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Hum Vaccin Immunother . Association between sex hormones and anti-S/RBD antibody responses to COVID-19 vaccines in healthcare workers

tetano

Editor, Senior Moderator
Hum Vaccin Immunother


. 2023 Dec 15;19(3):2273697.
doi: 10.1080/21645515.2023.2273697. Epub 2023 Nov 14. Association between sex hormones and anti-S/RBD antibody responses to COVID-19 vaccines in healthcare workers

Simona Anticoli[SUP] 1 [/SUP], Maria Dorrucci[SUP] 2 [/SUP], Elisabetta Iessi[SUP] 1 [/SUP], Flavia Chiarotti[SUP] 3 [/SUP], Reparata Rosa Di Prinzio[SUP] 4 [/SUP], Maria Rosaria Vinci[SUP] 4 [/SUP], Salvatore Zaffina[SUP] 4 [/SUP], Vincenzo Puro[SUP] 5 [/SUP], Francesca Colavita[SUP] 6 [/SUP], Klizia Mizzoni[SUP] 6 [/SUP], Silvia Meschi[SUP] 6 [/SUP], Nicoletta Vonesch[SUP] 7 [/SUP], Christian Albano[SUP] 8 [/SUP], Elena Ortona[SUP] 1 [/SUP], Anna Ruggieri[SUP] 1 [/SUP], Paola Tomao[SUP] 7 [/SUP]



Affiliations
Abstract

Healthcare workers (HCWs) are the target population for vaccination against coronavirus disease (COVID-19) as they are at a high risk of exposure and transmission of pathogens to patients. Neutralizing antibodies developed after COVID-19 vaccination decline within few months of vaccination. Several factors, including age and sex, can affect the intensity, efficacy, and duration of immune response to vaccines. However, sex-specific analyses of humoral responses to COVID-19 vaccines are lacking. This study aimed to evaluate sex-based differences in anti-S/RBD (Receptor Binding Domain) responses at three different time points after the second dose of mRNA COVID-19 vaccine in HCWs in relation to age, and to investigate the role of sex hormones as potential markers of response. Anti-S/RBD levels after two doses of the mRNA vaccine were collected from 521 HCWs naïve to COVID-19, working at two Italian Clinical Centers. Multiple regression analysis was applied to evaluate the association between anti-S levels and sex, age, and plasma levels of sex hormones. Significantly higher anti-S/RBD response to the COVID-19 vaccination was found in female HCWs, and a significant and more abrupt decline in response with time was observed in women than that in men. A novel, positive association of testosterone plasma levels and higher anti-S levels in male HCWs was found, suggesting its potential role as sex specific marker in males. In conclusion, understanding the sex-based differences in humoral immune responses to vaccines may potentially improve vaccination strategies and optimize surveillance programs for HCWs.

Keywords: COVID-19; anti-S/RBD; estrogen; healthcare workers; progesterone; sex difference; testosterone; vaccine.

 
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