Tom G. Caniels, Ilja Bontjer, Karlijn van der Straten, Meliawati Poniman, Judith A. Burger, Brent Appelman, Ayesha H.A. Lavell, Melissa Oomen, Gert-Jan Godeke, Coralie Valle, Ramona Mögling, Hugo D.G. van Willigen, Elke Wynberg, Michiel Schinkel, Lonneke A. van Vught, Denise Guerra, Jonne L. Snitselaar, Devidas N. Chaturbhuj, Isabel Cuella Martin, Amsterdam UMC COVID-19 S3/HCW study group, John P. Moore, Menno D. de Jong, Chantal Reusken, Jonne J. Sikkens, Marije K. Bomers, Godelieve J. de Bree, Marit J. van Gils, Dirk Eggink, Rogier W. Sanders



Emerging SARS-CoV-2 variants pose a threat to human immunity induced by natural infection and vaccination. We assessed the recognition of three variants of concern (B.1.1.7, B.1.351 and P.1) in cohorts of COVID-19 patients ranging in disease severity (n = 69) and recipients of the Pfizer/BioNTech vaccine (n = 50). Spike binding and neutralization against all three VOC was substantially reduced in the majority of samples, with the largest 4-7-fold reduction in neutralization being observed against B.1.351. While hospitalized COVID-19 patients and vaccinees maintained sufficient neutralizing titers against all three VOC, 39% of non-hospitalized patients did not neutralize B.1.351. Moreover, monoclonal neutralizing antibodies (NAbs) show sharp reductions in their binding kinetics and neutralizing potential to B.1.351 and P.1, but not to B.1.1.7. These data have implications for the degree to which pre-existing immunity can protect against subsequent infection with VOC and informs policy makers of susceptibility to globally circulating SARS-CoV-2 VOC.