Achievement of sufficient antibody response after a fourth dose of wild-type SARS-CoV-2 mRNA vaccine in nursing home residents.

Publication date: Aug 01, 2023

Infection control during COVID-19 outbreaks in nursing facilities is a critical public health issue. Antibody responses before and after the fourth (second booster) dose of wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in nursing home residents have not been fully characterized. This study included 112 individuals: 54 nursing home residents (mean age: 84. 4 years; 35 SARS-CoV-2-naive and 19 previously infected) and 58 healthcare workers (mean age: 47. 7 years; 25 SARS-CoV-2-naive and 33 previously infected). Antispike and antinucleocapsid antibody responses to messenger RNA vaccination were evaluated using serum samples collected shortly and 5 months after the third dose, and shortly after the fourth dose. The median immunoglobulin G (IgG) level in SARS-CoV-2-naive residents was similar to that in SARS-CoV-2-naive healthcare workers after the fourth dose (24,026. 3 vs. 30,328. 6 AU/mL, p = . 79), whereas after the third dose the IgG level of SARS-CoV-2-naive residents was approximately twofold lower than that in SARS-CoV-2-naive healthcare workers. In residents with previous SARS-CoV-2 infection, timing of infection in relation to vaccination affected the kinetics of antibody responses. Residents infected after the third dose showed the highest IgG levels after the fourth dose among all groups (median: 64,328. 8 AU/mL), in contrast to residents infected before initiating vaccination with antibody levels similar to those of SARS-CoV-2-naive residents. Advanced aged nursing home residents, poor responders in the initial SARS-CoV-2 vaccine series, could achieve sufficient antibody responses after the fourth (second booster) vaccination, comparable to those of younger adults.

Concepts Keywords
Coronavirus Adult
Months Aged
Mrna Aged, 80 and over
Nursing Antibody Formation
antibody response
COVID-19 Vaccines
COVID-19 Vaccines
fourth vaccination
Immunoglobulin G
Immunoglobulin G
Middle Aged
mRNA Vaccine
nursing home residents
Nursing Homes
second booster


Type Source Name
disease VO dose
disease VO vaccine
disease MESH Infection
disease MESH COVID-19
disease VO Severe acute respiratory syndrome coronavirus 2
disease VO vaccination
pathway REACTOME SARS-CoV-2 Infection

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