The urgent need for, but limited availability of, SARS-CoV-2 vaccines worldwide has led to widespread consideration of dose-sparing strategies. Here, we evaluate the SARS-CoV-2-specific antibody responses following BNT162b2 vaccination in 150 previously SARS-CoV-2-infected individuals from a population-based cohort. One week after first vaccine dose, spike protein antibody levels are 27-fold higher and neutralizing antibody titers 12-fold higher, exceeding titers of fully vaccinated SARS-CoV-2-naive controls, with minimal additional boosting after the second dose. Neutralizing antibody titers against four variants of concern increase after vaccination; however, overall neutralization breadth does not improve. Pre-vaccination neutralizing antibody titers and time since infection have the largest positive effect on titers following vaccination. COVID-19 severity and the presence of comorbidities have no discernible impact on vaccine response. In conclusion, a single dose of BNT162b2 vaccine up to 15 months after SARS-CoV-2 infection offers higher neutralizing antibody titers than 2 vaccine doses in SARS-CoV-2-naive individuals.

Original languageEnglish
Article number100486
JournalCell Reports Medicine
Issue number1
Early online date2022
Publication statusPublished - 18 Jan 2022


  • Adult
  • Aged
  • Antibodies, Neutralizing/blood
  • Antibodies, Viral/blood
  • BNT162 Vaccine/administration & dosage
  • BNT162b2
  • COVID-19
  • COVID-19/blood
  • Female
  • Follow-Up Studies
  • Humans
  • Immunogenicity, Vaccine/immunology
  • Immunoglobulin G/blood
  • Male
  • Middle Aged
  • Neutralization Tests
  • Prospective Studies
  • SARS-CoV-2
  • SARS-CoV-2/immunology
  • Severity of Illness Index
  • Spike Glycoprotein, Coronavirus/immunology
  • Treatment Outcome
  • Vaccination/methods
  • antibody response
  • mRNA vaccine
  • neutralization
  • previous infection
  • response predictors
  • variants

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