PONE-D-24-25908Risk reduction in SARS-CoV-2 infection and reinfection conferred by humoral antibody levels among essential workers during Omicron predominancePLOS ONE

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The study examined the protection conferred by antibody levels against SARS-CoV-2 in frontline workers. Higher receptor binding domain (RBD) antibody titers were linked to a reduced risk of first-time post-vaccination infection and reinfection, especially during the Omicron variant's predominance. Vaccinated individuals with higher antibody levels had a significantly lower risk of reinfection compared to unvaccinated ones. Immunity was assessed using the SARS-CoV-2 Washington-1 spike protein but the current variants and subvariants may escape immunity generated with the ancestral strain which was rightfully acknowledged as a limitation. The paper contributes to understanding the SARS-COV2 correlates of protection.

Minor comments

In line 59-60 ‘first-time post-vaccination and reinfection study samples, most were female (67%, 57%), non -Hispanic (82%, 68%), and without chronic conditions (65%, 65%)’ verify the percentages. Do the same for line 249-250

In line 308-309 ‘the 1:60 dilution, estimated risk reduction was 50% at RBD and S2 end titers between 1:540 and 1:1620 (Fig 2)’. Refer to table 2 instead of figure 2

Questions for Clarification:

Was recurrent SARS-CoV-2 detected in any of the participants? Given the high exposure levels of the participants, one may expect reinfections to occur from the time blood was drawn.

Was the Omicron variant detected the same, or were various Omicron sub-variants detected in the participants? Provide details on the sequencing results.

Reviewer #2: The manuscript set out to report on the risk reduction and reinfection outcomes following vaccination and natural infection. The manuscript had a logical flow in information and have shown a reduction of 21% infection and 58% reinfection reduction as a result of the study vaccines used. It was not clear however in the discussion as to which vaccines were used in the comparison studies that they reported on. As there some differences in vaccine type as well as manufacturer with regards to immunological response.

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Reviewer #1: No

Reviewer #2: Yes: Omphile E Simani

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Risk reduction in SARS-CoV-2 infection and reinfection conferred by humoral antibody levels among essential workers during Omicron predominance

PONE-D-24-25908R1

Dear Dr. Hollister,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Maemu Petronella Gededzha, Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The comments have been addressed to the satisfaction of the reviewers and the editor

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors have made all reviewers recommendations and the paper is acceptable for publication, no further comments

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If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

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