印度使用的两种 COVID-19 疫苗的免疫原性：来自一家三级保健医院的医护人员的观察性队列研究。
Immunogenicity of two COVID-19 vaccines used in India: An observational cohort study in health care workers from a tertiary care hospital.
机构信息
Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India.
Department of Pediatrics, Bharati Vidyapeeth Medical College, Bharati Vidyapeeth (Deemed to be) University, Pune, Maharashtra, India.
出版信息
Front Immunol. 2022 Sep 23;13:928501. doi: 10.3389/fimmu.2022.928501. eCollection 2022.
COVID-19 pandemic witnessed rapid development and use of several vaccines. In India, a country-wide immunization was initiated in January 2021. COVISHIELD, the chimpanzee adenoviral-vectored vaccine with full-length SARS-COV-2 spike insert and COVAXIN, the whole virus-inactivated vaccines were used. To assess and compare immune response of health-care-workers to COVISHIELD (n=187) and COVAXIN (n=21), blood samples were collected pre-vaccination, 1month post-1/post-2 doses and 6months post-dose-2 and tested for IgG-anti-SARS-CoV-2 (ELISA) and neutralizing (Nab,PRNT50) antibodies. Spike-protein-specific T cells were quantitated by IFN-γ-ELISPOT. In pre-vaccination-antibody-negative COVISHIELD recipients (pre-negatives, n=120), %Nab seroconversion (median, IQR Nab titers) increased from 55.1% (16, 2.5-36.3) post-dose-1 to 95.6% (64.5, 4.5-154.2, p<0.001) post-dose-2 that were independent of age/gender/BMI. Nab response was higher among pre-positives with hybrid immunity at all-time points (p<0.01-0.0001) and independent of age/gender/BMI/Comorbidities. Post-dose-2-seroconversion (50%, p<0.001) and Nab titers (6.75, 2.5-24.8, p<0.001) in COVAXIN-recipients were lower than COVISHIELD. COVAXIN elicited a superior IFN-γ-T cell response as measured by ELISPOT (100%; 1226, 811-1532 spot forming units, SFU/million PBMCs v/s 57.8%; 21.7,1.6-169.2; p<0.001). At 6months, 28.3% (15/53) COVISHIELD and 3/3COVAXIN recipients were Nab-negative. T cell response remained unchanged. During immunization, COVID-19 cases were detected among COVISHIELD (n=4) and COVAXIN (n=2) recipients. At 6months, 9cases were recorded in COVISHIELD-recipients. This first-time, systematic, real-world assessment and long-term follow up revealed generation of higher neutralizing antibody titers by COVISHIELD and stronger T-cell response by COVAXIN. Diminished Nab titers at 6months emphasize early booster. Immunogenicity/efficacy of vaccines will change with the progression of the pandemic needing careful evaluations in the field-settings.
COVID-19 大流行见证了几种疫苗的快速开发和使用。2021 年 1 月，印度开始在全国范围内进行免疫接种。使用了 Chimpanzee 腺病毒载体疫苗 COVISHIELD（全长 SARS-CoV-2 刺突插入物）和全病毒灭活疫苗 COVAXIN。为了评估和比较医护人员对 COVISHIELD（n=187）和 COVAXIN（n=21）的免疫反应，在接种前、接种后 1 个月/2 个月和接种后 6 个月采集血样，并通过 ELISA 检测 IgG-抗-SARS-CoV-2（ELISA）和中和（Nab，PRNT50）抗体，通过 IFN-γ-ELISPOT 定量检测 Spike 蛋白特异性 T 细胞。在接种前抗体阴性的 COVISHIELD 受种者（接种前阴性，n=120）中，Nab 血清转化率（中位数，IQR Nab 滴度）从第 1 剂后 55.1%（16，2.5-36.3）增加到第 2 剂后 95.6%（64.5，4.5-154.2，p<0.001），与年龄/性别/BMI 无关。在所有时间点，具有混合免疫的接种前阳性者的 Nab 反应更高（p<0.01-0.0001），且与年龄/性别/BMI/合并症无关。COVAXIN 受种者的第 2 剂后血清转化率（50%，p<0.001）和 Nab 滴度（6.75，2.5-24.8，p<0.001）均低于 COVISHIELD。COVAXIN 通过 ELISPOT（100%；1226，811-1532 个斑点形成单位，SFU/百万 PBMCs v/s 57.8%；21.7，1.6-169.2；p<0.001）产生了更高的 IFN-γ-T 细胞反应。6 个月时，53 名 COVISHIELD 受种者中有 28.3%（15 名）和 3 名 COVAXIN 受种者的 Nab 为阴性。T 细胞反应保持不变。在免疫接种期间，在 COVISHIELD（n=4）和 COVAXIN（n=2）受种者中检测到 COVID-19 病例。6 个月时，COVISHIELD 受种者中有 9 例记录。这是首次对 COVISHIELD 和 COVAXIN 进行系统的、真实世界的评估和长期随访，结果显示 COVISHIELD 产生了更高的中和抗体滴度，COVAXIN 产生了更强的 T 细胞反应。6 个月时 Nab 滴度下降，强调早期加强免疫。随着大流行的进展，疫苗的免疫原性/疗效将发生变化，需要在现场环境中进行仔细评估。
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