Puro Vincenzo, Castilletti Concetta, Agrati Chiara, Goletti Delia, Leone Sara, Agresta Alessandro, Cimini Eleonora, Tartaglia Eleonora, Casetti Rita, Colavita Francesca, Meschi Silvia, Matusali Giulia, Lapa Daniele, Najafi Fard Saeid, Aiello Alessandra, Farrone Chiara, Gallì Paola, Capobianchi Maria Rosaria, Ippolito Giuseppe
National Institute for Infectious Diseases Lazzaro Spallanzani, 00149 Rome, Italy.
Vaccines (Basel). 2021 Jun 8;9(6):615. doi: 10.3390/vaccines9060615.
Vaccination against SARS-CoV-2 is considered the most effective method of prevention to contain the pandemic. While highly effective SARS-CoV-2 vaccines are being applied on a large-scale, whether and to what extent the strength of the vaccine-induced immune response could be further potentiated is still an object of debate. Several reports studied the effect of different vaccines on the susceptibility and mortality of COVID-19, with conflicting results. We aimed to evaluate whether previous influenza and/or pneumococcal vaccination had an impact on the specific immune response to the SARS-CoV-2 BNT162b2 mRNA vaccine. The study population consists of 710 workers from our Institute who completed the BNT162b2 schedule and have been tested at least once after the second dose, from 27 December 2020 up to 15 April 2021. Of these, 152 (21.4%) had received an influenza and 215 (30.3%) a concomitant influenza and pneumococcal vaccination, a median of 102 days before the second dose of BNT162b2. Overall, 100% of workers were tested for anti-Spike receptor-binding domain (anti-S/RBD) antibodies, 224 workers for neutralization titer (Micro-neutralization assay, MNA), and 155 workers for a spike-specific T cell interferon-γ response (IFN-γ). The levels of anti-S/RBD, MNA and IFN-γ were evaluated and compared according to sex, age, involvement in direct care of COVID-19 patients, and previous influenza/pneumococcal vaccination. At the univariate analysis, no statistically significant association was observed with regard to a previous influenza and pneumococcal vaccination. A significant lower anti-S/RBD response was observed according to an older age and male sex, while MNA titers were significantly associated to sex but not to age. At the multivariable analysis, workers receiving a concomitant influenza and pneumococcal vaccination or only influenza showed a 58% ( 0.01) and 42% ( 0.07) increase in MNA titers, respectively, compared to those who did not receive an influenza/pneumococcal vaccination. Female workers showed an 81% MNA and a 44% anti-S/RBD increase compared to male workers ( < 0.001). Compared to workers aged 21 to 49 years, those aged 50 or older were associated with a reduction in the anti-S/RBD (16%; 0.005), MNA (31%; 0.019), and IFN.g (32%) immune response. Maintaining the influenza and pneumococcal immunization program for the coming season, in which COVID-19 could still be spreading, remains strongly recommended to protect those who are more vulnerable and to limit the potential burden of these infections on the healthcare system.
接种新型冠状病毒2（SARS-CoV-2）疫苗被认为是遏制这一全球大流行最有效的预防方法。虽然高效的SARS-CoV-2疫苗正在大规模应用，但疫苗诱导的免疫反应强度是否以及在何种程度上能够进一步增强仍是一个有争议的问题。几份报告研究了不同疫苗对新型冠状病毒肺炎（COVID-19）易感性和死亡率的影响，结果相互矛盾。我们旨在评估既往流感和/或肺炎球菌疫苗接种是否会对SARS-CoV-2 BNT162b2 mRNA疫苗的特异性免疫反应产生影响。研究人群包括我们研究所的710名工作人员，他们完成了BNT162b2疫苗接种程序，并在2020年12月27日至2021年4月15日期间第二次接种后至少接受了一次检测。其中，152人（21.4%）接种过流感疫苗，215人（30.3%）同时接种了流感和肺炎球菌疫苗，在第二次接种BNT162b2疫苗前的中位时间为102天。总体而言，100%的工作人员接受了抗刺突受体结合域（抗S/RBD）抗体检测，224名工作人员接受了中和滴度检测（微量中和试验，MNA），155名工作人员接受了刺突特异性T细胞干扰素-γ反应（IFN-γ）检测。根据性别、年龄、是否参与COVID-19患者的直接护理以及既往流感/肺炎球菌疫苗接种情况，对抗S/RBD、MNA和IFN-γ水平进行了评估和比较。在单因素分析中，未观察到既往流感和肺炎球菌疫苗接种有统计学显著关联。根据年龄较大和男性性别观察到抗S/RBD反应显著较低，而MNA滴度与性别显著相关，但与年龄无关。在多变量分析中，与未接种流感/肺炎球菌疫苗的工作人员相比，同时接种流感和肺炎球菌疫苗或仅接种流感疫苗的工作人员MNA滴度分别增加了58%（P<0.01）和42%（P<0.07）。与男性工作人员相比，女性工作人员的MNA增加了81%，抗S/RBD增加了44%（P<0.001）。与21至49岁的工作人员相比，50岁及以上的工作人员抗S/RBD（16%；P<0.005）、MNA（31%；P<0.019）和IFN-γ（32%）免疫反应降低。强烈建议在即将到来的季节维持流感和肺炎球菌免疫接种计划，因为届时COVID-19可能仍在传播，以保护那些更易感染的人群，并限制这些感染对医疗系统的潜在负担。
