Cross-reactive immunity against the SARS-CoV-2 Omicron variant is low in pediatric patients with prior COVID-19 or MIS-C

• Type of Material: Article
• Authors: Juanjie Tang, Food and Drug Administration; Tanya Novak, Boston Children’s Hospital; Julian Hecker, Brigham and Women's Hospital; Gabrielle Grubbs, Food and Drug Administration; Fatema Tuz Zahra, Food and Drug Administration; Lorenza Bellusci, Food and Drug Administration; Sara Pouhashemi, Food and Drug Administration; Janet Chou, Boston Children’s Hospital; Keiko Tarquinio, Emory University; Surender Khurana, Food and Drug Administration
• Language: English
• Date: 2022-05-27
• Publisher: Nature Research (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2022, corrected publication 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41467-022-30649-1
• Title of Journal or Parent Work: Nature Communications
• Volume: 13
• Grant/Funding Information: The research work described in this manuscript was supported by FDA Perinatal Health Center of Excellence (PHCE) grant #GCBER005 to S.K and the U.S. Centers for Disease Control and Prevention (contract #75D30120C07725) to A.G.R. and the National Institutes of Health (R01AI084011 to A.G.R., K23HL150244 to C.R., K23HD096018 to A.M., K23HL146936 to M.Z.). The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services or the Centers for Disease Control and Prevention, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
• Keywords: SARS-CoV-2; Vaccines; Antibodies; Viral infection
• Research Categories: Health Sciences, Immunology; Biology, Virology

Abstract

Neutralization capacity of antibodies against Omicron after a prior SARS-CoV-2 infection in children and adolescents is not well studied. Therefore, we evaluated virus-neutralizing capacity against SARS-CoV-2 Alpha, Beta, Gamma, Delta and Omicron variants by age-stratified analyses (<5, 5–11, 12–21 years) in 177 pediatric patients hospitalized with severe acute COVID-19, acute MIS-C, and in convalescent samples of outpatients with mild COVID-19 during 2020 and early 2021. Across all patients, less than 10% show neutralizing antibody titers against Omicron. Children <5 years of age hospitalized with severe acute COVID-19 have lower neutralizing antibodies to SARS-CoV-2 variants compared with patients >5 years of age. As expected, convalescent pediatric COVID-19 and MIS-C cohorts demonstrate higher neutralization titers than hospitalized acute COVID-19 patients. Overall, children and adolescents show some loss of cross-neutralization against all variants, with the most pronounced loss against Omicron. In contrast to SARS-CoV-2 infection, children vaccinated twice demonstrated higher titers against Alpha, Beta, Gamma, Delta and Omicron. These findings can influence transmission, re-infection and the clinical disease outcome from emerging SARS-CoV-2 variants and supports the need for vaccination in children.