![]() All participants were offered first and second doses of vaccine between March and April 2021. The second was to evaluate IgG antibody levels six months after the second vaccination, and 373 participants, including above 49 Analysis-1 participants, participated in the second sub-study (Analysis-2). This study consisted of two sub-studies: the first was to evaluate the dynamics of anti-spike IgG levels by measuring IgG antibody levels before the first vaccination, three weeks after the first vaccination (just before the second vaccination), and one month, two months, four months, and six months after the second vaccination included 49 participants in the first sub-study (Analysis-1). All studies were carried out in accordance with the principles of the Declaration of Helsinki, as revised in 2008, and approved by the Haradoi hospital institutional ethics review committee prior to data collection (Approval No. All participants provided written informed consent prior to enrollment. Because most of the study participants were nurses, approximately 80% of the participants were women. Of the total 485 health care workers in this hospital, 373 (76.9%) participated in this study. Study participants were recruited from health care workers in Haradoi Hospital, a care-mix hospital in Fukuoka. This study aims to investigate the dynamics of the anti-spike IgG levels in the health care workers during six months after being fully vaccinated and find indicators to whom we should strongly recommend the additional vaccination. Therefore, it is challenging to determine target individuals for the additional vaccination. However, it is also unclear how much IgG level is enough to avert COVID-19 severe disease. On the other hand, there are some reports that the effect of preventing severe disease is maintained even six months after the second vaccination. In addition, although the vaccine’s excellent effectiveness in preventing symptomatic infection in the early stage after the third vaccination has been reported, it is also unclear how long the effect will be maintained. However, it is still unclear how much IgG level is enough to prevent COVID-19 infection. The decrease in immunoglobulin G (IgG) level to spike protein six months after the second vaccination has been cited as a rationale for the third vaccination. In response to the resurgence of COVID-19, many countries are starting the administration of a third vaccination, and Israel was the first country to start the third vaccination in July 2021. ![]() The increase in infections and hospitalizations of vaccinated individuals in other countries with high vaccination rates potentially stems from a combination of waning vaccine immunity over time and potentially reduced vaccine effectiveness against the delta variant. However, it is difficult to estimate the vaccine’s effectiveness in the Japanese population, as the vaccination rate during the peak of the fifth pandemic wave in Japan was only about 40%. Japan has experienced its fifth pandemic wave since late June 2021, with up to 25,000 infections per day (20 / 100,000) and more than 800,000 hospitalizations in total (650 / 100,000). Because the Omicron strain is more transmissible than previous strains, including delta strains, and can reinfect people who have already had the virus or been vaccinated, concerns about a resurgence of the pandemic are rising. In addition, a new variant of SARS-CoV-2, B.1.1.529, was reported, and the World Health Organization named this new variant Omicron and classified it as a Variant of Concern on Novem. However, many countries are currently experiencing a resurgence of COVID-19, dominated by the Delta (B.1.617.2) variant of SARS-CoV-2. The mRNA coronavirus disease 2019 (COVID-19) vaccines, BNT162b2 (Pfizer/BioNTech) and mRNA-1273 (Moderna), have shown very high effectiveness in preventing COVID-19 in real-world practice.
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