Moghnieh Rima, El Hajj Claude, Abdallah Dania, Jbeily Nayla, Bizri Abdul Rahman, Sayegh Mohamed H
Division of Infectious Diseases, Department of Internal Medicine, Makassed General Hospital, Beirut P.O. Box 11-6301, Lebanon.
Faculty of Medicine, Lebanese University, Beirut P.O. Box 6573/14, Lebanon.
Vaccines (Basel). 2022 Sep 22;10(10):1596. doi: 10.3390/vaccines10101596.
In this study involving a cohort of employees of the National Airline company in Lebanon, we assessed humoral immunity levels and the effectiveness of two COVID-19 vaccines, Gam-COVID-Vac versus BNT162b2, after two doses and after a homologous and heterologous BNT162b2 booster, in addition to the impact of hybrid immunity. Vaccine effectiveness (VE) was retrospectively determined against laboratory-confirmed SARS-CoV-2 infection during the periods of Delta and Omicron variants' predominance, separately, and was calculated based on a case-control study design. The humoral immune response, measured by a SARS-CoV-2 anti-spike receptor-binding domain (RBD) IgG titer, was prospectively assessed after the aforementioned vaccination schemes at different time points. This study showed higher effectiveness of BNT162b2 after two doses (81%) compared to two doses of Gam-COVID-Vac (41.8%) against the Delta variant of SARS-CoV-2, which correlated with anti-spike antibody levels. Regarding the Omicron variant, protection against infection and antibody levels were severely compromised and the correlation between an anti-spike IgG titer and effectiveness was lost, unlike the situation during the Delta wave. Considering the booster vaccination schemes, a homologous BNT162b2 booster after a BNT162b2 primary vaccination induced a higher humoral immune response when compared to that induced by a heterologous BNT162b2 booster after a Gam-COVID-Vac primary vaccination. However, the VE of both booster regimens against the Omicron variant was almost equal (64% in the homologous regimen and 57% in heterologous regimen). Hybrid immunity evidenced a better humoral response and a greater and longer protection against Delta and Omicron infections compared to vaccination-induced immunity in COVID-19-naïve individuals. Finally, the findings show that VE waned with time during the same wave, highlighting the importance of reinforcing primary and booster COVID-19 vaccination mainly at the beginning of each wave during the surge of a new variant of concern.
在这项针对黎巴嫩国家航空公司一批员工的研究中，我们评估了两种新冠疫苗（Gam-COVID-Vac与BNT162b2）在接种两剂后、同源和异源BNT162b2加强剂接种后体液免疫水平和有效性，以及混合免疫的影响。疫苗有效性（VE）是在德尔塔和奥密克戎变异株占主导期间，分别针对实验室确诊的SARS-CoV-2感染进行回顾性测定的，并基于病例对照研究设计进行计算。通过SARS-CoV-2抗刺突受体结合域（RBD）IgG滴度测量的体液免疫反应，在上述不同时间点的疫苗接种方案后进行前瞻性评估。这项研究表明，与两剂Gam-COVID-Vac（41.8%）相比，两剂BNT162b2在针对SARS-CoV-2的德尔塔变异株时有效性更高（81%），这与抗刺突抗体水平相关。对于奥密克戎变异株，与德尔塔毒株流行期间的情况不同，预防感染的能力和抗体水平严重受损，抗刺突IgG滴度与有效性之间的相关性丧失。考虑到加强疫苗接种方案，BNT162b2初次接种后进行同源BNT162b2加强接种，与Gam-COVID-Vac初次接种后进行异源BNT162b2加强接种相比，诱导的体液免疫反应更高。然而，两种加强方案针对奥密克戎变异株的疫苗有效性几乎相等（同源方案为64%，异源方案为57%）。与未感染过新冠病毒个体的疫苗诱导免疫相比，混合免疫表现出更好的体液反应，以及对德尔塔和奥密克戎感染更强且更持久的保护。最后，研究结果表明，在同一波疫情期间，疫苗有效性随时间下降，突出了在新的关注变异株激增期间，主要在每一波疫情开始时加强新冠疫苗的初次接种和加强接种的重要性。
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