Initial COVID-19 Vaccination is Highly Immunogenic and Safe: A Stop the
Spread Ottawa Cohort Analysis
Abstract
INTRODUCTION: Predictors of COVID-19 vaccine immunogenicity and the
influence of prior SARS-CoV-2 infection require elucidation. METHODS:
Stop the Spread Ottawa is a prospective cohort of individuals at-risk
for or who have been infected with SARS-CoV-2, initially enrolled for 10
months beginning October 2020. This analysis focuses on safety and
immunogenicity of the initial two doses of COVID-19 vaccine. RESULTS:
Post-vaccination data with blood specimens were available for 930
participants. 22.8% were SARS-CoV2 infected prior to first vaccine
dose. Cohort characteristics include: median age 44 (22, 56), 66.6%
female, 89.0% white, 83.2% employed. 38.1% reported two or more
comorbidities and 30.8% reported immune compromising condition(s). Over
95% possessed IgG spike and RBD titres 3 months post second vaccine
dose. By multivariable analysis, increasing age and high-level immune
compromise predicted diminishing IgG spike and RBD titres at month 3
post second dose. IgG spike and RBD titres were higher immediately post
vaccination in those with SARS-CoV-2 infection prior to first
vaccination and spike titres were higher at 6 months in those with wider
time intervals between dose 1 and 2. IgG spike and RBD titres and
neutralization were generally similar by sex, weight and whether
receiving homogeneous or heterogeneous combinations of vaccines. Common
post dose 1 vaccine symptoms included fatigue (64.7%), injection site
pain (47.5%), headache (27.2%), fever/chills (26.2%), body aches
(25.3%). These symptoms are similar with subsequent doses. CONCLUSION:
The initial two COVID-19 vaccine doses are safe, well-tolerated and
highly immunogenic across a broad spectrum of vaccine recipients.