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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 6  |  Issue : 3  |  Page : 466-471

Evaluation of immunoglobulin G level among subjects vaccinated with different types of COVID-19 vaccines in the karbala population, Iraq


Department of Clinical Laboratories, College of Applied Medical Sciences, University of Kerbala, Karbala, Iraq

Date of Submission18-Jun-2022
Date of Acceptance14-Aug-2022
Date of Web Publication17-Sep-2022

Correspondence Address:
Rawaq Taleb Hassan
Department of Clinical Laboratories, College of Applied Medical Sciences, University of Kerbala, Karbala
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bbrj.bbrj_213_22

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  Abstract 


Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccines represent the only way in combating the COVID-19 pandemic. Studying the differences in immune response to different types of vaccines is considered an important tool for optimizing vaccine selection and dosage required. The aim of this study was to evaluate the immunoglobulin G (IgG) concentration following vaccination with Pfizer, AstraZeneca, and Sinopharm vaccines. A cross-sectional study was conducted between November 2021 and April 2022. Methods: A blood sample was obtained from 174 vaccinated persons, IgG levels were detected using the SARS-COV-2 IgG II Quant assay on the ARCHITECT I system. Statistical analysis used IBM SPSS VERSION 24 software. Quantitative results are indicated as mean ± standard deviation. The statistical significance level was set at P < 0.05. Results: Out of 60.3%, 33.9%, and 5.7% had received Pfizer, Sinopharm, and AstraZeneca vaccines, respectively. Ninety participants were men and 84 were women with ages ranging from 18 to 70 years. IgG concentrations were higher in participants vaccinated with Pfizer's vaccine. There were significant differences among the three types of vaccine within age groups. The mean IgG concentration was higher in male participants vaccinated with Pfizer and AstraZeneca. No significant variation was observed between the first and second doses for each type of the three vaccines. The IgG concentration for a vaccination with Pfizer varied significantly among the weeks after vaccination, the maximum concentration was seen between the 6th and 7th weeks. Conclusions: Participants vaccinated with the Pfizer vaccine produce the highest antibody concentration as compared to other vaccines, especially in male participants. Younger participants produce higher amount of antibody response.

Keywords: AstraZeneca, COVD-19 vaccine, immunoglobulin G concentration, Pfizer, Sinopharm


How to cite this article:
Hassan RT, Mohammed SH. Evaluation of immunoglobulin G level among subjects vaccinated with different types of COVID-19 vaccines in the karbala population, Iraq. Biomed Biotechnol Res J 2022;6:466-71

How to cite this URL:
Hassan RT, Mohammed SH. Evaluation of immunoglobulin G level among subjects vaccinated with different types of COVID-19 vaccines in the karbala population, Iraq. Biomed Biotechnol Res J [serial online] 2022 [cited 2022 Oct 5];6:466-71. Available from: https://www.bmbtrj.org/text.asp?2022/6/3/466/356155




  Introduction Top


Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is an emerging virus and considered a global public health concern, which requires a collaborative higher level of responsive measures from all countries.[1] The majority of virus-infected people suffer from a mild-to-severe respiratory illness and recover without the need for special treatment. The virus was rapidly spreading from its origins in Wuhan City, China, to the rest of the world. Hence, this virus proved to be disastrous as it affected a large population in the period of a few months.[2] Globally, there were approximately 554 million COVID-19 cases and 6.35 million fatalities as of July 7, 2022, and in Iraq, 2.44 million COVID-19 cases and 25,311 death.[3]

In a time never seen before, a variety of safe and efficient vaccines are now accessible. Depending on the platforms on which they were developed, vaccinations can be classified as either classical or new generation according to the most often used classification scheme.[4] Pfizer, AstraZeneca, and Sinopharm vaccines were the most significant and widely used in Iraq. The first messenger RNA (mRNA) vaccine, COMIRNATY (Pfizer/BioNTech), was created within a year of the WHO's pandemic statement. The BNT162b2 mRNA, which encodes the whole SARS-CoV-2 spike protein, was the active component. The mRNA vaccination serves as an adjuvant and antigen, which once inside the cell, triggers an immune response. The Oxford–AstraZeneca COVID-19 vaccine, on the other hand, utilized a replication-deficient chimpanzee adenovirus vector, which involved the removal of numerous significant genes in favor of a gene producing the spike protein. As a modified vector, the chimpanzee adenovirus ChAdOx1 was used.[5] Sinopharm, a state-owned Chinese business, is creating the Sinopharm/BIBP COVID-19 vaccine. These vaccines are based on the killed microorganisms and thus they are known as inactivated vaccines.[6] Its Contains viral particles and is administered to the body as a dead copy of SARS-CoV-2.[7] Thus, these vaccines are created using highly purified and noncontagious viruses.

The efficacy of the three types of vaccines ranged from 95% Pfizer-BioNTech vaccine 72% AstraZeneca vaccine, and 79% sinopharm vacane against symptomatic SARS-Cov-2 infection. In Iraq, the first type of vaccine introduced Baghdad was Sinopharm, On March 25, papa frag has received 336,000 doses of AstraZeneca. After receiving the COVID-19 vacane, It was immediately distributed across all departments of health in Baghdad and in all governorates including Kurdistan area to be used for protecting people within the priority groups according to the national vaccine deployment plan and framework. On December 1, 2021 - Over 2,9 million doses of the Pfizer COVID-19 vaccine arrived in Iraq.[8]

Despite impressive findings reported on the COVID-19 vaccine, there is still a lack of knowledge on the vaccination techniques that will be most effective in a given community.[9] The humoral immune response to vaccines varies greatly between individuals, and quantitative measurements of immunoglobulin G (IgG) (as a marker for humoral immune response) produced after vaccination in various individuals who received different types of vaccines may offer crucial information for updating vaccine development.

With the focus on several risk factors including age and sex, the objective of this study is to assess the humoral immune response among participants who have received various vaccines.


  Methods Top


A cross-sectional study was conducted in the College of Applied Medical Sciences at the University of Kerbala. From November 2021 to April 2022, blood samples were collected from people who had received the COVID vaccine. The participants' ages ranged from 18 to 70 years students of both sexes made up the majority. The information for each participant was documented according to the questionnaire form, which includes age, sex, type of vaccine taken, dose, and other information. Efforts have been made to avoid bias. The sample size has been arrived at using the sample size equation.[10] The SARS-CoV-2 IgG II Quant antibody test, which uses chemiluminescent microparticle immunoassay (CMIA) for the qualitative and quantitative measurement of IgG antibodies to SARS-COV-2 in human serum, was used to identify SARS-CoV-2 IgG levels.

IBM SPSS Version 24 (IBM Corp. Released 2016. IBM SPSS Statisties for Windows, version 24.0.Armonk,NY:IBM Corp) software was used for the statistical analysis of data. Quantitative results are indicated as mean ± standard deviation. The Pearson test was used for analyzing correlations between parameters. The statistical significance level was set at P < 0.05. ANOVA test and independent sample t-test was used to compare groups, and less significant differences (LSD) was calculated to analyze the presence of significant difference between the compared groups.


  Results Top


Serum samples were collected from 174 patients, from November 1, 2021, to April 2022 in Kerbala, Iraq. Most of the participants were medical students at Kerbala University. Fifty-nine (33.9%) of them received the Sinopharm vaccine, 105 (60.3%) received the Pfizer vaccine, and 10 (5.7%) received the AstraZeneca vaccine. The participants' ages ranged from 18 to 70 years, and they were divided into two groups: those under 25 years old (62.6%) and those over 25 years old (37.3%). Ninety participants (51.7%) were men and 84 (48.2%) were women. The sample was taken at various times and weeks. Some of the participants had received one dose (69, 39.6%), whereas the other part had received two doses (105, 60.3%) as shown in [Table 1].
Table 1: Demographic data

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Comparison of immunoglobulin G concentration among the three types of vaccines

As shown in [Table 2], comparing anti-spike (IgG) levels among the three types of vaccines revealed significant differences. AstraZeneca and Sinopharm vaccines had lower IgG concentrations as compared to Pfizer's vaccine.
Table 2: Comparison of IgG concentration among the three types of vaccines

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Differences in immunoglobulin G concentration according to age groups

The overall antibody concentration in participants under the age of 25 years was higher than that in people above the age of 25 years. There were significant differences among the three types of vaccine within both age groups, and the highest concentration was seen in participants vaccinated with Pfizer as shown in [Table 3]. Despite this, the current study does not observe any significant difference in IgG concentration between persons younger and older than 25 years who were vaccinated with Sinopharm and Pfizer vaccines, whereas there is a significant difference between the two age groups in participants vaccinated with the AstraZeneca vaccine.
Table 3: Differences in IgG concentration according to age groups

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Differences in immunoglobulin G concentration with sex

As shown in [Table 4], the current study revealed that there was a significant difference in IgG concentration among the three types of vaccines within male and female participants and the antibody production was higher in participants vaccinated with Pfizer. The mean of the IgG concentration was higher in males than in females in participants vaccinated with Pfizer and AstraZeneca. However, no significant difference was observed for each type of vaccine.
Table 4: Differences in IgG concentration with sex

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Differences in immunoglobulin G and interferon-gamma concentrations according to dose

There was no significant variation between the first and second dose in IgG concentration for each type of the three vaccines. However, there was a significant difference in IgG concentration between the Pfizer vaccine and Sinopharm for the first dose (all of the vaccinated participants with AstraZeneca had received two doses), and among the three types of vaccines in the second dose. The highest concentration was seen in the Pfizer vaccine as shown in [Table 5].
Table 5: Differences in IgG and interferon-gamma concentrations according to dose

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Differences in immunoglobulin G levels based on weeks after vaccination

The anti-spike IgG concentration for vaccination with Pfizer varied significantly among the weeks after vaccination, the concentration increases with weeks and the maximum concentration occurs between the 6th and 7th weeks and the lowest concentration occurs between the 10th and above weeks. The weeks after vaccination do not significantly differ for the Sinopharm and AstraZeneca vaccinations (number of participants vaccinated with AstraZeneca was low and had received the vaccine before a long period from this study). In addition, comparing the antibody levels and their presence for weeks after vaccination among the three types of vaccines revealed that they were significantly different and that the Pfizer vaccine had the highest level of antibody, as shown in [Table 6] and [Figure 1].
Table 6: Differences in immune response for vaccine within weeks

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Figure 1: Differences in IgG for vaccine within weeks. IgG: Immunoglobulin G

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Differences in immunoglobulin G concentrations based on sex and weeks after vaccination

[Figure 2] reflects that the antibody production appears to be higher in males than in females during the first 7 weeks after vaccination. However, females produce more antibodies than males after 7 weeks.
Figure 2: IgG level between male and female based on weeks after vaccination. IgG: Immunoglobulin G

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  Discussion Top


Humoral response against SARS-CoV-2 is one of the key aspects of understanding both viral clearance and vaccination effectiveness.[11] The current study was conducted to understand the variation in antibody level, if present, which formed against different types of vaccines available in Iraq, Pfizer, AstraZeneca, and Sinopharm.

Comparison of immunoglobulin G concentration among the three types of vaccines

Pfizer vaccine produces higher IgG concentrations as shown in [Table 2]. This result is in agreement with a previous study in which the author reported that the Pfizer-BioNTech vaccination produces greater antibody readings after a first dose than the Oxford–AstraZeneca vaccine.[12] In addition, other studies documented that a comparison of ChAdOx1 (Oxford–AstraZeneca) and BNT162b2 (Pfizer-BioNTech) revealed that the mRNA vaccine BNT162b2 induces a stronger humoral response than the adenovirus-based ChAdOx1 vaccine, both after the first and second doses.[13]

Differences in immunoglobulin G concentration according to age groups

A higher antibody concentration in younger participants than in older ones had been observed, as shown in [Table 3]. The result of the current study is in agreement with previous research showed that S1 IgG levels caused by BNT162b2 immunization decreased with age, with the maximum amounts seen in people between the ages of 12 and 19 years.[14] Furthermore, another study documented that the geometric mean concentration of anti-spike IgG was consistently lower in the older age group and declined following the second vaccination.[15] Elderly adults are also substantially more likely to have inadequate or no postvaccination humoral response, and the values of anti-SARS-CoV-2 antibodies after vaccination are higher than in the elderly.[16]

Differences in immunoglobulin G concentration with sex

Higher IgG concentration in males than in females was observed with Pfizer and AstraZeneca. However, no significant differences between sexes were observed for each type of vaccine as shown in [Table 4]. Similarly, in a previous study, the mean value for all types of vaccines Sinopharm, AstraZeneca, and Pfizer showed no significant differences in IgG for vaccinated males and females.[17] Inversely, a significant difference in IgG concentration between males and females was observed previously. The anti-spike-RBD IgG response was observed to be significantly more in females than in males after vaccination with BNT162b2.[18]

Differences of immunoglobulin G concentrations according to dose

No significant variation between the first and second doses was observed, as shown in [Table 5]. The highest concentration was seen in the Pfizer vaccine. The result of the current study is in agreement with other recent studies which found that the second dose of the vaccination did not improve humoral or cellular immune responses.[19] Another study stated that despite infected patients with COVID-19 showed robust humoral and antigen-specific responses to the first dose, these responses did not improve following the second dose of the vaccine.[20]

Differences in immunoglobulin G levels based on weeks after vaccination

The peak increase in IgG concentration occurs between the 6th and 7th weeks. The weeks after vaccination do not significantly differ for the Sinopharm and AstraZeneca vaccinations. In addition, comparing the antibody levels and their presence for weeks after vaccination among the three types of vaccines revealed that they were significantly different and that the Pfizer vaccine had the highest level of antibody, as shown in [Table 6].

In the line of the current study, the mean anti-RBD IgG was documented to be different among various vaccination types. Participants who received a third booster shot of the vaccination had the highest levels, followed by the Pfizer/BioNTech, AstraZeneca, and Sinopharm vaccines. The Pfizer vaccination group had the highest mean levels of anti-recepter binding doman (RBD) IgG antibodies after vaccination, but their levels began to decline after 60 days, in contrast to AstraZeneca and Sinopharm vaccine-induced antibodies, whose mean remained stable until 120 days but whose levels were significantly lower. The Sinopharm vaccination group suffered from the majority of breakthrough infections, which occurred at sporadic intervals for the three primary vaccine kinds.[21] Another study has documented that after 6 and 12 weeks after vaccination, the antibody levels decreased, pointing to a fading of the immunological response.[22] The Pfizer-BioNTech vaccine is about 90% effective against illnesses with high viral loads, per the manufacturer's specifications, but only 1 month after the second dosage. However, after 2 months and 3 months, this effectiveness falls to 85% and 78%, respectively. These statistics show a loss of several percentage points in the vaccine's protective abilities. In contrast, the Oxford–AstraZeneca vaccine's effectiveness dropped by only 6% points (the equivalent protection was 67%, 65%, and 61% over the same period). Consequently, this mRNA vaccine caused a rapid loss of antibodies in the first 6 months following the second dosage.[23]

Differences in immunoglobulin G concentrations based on sex and weeks after vaccination

[Figure 2] reflects that the antibody production appears to be higher in males during the 7 weeks from vaccination. However, females produce more antibodies than males after 7 weeks. Inversely, the evaluation of IgG between males and females showed that the levels of antibody increased in females in the first (3 weeks) and second (4 weeks and more) doses, and increase in IgG concentration after the second dose more than in females and decrease more than in males after 6 months from the second dose.[24] Importantly, these sex-based differences in humoral immunity contribute to variation in the responses to vaccines and may explain some disparities in vaccine efficacy between the sexes. Elevated humoral immunity in females compared with males is phylogenetically well-conserved, suggesting an adaptive advantage of elevated antibody for reproductive success, including for the transfer of protective antibodies to offspring (higher B-cell activity, including antibody production and activity of memory B-cells, in females, might improve vaccine efficacy in females compared with males.[25]


  Conclusions Top


Participants vaccinated with Pfizer vaccine produces the highest antibody concentration as compared to other vaccines where younger participants under the age of 25 years had higher antibody concentrations than older participants. The antibody production appears to be higher in males. The IgG level was significantly increased with weeks after vaccination with Pfizer and the maximum IgG concentration occurred between the 6th and 7th weeks, and the lowest concentration was between the 10th and above weeks.

Limitation of the study

Important limitations should be considered. The IgG concentration in each participant needs to be followed after vaccination of first and second doses. In addition, study factors that could be contributed to sex differences in immune response.

Ethics statement

This study was approved by the college of applied medical sciences. Serum sample collection was done after providing oral consent from participants.

Acknowledgment

We are grateful to all participants for generously participating in this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

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