Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines.
Disease Intervention & Prevention and Population Health Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA.
J Med Virol. 2022 Jul;94(7):2939-2961. doi: 10.1002/jmv.27688. Epub 2022 Mar 9.
Accumulating evidence shows a progressive decline in the efficacy of coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) messenger RNA (mRNA) vaccines such as Pfizer-BioNTech (mRNA BNT161b2) and Moderna (mRNA-1273) in preventing breakthrough infections due to diminishing humoral immunity over time. Thus, this review characterizes the kinetics of anti-SARS-CoV-2 antibodies after the second dose of a primary cycle of COVID-19 mRNA vaccination. A systematic search of the literature was performed and a total of 18 articles (N = 15 980 participants) were identified and reviewed. The percent difference of means of reported antibody titers was then calculated to determine the decline in humoral response after the peak levels postvaccination. Findings revealed that the peak humoral response was reached at 21-28 days after the second dose, after which serum levels progressively diminished at 4-6-month postvaccination. Additionally, results showed that regardless of age, sex, serostatus, and presence of comorbidities, longitudinal data reporting antibody measurement exhibited a decline of both anti-receptor binding domain immunoglobulin G (IgG) and anti-spike IgG, ranging from 94% to 95% at 90-180 days and 55%-85% at 140-160 days, respectively, after the peak antibody response. This suggests that the rate of antibody decline may be independent of patient-related factors and peak antibody titers but mainly a function of time and antibody class/molecular target. Hence, this study highlights the necessity of more efficient vaccination strategies to provide booster administration in attenuating the effects of waning immunity, especially in the appearance of new variants of concerns.
越来越多的证据表明，由于随着时间的推移，体液免疫逐渐减弱，导致新型冠状病毒病 2019（COVID-19）（严重急性呼吸综合征冠状病毒 2 [SARS-CoV-2]）信使 RNA（mRNA）疫苗（如辉瑞-生物技术公司 [mRNA BNT161b2] 和 Moderna [mRNA-1273]）预防突破性感染的效力逐渐下降。因此，本综述描述了 COVID-19 mRNA 疫苗初级周期第二针接种后抗 SARS-CoV-2 抗体的动力学。系统地检索了文献，共确定并审查了 18 篇文章（N=15980 名参与者）。然后计算报告的抗体滴度的平均值的百分比差异，以确定接种后峰值水平后的体液反应下降情况。研究结果表明，第二针接种后 21-28 天达到峰值体液反应，此后，在接种后 4-6 个月血清水平逐渐下降。此外，结果表明，无论年龄、性别、血清学状态和是否存在合并症，报告抗体测量的纵向数据都显示出抗受体结合域免疫球蛋白 G（IgG）和抗刺突 IgG 的下降，在 90-180 天分别下降了 94%-95%，在 140-160 天分别下降了 55%-85%，达到峰值抗体反应后。这表明，抗体下降的速度可能与患者相关因素和峰值抗体滴度无关，而主要是时间和抗体类别/分子靶标。因此，本研究强调了需要更有效的疫苗接种策略，通过加强免疫来减轻免疫减弱的影响，特别是在出现新的关注变体时。
