Legends
Figure 1: Level of anti-Spike IgG antibodies (A ) and (B ) presence of SARS-CoV-2 neutralizing antibodies (NA) in sera from healthy individuals (blue, controls) and in patients receiving drugs that inhibit tumor necrosis factor (red, anti-TNF). The horizontal lines indicate the cut-off values of the IgG enzyme immunoassay (25 BAU/ml) and virus neutralization assay (reciprocal titer >10), respectively. Where appropriate, the geometric mean and standard deviation of virus-neutralizing antibody titers were calculated. Individual samples were collected on the day of the fourth or fifth SARS-CoV-2 vaccination (0 days, empty triangle and circles) and one week later (7 days, filled triangle and circles). Details of the vaccination schedule used are provided in Table 1. Titers were determined with a Vero cell-based virus neutralization assay using a member of the 2020 lineage B.1.513, and previous or current SARS-CoV-2 variants Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (BA.1.17.2, BA.2, BA.5.2.1, BQ.1.1.1, XBB.1.5) as antigens. These strains were isolated by us under BSL-3 conditions from patient material and characterized by whole genome sequencing. The x-fold increase in geometric mean titer between day 0 and day 7 is shown in green for anti-TNF patients. In addition, the x-fold decrease (รท) in geometric mean titers between controls and anti-TNF patients is reported for day 7 after booster vaccination. Anti-nucleoprotein IgG was detected in one subject in the control group, indicating that she had undergone SARS-CoV-2 infection. Her results are therefore presented separately (blue triangle) and not included in the calculation of the geometric mean titer of the control group.
Table 1: Characteristics of four patients treated with anti-tumor necrosis factor (TNF) agents and three healthy control subjects. All individuals are female. Previous SARS-CoV-2 vaccinations are indicated in order of application. Sera were collected on the day of a booster vaccination with mRNA vaccine adapted to Omicron BA.4 and BA.5 and 7 days later. IgG avidity was measured by immunoblot. Based on the comparison of band intensities of the avidity reagent-treated sample with the untreated sample, IgG avidity is classified as low, medium, and high. The intensity ratios measured are also listed. The presence of anti-nucleoprotein IgG (data not shown) in the immunoblot of subject #5 indicates that she had COVID-19. Abbreviations: messenger RNA-based SARS-CoV-2 vaccines, BNT162b2 and mRNA-1273; replication-deficient chimpanzee adenoviral vector containing the SARS-CoV-2 spike protein, ChAdOx1; healthy control, HC; Rheumatoid arthritis, RA; receptor-binding domain of the spike protein, RBD; subunit 1 of the spike protein, S1; wild type, wt.