Diverse immune responses in vaccinated individuals with and without symptoms after omicron exposure during the recent outbreak in Guangzhou, China.

Objectives: During the recent wave of coronavirus disease 2019 (COVID-19) infections in China, most individuals have been vaccinated and exposed to the omicron variant. In the present study, two cohorts were observed in the vaccinated population: vaccinated individuals with symptoms (VIWS) and those without symptoms (VIWOS). Our study aimed to characterize the antibody response in two cohorts: VIWS and VIWOS.

Methods: A questionnaire survey was conducted in the community. Blood and saliva samples were collected from 124 individuals in the VIWS and VIWOS cohorts. Capture enzyme-linked immunosorbent assay (ELISA) was performed to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific antibodies.

Results: The questionnaire survey revealed that 30.0 % (302/1005) of individuals in the older adult group (≥65 years) experienced no symptoms, whereas the rate of individuals without symptoms in the younger group (<65 years) was 17.8 % (166/932). Nucleocapsid (N)-specific IgM (N-IgM) was detected in the blood samples at a rate of 69.2 % (54/78) in the VIWS cohort. The positivity rate for N-specific IgA (N-IgA) was 93.6 % (73/78). In addition, the positivity rates of spike (S)-specific IgA (S-IgA) and N-IgA detected in saliva samples were 42 % (21/50) and 54 % (27/50), respectively. Both N-IgA positivity and negativity were observed in the VIWOS cohort. The detection rate of N-IgM positivity was 57.1 % (12/21) in the N-IgA-positive group. In addition, 54.3 % (25/46) of the vaccinated individuals without symptoms were IgA-negative.

Conclusions: Our study indicates that substantial N-specific antibodies were induced during omicron infection and that testing for N-IgA in both blood and saliva may aid in the diagnosis of SARS-CoV-2 infection in vaccinated populations.