SARS-CoV-2 antibody immunity across three continents: the West Africa, West Indies, West London Consortium

Background The experience of the COVID-19 pandemic has differed across continents. We hypothesized that regional differences in SARS-CoV-2 immunity might explain this observation. We therefore established the WWW Consortium in Ghana, W Africa; Jamaica, W Indies; and W London. Here, we describe the extent to which antibody immunity differs between these geographic locations.

The WWW Consortium harmonises across the HERITAGE (Accra, Ghana), WINDFall (Kingston, Jamaica) and Legacy (London, UK) studies, establishing sharing frameworks for samples, metadata, and data; related permissions and oversight; and associated physical and cloud infrastructure. With centralised testing, we performed serological assessments across all three locations at two snapshots in 2024 (April 1st – August 18th; August 19th – December 31st) using high-throughput live virus neutralization and anti-nucleocapsid IgG, including n=763 individuals. Findings We found that across all sites most participants had detectable neutralising antibody titres against JN.1 and XEC – the predominant variants in 2024. There were site-related differences in immunity: vaccine-included SARS-CoV-2 strains were better neutralised by participants from the Legacy study – Ancestral, BA.5, XBB.1.5 initially, and JN.1 after a homologous booster in autumn 2024. For HERITAGE, neutralisation of both alpha- (HCoV-229E) and beta-coronaviruses (HCoV-OC43) was higher than WINDFall suggesting a cross-coronavirus serological response in West Africa. Finally, antigenic cartography identified two distinct antibody landscapes, with JN.1 and XEC antigenically distant in Legacy, but not in HERITAGE and WINDFall. Interpretation There is international heterogeneity in SARS-CoV-2 antibody immunity. Global recommendations for vaccine strain selection should incorporate data from diverse populations to ensure accurate, equitable recommendations. Funding The Wellcome Trust. Competing Interest Statement YB and JMN & DH within the HERITAGE study team own shares of Yemaachi Biotech. ECW reports consulting for AstraZeneca and CSL-Seqirus unrelated to this work. DLVB reports commercial agreements between the Francis Crick institute and GSK for SARS-CoV-2 antiviral testing, agreements between the Crick and Pfizer for laboratory to rent laboratory space, and grants to the Crick from AstraZeneca unrelated to this work. Declarations from other consortium authors deemed not relevant to this work. Funding Statement This work was supported by the Wellcome Trust (226142/Z/22/Z). Part of this work was supported by the Bill & Melinda Gates Foundation (BMGF-Calestous Juma Science Leadership Fellowship INV-036643) to YB. Part of the work was undertaken at UCLH/UCL who received a proportion of funding from the National Institute for Health Research (NIHR) University College London Hospitals Department of Health's NIHR Biomedical Research Centre (BRC). ECW is supported by the Centre's funding scheme. This work was supported jointly by the BRC and core funding from the Francis Crick Institute, which receives its funding from Cancer Research UK, the UK Medical Research Council, and the Wellcome Trust. Shanice Redman and Jenene Cameron are global infectious diseases scholars who received mentored research training in work leading to the development of this manuscript. This training was supported in part by the University of Buffalo Clinical and Translational Science Institute (award no. UL1TR001412) and the Global Infectious Diseases Research Training Program (award no. D43TW010919). EJC is supported by an UK MRC clinician scientist fellowship. DLVB is additionally supported by the Genotype-to-Phenotype National Virology Consortium (G2P-UK), Genotype-to-Phenotype 2 (G2P2-UK) and via UK Research and Innovation and the UK Medical Research Council. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethics Review Committee of the Ghana Health Service gave ethical approval for the HERITAGE study (Reference: GHS-ERC-005/06/2). The London Camden and Kings Cross Health Research Authority (HRA) Research and Ethics committee gave ethical approval for the Legacy study (REC, reference 20/HRA/4717) IRAS number 286469, which was sponsored by University College London. The Mona Campus Research Ethics Committee gave ethical approval for the WINDFall study, with extensions granted yearly. All participants gave written informed consent for inclusion in the studies. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes Consortia members are listed at the end of the manuscript Data Availability Requests to access de-identified participant data will first be considered by the WWWc Data Management Board (DMB), to which partners nominated a representative from their respective organisations (but outside their core team). After approval by the WWWc DMB, requests will be passed to the relevant study, or studies, to complete per study access request processes. Depending on the nature of the request Material Transfer Agreement(s) might be required, with one or more consortium studies, prior to data sharing.