Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford, UK.
Oxford University Hospitals NHS Foundation Trust, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in Partnership with Public Health England, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Clin Microbiol Infect. 2021 Oct;27(10):1516.e7-1516.e14. doi: 10.1016/j.cmi.2021.05.041. Epub 2021 Jun 7.
We investigated determinants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike IgG responses in healthcare workers (HCWs) following one or two doses of Pfizer-BioNTech or Oxford-AstraZeneca vaccines.
HCWs participating in regular SARS-CoV-2 PCR and antibody testing were invited for serological testing prior to first and second vaccination, and 4 weeks post-vaccination if receiving a 12-week dosing interval. Quantitative post-vaccination anti-spike antibody responses were measured using the Abbott SARS-CoV-2 IgG II Quant assay (detection threshold: ≥50 AU/mL). We used multivariable logistic regression to identify predictors of seropositivity and generalized additive models to track antibody responses over time.
3570/3610 HCWs (98.9%) were seropositive >14 days post first vaccination and prior to second vaccination: 2706/2720 (99.5%) were seropositive after the Pfizer-BioNTech and 864/890 (97.1%) following the Oxford-AstraZeneca vaccines. Previously infected and younger HCWs were more likely to test seropositive post first vaccination, with no evidence of differences by sex or ethnicity. All 470 HCWs tested >14 days after the second vaccination were seropositive. Quantitative antibody responses were higher after previous infection: median (IQR) >21 days post first Pfizer-BioNTech 14 604 (7644-22 291) AU/mL versus 1028 (564-1985) AU/mL without prior infection (p < 0.001). Oxford-AstraZeneca vaccine recipients had lower readings post first dose than Pfizer-BioNTech recipients, with and without previous infection, 10 095 (5354-17 096) and 435 (203-962) AU/mL respectively (both p < 0.001 versus Pfizer-BioNTech). Antibody responses >21 days post second Pfizer vaccination in those not previously infected, 10 058 (6408-15 582) AU/mL, were similar to those after prior infection followed by one vaccine dose.
SARS-CoV-2 vaccination leads to detectable anti-spike antibodies in nearly all adult HCWs. Whether differences in response impact vaccine efficacy needs further study.
我们研究了在接受辉瑞-生物技术公司或牛津-阿斯利康一剂或两剂疫苗后，医护人员（HCWs）中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）抗刺突 IgG 反应的决定因素。
参加定期 SARS-CoV-2 PCR 和抗体检测的 HCWs 受邀在首次和第二次接种前进行血清学检测，如果接种 12 周间隔，则在接种后 4 周进行检测。使用 Abbott SARS-CoV-2 IgG II Quant 测定法（检测阈值：≥50 AU/mL）测量接种后的定量抗刺突抗体反应。我们使用多变量逻辑回归来确定血清阳性的预测因素，并使用广义加性模型来跟踪随时间的抗体反应。
3570/3610 名 HCWs（98.9%）在首次接种后 14 天以上且在第二次接种前呈血清阳性：2706/2720 名（99.5%）接种辉瑞-生物技术公司疫苗后呈血清阳性，864/890 名（97.1%）接种牛津-阿斯利康疫苗后呈血清阳性。先前感染和年轻的 HCWs 更有可能在首次接种后检测到血清阳性，且无性别或种族差异的证据。所有 470 名在第二次接种后 14 天以上的 HCWs 均呈血清阳性。先前感染后抗体反应更高：中位数（IQR）首次接种辉瑞-生物技术公司后>21 天 14604（7644-22291）AU/mL 与无先前感染时的 1028（564-1985）AU/mL 相比（p<0.001）。牛津-阿斯利康疫苗接种者在首次接种后比辉瑞-生物技术公司接种者的读数低，无论是否有先前感染，分别为 10095（5354-17096）和 435（203-962）AU/mL（均与辉瑞-生物技术公司相比，p<0.001）。在未感染的情况下，第二次接种后 21 天以上的 Pfizer 疫苗接种者的抗体反应为 10058（6408-15582）AU/mL，与先前感染后接种一剂疫苗后的反应相似。
SARS-CoV-2 疫苗接种几乎可使所有成年 HCWs 产生可检测的抗刺突抗体。反应差异是否会影响疫苗效力还需要进一步研究。
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