Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland

Calum Macdonald; Norah Palmateer; Andrew McAuley; Laura Lindsay; Taimoor Hasan; Safraj Shahul Hameed; Elliot Hall; Karen Jeffrey; Zoë Grange; Petros Gousias; Sally Mavin; Lisa Jarvis; J. Claire Cameron; Luke Daines; Holly Tibble; Colin R. Simpson; Colin McCowan; Srinivasa Vittal Katikireddi; Igor Rudan; Adeniyi Francis Fagbamigbe; Lewis Ritchie; Ben Swallow; Paul Moss; Chris Robertson; Aziz Sheikh; Josie Murray

doi:10.1038/s41541-024-00898-w

Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland

Calum Macdonald^*, Norah Palmateer^*, Andrew McAuley, Laura Lindsay, Taimoor Hasan, Safraj Shahul Hameed, Elliot Hall, Karen Jeffrey, Zoë Grange, Petros Gousias, Sally Mavin, Lisa Jarvis, J. Claire Cameron, Luke Daines, Holly Tibble, Colin R. Simpson, Colin McCowan, Srinivasa Vittal Katikireddi, Igor Rudan, Adeniyi Francis FagbamigbeLewis Ritchie, Ben Swallow, Paul Moss, Chris Robertson, Aziz Sheikh, Josie Murray

^*Corresponding author for this work

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Abstract

Several population-level studies have described individual clinical risk factors associated with suboptimal antibody responses following COVID-19 vaccination, but none have examined multimorbidity. Others have shown that suboptimal post-vaccination responses offer reduced protection to subsequent SARS-CoV-2 infection; however, the level of protection from COVID-19 hospitalisation/death remains unconfirmed. We use national Scottish datasets to investigate the association between multimorbidity and testing antibody-negative, examining the correlation between antibody levels and subsequent COVID-19 hospitalisation/death among double-vaccinated individuals. We found that individuals with multimorbidity ( ≥ five conditions) were more likely to test antibody-negative post-vaccination and 13.37 [6.05–29.53] times more likely to be hospitalised/die from COVID-19 than individuals without conditions. We also show a dose-dependent association between post-vaccination antibody levels and COVID-19 hospitalisation or death, with those with undetectable antibody levels at a significantly higher risk (HR 9.21 [95% CI 4.63–18.29]) of these serious outcomes compared to those with high antibody levels.

Original language	English
Article number	107
Number of pages	12
Journal	NPJ vaccines
Volume	9
Issue number	1
DOIs	https://doi.org/10.1038/s41541-024-00898-w
Publication status	Published - 14 Jun 2024

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Macdonald, C., Palmateer, N., McAuley, A., Lindsay, L., Hasan, T., Hameed, S. S., Hall, E., Jeffrey, K., Grange, Z., Gousias, P., Mavin, S., Jarvis, L., Cameron, J. C., Daines, L., Tibble, H., Simpson, C. R., McCowan, C., Katikireddi, S. V., Rudan, I., ... Murray, J. (2024). Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland. NPJ vaccines, 9(1), Article 107. https://doi.org/10.1038/s41541-024-00898-w

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title = "Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland",

abstract = "Several population-level studies have described individual clinical risk factors associated with suboptimal antibody responses following COVID-19 vaccination, but none have examined multimorbidity. Others have shown that suboptimal post-vaccination responses offer reduced protection to subsequent SARS-CoV-2 infection; however, the level of protection from COVID-19 hospitalisation/death remains unconfirmed. We use national Scottish datasets to investigate the association between multimorbidity and testing antibody-negative, examining the correlation between antibody levels and subsequent COVID-19 hospitalisation/death among double-vaccinated individuals. We found that individuals with multimorbidity ( ≥ five conditions) were more likely to test antibody-negative post-vaccination and 13.37 [6.05–29.53] times more likely to be hospitalised/die from COVID-19 than individuals without conditions. We also show a dose-dependent association between post-vaccination antibody levels and COVID-19 hospitalisation or death, with those with undetectable antibody levels at a significantly higher risk (HR 9.21 [95% CI 4.63–18.29]) of these serious outcomes compared to those with high antibody levels.",

author = "Calum Macdonald and Norah Palmateer and Andrew McAuley and Laura Lindsay and Taimoor Hasan and Hameed, {Safraj Shahul} and Elliot Hall and Karen Jeffrey and Zo{\"e} Grange and Petros Gousias and Sally Mavin and Lisa Jarvis and Cameron, {J. Claire} and Luke Daines and Holly Tibble and Simpson, {Colin R.} and Colin McCowan and Katikireddi, {Srinivasa Vittal} and Igor Rudan and Fagbamigbe, {Adeniyi Francis} and Lewis Ritchie and Ben Swallow and Paul Moss and Chris Robertson and Aziz Sheikh and Josie Murray",

year = "2024",

month = jun,

day = "14",

doi = "10.1038/s41541-024-00898-w",

language = "English",

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Macdonald, C, Palmateer, N, McAuley, A, Lindsay, L, Hasan, T, Hameed, SS, Hall, E, Jeffrey, K, Grange, Z, Gousias, P, Mavin, S, Jarvis, L, Cameron, JC, Daines, L, Tibble, H, Simpson, CR, McCowan, C, Katikireddi, SV, Rudan, I, Fagbamigbe, AF, Ritchie, L, Swallow, B, Moss, P, Robertson, C, Sheikh, A & Murray, J 2024, 'Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland', NPJ vaccines, vol. 9, no. 1, 107. https://doi.org/10.1038/s41541-024-00898-w

TY - JOUR

T1 - Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland

AU - Macdonald, Calum

AU - Palmateer, Norah

AU - McAuley, Andrew

AU - Lindsay, Laura

AU - Hasan, Taimoor

AU - Hameed, Safraj Shahul

AU - Hall, Elliot

AU - Jeffrey, Karen

AU - Grange, Zoë

AU - Gousias, Petros

AU - Mavin, Sally

AU - Jarvis, Lisa

AU - Cameron, J. Claire

AU - Daines, Luke

AU - Tibble, Holly

AU - Simpson, Colin R.

AU - McCowan, Colin

AU - Katikireddi, Srinivasa Vittal

AU - Rudan, Igor

AU - Fagbamigbe, Adeniyi Francis

AU - Ritchie, Lewis

AU - Swallow, Ben

AU - Moss, Paul

AU - Robertson, Chris

AU - Sheikh, Aziz

AU - Murray, Josie

PY - 2024/6/14

Y1 - 2024/6/14

N2 - Several population-level studies have described individual clinical risk factors associated with suboptimal antibody responses following COVID-19 vaccination, but none have examined multimorbidity. Others have shown that suboptimal post-vaccination responses offer reduced protection to subsequent SARS-CoV-2 infection; however, the level of protection from COVID-19 hospitalisation/death remains unconfirmed. We use national Scottish datasets to investigate the association between multimorbidity and testing antibody-negative, examining the correlation between antibody levels and subsequent COVID-19 hospitalisation/death among double-vaccinated individuals. We found that individuals with multimorbidity ( ≥ five conditions) were more likely to test antibody-negative post-vaccination and 13.37 [6.05–29.53] times more likely to be hospitalised/die from COVID-19 than individuals without conditions. We also show a dose-dependent association between post-vaccination antibody levels and COVID-19 hospitalisation or death, with those with undetectable antibody levels at a significantly higher risk (HR 9.21 [95% CI 4.63–18.29]) of these serious outcomes compared to those with high antibody levels.

AB - Several population-level studies have described individual clinical risk factors associated with suboptimal antibody responses following COVID-19 vaccination, but none have examined multimorbidity. Others have shown that suboptimal post-vaccination responses offer reduced protection to subsequent SARS-CoV-2 infection; however, the level of protection from COVID-19 hospitalisation/death remains unconfirmed. We use national Scottish datasets to investigate the association between multimorbidity and testing antibody-negative, examining the correlation between antibody levels and subsequent COVID-19 hospitalisation/death among double-vaccinated individuals. We found that individuals with multimorbidity ( ≥ five conditions) were more likely to test antibody-negative post-vaccination and 13.37 [6.05–29.53] times more likely to be hospitalised/die from COVID-19 than individuals without conditions. We also show a dose-dependent association between post-vaccination antibody levels and COVID-19 hospitalisation or death, with those with undetectable antibody levels at a significantly higher risk (HR 9.21 [95% CI 4.63–18.29]) of these serious outcomes compared to those with high antibody levels.

U2 - 10.1038/s41541-024-00898-w

DO - 10.1038/s41541-024-00898-w

M3 - Article

SN - 2059-0105

VL - 9

JO - NPJ vaccines

JF - NPJ vaccines

IS - 1

M1 - 107

ER -

Association between antibody responses post-vaccination and severe COVID-19 outcomes in Scotland

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