两剂 BNT162b2 疫苗接种后对 SARS-CoV-2 刺突抗体的强烈衰减，以及在疗养院居民中对第三剂的高抗体反应。
Strong Decay of SARS-CoV-2 Spike Antibodies after 2 BNT162b2 Vaccine Doses and High Antibody Response to a Third Dose in Nursing Home Residents.
机构信息
Department of Internal Medicine and Geriatrics, MUSE University, Montpellier, France.
INSERM U 1058/EFS, University Hospital, Montpellier, France.
出版信息
J Am Med Dir Assoc. 2022 May;23(5):750-753. doi: 10.1016/j.jamda.2022.02.006. Epub 2022 Feb 23.
OBJECTIVES
To measure the antibody decay after 2 BNT162b2 doses and the antibody response after a third vaccine dose administered 6 months after the second one in nursing home residents with and without prior COVID-19.
DESIGN
Cohort study.
SETTING AND PARTICIPANTS
Four hundred-eighteen residents from 18 nursing homes.
METHODS
Blood receptor-binding domain (RBD)-IgG (IgG II Quant assay, Abbott Diagnostics; upper limit: 5680 BAU) and nucleocapsid-IgG (Abbott Alinity) were measured 21‒28 days after the second BNT162b2 dose, as well as 1‒3 days before and 21‒28 days after the third vaccine dose. RBD-IgG levels of ≥592 BAU/mL were considered as high antibody response. Residents with prior positive quantitative reverse transcription polymerase chain reaction on a nasopharyngeal swab or with N-IgG levels above 0.8 S/CO were considered as prior COVID-19 residents.
RESULTS
In prior COVID-19 residents (n = 122), RBD-IgG median levels decreased by 82% in 167 days on average. In the same period, the number of residents with a high antibody response decreased from 88.5% to 54.9% (P < .0001) and increased to 97.5% after the third vaccine dose (P = .02 vs the first measure). In residents without prior COVID-19 (n = 296), RBD-IgG median levels decreased by 89% in 171 days on average. The number of residents with a high antibody response decreased from 29.4% to 1.7% (P < .0001) and increased to 88.4% after the third vaccine dose (P < .0001 vs the first measure).
CONCLUSIONS AND IMPLICATIONS
The strong and rapid decay of RBD-IgG levels after the second BNT162b2 dose in all residents and the high antibody response after the third dose validate the recommendation of a third vaccine dose in residents less than 6 months after the second dose, prioritizing residents without prior COVID-19. The slope of RBD-IgG decay after the third BNT162b2 dose and the protection level against SARS-CoV-2 B.1.1.529 (omicron) and other variants of concern provided by the high post-boost vaccination RBD-IgG response require further investigation in residents.
目的
测量接种 2 剂 BNT162b2 后抗体衰减情况，以及在第 2 剂后 6 个月接种第 3 剂疫苗后，有和无既往 COVID-19 的养老院居民的抗体反应。
设计
队列研究。
地点和参与者
来自 18 家养老院的 418 名居民。
方法
在第 2 剂 BNT162b2 后 21-28 天，以及第 3 剂疫苗前 1-3 天和后 21-28 天，测量血液受体结合域（RBD）-IgG（雅培诊断 IgG II Quant 检测；上限：5680 BAU）和核衣壳-IgG（雅培 Alinity）。RBD-IgG 水平≥592 BAU/mL 被认为是高抗体反应。鼻咽拭子定量逆转录聚合酶链反应阳性或 N-IgG 水平高于 0.8 S/CO 的居民被认为是既往 COVID-19 居民。
结果
在既往 COVID-19 居民（n=122）中，RBD-IgG 中位数水平平均在 167 天内下降 82%。在此期间，高抗体反应居民的数量从 88.5%下降到 54.9%（P<0.0001），并在第 3 剂疫苗后增加到 97.5%（P=0.02 与首次测量相比）。在无既往 COVID-19 的居民（n=296）中，RBD-IgG 中位数水平平均在 171 天内下降 89%。高抗体反应居民的数量从 29.4%下降到 1.7%（P<0.0001），并在第 3 剂疫苗后增加到 88.4%（P<0.0001 与首次测量相比）。
结论和意义
所有居民在接种第 2 剂 BNT162b2 后 RBD-IgG 水平的快速衰减以及第 3 剂疫苗后的高抗体反应证实了在第 2 剂后 6 个月内为居民接种第 3 剂疫苗的建议，优先考虑无既往 COVID-19 的居民。第 3 剂 BNT162b2 后 RBD-IgG 衰减的斜率和高疫苗后接种 RBD-IgG 反应对 SARS-CoV-2 B.1.1.529（奥密克戎）和其他关注变体的保护水平需要在居民中进一步研究。
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