Evaluating SARS-CoV-2 T Cell Immunity in COVID-19-Naive Vaccinated Individuals with and Without Spike Protein IgG Antibodies

<b>Background:</b> The effective management of vaccination schedules requires thorough knowledge of an individual's immunoprotection level, including the interaction and persistence of immune responses at both the humoral and cellular levels following SARS-CoV-2 vaccination. This study aimed to investigate the potential relationship between the levels and duration of the SARS-CoV-2 T cell response and IgG measurements in a cohort of COVID-19-naive individuals who had received the SARS-CoV-2 vaccine. <b>Methods:</b> We performed a retrospective descriptive analysis utilizing data retrieved from the electronic medical records of consecutive COVID-19-naive and vaccinated adult individuals who underwent COVID-19 immunity screening at a private healthcare center from September 2021 to September 2022. T cell response was evaluated using the IGRA methodology T-SPOT^®.COVID (Oxford Immunotec, Abingdon, Oxfordshire, UK). <b>Results:</b> A retrospective analysis was conducted on a cohort of 262 individuals, comprising 148 females (56.5%) and 114 males (43.5%), with ages ranging from 17 to 92 years (mean age: 59.47 ± 15.5 years). Among the participants, 216/262 (82.4%) tested negative for SARS-CoV-2 IgG antibodies (group A), while 46/262 (17.6%) tested positive (group B). No significant difference was observed between the two groups in the time period post vaccination, with the mean times after vaccination being 136.38 ± 78.68 days in group A and 140.6 ± 79.5 days in group B (T-test, <i>p</i> = 0.74). Among the two groups, a positive T cell reaction against the S antigen was reported in 132/216 (61.1%) participants in group A and 39/46 (84.8%) in group B (<i>X</i>² test, <i>p</i> = 0.002). Additionally, individuals with a positive antibody response demonstrated statistically significant higher T SPOT results compared to those with undetectable antibody levels, with a mean SFC count of 125.70 for group A and 158.73 for group B (Mann-Whitney test, <i>p</i> = 0.006). <b>Conclusions:</b> Our findings suggest that T cell immunity may persist even when antibodies are undetectable, highlighting the potential role of cellular immunity in providing protection against COVID-19 over time. Additionally, this study demonstrates a significant correlation between humoral and cellular immune response levels to SARS-CoV-2, suggesting that the activation of humoral immunity following SARS-CoV-2 vaccination is associated with higher levels of cellular immunity compared to individuals with undetectable antibody levels.