Post-vaccination IgG4 and IgG2 class switch associates with increased risk of SARS-CoV-2 infections

DOI

Objectives: Repeated COVID-19 mRNA vaccinations increase SARS-CoV-2 IgG4 antibodies, indicating extensive IgG class switching following the first booster dose. This shift in IgG subclasses raises concerns due to the limited ability of IgG4 to mediate Fc-dependent effector functions.Methods: To assess the impact of IgG4 induction on protective immunity, we analyzed longitudinal SARS-CoV-2 IgG subclasses, C1q and FcγR responses, and neutralizing activity in a well-characterized cohort of healthcare workers in Spain.Results: Elevated IgG4 levels and higher ratios of non-cytophilic to cytophilic antibodies after booster vaccination were significantly associated with an increased risk of breakthrough infections (IgG4 HR[10-fold increase]=1.8, 95% CI=1.2–2.7; non-cytophilic to cytophilic ratio HR[10-fold increase]=1.5, 95% CI=1.1–1.9). Moreover, an increased non-cytophilic to cytophilic antibody ratio correlated with reduced functionality, including neutralization.Conclusions: These findings suggest a potential association between IgG4 induction by mRNA vaccination and a higher risk of breakthrough infection, warranting further investigation into vaccination strategies to ensure sustained protection.

Identifier
DOI https://doi.org/10.34810/data2128
Related Identifier IsCitedBy https://doi.org/10.1016/j.jinf.2025.106473
Metadata Access https://dataverse.csuc.cat/oai?verb=GetRecord&metadataPrefix=oai_datacite&identifier=doi:10.34810/data2128
Provenance
Creator Carla Martin Perez ORCID logo; Silvia Ruiz Rius ORCID logo; Anna Ramirez Morros ORCID logo; Marta Vidal ORCID logo; Herbert Opi ORCID logo; Pere Santamaria ORCID logo; Julia Blanco ORCID logo; Josep Vidal Alaball ORCID logo; James G. Beeson ORCID logo; Luis M. Molinos-Albert ORCID logo; Ruth Aguilar ORCID logo; Anna Ruiz-Comellas ORCID logo; Gemma Moncunill ORCID logo; Carlota Dobaño ORCID logo
Publisher CORA.Repositori de Dades de Recerca
Contributor UBIOESGD
Publication Year 2025
Rights CC BY-NC-SA 4.0; info:eu-repo/semantics/openAccess; http://creativecommons.org/licenses/by-nc-sa/4.0
OpenAccess true
Contact UBIOESGD (Barcelona Institute for Global Health)
Representation
Resource Type Experimental data; Dataset
Format text/tab-separated-values; text/comma-separated-values; text/plain; text/x-r-notebook; text/csv
Size 126718477; 6262380; 149500; 42145868; 22382; 1506461; 2366361; 3113332; 2496; 3948; 3593787; 191370; 2187; 4895; 156509; 50773; 71799; 15592; 990
Version 1.0
Discipline Life Sciences; Medicine