Age-associated differences in XBB.1.5 trivalent booster vaccine-induced adaptive responses revealed by single-cell RNA sequencing

Older adults remain highly vulnerable to severe SARS-CoV-2 outcomes despite multiple vaccinations, yet age-associated differences in immune responses to updated COVID-19 booster vaccines remain incompletely characterized. Here, we administered an XBB.1.5 trivalent recombinant protein booster (WSK-V102C) to 22 individuals (<38 years) and 20 individuals (≥73 years), all of whom had previously received 2-3 doses of inactivated COVID-19 vaccines. Neutralizing antibody responses against multiple SARS-CoV-2 variants were quantified and compared between age groups. Meanwhile, single-cell RNA sequencing was also performed on peripheral blood mononuclear cells (PBMCs) collected at baseline and 28 days post-vaccination to profile age-associated immune features following boosting. Following booster immunization, both age groups achieved significantly elevated antibody titers against all tested strains. Nevertheless, the magnitude of antibody fold increase was consistently lower in elderly individuals than in younger adults. Single-cell analyses revealed age-associated differences in post-vaccination immune organization. In elderly individuals, B-cell state transitions were characterized by transcriptional signatures consistent with memory B cell-to-plasmablast differentiation, whereas younger individuals predominantly exhibited transitions from naïve B cells. CD4+ T cells from elderly individuals displayed altered transcriptional trajectories and reduced T-cell receptor diversity relative to younger adults. In contrast, younger individuals showed coordinated B- and T-cell-associated transcriptional programs, including enrichment of transcription factors such as KLF7, CEBPB, CEBPD, and MAFB. Collectively, our study describes age-associated differences in immune coordination and cellular response patterns following XBB.1.5 booster vaccination. Further longitudinal and functional studies will be required to clarify the mechanistic basis and clinical implications of these observations.