Ethno-demographic disparities in humoral responses to the COVID-19 vaccine among healthcare workers

Pankaj Ahluwalia, Ashutosh Vashisht, Harmanpreet Singh, Nikhil Shri Sahajpal, Ashis K. Mondal, Kimya Jones, Jaspreet Farmaha, Ryan Bloomquist, Caroline Marie Carlock, Drew Fransoso, Christina Sun, Tyler Day, Comfort Prah, Trinh Vuong, Patty Ray, Danielle Bradshaw, Marisol Miranda Galvis, Sadanand Fulzele, Girindra Raval, Justin Xavier MooreJorge Cortes, Jeffrey N. James, Vamsi Kota, Ravindra Kolhe

Research output: Contribution to journalArticlepeer-review


The COVID-19 pandemic had a profound impact on global health, but rapid vaccine administration resulted in a significant decline in morbidity and mortality rates worldwide. In this study, we sought to explore the temporal changes in the humoral immune response against SARS-CoV-2 healthcare workers (HCWs) in Augusta, GA, USA, and investigate any potential associations with ethno-demographic features. Specifically, we aimed to compare the naturally infected individuals with naïve individuals to understand the immune response dynamics after SARS-CoV-2 vaccination. A total of 290 HCWs were included and assessed prospectively in this study. COVID status was determined using a saliva-based COVID assay. Neutralizing antibody (NAb) levels were quantified using a chemiluminescent immunoassay system, and IgG levels were measured using an enzyme-linked immunosorbent assay method. We examined the changes in antibody levels among participants using different statistical tests including logistic regression and multiple correspondence analysis. Our findings revealed a significant decline in NAb and IgG levels at 8−12 months postvaccination. Furthermore, a multivariable analysis indicated that this decline was more pronounced in White HCWs (odds ratio [OR] = 2.1, 95% confidence interval [CI] = 1.07−4.08, p = 0.02) and IgG (OR = 2.07, 95% CI = 1.04−4.11, p = 0.03) among the whole cohort. Booster doses significantly increased IgG and NAb levels, while a decline in antibody levels was observed in participants without booster doses at 12 months postvaccination. Our results highlight the importance of understanding the dynamics of immune response and the potential influence of demographic factors on waning immunity to SARS-CoV-2. In addition, our findings emphasize the value of booster doses to ensure durable immunity.

Original languageEnglish
Article numbere29067
JournalJournal of Medical Virology
Issue number9
StatePublished - Sep 2023

Bibliographical note

Funding Information:
Part of this project has been funded in the lab by a subcontract from the National Institute of Allergy and Infectious Diseases, a component of the NIH, Department of Health and Human Services, under contract 75N93019C00052 to UGA. In addition, R. K. is supported by startup funds from the Medical College of Georgia at Augusta University.

Publisher Copyright:
© 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.


  • COVID-19
  • SARS-CoV-2
  • antibodies
  • booster
  • ethnicity
  • neutralizing antibody
  • pandemic
  • racial disparity
  • vaccine
  • virus

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology


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