Journal
CLINICAL INFECTIOUS DISEASES
Volume 74, Issue 4, Pages 734-742Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciab646
Keywords
natural infection; neutralizing antibodies; SARS-CoV-2 variants; vaccination
Categories
Funding
- National Science Fund for Distinguished Young Scholars [81525023]
- National Science and Technology Major project of China [2018ZX10201001-010]
- US National Institutes of Health [R01 AI135115]
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Emerging SARS-CoV-2 variants pose a threat to immunity, with varying reductions in neutralizing antibody titers. Vaccines induce neutralizing antibodies that can effectively neutralize the newer variants, but with significant reductions in neutralizing titers.
Recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may pose a threat to immunity. A systematic landscape of neutralizing antibodies against emerging variants is needed. We systematically searched for studies that evaluated neutralizing antibody titers induced by previous infection or vaccination against SARS-CoV-2 variants and collected individual data. We identified 106 studies meeting the eligibility criteria. Lineage B.1.351 (beta), P.1 (gamma) and B.1.617.2 (delta) significantly escaped natural infection-mediated neutralization, with an average of 4.1-fold (95% confidence interval [CI]: 3.6-4.7-fold), 1.8-fold (1.4-2.4-fold), and 3.2-fold (2.4-4.1-fold) reduction in live virus neutralization assay, while neutralizing titers against B.1.1.7 (alpha) decreased slightly (1.4-fold [95% CI: 1.2-1.6-fold]). Serum from vaccinees also led to significant reductions in neutralization of B.1.351 across different platforms, with an average of 7.1-fold (95% CI: 5.5-9.0-fold) for nonreplicating vector platform, 4.1-fold (3.7-4.4-fold) for messenger RNA platform, and 2.5-fold (1.7-2.9-fold) for protein subunit platform. Neutralizing antibody levels induced by messenger RNA vaccines against SARS-CoV-2 variants were similar to, or higher, than that derived from naturally infected individuals. Antibody response established by infection or vaccination might enable effectively neutralize B.1.1.7 (alpha), but with large reductions in neutralizing titers against B.1.351 (beta), B.1.617.2 (delta) and P.1 (gamma). Standardized protocols for neutralization assays and updated prevention and treatment are needed.
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