Cluff Emily, Bellusci Lorenza, Golding Hana, Khurana Surender
Center for Biologics Evaluation and Research (CBER), Division of Viral Products, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA.
Vaccines (Basel). 2022 Mar 15;10(3):450. doi: 10.3390/vaccines10030450.
In healthy adults, hybrid immunity induced by prior SARS-CoV-2 infection followed by two doses of mRNA vaccination provide protection against symptomatic SARS-CoV-2 infection. However, the role of hybrid immunity in autoimmune patients against Omicron is not well documented. Here, we report a young autoimmune patient with prior infection and two doses of mRNA-1273 vaccination who was exposed to Omicron and developed a symptomatic disease. Prior to Omicron infection, the patient had strong neutralizing antibody titers against the vaccine strain, but no neutralization of Omicron. Post Omicron infection, high neutralizing titers against Omicron were observed. Furthermore, enhanced neutralizing antibody titers against other variants of concern-Alpha, Beta, Gamma, and Delta-were observed, suggesting an expansion of cross-reactive memory B-cell response by the SARS-CoV-2 Omicron infection. Autoimmune patients may require careful monitoring of immune function over time to optimize booster vaccine administration.
在健康成年人中，先前感染过严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后再接种两剂信使核糖核酸（mRNA）疫苗所诱导的混合免疫可提供针对有症状SARS-CoV-2感染的保护。然而，混合免疫在自身免疫性疾病患者中针对奥密克戎毒株的作用尚无充分记录。在此，我们报告一名年轻的自身免疫性疾病患者，其先前感染过SARS-CoV-2且接种过两剂mRNA-1273疫苗，接触奥密克戎毒株后出现了有症状疾病。在感染奥密克戎毒株之前，该患者针对疫苗毒株有很强的中和抗体滴度，但对奥密克戎毒株无中和作用。感染奥密克戎毒株后，观察到针对奥密克戎毒株的高中和滴度。此外，还观察到针对其他关注变异株——阿尔法、贝塔、伽马和德尔塔——的中和抗体滴度增强，这表明SARS-CoV-2奥密克戎毒株感染使交叉反应性记忆B细胞反应得到扩展。自身免疫性疾病患者可能需要长期仔细监测免疫功能，以优化加强疫苗的接种。
