Functional Antibody Responses to Severe Acute Respiratory Syndrome Coronavirus 2 Variants in Children With Coronavirus Disease 2019, Multisystem Inflammatory Syndrome in Children, and After Two Doses of BNT162b2 Vaccination
JOURNAL OF INFECTIOUS DISEASES(2022)
Abstract
Background Although neutralizing antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) correlate with protection against coronavirus disease 2019 (COVID-19), little is known about the neutralizing and antibody-dependent cell-mediated cytotoxicity (ADCC) responses to COVID-19, multisystem inflammatory syndrome in children (MIS-C), and COVID-19 vaccination in children. Methods We enrolled children 0-21 years of age with a history of COVID-19 (n = 13), MIS-C (n = 13), or 2 doses of BNT162b2 vaccination (n = 14) into a phlebotomy protocol. We measured pseudovirus neutralizing and functional ADCC antibodies to SARS-CoV-2 variants, including Omicron (B.1.1.529). Results The primary BNT162b2 vaccination series elicited higher neutralizing and ADCC responses with greater breadth to SARS-CoV-2 variants than COVID-19 or MIS-C, although these were diminished against Omicron. Conclusions Serologic responses were significantly reduced against variants, particularly Omicron. Binding, neutralizing, and antibody-dependent cell-mediated cytotoxicity (ADCC) responses against SARS-CoV-2 variants including Omicron (B.1.1.529) were assessed in children with MIS-C, convalescing from COVID-19, and after BNT162b2 vaccination. Vaccination elicited greater and broader responses against variants than COVID-19 or MIS-C.
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Key words
ADCC, COVID, MIS-C, SARS-CoV-2, pediatric
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