B cell-derived cfDNA after primary BNT162b2 mRNA vaccination anticipates memory B cells and SARS-CoV-2 neutralizing antibodies

Ilana Fox-Fisher, Sheina Piyanzin, Mayan Briller, Esther Oiknine-Djian, Or Alfi, Roni Ben-Ami, Ayelet Peretz, Daniel Neiman, Bracha Lea Ochana, Ori Fridlich, Zeina Drawshy, Agnes Klochendler, Judith Magenheim, Danielle Share, Ran Avrahami, Yaarit Ribak, Aviv Talmon, Limor Rubin, Neta Milman, Meital SegevErik Feldman, Yuval Tal, Shai S. Shen-Orr, Benjamin Glaser, Ruth Shemer, Dana Wolf, Yuval Dor*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Much remains unknown regarding the response of the immune system to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination. Methods: We employed circulating cell-free DNA (cfDNA) to assess the turnover of specific immune cell types following administration of the Pfizer/BioNTech vaccine. Findings: The levels of B cell cfDNA after the primary dose correlated with development of neutralizing antibodies and memory B cells after the booster, revealing a link between early B cell turnover—potentially reflecting affinity maturation—and later development of effective humoral response. We also observed co-elevation of B cell, T cell, and monocyte cfDNA after the booster, underscoring the involvement of innate immune cell turnover in the development of humoral and cellular adaptive immunity. Actual cell counts remained largely stable following vaccination, other than a previously demonstrated temporary reduction in neutrophil and lymphocyte counts. Conclusions: Immune cfDNA dynamics reveal the crucial role of the primary SARS-CoV-2 vaccine in shaping responses of the immune system following the booster vaccine. Funding: This work was supported by a generous gift from Shlomo Kramer. Supported by grants from Human Islet Research Network (HIRN UC4DK116274 and UC4DK104216 to R.S. and Y.D.), Ernest and Bonnie Beutler Research Program of Excellence in Genomic Medicine, The Alex U Soyka Pancreatic Cancer Fund, The Israel Science Foundation, the Waldholtz/Pakula family, the Robert M. and Marilyn Sternberg Family Charitable Foundation, the Helmsley Charitable Trust, Grail, and the DON Foundation (to Y.D.). Y.D. holds the Walter and Greta Stiel Chair and Research Grant in Heart Studies. I.F.-F. received a fellowship from the Glassman Hebrew University Diabetes Center.

Original languageAmerican English
Pages (from-to)468-480.e5
Issue number7
StatePublished - 8 Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Inc.


  • BNT162b2
  • DNA methylation
  • SARS-CoV-2
  • Translation to patients
  • cfDNA
  • liquid biopsy
  • mRNA vaccine
  • memory B-cell
  • neutralizing antibody
  • tissue dynamics


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