mRNA booster vaccination protects extremely aged mice against the SARS-CoV-2 Omicron variant

Abstract The SARS-CoV-2 Omicron variant evades vaccine-induced immunity. While a booster dose of ancestral mRNA vaccines effectively elicits neutralizing antibodies against variants, its efficacy against Omicron in older adults, who are at the greatest risk of severe disease, is not fully elucidated. Here, we evaluated multiple longitudinal immunization regimens of mRNA BNT162b2 to assess the effects of a booster dose provided >8 months after the primary immunization series across the murine lifespan, including in extremely aged 21-month-old mice. Boosting dramatically enhanced humoral and cell-mediated responses with evidence of Omicron cross-recognition. Furthermore, while younger mice were protected without a booster dose, boosting provided sterilizing immunity against Omicron-induced lung infection in extremely aged mice. Correlational analyses revealed that neutralizing activity against Omicron was strongly associated with protection. Overall, our findings indicate age dependent vaccine efficacy and demonstrate the potential benefit of mRNA booster immunization to protect vulnerable older populations against SARS-CoV-2 variants.