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ORIGINAL
Immune response evaluation after Sputnik V vaccination inSari healthcare population
Ahmad Najafi1, 2, Hossien Jalali2, 3, Yousef Noshi2, Mehrad Mahdavi2, and Mohammad Reza Mahdavi Amiri2, 3Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran, 2Sinayemehr Research Center,Mazandaran University of Medical Sciences, Sari, Iran, 3Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran Universityof Medical Sciences, Sari, Mazandaran, Iran1

Abstract : Background and objective : Generally, protection against SARS-CoV-2 was assessed by the measurement of antibody titers against spike protein and receptor binding domain “RBD”. Many global efforts lead todevelopment of several vaccines based on various strategies. The aim of the present study was to evaluate theefficacy of Sputnik V vaccine among Sari healthcare staff population, Iran. Methods : Seventy-nine health professional staffs that were vaccinated with two doses of Sputnik V vaccine were selected. The Immune response
against spike and RBD proteins was evaluated by ELISA assays 3-4 weeks after second dose of vaccine injection.
Results : The results showed the antibody titers were raised after vaccination. Data analysis has also demonstrated that the efficacy of vaccine was not related to age, gender and previous infection of SARS-CoV-2. Conclusion : Sputnik V vaccine can lead to a protective response against COVID-19 infection in high percentage of thepopulation. J. Med. Invest. 70 : 317-320, August, 2023
Keywords : SARS-CoV-2, Sputnik V vaccine, Anti-Spike, Anti-RBD, Neutralizing Ab

INTRODUCTION
The Severe Acute Respiratory Syndrome Coronavirus 2“SARS-CoV-2” has been recently caused a human pandemic ofcoronavirus disease since 2019 “COVID-19” (1). Although mostinfected patients showed mild symptoms, around 10% had severe symptoms including dyspnea, high respiratory rate, and low
blood oxygen saturation which can even lead to death becauseof respiratory or multiple organs failure (2). There is currently
no specific treatment for the disease and thus the patients aretreated with supportive care (1).
Among the coronaviruses structural proteins, the Spike (S)and the Nucleocapsid (N) proteins have been introduced as
the main immunogens (3-5). Similar to other coronaviruses,
the entrance of SARS-CoV-2 into host cells is mediated by thetransmembrane spike (S) glycoprotein that forms prominent
homotrimers protruding from the viral surface (4). The S protein
is comprised of one : an S1 subunit, recognizes host cell receptors(and is divided into A, B, C, and D domains), and two : an S2 subunit that promotes fusion of the viral and cellular membranes toinitiate the infection. The SARS-CoV-2 S domain B (so-called receptor-binding domain or RBD) binds to angiotensin-converting
enzyme 2 (ACE2) that serves as an entry receptor. The molecular mechanism of RDB attachment to ACE2 have been recently
unveiled and it is the main target of neutralizing Abs (nAbs)
applied in therapeutic and vaccine design efforts (5). Commercial
SARS-CoV-2 serological assays that detect antibodies specificto these viral proteins / domains have become now commerciallyavailable. Up to now, several vaccines have been introduced
using various technologies such as mRNA, recombinant protein,adenoviral vector, and inactivated virus-based platforms but
Received for publication July 12, 2021 ; accepted November 24, 2021.
Address correspondence and reprint requests to Mohammad Reza
Mahdavi Amiri, Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari,
Mazandaran, Iran and Fax : +981133292929.

there is little evidence to determine what proportion of patients
produce antibodies after vaccination and how long they can protect the recipients against a new infection. Therefore, the goalof the present was to evaluate the response of anti-Spike, anti-RBD, and Neutralizing antibodies after Sputnik V vaccinationin Sari healthcare staffs population, Iran.

MATERIAL & METHODSPatients and Controls

In this study seventy-nine people (Healthcare staffs form
Mazandaran University of Medical Sciences) (49 males) thatwere vaccinated with the Sputnik V vaccine were selected to include the study. The participant’s age was between 22-75 years.
All participants have no underlying disease such as diabetes
mellitus, chronic kidney disease “CKD”, cardiovascular disease“CVD”, malignancy or a history of pulmonary involvement suchas tuberculosis, chronic obstructive pulmonary disease “COPD”
The serum samples were taken 3-4 weeks after second dose ofvaccination.
Participants were divided into four subgroup according to age( > 50, < 50), gender (male, female), previous infection of COVID19 (infected and non-infected), and severity of disease (mild1,moderate2 , severe3). Analysis was done to find the relationshipbetween vaccine efficacy and age, gender, previous infection of
COVID-19 and severity of the disease.

Laboratory measurements
The anti-spike IgG and anti-RBD IgG enzyme link immune
sorbent assays “ELISA” (14002-Pishtazteb) were carried out toassess the immune response and the Neutralization test wasperformed by competitive ELISA (14002-Pishtazteb).

1
2
3

PCR positive without typical symptom
PCR positive with taking medicine
PCR positive with hospitalization

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Statistical analysis
Data was analyzed using unpaired T and Mann-Whitney Utests. A two-sided p value of < 0.05 was regarded as statisticallysignificant.

RESULT
Seventy-nine healthcare staffs that received the two dose of
the Sputnik V COVID-19 vaccine were selected. The medianage of the participants was 51 years that 44.3% of them over 50
years old. 62% of the precipitants were males. 24% of participant
had previous experience of SARS-CoV-2 infection that according
to the severity of the disease were divided into 3 groups, 10.1%
mild, 6.3% moderate, and 7.6% severe (Table 1). The mean Abtiters against spike and RBD were significantly high. Theseresults demonstrated that the Sputnik V vaccine leads to a protective immunity against SARS-CoV-2.
The results of neutralizing antibody showed that administration of the Sputnik V vaccine caused production of neutralizing
antibody in 88.6% of the participants. (Fig 1b, 2b, 3b, 3d). So
neutralizing results in plasma from vaccinated individuals
demonstrated that anti-RBD SARS-CoV-2 efficiently prohibited
binding of the ACE2.
The anti-spike and anti-RBD levels were not significantly
different between male and female participants. Moreover thissignificant difference was not also observed between cases withless and above 50 years old (Fig1, 2).
Likewise, the results showed that there is no correlation between previous history of disease and even severity of infection
to SARS-CoV-2 with immune response after vaccination. (Fig 3)

Table 1. demographic parameters of participants receiving Sputnik

V vaccine

Characteristicn%

Age> 503949.4< 504050.6

Male4962.5Female

3037.5

GenderHistory of COVID-19 infection
Uninfected6076

Infected1924• Mild810• Moderate

56.3• Severe

67.6

Figure 1. Humoral immune response in 79 healthcare staffs after (vaccination) receiving the sputnik V vaccine. a) antiRBD, anti-spike titer in based on two age group, b) Nab based on two age group.

Figure 2. Humoral immune response in 79 healthcare staffs after receiving the sputnik V vaccine. a) anti-RBD, anti-spikein male and female, b) Nab in male and female.

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Figure 3. Humoral immune response in 79 healthcare staffs after receiving the sputnik V vaccine. a) anti-RBD in antispike in infected and non-infected participants, b) Nab in infected and non-infected participants, c) anti-RBD, anti-spike inparticipants with previous infection of COVID-19 based on severity of disease, d) Nab in participants with previous infectionof COVID-19 based on severity of disease.

DISCUSSION
Since the beginning of the COVID-19 pandemic, many attempts have been made to develop a vaccine to control thepandemic (6). Several vaccines with different platforms suchas nucleic acid, viral-vectored vaccines and inactivated virus
have been developed based on inhibition of viral cellular entry
mechanism (7).
In order to choose appropriate vaccine, Evaluation of theefficacy of these vaccines in different populations is critical. Furthermore, studying the efficacy of vaccine can help researchers toidentify the limitations of these current platforms such as reduction of vaccine effectiveness in elderly population, vaccine-associated side effects, and decrease of vaccines efficacy encountering
new variants of coronavirus (8). Therefore, accelerating development of new comprehensive vaccine technology is necessary (9).
Due to insufficient information about immune response
against COVID-19 after vaccination in different population withdifferent genetics backgrounds around the world, several studies
are required to provide definitive consequences.
Healthcare staffs are highly exposed to risk of the COVID-19
infection in comparison of other people. Additionally, they canbe carriers of COVID-19. In this study we evaluated induced
protective immune response results of the Sputnik V vaccine inhealthcare staffs of Sari, Iran.
The present study may indicate the efficacy of the vaccine
based on measurements of antibody against spike and RBD.
One of the most important concerns about vaccine efficacy is

reducing the effectiveness of vaccines among the old individuals.
Several studies have demonstrated that the vaccine efficacy isassociated with age (7). In this study, antibody response wasevaluated in both groups of participants ( < 50 and > 50 years old)
and there were no significant differences between the groups.
The immune system and its orchestrated response is affectedby a multitude of endogenous and exogenous factors (10). One of
the most frequent differences described in the immune response
is its vigor and activity in females compared to males. Our present knowledge on sex differences in the immune response aremainly included the hormonal and genetic effects that have been
proposed as explanatory mechanisms. Sexual hormones, mostly
estrogen, and also progesterone and testosterone affect immune
cells quantitatively and qualitatively. Relevant researches haveindicated the impact of hormones on cytokine production by different effector cells, as well as their impact on immunoglobulin
production by B lymphocytes and activity of granulocytes andNK cells. Importantly, these sex-based immunological differences contribute to variations in the incidence of autoimmune
diseases, malignancies, susceptibility to infectious diseases,
and responses to vaccines in males and females (10, 11). Unlike
other studies, in the present study subgroup analysis by genderdemonstrated that there were no statistical differences in immune responses toward COVID-19 between male and females.
This may be due to the small sample size.
Although our study showed effectiveness of Sputnik V vaccine
against COVID-19, there are several limitations in this research
including lack of appropriative baseline, insufficient number of

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participants, and uninvestigated antibody titer after first dose ofvaccine injection. However, further studies with higher sample
size are recommended to evaluate the efficiency of Sputnik V andother vaccines in different populations.

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