation of the influencing factors with NTs can provide an indicator for selecting COVID-19 vaccines based on personal attributes.(c) 2022 Published by Elsevier Masson SAS on behalf of Institut Pasteur.

Automated summary

The importance of an international standard for SARS-CoV-2 neutralizing antibody titer detection has been highlighted by the World Health Organization. In this study, we calibrated neutralizing antibody titers in response to COVID-19 vaccination using the international standard and analyzed the association between different factors and neutralizing antibodies. The findings have significant implications for vaccine development and the implementation of non-inferiority trials.