Abstract

Anna Sabrina Kuechler41819*, Karin Schulze-Bosse41820 and Lisa Müller41821

Until today, vaccination against COVID-19 is handled by fixed and blind immunization-schedules. This work overviews and discusses the opportunities and limitations of different Severe Acute Respiratory Syndrome Corona Virus type 2 (SARS-CoV-2) antibody tests and their suitability as SARS-CoV-2 vaccination companion diagnostics. These tests are not officially recommended for evaluating the necessity of (re-) immunization yet, but novel studies contribute to understanding their informative value, their complementary relationships and thus their potential for using them as a predictor for immune-protection against COVID-19.

We found that serological assays detecting antibodies against SARS-CoV-2 and their neutralizing capacity can form a diagnostic strategy for individualized vaccination schedules due to their specific informative values. Serological antibody tests as SARS-CoV-2 vaccination companion diagnostics thus constitute a novel perspective for optimized and individualized time points for (re-)immunization. Despite being time and cost consuming for the health care system they represent a great benefit for closing gaps in immune-protection for people at risk. SARS-CoV-2 vaccination companion diagnostics may also reduce the amount of severe short term vaccination side effects and consequences like t-cell exhaustion or auto- immune diseases by over-vaccination in long term. Nonetheless, future research directions concerning SARS-CoV-2 vaccination companion diagnostics are manifold and official clinical guidelines still need to be established.