COVID-19 point-of-care tests can identify low-antibody individuals: In-depth immunoanalysis of boosting benefits in a healthy cohort

Michael Mallory, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Jennifer E. Munt, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Tara M. Narowski, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Izabella Castillo, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Edwing Cuadra, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Nora Pisanic, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Paul Fields, Adaptive Biotechnologies, Seattle, WA, USA.
John M. Powers, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Alexandria Dickson, Department of Molecular Microbiology and Immunology, Saint Louis University, Saint Louis, MO, USA.
Rohan Harris, Department Emergency Medicine, George Washington University School of Medicine, Washington, DC, USA.
Richard Wargowsky, Department of Medicine, Division of Genomic Medicine, The George Washington University Medical Center, Washington, DC, USA.
Seamus Moran, Department Emergency Medicine, George Washington University School of Medicine, Washington, DC, USA.
Ahmed Allabban, Department Emergency Medicine, George Washington University School of Medicine, Washington, DC, USA.
Kristin Raphel, Department Emergency Medicine, George Washington University School of Medicine, Washington, DC, USA.
Timothy A. McCaffrey, Department of Medicine, Division of Genomic Medicine, The George Washington University Medical Center, Washington, DC, USA.
James D. Brien, Department of Molecular Microbiology and Immunology, Saint Louis University, Saint Louis, MO, USA.
Christopher D. Heaney, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
John E. Lafleur, Department Emergency Medicine, George Washington University School of Medicine, Washington, DC, USA.
Ralph S. Baric, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Lakshmanane Premkumar, Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Document Type

Journal Article

Publication Date

6-14-2024

Journal

Science advances

Volume

10

Issue

24

DOI

10.1126/sciadv.adi1379

Abstract

The recommended COVID-19 booster vaccine uptake is low. At-home lateral flow assay (LFA) antigen tests are widely accepted for detecting infection during the pandemic. Here, we present the feasibility and potential benefits of using LFA-based antibody tests as a means for individuals to detect inadequate immunity and make informed decisions about COVID-19 booster immunization. In a health care provider cohort, we investigated the changes in the breadth and depth of humoral and T cell immune responses following mRNA vaccination and boosting in LFA-positive and LFA-negative antibody groups. We show that negative LFA antibody tests closely reflect the lack of functional humoral immunity observed in a battery of sophisticated immune assays, while positive results do not necessarily reflect adequate immunity. After booster vaccination, both groups gain depth and breadth of systemic antibodies against evolving SARS-CoV-2 and related viruses. Our findings show that LFA-based antibody tests can alert individuals about inadequate immunity against COVID-19, thereby increasing booster shots and promoting herd immunity.

Department

Emergency Medicine

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