Durability and Cross-Reactivity of SARS-CoV-2 mRNA Vaccine in Adolescent Children

The emergence of the Omicron variant has called into question the long-term efficacy of current vaccine platforms and dosing regimens in children. Therefore, immune responses from children across all pediatric age groups must be understood to optimize vaccination strategies with the goal of preventing infection and associated complications.

A study was conducted to quantify relative antibody responses in adolescent children immediately following the Pfizer-BioNTech mRNA vaccination and six months post-inoculation. Moreover, the efficacy of the humoral response against the D614G (“wild type”) SARS-CoV-2 and the latest variant of concern (VOC), Omicron was analyzed.

Seventy-seven children were enrolled in our study, with a median age of 14 years; sixty-eight children were between the ages of 12–15 years; nine were between the ages of 16–19 years. Ninety-five per cent of participants denied SARS-CoV-2 infection prior to enrollment and throughout the course of the study.

It was observed that after completion of a two-vaccine series, cross-reactivity against Omicron-specific receptor-binding domain (RBD) was seen. Interestingly, there was no increase in antibodies against Omicron RBD after the first vaccine dose but a significant increase in titers was seen following a second vaccine dose. However, there was a subsequent loss of all anti-SARS-CoV-2 antibody responses by six months. Evidence of waning mRNA-induced vaccine immunity underscores vulnerabilities in long-term pediatric protection against SARS-CoV-2 infection, while cross-reactivity highlights the additional benefits of vaccination.

In conclusion, adolescent children exhibit waning antibody immune responses six months post-mRNA vaccination. mRNA boosters will play a critical role in sustaining durable immune responses in adolescent children, while also reducing pediatric infection, severe illness, and transmission as we traverse the surges of the COVID-19 pandemic. Characterization of adolescent immune signatures post-vaccination will inform guidance on vaccine platforms and timelines, and ultimately optimize immunoprotection of children.

Content Source: BioRxiv


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