Interdependencies of cellular and humoral immune responses in
heterologous and homologous SARS‑CoV‑2 vaccination
Abstract
Background: Homologous and heterologous SARS-CoV-2 vaccinations
yield different spike protein-directed humoral and cellular immune
responses. This study aimed to explore their currently unknown
interdependencies. Methods: COV-ADAPT is a prospective,
observational cohort study of 417 healthcare workers who received
vaccination with homologous ChAdOx1 nCoV-19, homologous BNT162b2 or with
heterologous ChAdOx1 nCoV-19/BNT162b2. We assessed humoral
(anti-spike-RBD-IgG, neutralizing antibodies, avidity) and cellular
(spike-induced T cell interferon‑γ release) immune responses in blood
samples up to 2 weeks before (T1) and 2 to 12 weeks following secondary
immunization (T2). Results: Initial vaccination with ChAdOx1
nCoV-19 resulted in lower anti-spike-RBD-IgG compared to BNT162b2
(70±114 vs. 226±279 BAU/ml, p<0.01) at T1. Booster vaccination
with BNT162b2 proved superior to ChAdOx1 nCoV-19 at T2
(anti-spike-RBD-IgG: ChAdOx1 nCoV-19/BNT162b2 2387±1627 and homologous
BNT162b2 3202±2184 vs. homologous ChAdOx1 nCoV-19 413±461 BAU/ml, both
p<0.001; spike-induced T cell interferon-γ release: ChAdOx1
nCoV-19/BNT162b2 5069±6733 and homologous BNT162b2 4880±7570 vs.
homologous ChAdOx1 nCoV-19 1152±2243 mIU/ml, both p<0.001). No
significant differences were detected between BNT162b2-boostered groups
at T2. For ChAdOx1 nCoV-19, no booster effect on T cell activation could
be observed. We found associations between anti-spike-RBD-IgG levels
(ChAdOx1 nCoV-19/BNT162b2 and homologous BNT162b2) and T cell responses
(homologous ChAdOx1 nCoV-19 and ChAdOx1 nCoV-19/BNT162b2) from T1 to T2.
Additionally, anti-spike-RBD-IgG and T cell response were linked at both
time points (all groups combined). All regimes yielded neutralizing
antibodies and increased antibody avidity at T2. Conclusions:
Interdependencies between humoral and cellular immune responses differ
between common SARS-CoV-2 vaccination regimes. T cell activation is
unlikely to compensate for poor humoral responses.