San Román Jesús, Candel Francisco Javier, Sanz Juan Carlos, López Paloma, Menéndez-Colino Rocío, Barreiro Pablo, Carretero María Del Mar, Pérez-Abeledo Marta, Viñuela-Prieto José Manuel, Ramos Belén, Canora Jesús, Barba Raquel, Zapatero-Gaviria Antonio, Martínez-Peromingo Franciso Javier
Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, 28922 Madrid, Spain.
Unit of Microbiology, Regional Laboratory of Public Health, Hospital Enfermera Isabel Zendal, 28055 Madrid, Spain.
Vaccines (Basel). 2022 Mar 2;10(3):383. doi: 10.3390/vaccines10030383.
Background: Most residents and staff in nursing homes have received full vaccination. Factors related to the immune response to vaccination might be related to the risk of future severe COVID-19 and may guide the need for vaccine boosters. Design: Nursing homes that were tested in a point survey in July-October 2020 were again analyzed after a vaccination campaign in June-July 2021. Immune responses according to IgG against nucleocapsid and spike antigens, and CD4 and CD8 interferon-gamma release assay against spike antigens, were evaluated. Results: A total of 1973 subjects were tested (61.7% residents, 48.3% staff), with a mean (SD) follow-up of 46.4 (3.6) weeks between assessments. More than half of residents and more than a third of staff had evidence of COVID-19 before vaccination; 26.9% and 22.7% had seroreversion of IgG-N, and 8.9% and 4.6% had IgG-N seroconversion at second assessment, respectively. Up to 96.8% of residents and 98.1% of workers had positive IgG-S after a mean of 19.9 (2.1) weeks after vaccination. In residents with vs without a history of COVID-19, IgG-S titers were 4.11 (0.54) vs. 2.73 (0.74) logAU/mL (p < 0.001); in workers these titers were 3.89 (0.61) vs. 3.15 (0.64) logAU/mL (p < 0.001). Linear regression analysis showed that younger age (OR: −0.03 per 10 years-older [95% CI, −0.04 to −0.02], p < 0.001) and evidence of COVID-19 (OR: 1.14 [95% CI, 1.08 to 1.20], p < 0.001) are associated with greater IgG-S titers after vaccination. A direct association was found between IgG-S titers and the intensity of IFN-gamma response against spike antigens. Conclusions: Waning of humoral response and reinfection seems to be more frequent in older as compared to younger adults, although cellular responses shortly after vaccination are comparable between these groups. Younger age and prior COVID-19 are related to greater humoral response after vaccination against SARS-CoV-2.
大多数养老院的居民和工作人员都已接种了全程疫苗。与疫苗免疫反应相关的因素可能与未来发生严重新冠病毒病的风险有关，并可能指导疫苗加强针的需求。设计：对2020年7月至10月进行的一次定点调查中接受检测的养老院，在2021年6月至7月开展疫苗接种活动后再次进行分析。评估了针对核衣壳和刺突抗原的IgG免疫反应，以及针对刺突抗原的CD4和CD8干扰素-γ释放试验。结果：共对1973名受试者进行了检测（61.7%为居民，48.3%为工作人员），两次评估之间的平均（标准差）随访时间为46.4（3.6）周。超过一半的居民和超过三分之一的工作人员在接种疫苗前有新冠病毒病感染证据；在第二次评估时，分别有26.9%和22.7%的居民和工作人员IgG-N抗体血清转化消失，8.9%和4.6%的居民和工作人员IgG-N抗体血清转化出现。接种疫苗后平均19.9（2.1）周，高达96.8%的居民和98.1%的工作人员IgG-S呈阳性。有新冠病毒病病史的居民与无病史的居民相比，IgG-S滴度分别为4.11（0.54）和2.73（0.74）logAU/mL（p<0.001）；工作人员的这些滴度分别为3.89（0.61）和3.15（0.64）logAU/mL（p<0.001）。线性回归分析显示，年龄较小（每大10岁的比值比：-0.03[95%置信区间，-0.04至-0.02]，p<0.001）和有新冠病毒病感染证据（比值比：1.14[95%置信区间，1.08至1.20]，p<0.001）与接种疫苗后更高的IgG-S滴度相关。发现IgG-S滴度与针对刺突抗原的干扰素-γ反应强度之间存在直接关联。结论：与年轻人相比，老年人的体液免疫反应减弱和再次感染似乎更常见，尽管两组在接种疫苗后不久的细胞免疫反应相当。年龄较小和既往感染新冠病毒病与接种针对严重急性呼吸综合征冠状病毒2的疫苗后更强的体液免疫反应有关。
