The Francis Crick Institute
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Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes

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journal contribution
posted on 2023-02-07, 11:25 authored by G Tut, T Lancaster, M Krutikov, P Sylla, D Bone, E Spalkova, C Bentley, U Amin, A Jadir, S Hulme, N Kaur, E Tut, R Bruton, MY Wu, R Harvey, EJ Carr, B Clayton, S Namjou, V Silva, M Poulten, P Bawumia, M Miah, S Sade, M Miranda, T Taylor, I D'angelo, M Cabrera Jarana, M Rahman, J Abreu, S Sandhar, N Bailey, S Caidan, M Caulfield, M Wu, L Adams, C Kavanagh, S Warchal, C Sawyer, M Gavrielides, J Kandasamy, K Ambrose, A Strange, T Abiola, N O'Reilly, P Hobson, A Agua-Doce, E Russell, A Riddell, S Kjaer, A Borg, C Roustan, C Queval, R Ulferts, C Swanton, S Gandhi, S Gamblin, R Beale, O Stirrup, M Shrotri, B Azmi, C Fuller, V Baynton, A Irwin-Singer, A Hayward, A Copas, L Shallcross, P Moss
Third-dose coronavirus disease 2019 vaccines are being deployed widely but their efficacy has not been assessed adequately in vulnerable older people who exhibit suboptimal responses after primary vaccination series. This observational study, which was carried out by the VIVALDI study based in England, looked at spike-specific immune responses in 341 staff and residents in long-term care facilities who received an mRNA vaccine following dual primary series vaccination with BNT162b2 or ChAdOx1. Third-dose vaccination strongly increased antibody responses with preferential relative enhancement in older people and was required to elicit neutralization of Omicron. Cellular immune responses were also enhanced with strong cross-reactive recognition of Omicron. However, antibody titers fell 21–78% within 100 d after vaccine and 27% of participants developed a breakthrough Omicron infection. These findings reveal strong immunogenicity of a third vaccine in one of the most vulnerable population groups and endorse an approach for widespread delivery across this population. Ongoing assessment will be required to determine the stability of immune protection.


Crick (Grant ID: CC2087, Grant title: Beale CC2087) Crick (Grant ID: CC2060, Grant title: Gamblin CC2060) Crick (Grant ID: CC2041, Grant title: Swanton CC2041) Crick (Grant ID: CC1062, Grant title: STP Flow Cytometry) Crick (Grant ID: CC1071, Grant title: STP High Throughput Screening) Crick (Grant ID: 10013, Grant title: STP Peptide Chemistry) Crick (Grant ID: CC1119, Grant title: STP Scientific Computing) Crick (Grant ID: CC1068, Grant title: STP Structural Biology) Crick (Grant ID: CC1109, Grant title: STP BRF)