Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Department of Medical Microbiology and Infectious Diseases, Oxford University Hospitals, Oxford, UK.
BMJ Open. 2022 Dec 1;12(12):e066766. doi: 10.1136/bmjopen-2022-066766.
To examine antibody responses after the second vaccination in healthcare workers (HCWs) with underlying health conditions.
Cohort study.
Oxford University Hospitals in the United Kingdom.
Healthcare workers who had SARS-CoV-2 serological data available and received two SARS-CoV- 2 vaccinations.
Peak SARS-CoV-2 anti-spike IgG responses after the second vaccination and associations with underlying health conditions and the estimated risk of severe COVID-19 using an occupational health risk assessment tool.
We used univariable and multivariable linear regression models to investigate associations between antibody levels and demographics (age, sex, ethnicity), healthcare role, body mass index, underlying health conditions, vaccination status, prior infection and the Association of Local Authority Medical Advisors COVID-age risk score.
1635 HCWs had anti-spike IgG measurements 14-84 days after second vaccination and data on any underlying health conditions. Only five HCWs (0.3%), all on immunosuppressive treatment, (including four organ transplant recipients), did not seroconvert after second vaccination. Antibody levels were independently lower with older age, diabetes, immunosuppression, respiratory disorders other than asthma and markedly so in organ transplant recipients. Levels were independently lower in ChAdOx1 versus BNT162b2 recipients and higher following previous infection. HCWs with 'very high' COVID-age risk scores had lower median antibody levels than those with 'low', 'medium' or 'high' risk scores; 4379 AU/mL, compared with 12 337 AU/mL, 9430 AU/mL and 10 524 AU/mL, respectively.
Two vaccine doses are effective in generating antibody responses among HCWs, including those with a high occupational risk. However, HCWs with underlying health conditions, especially diabetes, immunosuppression and organ transplant, had lower antibody levels, and vaccine response monitoring may be needed.
研究有基础疾病的医护人员（HCWs）第二次接种后的抗体反应。
队列研究。
英国牛津大学医院。
有 SARS-CoV-2 血清学数据且接种了两剂 SARS-CoV-2 疫苗的医护人员。
第二次接种后 SARS-CoV-2 抗刺突 IgG 反应峰值及与基础健康状况的关系，并使用职业健康风险评估工具评估与严重 COVID-19 的相关性。
我们使用单变量和多变量线性回归模型，研究抗体水平与人口统计学因素（年龄、性别、种族）、医护角色、体重指数、基础健康状况、疫苗接种状况、既往感染和地方当局医学顾问 COVID-年龄风险评分之间的关系。
1635 名 HCWs 在第二次接种后 14-84 天进行了抗刺突 IgG 测量，且有任何基础健康状况的数据。只有 5 名 HCWs（0.3%），均接受免疫抑制治疗，（包括 4 名器官移植受者），第二次接种后未发生血清转化。年龄较大、患有糖尿病、免疫抑制、除哮喘外的呼吸系统疾病，以及器官移植受者的抗体水平独立较低。与 BNT162b2 相比，ChAdOx1 组的抗体水平较低，且既往感染后抗体水平较高。COVID-年龄风险评分较高的 HCWs 的中位抗体水平低于低、中、高风险评分的 HCWs；分别为 4379 AU/mL、12337 AU/mL、9430 AU/mL 和 10524 AU/mL。
两剂疫苗可有效在 HCWs 中产生抗体反应，包括高职业风险的 HCWs。然而，有基础疾病的 HCWs，尤其是糖尿病、免疫抑制和器官移植受者，抗体水平较低，可能需要进行疫苗反应监测。
