Université de Lorraine, CNRS, LCPME, Nancy, France.
Université de Lorraine, CHRU-Nancy Brabois, Departement of Virology, Vandœuvre-lès-Nancy, France.
J Am Geriatr Soc. 2022 Sep;70(9):2552-2560. doi: 10.1111/jgs.17837. Epub 2022 May 10.
Duration of post-vaccination protection against COVID-19 in nursing home (NH) residents is a critical issue. The objective of this study was to estimate the duration of the IgG(S) response to the mRNA BNT162b2 vaccine in NH residents with (COV-Yes) or without (COV-No) history of SARS-CoV-2 infection.
A 574 COV-Yes and COV-No NH residents were included in 2 cohorts: Main (n = 115, median age 87 years) or Confirmatory (n = 459, median age 89 years). IgG(S) quantification was carried out at three different time points following the BNT162b2 vaccine: three (1st) and seven (2nd) months after the 2nd dose, and 1 month after the 3rd dose (3rd quantification) in the Main cohort, and twice (2nd and 3rd) in the Confirmatory cohort. The seroneutralization capacity according to COVID-19 history was also measured in a subgroup of patients.
Neutralization capacity was strongly correlated with IgG(S) levels (R :76%) without any difference between COV-Yes and COV-No groups for the same levels of IgG(S). After the 2nd dose, duration of the assumed robust protection (IgG(S) >264 BAU/ml) was two-fold higher in the COV-Yes vs. COV-No group: 12.60 (10.69-14.44) versus 5.76 (3.91-8.64) months, with this advantage mainly due to the higher IgG(S) titers after the 2nd dose and secondary to a slower decay over time. After the 3rd dose, duration of robust protection was estimated at 11.87 (9.88-14.87) (COV-Yes) and 8.95 (6.85-11.04) (COV-No) months. These results were similar in both cohorts.
In old subjects living in NH, history of SARS-CoV-2 infection provides a clear advantage in the magnitude and duration of high IgG(S) titers following the 2nd dose. Importantly, the 3rd dose induces a much more pronounced IgG(S) response than the 2nd dose in COV-No subjects, the effect of which should be able to ensure a prolonged protection against severe forms of COVID-19 in these subjects.
养老院（NH）居民接种 COVID-19 疫苗后的保护持续时间是一个关键问题。本研究的目的是估计 mRNA BNT162b2 疫苗接种后 NH 居民 IgG(S) 应答的持续时间，这些居民有（COV-Yes）或没有（COV-No）SARS-CoV-2 感染史。
将 574 名 COV-Yes 和 COV-No NH 居民纳入两个队列：主要队列（n=115，中位年龄 87 岁）或确认队列（n=459，中位年龄 89 岁）。在 BNT162b2 疫苗接种后三个不同时间点进行 IgG(S) 定量：第 2 剂后 3 个月（第 1 次）和 7 个月（第 2 次），以及第 3 剂后 1 个月（第 3 次定量）在主要队列中，确认队列中进行了两次（第 2 次和第 3 次）。还在一组患者中测量了根据 COVID-19 史的血清中和能力。
中和能力与 IgG(S) 水平呈强相关性（R：76%），COV-Yes 和 COV-No 组之间没有任何差异。在第 2 剂后，假设的强保护持续时间（IgG(S) >264 BAU/ml）在 COV-Yes 组是 COV-No 组的两倍：12.60（10.69-14.44）与 5.76（3.91-8.64）个月，这种优势主要归因于第 2 剂后更高的 IgG(S) 滴度，其次是随时间推移的衰减较慢。在第 3 剂后，强保护的持续时间估计为 11.87（9.88-14.87）（COV-Yes）和 8.95（6.85-11.04）（COV-No）个月。这些结果在两个队列中均相似。
在 NH 居住的老年人群中，SARS-CoV-2 感染史在第 2 剂后高 IgG(S) 滴度的幅度和持续时间方面提供了明显优势。重要的是，第 3 剂在 COV-No 受试者中引起的 IgG(S) 反应比第 2 剂更明显，这种效应应该能够确保这些受试者对严重形式的 COVID-19 产生长期保护。
