Shanghai Journal of Preventive Medicine, Volume. 37, Issue 5, 403(2025)
Seroprevalence and influencing factors of low-level neutralizing antibodies against SARS-CoV-2 in community residents
[Objective]To understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum.[Methods]On the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0-14, 15-24, 25-59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25th percentile of NAb.[Results]A total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19-0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16-0.35) and booster immunization (aOR=0.12, 95%CI: 0.08-0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14 - 0.52) showed a negative correlation with the risk of low-level NAb.[Conclusions]The population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals, especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.
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YUAN Shiying, ZHANG Jingyi, WU Huanyu, WANG Weibing, ZHAO Genming, YU Xiao, MA Xiaoying, CHEN Min, SUN Xiaodong, HUANG Zhuoying, MA Zhonghui, ZHENG Yaxu, CHEN Jian. Seroprevalence and influencing factors of low-level neutralizing antibodies against SARS-CoV-2 in community residents[J]. Shanghai Journal of Preventive Medicine, 2025, 37(5): 403
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Received: Aug. 8, 2024
Accepted: Aug. 26, 2025
Published Online: Aug. 26, 2025
The Author Email: ZHENG Yaxu (157202047@qq.com)