The evaluation of factors affecting antibody response after administration of the BNT162b2 vaccine: A prospective study in Japan
Authors: Mitsunaga Toshiya , Ohtaki Yuhei , Seki Yutaka , Yoshioka Masakata , Mori Hiroshi , Suzuka Midori , Mashiko Syunsuke , Takeda Satoshi , Mashiko Kunihiro 
Published: June 2021

The aim of this study was to evaluate the antibody reaction after administration of the BNT162b2 vaccine, and to reveal the factors that affect antibody production. This prospective study was carried out in the Association of EISEIKAI Medical and Healthcare Corporation Minamitama Hospital, in Tokyo, Japan, from April 15, 2021 to June 09, 2021. All our hospital’s workers who were administered the BNT162b2 vaccine as part of a routine program were included in this study.

We calculated the anti-SARS-CoV-2 spike-specific antibody titter 1) before vaccination, 2) seven to twenty days after the first vaccination, and 3) seven to twenty days after the second vaccination.

The low-antibody titer group (LABG) was defined as the group having less than 25 percentiles of antibody titer. Univariate and Multivariate logistic regression analysis were performed to ascertain the effects of factors on the likelihood of LABG. 374 participants were eventually included in our study, and they were divided into 94 LABG and 280 non-LABG. All samples showed significant antibody elevation in the second antibody test, with a mean value of 3476 U/mL. When comparing the LABG and non-LABG groups, the median age, blood sugar, and HbA1c were significantly higher in the LABG group. The rates of participants with low BMI (<18.5) and high BMI (>30) were significantly higher in the LABG group. The proportion of chronic lung disease, hypertension, diabetes, dyslipidemia, autoimmune disease, and cancer were significantly higher in the LABG group. Although there was no significant difference confirmed with respect to the exercise hours per day, the proportion of participants that did not perform outdoor activities was significantly higher in the LABG group. The time interval between the second vaccination and the second antibody test, and between the first and the second vaccination was significantly longer in the non-LABG group.

Our logistic regression analysis revealed that the age, obesity, hypertension, diabetes, dyslipidemia, antihypertensive drug, antilipid drug, γ-GT, BS, HbA1c, and lack of outdoor activity were significant suppressors of antibody reaction, whereas maintaining the appropriate time interval between the first and the second vaccination could promote a significant antibody response. In the multivariate logistic regression analysis, age, obesity, and lack of outdoor activities were significant suppressors of antibody reaction, whereas the length of days from the first to the second vaccination promoted a significant antibody response.

Our single-center study demonstrates that age, obesity, and lack of outdoor activities were significant suppressors of antibody response, whereas maintaining the appropriate time interval between the first and the second vaccination could promote a significant antibody response. Evidence from multi-center studies is needed to develop further vaccination strategies.