Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;24(2):140-147.e2.
doi: 10.1016/j.jamda.2022.11.024. Epub 2022 Dec 7.

T-Cell Mediated Response after Primary and Booster SARS-CoV-2 Messenger RNA Vaccination in Nursing Home Residents

Collaborators, Affiliations
Free PMC article

T-Cell Mediated Response after Primary and Booster SARS-CoV-2 Messenger RNA Vaccination in Nursing Home Residents

Ilaria Schiavoni et al. J Am Med Dir Assoc. 2023 Feb.
Free PMC article

Abstract

Objectives: Nursing home (NH) residents have been significantly affected by the coronavirus disease 2019 (COVID-19) pandemic. Studies addressing the immune responses induced by COVID-19 vaccines in NH residents have documented a good postvaccination antibody response and the beneficial effect of a third booster vaccine dose. Less is known about vaccine-induced activation of cell-mediated immune response in frail older individuals in the long term. The aim of the present study is to monitor messenger RNA SARS-CoV-2 vaccine-induced T-cell responses in a sample of Italian NH residents who received primary vaccine series and a third booster dose and to assess the interaction between T-cell responses and humoral immunity.

Design: Longitudinal cohort study.

Setting and participants: Thirty-four residents vaccinated with BNT162b2 messenger RNA SARS-CoV-2 vaccine between February and April 2021 and who received a third BNT162b2 booster dose between October and November 2021 were assessed for vaccine-induced immunity 6 (prebooster) and 12 (postbooster) months after the first BNT162b2 vaccine dose.

Methods: Pre- and postbooster cell-mediated immunity was assessed by intracellular cytokine staining of peripheral blood mononuclear cells stimulated in vitro with peptides covering the immunodominant sequence of SARS-CoV-2 spike protein. The simultaneous production of interferon-γ, tumor necrosis factor-α, and interleukin-2 was measured. Humoral immunity was assessed in parallel by measuring serum concentration of antitrimeric spike IgG antibodies.

Results: Before the booster vaccination, 31 out of 34 NH residents had a positive cell-mediated immunity response to spike. Postbooster, 28 out of 34 had a positive response. Residents without a previous history of SARS-CoV-2 infection, who had a lower response prior the booster administration, showed a greater increase of T-cell responses after the vaccine booster dose. Humoral and cell-mediated immunity were, in part, correlated but only before booster vaccine administration.

Conclusions and implications: The administration of the booster vaccine dose restored spike-specific T-cell responses in SARS-CoV-2 naïve residents who responded poorly to the first immunization, while a previous SARS-CoV-2 infection had an impact on the magnitude of vaccine-induced cell-mediated immunity at earlier time points. Our findings imply the need for a continuous monitoring of the immune status of frail NH residents to adapt future SARS-CoV-2 vaccination strategies.

Keywords: COVID-19 vaccines; SARS-CoV-2; cell-mediated immunity; nursing homes; vaccine booster.

Figures

Fig. 1
Fig. 1
T-cell mediated immune response in NH residents 6 months (pre-booster, T6) and 12 months (postbooster, T12) after first immunization. (A) Frequencies of CD4 and CD8 T cells producing IFN-γ, TNF-α, and IL-2 in response to in vitro stimulation with spike. (B) Percentages of persons with nonresponding CD4+ and CD8+ T cells or producing 1 to 3 cytokines pre- and postbooster. Differences between median frequencies of cytokine positive T cells at T6 and T12 were calculated by the Wilcoxon test.
Fig. 2
Fig. 2
T-cell mediated immune response in NH residents with a history of SARS-CoV-2 infection 6 months (prebooster, T6) and 12 months (postbooster, T12) after first immunization. (A) Frequencies of CD4 and CD8 T cells producing IFN-γ, TNF-α, and IL-2 in response to spike. (B) Percentages of previously infected NH residents with nonresponding CD4+ and CD8+ T cells or producing 1 to 3 cytokines pre- and post-booster. Differences between median frequencies of cytokine positive T cells at T6 and T12 were calculated by the Wilcoxon test.
Fig. 3
Fig. 3
T-cell mediated immune response in SARS-CoV-2 naïve NH residents 6 months (prebooster, T6) and 12 months (postbooster, T12) after first immunization. (A) Frequencies of CD4 and CD8 T cells producing IFN-γ, TNF-α, and IL-2 in response to spike. (B) Percentages of SARS-CoV-2 naive NH residents with nonresponding CD4+ and CD8+ T cells or producing 1 to 3 cytokines pre- and postbooster. Differences between median frequencies of cytokine positive T cells at T6 and T12 were calculated by the Wilcoxon test.
Supplementary Fig. 1
Supplementary Fig. 1
Study design. Immune response to vaccination was assessed in a sample of 34 NH residents 6 and 12 months after the first SARS-CoV-2 vaccination (T6 and T12). A booster SARS-CoV-2 vaccine dose was administered to NH residents after blood sampling at T6. Mean follow-up time between booster dose and T12 assessment was 5 months.

Similar articles

References

    1. Mueller A.L., McNamara M.S., Sinclair D.A. Why does COVID-19 disproportionately affect older people? Aging. 2020;12:9959–9981. - PMC - PubMed
    1. Palmieri L., Vanacore N., Donfrancesco C., et al. Clinical characteristics of hospitalized individuals dying with COVID-19 by Age Group in Italy. J Gerontol A Biol Sci Med Sci. 2020;75:1796–1800. - PMC - PubMed
    1. Heckman G.A., Kay K., Morrison A., et al. Proceedings from an International virtual townhall: reflecting on the COVID-19 pandemic: themes from long-term care. J Am Med Dir Assoc. 2021;22:1128–1132. - PMC - PubMed
    1. Fisman D.N., Bogoch I., Lapointe-Shaw L., McCready J., Tuite A.R. Risk factors associated with mortality among residents with coronavirus disease 2019 (COVID-19) in long-term care facilities in Ontario, Canada. JAMA Netw Open. 2020;3:e2015957. - PMC - PubMed
    1. Malara A., Noale M., Abbatecola A.M., et al. GeroCovid LTCFs Working Group Clinical features of SARS-CoV-2 infection in italian long-term care facilities: GeroCovid LTCFs Observational Study. J Am Med Dir Assoc. 2022;23:15–18. - PMC - PubMed