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Limited and Short-Lasting Virus Neutralizing Titers Induced by Inactivated SARS-CoV-2 Vaccine
Author affiliations: Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand (T. Hunsawong, S. Fernandez, K. Rungrojchareonkit, J. Lohachanakul, R. Suthangkornkul, K. Tayong, A.T. Huang, C. Klungthong, P. Chinnawirotpisan, Y. Poolpanichupatam, A.R. Jones, E.D. Lombardini); Ministry of Public Health, Nonthaburi, Thailand (R. Buathong); Ministry of Public Health, Samut Sakhon Province, Samut Sakhon, Thailand (N. Khadthasrima); Thai Red Cross Emerging Infectious Diseases Clinical Center, Bangkok (S. Wacharapluesadee); Chulalongkorn University Faculty of Medicine, Bangkok (O. Putcharoen)
In vitro determination of severe acute respiratory syndrome coronavirus 2 neutralizing antibodies induced in serum samples from recipients of the CoronaVac vaccine showed a short protection period against the original virus strain and limited protection against variants of concern. These data provide support for vaccine boosters, especially variants of concern circulate.
Circulation of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants capable of evading vaccine-derived protection is challenging the efficacy of coronavirus disease (COVID-19) vaccines (1). The inactivated SARS-CoV-2 vaccine CoronaVac (Sinovac Biotech, http://www.sinovac.com), 1 of 2 COVID-19 vaccines licensed in Thailand, has been widely administered to health care workers. Clinical studies show CoronaVac efficacy against symptomatic COVID-19 ranging from 51% (Brazil) to 65.9% (Chile) and 100% against severe illness and illness requiring hospitalization (2,3). However, data on CoronaVac efficacy against variants of concern are very limited. Our study was approved by the Research Ethics Review Committee, Faculty of Medicine, Chulalongkorn University (Bangkok, Thailand) and recorded in the Thai Clinical Trial Registry (TCTR20210325003). Investigators adhered to U.S. Department of Defense AR 70–25 policies for protection of human subjects.
For this study, we enrolled 207 health care workers in Thailand who were fully vaccinated with 2 doses of CoronaVac (0.5 mL/dose, 2–4 wk between doses); all had received their first dose during February 22–March 12, 2021. Median age was 39 (interquartile range 30–51) years of age; 103 (49.6%) were men. Among study participants, 58 (28%) provided blood samples only at baseline (when the first dose was administered), 93 (44.0%) both at baseline and 2–3 weeks after the second dose, and 56 (27.0%) at baseline and at 2–3 weeks and 10–12 weeks after the second dose. Using an in vitro system (Appendix), we evaluated the ability of the serum of CoronaVac recipients to neutralize SARS-CoV-2. We measured circulating serum neutralizing antibodies to the original SARS-CoV-2 Wuhan, China, strain by using a cPass receptor binding domain antigen-based surrogate virus neutralization test (sVNT) ELISA (GeneScript, https://www.genscript.com) (4) and using a microneutralization assay (MNA) (5) for SARS-CoV-2 Wuhan strain and Alpha, Beta, and Delta neutralizing antibodies. Seroconversion rates for CoronaVac-vaccinated participants, determined by sVNT ELISA using 30% inhibition as cutoff, were 85.2% (78.2% mean inhibition level) at 2–3 weeks and 35% (25.4% mean inhibition level) at 10–12 weeks. The MNA seropositivity cutoff was set at ≥50%.
At 2–3 weeks after the second dose, 61.1% (91/149) of participants were seropositive against the Wuhan strain, 35.6% (53/149) against Alpha variant, 3.4% (5/149) against Beta, and 8.7% (13/149) against Delta (Figure). Mean neutralizing rate at 2–3 weeks was 49.3% (95% CI 44.9%–53.6%) against Wuhan strain, 40.9% (95% CI 37.8%–43.9%) against Alpha variant, 9.0% (95% CI 6.1%–11.8%) against Beta, and 10.8% (95% CI 7.1%–14.5%) against Delta. At 10–12 weeks after the second dose, the proportion of seropositive participants fell to 50% (28/56) against Wuhan strain and was significantly reduced (p < 0.001) to 17.9% (10/56) against Alpha variant, 1.8% (1/56) against Beta, and 1.8% (1/56) against Delta. Mean neutralizing rates at 10–12 weeks were 48.0% (95% CI 39.9%–56.1%) against Wuhan strain, 21.8% (95% CI 37.8%–43.9%) against Alpha variant, 1.2% (95% CI 3.5%–8.8%) against Beta, and 1.0% (95% CI 2.9%–7.5%) against Delta.
Comparing sVNT ELISA results between the 2 time points, Wuhan strain antibodies appear to have a half-life of 83.4 days (95% CI 76.6–90.3 days). However, when the MNA was used, neutralizing antibodies waned in a time- and variant-dependent manner. The half-life of neutralizing antibodies was as low as 47.2 days (95% CI 37.5–56.9 days) for Wuhan strain, 38.6 days (95% CI 31.2–45.9 days) for Alpha variant, 6.9 days (95% CI 3.2–10.6 days) for Beta, and 12.3 days (95% CI 6.8–17.8 days) for Delta (Table). These data indicate additional short-term coronavirus disease protection, including limited protection against variants of concern, and support administering vaccine boosters, especially where these variants circulate.
Dr. Hunsawong is a research scientist in the Department of Virology of the US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences in Bangkok, Thailand. Her research interests include host-immune response to arbovirus and respiratory virus infections, vaccine development and anti-viral drug testing.
Our sincere thanks to all participants in this study.
We also thank Bassam Hallis, Alex Sigal, and Tulio de Oliveira of BEI resources of the National Institute of Allergy and Infectious Diseases, National Institutes of Health, who provided SARS–CoV–2 Wuhan virus, and Alpha and Beta variants. Research was supported by NIH/NIAID award no. U01AI151797 and National Research Council of Thailand award no. N35A640037.
Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (award no. U01AI151797). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also partially funded by National Research Council of Thailand under Award Number N35A640037.
Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation or publication. The opinions or assertions contained herein are the private views of the authors, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense. The investigators have adhered to the policies for protection of human subjects as prescribed in AR 70–25.
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Suggested citation for this article: Hunsawong T, Fernandez S, Buathong R, Khadthasrima N, Rungrojchareonkit K, Lohachanakul J, et al. Limited protection of inactivated SARS-CoV-2 vaccine against Wuhan strain and variants of concern. Emerg Infect Dis. 2021 Dec [date cited]. https://doi.org/10.3201/eid2712.211772
Original Publication Date: September 24, 2021
Page created: September 16, 2021
Page updated: October 07, 2021
Page reviewed: October 07, 2021
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