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

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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 languageEnglish
Article number107
Journalnpj Vaccines
Issue number1
Publication statusPublished - 14 Jun 2024


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