Post-vaccination SARS-CoV-2 IgG spike antibody responses and risk factors among healthcare workers: a cross-sectional serological study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20261033Keywords:
COVISHIELD, HCWs, IgG spike antibody, Post vaccination, SARS‐CoV‐2Abstract
Background: Healthcare workers (HCWs) are considered at high risk of SARS-CoV-2 infection due to direct exposure to patients. Vaccination has been recommended as the main protective strategy against SARS-CoV-2 severity and even death among HCWs and the geriatric population.
Methods: In the current cross-sectional serological study, demographic details, risk factors and blood samples were collected from 1044 HCWs working at Government Medical College and its associated hospitals (GMC&AHJ), Jammu (J&K). Levels of SARS-CoV-2 spike antibody levels assay were determined after six months of the 2nd dose of the COVISHIELD vaccine using the chemiluminescent microparticle immunoassay method (CMIA).
Results: SARS-CoV-2 IgG spike antibodies were detected in 97.4% of HCWs. SARS-CoV-2 IgG spike seropositivity was found to be higher among females than males. SARS-CoV-2 IgG spike antibody levels were found to be statistically significantly higher in age group 1 (18–30 years) compared to age group 2 (18–50 years) and age group 3 (50 years and above) (both p<0.01) in males and females. IgG spike antibody titers were found significantly higher in those who were SARS-CoV-2 positive before vaccination than those who were not, whereas the presence of comorbidity, high BMI and smoking has adversely lowered the SARS-CoV-2 IgG spike antibody titer in the present study.
Conclusions: It was observed that SARS-CoV-2 IgG spike seropositivity remained in almost all participants even after six months of vaccination. However, it was observed that risk factors such as smoking, High BMI, and comorbidity have detrimental effects on IgG spike antibody titer.
Metrics
References
COVID-19 Vaccine Breakthrough Infections Reported to CDC- United States, January 1–April 30, 2021. MMWR Morb Mortal Wkly Rep. 2021;70. DOI: https://doi.org/10.15585/mmwr.mm7021e3
World Health Organization. Weekly Epidemiological Update on COVID-19-1 June. Available at: https://www.who.int/ publications/m/item/weekly-epidemiological-update. Accessed on 21 August 2025.
John Hopkins Coronavirus Resource Tracker. Available at https://coronavirus.jhu.edu/map.html. Accessed on 6th June, 2021.
World Health Organization. Statement for Healthcare Professionals: How COVID-19 Vaccines Are Regulated for Safety and Effectiveness (Revised March 2022). Available at: https://www.who.int/news/item/17-05-2022-statement-for-healthcareprofessionals-how-covid-19-vaccines-are-regulated-for-safety-and-effectiveness. Accessed on 9 June 2022.
PM Launches pan India rollout of COVID-19 vaccination drive. Available at: https://pib.gov.in/Pressreleaseshare.aspx?PRID=1689021. Ministry of Health and Family Welfare. Last Accessed on 6th June, 2021.
Serum Institute of India Pvt. Ltd Fact sheet for vaccine recipient approved for restricted use in an emergency situation of ChAdOx1 nCoV 19 Corona Virus Vaccine (Recombinant). Available at https://www. seruminstitute.com/pdf/Covishield_fact_sheet.pdf.
World Health Organization. COVID-19 Vaccines. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines. Accessed on 6th June, 2021.
Milne G, Hames T, Scotton C, Gent N, Johnsen A, Anderson RM, et al. Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity. Lancet Resp Med. 2021;9(12):1450-66. DOI: https://doi.org/10.1016/S2213-2600(21)00407-0
Van Elslande J, Decru B, Jonckheere S, Van Wijngaerden E, Houben E, Vandecandelaere P, et al. Antibody response against SARS-CoV-2 spike protein and nucleoprotein evaluated by four automated immunoassays and three ELISAs. Clin Microb Infect. 2020;26(11):1557. DOI: https://doi.org/10.1016/j.cmi.2020.07.038
Rezaei M, Sadeghi M, Korourian A, Tabarsi P, Porabdollah M, Askari E, et al. Comparative evaluation of SARS-CoV-2 IgG assays against nucleocapsid and spike antigens. Human Antibodies. 2021;29(2):109-13. DOI: https://doi.org/10.3233/HAB-210440
Awandu SS, Ochieng Ochieng A, Onyango B, Magwanga RO, Were P, Atieno Ochung’ A, et al. High seroprevalence of Immunoglobulin G (IgG) and IgM antibodies to SARS-CoV-2 in asymptomatic and symptomatic individuals amidst vaccination roll-out in western Kenya. PLOS ONE 2022L17(12):72751. DOI: https://doi.org/10.1371/journal.pone.0272751
Onifade AA, Fowotade A, Rahamon SK, Edem VF, Yaqub SA, Akande OK, et al. Seroprevalence of anti-SARS-CoV-2 specific antibodies in vaccinated and vaccine naïve adult Nigerians. PLOS ONE. 2023;18(1):80276. DOI: https://doi.org/10.1371/journal.pone.0280276
Aguilera X, González C, Apablaza M, Rubilar P, Icaza G, Ramírez-Santana M, et al. 2022. Immunization and SARS-CoV-2 antibody seroprevalence in a country with high vaccination coverage: lessons from chile. Vaccines. 2022;10(7):1002. DOI: https://doi.org/10.3390/vaccines10071002
Kajanova I, Lukacikova L, Jelenska L, Grossmannova K, Radikova Z, Vlcek M, Klempa B, et al. Seroprevalence of SARS-CoV-2 IgG antibodies in the staff of the Slovak Academy of Sciences in response to COVID-19 and/or vaccination: situation in August 2021. Acta Virologica. 2022;65(4):420–32. DOI: https://doi.org/10.4149/av_2021_407
Ben Houmich T, Tali A, Debbagh F, Lamrani Hanchi A, Soraa N. Seroprevalence of SARS-CoV-2 antibodies in vaccinated healthcare workers in Marrakech (Morocco). International J Immunopathol Pharmacol. 2022;5;36:3997. DOI: https://doi.org/10.1177/03946320221133697
Decarreaux D, Pouquet M, Souty C, Vilcu A-M, Prévot-Monsacre P, Fourié T, et al. 2022. Seroprevalence of SARS-CoV-2 IgG antibodies and factors associated with SARS-CoV-2 IgG neutralizing activity among primary health care workers 6 months after vaccination rollout in France. Viruses. 2022;14(5):957. DOI: https://doi.org/10.3390/v14050957
Elangovan D, Hussain SMS, Virudhunagar Muthuprakash S. Impact of COVID-19 vaccination on seroprevalence of SARS-CoV-2 among the health care workers in a tertiary care centre, South India. Vaccines 10(11):1967. DOI: https://doi.org/10.3390/vaccines10111967
Bielicki JA, Duval X, Gobat N, Goossens H, Koopmans M, Tacconelli E, et al. Monitoring approaches for health-care workers during the COVID-19 pandemic. Lancet. 2020;20(10):261-7. DOI: https://doi.org/10.1016/S1473-3099(20)30458-8
Kajanova I, Jelenska L, Lukacikova L, Grossmannova K, Belisova M, Istvanova N, et al. Influence of the SARS-CoV-2 Omicron (B. 1.1. 529) variant and booster vaccine doses on the seroprevalence of specific IgG antibodies in the staff of the Slovak Academy of Sciences. Acta Virologica. 2023;28;67:11637. DOI: https://doi.org/10.3389/av.2023.11637
Bayram A, Demirbakan H, Günel Karadeniz P, Erdoğan M, Koçer I. Quantitation of antibodies against SARS‐CoV‐2 spike protein after two doses of CoronaVac in healthcare workers. J Med Virol. 2021;93:5560‐7. DOI: https://doi.org/10.1002/jmv.27098
Hossain A, Nasrullah SM, Tasnim Z, Hasan MK, Hasan MM. Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis. EClinicalMedicine. 2021;1:33. DOI: https://doi.org/10.1016/j.eclinm.2021.100770
Çağlayan D, Süner AF, Şiyve N, Güzel I, Irmak Ç, Işik E, et al. An analysis of antibody response following the second dose of CoronaVac and humoral response after booster dose with BNT162b2 or CoronaVac among healthcare workers in Turkey. J Med Virol. 2022;94(5):2212-21. DOI: https://doi.org/10.1002/jmv.27620
Costa C, Migliore E, Galassi C, Scozzari G, Ciccone G, Coggiola M, et al. Factors influencing level and persistence of anti-SARS-CoV-2 IgG after BNT162b2 vaccine: evidence from a large cohort of healthcare workers. Vaccines. 2022;10(3):474. DOI: https://doi.org/10.3390/vaccines10030474
Nomura Y, Sawahata M, Nakamura Y, Kurihara M, Koike R, Katsube O, et al. Age and smoking predict antibody titers at 3 months after the second dose of the BNT162b2 COVID-19 vaccine. Vaccines. 2021;9(9):1042. DOI: https://doi.org/10.3390/vaccines9091042
Salvagno GL, Henry BM, Di Piazza G, Pighi L, De Nitto S, Bragantini D, et al. Anti-SARS-CoV-2 receptor-binding domain total antibodies response in seropositive and seronegative healthcare workers undergoing COVID-19 mRNA BNT162b2 vaccination. Diagnostics. 2021;11(5):832. DOI: https://doi.org/10.3390/diagnostics11050832
Damerau L, Mühlenbruch G, Evenschor-Ascheid A, Fussen C, Nienhaus A, Terschüren C, et al. Coronavirus vaccination: spike antibody levels in health workers after six months a cross-sectional study. International J Environ Res Public Health. 2022;9(18):11422. DOI: https://doi.org/10.3390/ijerph191811422
Vassilaki N, Gargalionis AN, Bletsa A, Papamichalopoulos N, Kontou E, Gkika M, et al. Impact of age and sex on antibody response following the second dose of COVID-19 BNT162b2 mRNA vaccine in Greek healthcare workers. Microorganisms. 2021;9(8):1725. DOI: https://doi.org/10.3390/microorganisms9081725
Robbiani DF, Gaebler C, Muecksch F, Lorenzi JC, Wang Z, Cho A, et al. Convergent antibody responses to SARS-CoV-2 in convalescent individuals. Nature. 2020;584(7821):437-42. DOI: https://doi.org/10.1038/s41586-020-2456-9
Ishaq SE, Abdulqadir SZ, Omar SA, Qadir MK, khdir Awla H, Rasul MF, et al. Comparative study of SARS-CoV-2 antibody titers between male and female COVID-19 patients living in Kurdistan region of Iraq. Gene Reports. 2021;25:101409. DOI: https://doi.org/10.1016/j.genrep.2021.101409
Pani A, Cento V, Vismara C. Antibody response to BNT162b vaccine is almost universal in health care workers. Results from the RENAISSANCE study: REsponse to BNT162b2 COVID-19 vaccine-short- and long-term immune response evaluation in healthcare workers. In Mayo Clin Proc. 2021;96(12):2966-79. DOI: https://doi.org/10.1016/j.mayocp.2021.08.013
Demonbreun AR, Sancilio A, Velez ME. COVID-19 mRNA Vaccination Generates Greater Immunoglobulin G Levels in Women Compared to Men. J Infect Dis. 2021;224(5):793–7. DOI: https://doi.org/10.1093/infdis/jiab314
Pang NYL, Pang ASR, Chow VT, Wang DY. Understanding neutralising antibodies against SARS-CoV-2 and their implications in clinical practice. Military Med Res. 2021;8(1):47. DOI: https://doi.org/10.1186/s40779-021-00342-3
Pellini R, Venuti A, Pimpinelli F. Initial observations on age, gender, BMI and hypertension in antibody responses to SARS-CoV-2 BNT162b2 vaccine. E Clin Med. 2021;36:100928. DOI: https://doi.org/10.1016/j.eclinm.2021.100928
Yalcin D, Bennett SJ, Sheehan J, Trauth AJ, Tso FY, West JT, et al. Longitudinal variations in antibody responses against SARS-CoV-2 spike epitopes upon serial vaccinations. International journal of molecular sciences. 2023;24(8):7292. DOI: https://doi.org/10.3390/ijms24087292
Kutsuna S, Asai Y, Matsunaga A, Kinoshita N, Terada M, Miyazato Y, et al. Factors associated with anti-SARS-CoV-2 IgG antibody production in patients convalescing from COVID-19. Journal of Infection and Chemotherapy. 2021;27(6):808-13. DOI: https://doi.org/10.1016/j.jiac.2021.01.006
Kusunoki H, Ohkusa M, Iida R, Saito A, Kawahara M, Ekawa K, et al. Longitudinal changes in IgG-type SARS-CoV-2 antibody titers after COVID-19 vaccination and a prominent increase in antibody titers when infected after vaccination. Vaccines. 2023;11(4):860. DOI: https://doi.org/10.3390/vaccines11040860
Fonseca MH, de Souza TD, de Carvalho Araújo FM, de Andrade LO. Dynamics of antibody response to CoronaVac vaccine. Journal of Medical Virology. 2022;94(5):2139-48. DOI: https://doi.org/10.1002/jmv.27604
Chiarella SE, Jenkins SM, Smith CY, Prasad V, Shakuntulla F, Ahluwalia V, et al. Predictors of seroconversion after coronavirus disease 2019 vaccination. Ann Allergy, Asthma Immunol. 2022;129(2):189-93. DOI: https://doi.org/10.1016/j.anai.2022.05.026
Malagón-Rojas J, Mercado-Reyes M, Toloza-Pérez YG, Galindo M, Palma RM, Catama J, et al. Comparison of anti-SARS-CoV-2 IgG antibody responses generated by the administration of Ad26. COV2. S, AZD1222, BNT162b2 or CoronaVac: longitudinal prospective cohort study in the Colombian population, 2021/2022. Vaccines. 2022;10(10):1609. DOI: https://doi.org/10.3390/vaccines10101609
Soeorg H, Jogi P, Naaber P, Ottas A, Toompere K, Lutsar I. Seroprevalence and levels of IgG antibodies after COVID-19 infection or vaccination. Infect Diseases. 2022;54(1):63-71. DOI: https://doi.org/10.1080/23744235.2021.1974540
Hiramoto S, Miyashita D, Kimura T. Serological Screening of Immunoglobulin G against SARS-CoV-2 Nucleocapsid and Spike Protein before and after Two Vaccine Doses among Healthcare Workers in Japan. Tohoku J Exp Med. 2022;257(1):57-64. DOI: https://doi.org/10.1620/tjem.2022.J017
Ebinger JE, Fert-Bober J, Printsev I, Wu M, Sun N, Prostko JC, et al. Antibody responses to the BNT162b2 mRNA vaccine in individuals previously infected with SARS-CoV-2. Nature Med. 2021;27(6):981-4. DOI: https://doi.org/10.1038/s41591-021-01325-6
Favresse J, Eucher C, Elsen M, Gillot C, Van Eeckhoudt S, Dogné JM, et al. Persistence of anti-SARS-CoV-2 antibodies depends on the analytical kit: a report for up to 10 months after infection. Microorganisms. 2021;9(3):556. DOI: https://doi.org/10.3390/microorganisms9030556
Van Elslande J, Weemaes M, Godderis L, Van Pottelbergh G, Bossuyt X, Vermeersch P. IgG anti-spike antibody levels in healthcare workers with and without prior COVID-19 up to 3 months after BNT162b2 vaccination. Diagnostic Microbiology and Infectious Disease. 2022;102(4):115638. DOI: https://doi.org/10.1016/j.diagmicrobio.2022.115638
Robertson LJ, Price R, Moore JS. IgG antibody production and persistence to 6 months following SARS-CoV-2 vaccination: A Northern Ireland observational study. Vaccine. 2022;40(18):2535-9. DOI: https://doi.org/10.1016/j.vaccine.2022.02.087
Kwetkat A, Heppner HJ. Comorbidities in the elderly and their possible influence on vaccine response. Interdis Gerontol Geriat. 2020;43:73-85. DOI: https://doi.org/10.1159/000504491
Huang CF, Jang TY, Wu PH, Kuo MC, Yeh ML, Wang CW, et al. Impact of comorbidities on the serological response to COVID-19 vaccination in a Taiwanese cohort. Virol J. 2023;20(1):112. DOI: https://doi.org/10.1186/s12985-023-02056-5
Robinson AV, Weaving G, Philips BJ, Eziefula AC, Shipman KE, Chevassut T. Real-world experience of SARS-CoV-2 antibody assays in UK healthcare workers. Clin Med. 2021;21(3):30. DOI: https://doi.org/10.7861/clinmed.2020.1007
Downloads
Published
How to Cite
Issue
Section
