MMWR Morb Mortal Wkly Rep. 2023 Jan 27;72(4):100-106. doi: 10.15585/mmwr.mm7204a4.
Introduction of monovalent COVID-19 mRNA vaccines in late 2020 helped to mitigate disproportionate COVID-19-related morbidity and mortality in U.S. nursing homes (1); however, reduced effectiveness of monovalent vaccines during the period of Omicron variant predominance led to recommendations for booster doses with bivalent COVID-19 mRNA vaccines that include an Omicron BA.4/BA.5 spike protein component to broaden immune response and improve vaccine effectiveness against circulating Omicron variants (2). Recent studies suggest that bivalent booster doses provide substantial additional protection against SARS-CoV-2 infection and severe COVID-19-associated disease among immunocompetent adults who previously received only monovalent vaccines (3).* The immunologic response after receipt of bivalent boosters among nursing home residents, who often mount poor immunologic responses to vaccines, remains unknown. Serial testing of anti-spike protein antibody binding and neutralizing antibody titers in serum collected from 233 long-stay nursing home residents from the time of their primary vaccination series and including any subsequent booster doses, including the bivalent vaccine, was performed. The bivalent COVID-19 mRNA vaccine substantially increased anti-spike and neutralizing antibody titers against Omicron sublineages, including BA.1 and BA.4/BA.5, irrespective of previous SARS-CoV-2 infection or previous receipt of 1 or 2 booster doses. These data, in combination with evidence of low uptake of bivalent booster vaccination among residents and staff members in nursing homes (4), support the recommendation that nursing home residents and staff members receive a bivalent COVID-19 booster dose to reduce associated morbidity and mortality (2).
2020 年末引入单价 COVID-19 mRNA 疫苗有助于减轻美国养老院中不成比例的 COVID-19 相关发病率和死亡率(1);然而,Omicron 变体为主导时期单价疫苗的有效性降低,导致建议使用包含 Omicron BA.4/BA.5 刺突蛋白成分的二价 COVID-19 mRNA 疫苗进行加强针接种,以扩大免疫反应并提高针对循环 Omicron 变体的疫苗有效性(2)。最近的研究表明,二价加强针为以前仅接种单价疫苗的免疫功能正常成年人提供了针对 SARS-CoV-2 感染和与 COVID-19 相关的严重疾病的实质性额外保护(3)。* 接种二价加强针后,养老院居民的免疫反应如何,他们通常对疫苗产生较差的免疫反应,这一点尚不清楚。对 233 名长期居住在养老院的居民的血清中的抗刺突蛋白抗体结合和中和抗体滴度进行了连续检测,这些居民在接种完初始疫苗系列后,包括任何后续的加强针接种,包括二价疫苗。二价 COVID-19 mRNA 疫苗大大提高了针对 Omicron 亚谱系(包括 BA.1 和 BA.4/BA.5)的抗刺突和中和抗体滴度,无论以前是否感染过 SARS-CoV-2 或以前是否接种过 1 剂或 2 剂加强针。这些数据结合养老院居民和工作人员二价加强针接种率低的证据(4),支持建议养老院居民和工作人员接种二价 COVID-19 加强针以降低相关发病率和死亡率(2)。
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