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Study Suggests Lasting Immunity After COVID-19,

With a Big Boost From Vaccination
Jennifer Abbasi

A
fter an infection with SARS-CoV-2, tions. Only 10% had been hospitalized • Compared with unvaccinated par-
most people—even those with for their illness during the prior year. Since ticipants, those who had received at
mild infections—appear to have then, 41% had received at least 1 dose least 1 dose had higher plasma anti-RBD
some protection against the virus for at of an mRNA vaccine an average of 40 antibodies and a nearly 50-fold increase
least a year, a recent follow-up study of days before the 12-month follow-up visit. in neutralizing activity. According to
recovered patients published in Nature All tested negative for SARS-CoV-2 at Nussenzweig, vaccination boosts the
suggests. What’s more, this and other the follow-up. memory antibodies that develop after in-
research demonstrates that vaccinating fection, producing an “outstanding re-
these individuals substantially enhances sponse.” In this group, neutralizing anti-
their immune response and confers strong body levels against the variants surpassed
resistance against variants of concern, the levels observed against the wild-type
including the B.1.617.2 (delta) variant. virus in infected or fully vaccinated indi-
viduals in other studies. Additional re-
The Backstory search supports this. Two teams, in North
Michel Nussenzweig, MD, PhD, and col- America and the UK, recently published
leagues previously characterized im- studies in Science demonstrating that a
munity in a group of recovered adult single dose of an mRNA vaccine substan-
patients about 1 month and 6 months tially enhances the immune response to
after their COVID-19 symptoms began. SARS-CoV-2 variants among patients with
Some of the study participants returned a prior infection—a phenomenon some are
in February or March for a 12-month calling “hybrid immunity.”
follow-up blood draw. “We wanted to un-
derstand how immunity evolves after What About the Delta Variant?
infection,” Nussenzweig, who heads In early July, the World Health Organiza-
The Rockefeller University’s Laboratory of tion forecast that the delta variant, origi-
Molecular Immunology, wrote in an email. What We’ve Learned nally detected in India, was poised to soon
Nussenzweig’s team found that antibodies outcompete other variants globally. A
Who They Studied against SARS-CoV-2 continue to evolve up to recent study by researchers in France, also
The initial study included 149 participants a year after infection. Vaccines improve the published in Nature, included an analysis
who were considered recovered from immune response. of recovered patients’ immunity against
COVID-19. Individuals were not eligible if they • Compared with 6 months prior, par- the highly transmissible variant.
had any of the following within the previ- ticipants who were not vaccinated Unvaccinated health care workers
ous 2 weeks: maintained most of their plasma anti- appeared to have less protection against
• Chronic shortness of breath or fatigue bodies against the virus’s receptor bind- the delta and beta variants compared with
• Deficit in athletic ability ing domain (RBD) and their plasma alpha about a year after they recovered
• Three or more long-term symptoms, such had similar neutralizing activity against from mild COVID-19. While 88% of this
as persistent unexplained fever, chest pain, a nonreplicating virus engineered with group had neutralizing antibodies against
or loss of taste or smell the SARS-CoV-2 spike protein. Their alpha, only 47% neutralized delta.
The participants’ infections either had memory B cells that produce anti-RBD However, recovered health care
been verified with polymerase chain reac- antibodies were only slightly lower in workers who had received 1 dose of the
tion (PCR) testing or suspected based on number than at the previous visit and AstraZeneca, Pfizer, or Moderna vaccines had
symptoms and close contact with a person had evolved to produce a broader a marked increase in neutralizing antibody
with a confirmed infection. and more potent range of antibodies. levels against all 3 of these variants com-
Of the original cohort, 87 individuals However, their plasma had less neutraliz- pared with their unvaccinated peers.
returned for the 6-month follow-up ing activity against the variants B.1.1.7 “Vaccination of convalescent individuals
and 63 came back for the 12-month visit. (alpha), B.1.351 (beta), B.1.526 (iota), and boosted the humoral immune response
The latter participants—the subject of the P.1 (gamma), with the greatest loss of [against delta] well above the threshold of
most recent study—were aged 26 to 73 activity against the beta variant first neutralization,” the authors wrote. “These re-
years and had had relatively mild infec- detected in South Africa. sults strongly suggest that vaccination of

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According to Rachel Presti, MD, PhD,

a coauthor of the study, her team’s findings
suggest that the mRNA vaccine likely gen-
erates a fairly durable and broad response,
although she cautioned that further evi-
dence is needed to confirm these implica-
tions. “Unless COVID mutates enough to
really escape the immune response, I don’t
think we will need boosters soon,” Presti, an
associate professor in the Division of Infec-
tious Diseases at the Washington Univer-
sity School of Medicine in St Louis, wrote in
an email.
Nussenzweig said he believes immu-
nized people who weren’t previously in-
fected will need boosters at some point, but
it’s unknown how soon that will be. In the
study from France, such individuals had high
neutralizing antibody levels against the al-
pha, beta, and delta variants 8 to 16 weeks af-
previously infected individuals will be most not previously infected had a surprisingly ter they received a 2-dose vaccine regimen.
likely protective against a large array of circu- high number of SARS-CoV-2 spike protein–
lating viral strains, including variant [d]elta.” targeting B cells in the germinal centers of The Clinical Takeaway
their lymph nodes, where these cells are Nussenzweig predicted that variants will not
What About Vaccination Alone? trained to produce and perfect antibodies. cause serious illness in most people who have
Nussenzweig said an open question is how Some of the antibodies generated from recovered from COVID-19. Nevertheless, he
long immunity lasts after vaccination the B cells cross-reacted with seasonal said,theyshouldbevaccinated“becausethey
alone. One recent study found that at least betacoronaviruses or bound to unique become bulletproof when they do so.”
12 weeks after their second dose of regions of the virus’s spike protein, the sci- Note: Source references are available through
Pfizer’s mRNA vaccine, people who were entists reported in Nature. embedded hyperlinks in the article text online.
Michael Siluk/Education Images/UIG/sciencesource.com

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