Omicron infection enhances Delta antibody immunity in vaccinated persons

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  • Khadija Khan
  • Farina Karim
  • Sandile Cele
  • Kajal Reedoy
  • James Emmanuel San
  • Gila Lustig
  • Houriiyah Tegally
  • Yuval Rosenberg
  • Mallory Bernstein
  • Zesuliwe Jule
  • Yashica Ganga
  • Nokuthula Ngcobo
  • Matilda Mazibuko
  • Ntombifuthi Mthabela
  • Zoey Mhlane
  • Nikiwe Mbatha
  • Yoliswa Miya
  • Jennifer Giandhari
  • Yajna Ramphal
  • Taryn Naidoo
  • Aida Sivro
  • Natasha Samsunder
  • Ayesha B.M. Kharsany
  • Daniel Amoako
  • Jinal N. Bhiman
  • Nithendra Manickchund
  • Quarraisha Abdool Karim
  • Nombulelo Magula
  • Salim S. Abdool Karim
  • Glenda Gray
  • Willem Hanekom
  • Anne von Gottberg
  • Rohen Harrichandparsad
  • Kobus Herbst
  • Prakash Jeena
  • Thandeka Khoza
  • Kløverpris, Henrik Nyhus
  • Alasdair Leslie
  • Rajhmun Madansein
  • Mohlopheni Marakalala
  • Mosa Moshabela
  • Kogie Naidoo
  • Zaza Ndhlovu
  • Thumbi Ndung’u
  • Kennedy Nyamande
  • Vinod Patel
  • Theresa Smit
  • Adrie Steyn
  • Emily Wong
  • Ron Milo
  • COMMIT-KZN Team

The extent to which Omicron infection1–9, with or without previous vaccination, elicits protection against the previously dominant Delta (B.1.617.2) variant is unclear. Here we measured the neutralization capacity against variants of severe acute respiratory syndrome coronavirus 2 in 39 individuals in South Africa infected with the Omicron sublineage BA.1 starting at a median of 6 (interquartile range 3–9) days post symptom onset and continuing until last follow-up sample available, a median of 23 (interquartile range 19–27) days post symptoms to allow BA.1-elicited neutralizing immunity time to develop. Fifteen participants were vaccinated with Pfizer's BNT162b2 or Johnson & Johnson's Ad26.CoV2.S and had BA.1 breakthrough infections, and 24 were unvaccinated. BA.1 neutralization increased from a geometric mean 50% focus reduction neutralization test titre of 42 at enrolment to 575 at the last follow-up time point (13.6-fold) in vaccinated participants and from 46 to 272 (6.0-fold) in unvaccinated participants. Delta virus neutralization also increased, from 192 to 1,091 (5.7-fold) in vaccinated participants and from 28 to 91 (3.0-fold) in unvaccinated participants. At the last time point, unvaccinated individuals infected with BA.1 had low absolute levels of neutralization for the non-BA.1 viruses and 2.2-fold lower BA.1 neutralization, 12.0-fold lower Delta neutralization, 9.6-fold lower Beta variant neutralization, 17.9-fold lower ancestral virus neutralization and 4.8-fold lower Omicron sublineage BA.2 neutralization relative to vaccinated individuals infected with BA.1. These results indicate that hybrid immunity formed by vaccination and Omicron BA.1 infection should be protective against Delta and other variants. By contrast, infection with Omicron BA.1 alone offers limited cross-protection despite moderate enhancement.

Original languageEnglish
JournalNature
Volume607
Issue number7918
Pages (from-to)356-359
Number of pages4
ISSN0028-0836
DOIs
Publication statusPublished - 2022

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