The Journal of infectious diseases · 2025
Estimated US Trends in SARS-CoV-2 Spike Antibody Concentrations and Correlation to Risk of First-Time Infections Based on Blood Donations, 2022.
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Jones Jefferson M, Grebe Eduard, Lartey Isaac, Stone Mars, Spencer Bryan R, Akinseye Akitunde, Molina Manrique Irene, Fink Rebecca V, Green Valerie, Saa Paula, Biggerstaff Brad J, Coughlin Melissa M, Briggs-Hagen Melissa, Lanteri Marion C, Opsomer Jean, Wright David J, Busch Michael P
Аннотация
BACKGROUND: By the end of 2021 in the United States, spike (S) antibody seroprevalence from coronavirus disease 2019 (COVID-19) vaccination, infection, or both (hybrid immunity) reached over 90%. With high seroprevalence, quantitative antibody concentrations are needed to characterize population immunity. We measured quantitative S antibody concentrations in a national blood donor cohort and evaluated their correlation with protection against infection.
METHODS: One blood specimen per quarter in 2022 was tested for quantitative S immunoglobulin G (IgG) and infection-induced (nucleocapsid [N]) total Ig antibodies from a national blood donor cohort of 106 969 people. Median S antibody concentrations were calculated by quarter and by history of vaccination and infection. Among vaccinated donors without N antibodies, protection (measured as 1 minus hazard ratios compared with unvaccinated donors) against N antibody seroconversion was estimated by S antibody concentration. Median S antibody levels were compared using the Kruskal-Wallis tests.
RESULTS: Median S antibody concentrations increased from 1380 binding antibody units (BAU)/mL in quarter 1 of 2022 to 1720 BAU/mL in quarter 4 of 2022. In quarter 4, S antibody levels were lowest in the infection-only group (median, 75 BAU/mL) and higher in the vaccine-only group (median, 1950 BAU/mL) and hybrid immunity group (median, 2550 BAU/mL). Protection against first-time infection increased with higher antibody concentrations; 5010 BAU/mL (95% confidence interval, 4120-6550 BAU/mL) was associated with 50% protection.
DISCUSSION: During 2022, this nationwide study showed mildly increased S IgG concentrations over time among blood donors. Vaccination and hybrid immunity resulted in higher antibody concentrations than infection alone. Higher antibody concentrations were associated with increased protection from infection.
METHODS: One blood specimen per quarter in 2022 was tested for quantitative S immunoglobulin G (IgG) and infection-induced (nucleocapsid [N]) total Ig antibodies from a national blood donor cohort of 106 969 people. Median S antibody concentrations were calculated by quarter and by history of vaccination and infection. Among vaccinated donors without N antibodies, protection (measured as 1 minus hazard ratios compared with unvaccinated donors) against N antibody seroconversion was estimated by S antibody concentration. Median S antibody levels were compared using the Kruskal-Wallis tests.
RESULTS: Median S antibody concentrations increased from 1380 binding antibody units (BAU)/mL in quarter 1 of 2022 to 1720 BAU/mL in quarter 4 of 2022. In quarter 4, S antibody levels were lowest in the infection-only group (median, 75 BAU/mL) and higher in the vaccine-only group (median, 1950 BAU/mL) and hybrid immunity group (median, 2550 BAU/mL). Protection against first-time infection increased with higher antibody concentrations; 5010 BAU/mL (95% confidence interval, 4120-6550 BAU/mL) was associated with 50% protection.
DISCUSSION: During 2022, this nationwide study showed mildly increased S IgG concentrations over time among blood donors. Vaccination and hybrid immunity resulted in higher antibody concentrations than infection alone. Higher antibody concentrations were associated with increased protection from infection.