2021 年 7 月至 8 月，台湾免疫功能低下患者接种 COVID-19 mRNA-1273 加强针后的血清学反应。
Serological response after COVID-19 mRNA-1273 booster dose in immunocompromised patients, Taiwan, July to August 2021.
机构信息
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Occupational Safety and Health Office, National Taiwan University Hospital, Taipei, Taiwan.
出版信息
J Formos Med Assoc. 2022 Dec;121(12):2438-2445. doi: 10.1016/j.jfma.2022.08.017. Epub 2022 Aug 31.
BACKGROUND
Whether immunocompromising conditions affect the immunogenicity of COVID-19 booster vaccination remains a concern, which impedes the vaccination campaign in people most vulnerable to COVID-19-associated morbidity and mortality. We aimed to evaluate the effect of immune dysfunction on immunogenicity of homologous and heterologous prime-boost COVID-19 vaccination.
METHODS
Between July and August, 2021, 399 participants were randomized to receive ChAdOx1/ChAdOx1 8 weeks apart, ChAdOx1/mRNA-1273 8 weeks apart, ChAdOx1/mRNA-1273 4 weeks apart, and mRNA-1273/mRNA-1273 4 weeks apart. The anti-SARS-CoV-2 spike IgG antibody titers on the day before booster vaccination and 4 weeks after booster vaccination were compared between participants with and without immunocompromising conditions.
RESULTS
Among ChAdOx1-primed participants, a trend of lower anti-SARS-CoV-2 spike IgG titers before booster vaccination were found in participants with autoimmune diseases (geometric means, 34.76 vs. 84.25 binding antibody units [BAU]/mL, P = 0.173), compared to those without. Participants receiving immunosuppressants and/or immunomodulators had significant lower anti-SARS-CoV-2 spike IgG titers before booster vaccination than those without (geometric means, 36.39 vs. 83.84 BAU/mL; P = 0.001). Among mRNA-1273-boosted participants, anti-SARS-CoV-2 spike IgG titers 4 weeks after booster vaccination were similar across all the strata. Participants with autoimmune diseases and receiving immunosuppressants and/or immunomodulators, had numerically lower anti-SARS-CoV-2 spike IgG titers 4 weeks after booster vaccination compared to those without (geometric means, 1474.34 vs. 1923.23 and 1590.61 vs. 1918.38 BAU/mL; P > 0.05).
CONCLUSION
The immunogenicity of prime vaccination with ChAdOx1 decreased by immune dysfunction, but enhanced after receiving boost vaccination with mRNA-1273. Our study results support the efficacy of mRNA-1273 booster dose among immunocompromised hosts.
背景
免疫功能低下是否会影响 COVID-19 加强针疫苗的免疫原性仍然是一个关注点，这阻碍了最容易受到 COVID-19 相关发病率和死亡率影响的人群的疫苗接种活动。我们旨在评估免疫功能障碍对同源和异源初级加强 COVID-19 疫苗接种的免疫原性的影响。
方法
2021 年 7 月至 8 月，399 名参与者被随机分配接受间隔 8 周的 ChAdOx1/ChAdOx1、间隔 8 周的 ChAdOx1/mRNA-1273、间隔 4 周的 ChAdOx1/mRNA-1273 和间隔 4 周的 mRNA-1273/mRNA-1273。在加强针接种前一天和加强针接种后 4 周，比较有和无免疫功能低下情况的参与者的抗 SARS-CoV-2 刺突 IgG 抗体滴度。
结果
在 ChAdOx1 初免参与者中，与无自身免疫性疾病的参与者相比，自身免疫性疾病参与者的加强针前抗 SARS-CoV-2 刺突 IgG 滴度呈下降趋势（几何平均，34.76 与 84.25 结合抗体单位 [BAU]/mL，P=0.173）。接受免疫抑制剂和/或免疫调节剂的参与者与无免疫抑制剂和/或免疫调节剂的参与者相比，加强针前抗 SARS-CoV-2 刺突 IgG 滴度显著降低（几何平均，36.39 与 83.84 BAU/mL；P=0.001）。在接受 mRNA-1273 加强针的参与者中，加强针后 4 周的抗 SARS-CoV-2 刺突 IgG 滴度在所有分层中均相似。与无免疫功能低下情况的参与者相比，有自身免疫性疾病和接受免疫抑制剂和/或免疫调节剂的参与者加强针后 4 周的抗 SARS-CoV-2 刺突 IgG 滴度数值较低（几何平均，1474.34 与 1923.23 和 1590.61 与 1918.38 BAU/mL；P>0.05）。
结论
ChAdOx1 初免的免疫原性因免疫功能障碍而降低，但接受 mRNA-1273 加强针后增强。我们的研究结果支持在免疫功能低下宿主中使用 mRNA-1273 加强剂量的有效性。
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