Evaluation of the humoral immune response to primary and booster covid-19 vaccination
DOI:
https://doi.org/10.21527/2176-7114.2026.51.16883Palavras-chave:
COVID-19, SARS-CoV-2, antibodies, Immunoglobulin G, COVID-19 VaccinesResumo
This study aimed to evaluate the efficacy of the primary and booster vaccination response against COVID-19. This prospective cohort study was conducted in the Archipelago of Fernando de Noronha (Pernambuco, Brazil). A total of 350 adults (≥18 years), with and without previous SARS-CoV-2 infection, were included. Data collection occurred between May 2020 and May 2022. Serum levels of anti-SARS-CoV-2 IgG were evaluated before vaccination (T0), after the primary vaccination schedule with homologous vaccines (CoronaVac or ChAdOx1 – AstraZeneca/Oxford-Fiocruz), and after the heterologous booster dose with BNT162b2 (Pfizer-BioNTech). Detection of IgG antibodies was performed using a chemiluminescent immunoassay. Data were analyzed using GraphPad Prism 9.0 and SPSS 18.0 software, applying the Mann-Whitney and Sidak tests for longitudinal comparisons (p < 0.05). Participants were divided into two groups according to previous SARS-CoV-2 infection: infected (G1; n = 81) and not infected (G2; n = 269). In both groups, anti-SARS-CoV-2 IgG levels significantly increased after the primary vaccination scheme compared with pre-vaccination levels (p < 0.05). In G1, anti-SARS-CoV-2 IgG levels reduced after an interval between 14 and 30 days. After the booster dose with BNT162b2, anti-SARS-CoV-2 IgG levels increased and kept high for 233 days after vaccination. The decline in antibody levels observed after the primary vaccination with two homologous doses reinforces the need for a heterologous booster dose to maintain the humoral immune response.
Referências
1. World Health Organization (WHO). Timeline of WHO’s response to COVID-19. Geneva: WHO; 2020 [Accessed 2023 Nov 22]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline
2. World Health Organization (WHO). WHO Director-General’s opening remarks at the media briefing on COVID-19 – 21 December 2020. Geneva: WHO; 2020 [Accessed 2023 Nov 22]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---21-december-2020
3. World Health Organization (WHO). WHO COVID-19 dashboard. Geneva: WHO; 2023 [Accessed 2023 Nov 22]. Available from: https://covid19.who.int/region/amro/country/br
4. Bonanni P, Cantón R, Gill D, Halfon P, Liebert UG, Crespo KA, et al. The role of serology testing to strengthen vaccination initiatives and policies for COVID-19 in Europe. COVID. 2021;1(1):20–38. https://doi.org/10.3390/covid1010004
5. Min L, Sun Q. Antibodies and vaccines target RBD of SARS-CoV-2. Front Mol Biosci. 2021;8:671633. https://doi.org/10.3389/fmolb.2021.671633
6. World Health Organization (WHO). Update 34 – What we know about the COVID-19 immune response: the latest on COVID-19 immunity & the current global situation. Geneva: WHO; 2020 [Accessed 2023 Nov 22]. Available from: https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-34-immunity-2nd.pdf?sfvrsn=8a488cb6_2
7. Decru B, Van Elslande J, Steels S, Van Pottelbergh G, Godderis L, Van Holm B, et al. IgG anti-spike antibodies and surrogate neutralizing antibody levels decline faster 3 to 10 months after BNT162b2 vaccination than after SARS-CoV-2 infection in healthcare workers. Front Immunol. 2022;13:909910. https://doi.org/10.3389/fimmu.2022.909910
8. Havervall S, Jernbom Falk A, Klingström J, Ng H, Greilert-Norin N, Gabrielsson L, et al. SARS-CoV-2 induces a durable and antigen-specific humoral immunity after asymptomatic to mild COVID-19 infection. PLoS One. 2022;17(1):e0262169. https://doi.org/10.1371/journal.pone.0262169
9. Mahase E. COVID-19: vaccine brands can be mixed in “extremely rare occasions,” says Public Health England. BMJ. 2021;372:n12. https://doi.org/10.1136/bmj.n12
10. Lu S. Heterologous prime–boost vaccination. Curr Opin Immunol. 2009;21:346–51. https://doi.org/10.1016/j.coi.2009.05.016
11. Yue L, Zhou J, Zhou Y, Yang X, Xie T, Yang M, et al. Antibody response elicited by a third boost dose of inactivated SARS-CoV-2 vaccine can neutralize SARS-CoV-2 variants of concern. Emerg Microbes Infect. 2021;10:2125–7. https://doi.org/10.1080/22221751.2021.1996210
12. Munro AP, Janani L, Cornelius V, Aley PK, Babbage G, Baxter D, et al. Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomised, controlled, phase 2 trial. Lancet. 2021;398(10318):2258–76. https://doi.org/10.1016/S0140-6736(21)02717-3
13. Munro AP, Feng S, Janani L, Cornelius V, Aley PK, Babbage G, et al. Safety, immunogenicity, and reactogenicity of BNT162b2 and mRNA-1273 COVID-19 vaccines given as fourth-dose boosters following two doses of ChAdOx1 nCoV-19 or BNT162b2 and a third dose of BNT162b2 (COV-BOOST): a multicentre, blinded, phase 2, randomised trial. Lancet Infect Dis. 2022;22(8):1131–41. https://doi.org/10.1016/S1473-3099(22)00271-7
14. Lustig Y, Sapir E, Regev-Yochay G, Cohen C, Fluss R, Olmer L, et al. BNT162b2 COVID-19 vaccine and correlates of humoral immune responses and dynamics: a prospective, single-centre, longitudinal cohort study in healthcare workers. Lancet Respir Med. 2021;9(9):999–1009. https://doi.org/10.1016/S2213-2600(21)00220-4
15. Franzese M, Coppola L, Silva R, Santini SA, Cinquanta L, Ottomano C, et al. SARS-CoV-2 antibody responses before and after a third dose of the BNT162b2 vaccine in Italian healthcare workers aged ≤60 years: one year of surveillance. Front Immunol. 2022;13:947187. https://doi.org/10.3389/fimmu.2022.947187
16. Voysey M, Clemens SA, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al. Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials. Lancet. 2021;397:881–91. https://doi.org/10.1016/S0140-6736(21)00432-3
17. Clemens SA, Weckx L, Clemens R, Mendes AV, Souza AR, Silveira MB, et al. Heterologous versus homologous COVID-19 booster vaccination in previous recipients of two doses of CoronaVac COVID-19 vaccine in Brazil (RHH-001): a phase 4, non-inferiority, single-blind, randomised study. Lancet. 2022;399:521–9. https://doi.org/10.1016/S0140-6736(22)00094-0
18. Hayashi JY, Simizo A, Miyamoto JG, Costa LV, Souza OF, Chiarelli T, et al. Humoral and cellular responses to vaccination with homologous CoronaVac or ChAdOx1 and heterologous third dose with BNT162b2. J Infect. 2022;84(6):834–72. https://doi.org/10.1016/j.jinf.2022.02.026
19. Instituto Brasileiro de Geografia e Estatística (IBGE). Estimativas da população 2020. Rio de Janeiro: IBGE; 2020 [Accessed 2023 Apr 26]. Available from: https://ftp.ibge.gov.br/Estimativas_de_Populacao/Estimativas_2020/estimativa_dou_2020.pdf
20. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Imunização e Doenças Transmissíveis. Coordenação-Geral do Programa Nacional de Imunizações. Plano nacional de operacionalização da vacinação contra a COVID-19. 2ª ed. Brasília: Ministério da Saúde; 2021 [Accessed 2023 Nov 22]. Available from: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/coronavirus/plano-nacional-de-operacionalizacao-da-vacinacao-contra-a-covid-19-pno-2a-edicao-com-isbn/view
21. Abbott Laboratories. Abbott ARCHITECT SARS-CoV-2 IgG II Quant reagent instructions for use. Abbott Park (IL): Abbott; 2022 [Accessed 2023 Nov 26]. Available from: https://www.corelaboratory.abbott/int/en/offerings/segments/infectious-disease/sars-cov-2.html
22. Lo Sasso B, Giglio RV, Vidali M, Scazzone C, Bivona G, Gambino CM, et al. Evaluation of anti–SARS-CoV-2 S-RBD IgG antibodies after COVID-19 mRNA BNT162b2 vaccine. Diagnostics. 2021;11(7):1135. https://doi.org/10.3390/diagnostics11071135
23. Yalçın TY, Topçu Dİ, Doğan Ö, Aydın S, Sarı N, Erol Ç, et al. Immunogenicity after two doses of inactivated virus vaccine in healthcare workers with and without previous COVID-19 infection: prospective observational study. J Med Virol. 2022;94:279–86. https://doi.org/10.1002/jmv.27316
24. Mak WA, Koeleman JG, van der Vliet M, Keuren F, Ong DS. SARS-CoV-2 antibody and T cell responses one year after COVID-19 and the booster effect of vaccination: a prospective cohort study. J Infect. 2022;84(2):171–8. https://doi.org/10.1016/j.jinf.2021.12.003
25. Sharif N, Alzahrani KJ, Ahmed SN, Dey SK. Efficacy, immunogenicity and safety of COVID-19 vaccines: a systematic review and meta-analysis. Front Immunol. 2021;12:714170. https://doi.org/10.3389/fimmu.2021.714170
26. Santos-Filho A, Vieira L, Lima A. COVID-19: imunidade natural e vacinal. In: Secretaria de Saúde de Goiás, editor. Síntese de evidências CONECTA-SUS. Goiânia: Gerência de Informações Estratégicas em Saúde; 2022 [Accessed 2023 Nov 22]. Available from: https://www.saude.go.gov.br/files/banner_coronavirus/protocolos-notas/S%C3%ADnteses%20de%20Evid%C3%AAncias/2021/Imunidade%20Natural%20e%20Vacinal.pdf
27. Callaway E. COVID vaccine boosters: the most important questions. Nature. 2021;596:178–80. https://doi.org/10.1038/d41586-021-02158-6
28. Benotmane I, Gautier G, Perrin P, Olagne J, Cognard N, Fafi-Kremer S, et al. Antibody response after a third dose of the mRNA-1273 SARS-CoV-2 vaccine in kidney transplant recipients with minimal serologic response to two doses. JAMA. 2021;326:1063–5. https://doi.org/10.1001/jama.2021.12339
29. Sales MJ, Kerr LR, Brizolara RV, Barreto IC, de Almeida RL, Angeiras PS, et al. Fernando de Noronha: how an island controlled the community transmission of COVID-19 in Brazil. medRxiv. 2020;2020-10. https://doi.org/10.1101/2020.10.22.20216010
30. Instituto Brasileiro de Geografia e Estatística (IBGE). Estatísticas das cidades: Fernando de Noronha, PE. Rio de Janeiro: IBGE; 2019 [Accessed 2023 Feb 22]. Available from: https://cidades.ibge.gov.br/brasil/pe/fernando-de-noronha/panorama
31. Costa PR, Correia CA, Marmorato MP, de Carvalho Dias JZ, Thomazella MV, da Silva AC, et al. Humoral and cellular immune responses to CoronaVac assessed up to one year after vaccination. medRxiv. 2022. https://doi.org/10.1101/2022.03.16.22272513
32. Michos A, Tatsi EB, Filippatos F, Dellis C, Koukou D, Efthymiou V, et al. Association of total and neutralizing SARS-CoV-2 spike-receptor binding domain antibodies with epidemiological and clinical characteristics after immunization with the 1st and 2nd doses of the BNT162b2 vaccine. Vaccine. 2021;39:5963–7. https://doi.org/10.1016/j.vaccine.2021.07.067
33. Trougakos IP, Terpos E, Zirou C, Sklirou AD, Apostolakou F, Gumeni S, et al. Comparative kinetics of SARS-CoV-2 anti-spike protein RBD IgGs and neutralizing antibodies in convalescent and naïve recipients of the BNT162b2 mRNA vaccine versus COVID-19 patients. BMC Med. 2021;19:90. https://doi.org/10.1186/s12916-021-02090-6
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Mozart Julio Tabosa Sales, Leuridan Cavalcante Torres, José Roberto da Silva Junior, Amanda Carolina Félix Cavalcanti de Abreu, Caio César Arruda da Silva, Ehidee Isabel Gomez La Rotta, Gabriel Duarte Muniz de Possidio Marques, Guilherme Barros Alves de Carvalho, Patrícia Silveira Rodrigues
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Ao publicar na Revista Contexto & Saúde, os autores concordam com os seguintes termos:
Os trabalhos seguem a licença Creative Commons Atribuição 4.0 Internacional (CC BY 4.0), que permite:
Compartilhar — copiar e redistribuir o material em qualquer meio ou formato;
Adaptar — remixar, transformar e criar a partir do material para qualquer fim, inclusive comercial.
Essas permissões são irrevogáveis, desde que respeitados os seguintes termos:
Atribuição — os autores devem ser devidamente creditados, com link para a licença e indicação de eventuais alterações realizadas.
Sem restrições adicionais — não podem ser aplicadas condições legais ou tecnológicas que restrinjam o uso permitido pela licença.
Avisos:
A licença não se aplica a elementos em domínio público ou cobertos por exceções legais.
A licença não garante todos os direitos necessários para usos específicos (ex.: direitos de imagem, privacidade ou morais).
A revista não se responsabiliza pelas opiniões expressas nos artigos, que são de exclusiva responsabilidade dos autores. O Editor, com o apoio do Comitê Editorial, reserva-se o direito de sugerir ou solicitar modificações quando necessário.
Somente serão aceitos artigos científicos originais, com resultados de pesquisas de interesse que não tenham sido publicados nem submetidos simultaneamente a outro periódico com o mesmo objetivo.
A menção a marcas comerciais ou produtos específicos destina-se apenas à identificação, sem qualquer vínculo promocional por parte dos autores ou da revista.
Contrato de Licença (para artigos publicados a partir de setembro/2025): Os autores mantém os direitos autorais sobre seu artigo, e concedem à Revista Contexto & Saúde o direito de primeira publicação.
