Klingel Hanna, Krüttgen Alexander, Imöhl Matthias, Kleines Michael
Laboratory Diagnostic Center, University Hospital RWTH Aachen, Aachen, Germany.
Clin Exp Vaccine Res. 2023 Jan;12(1):60-69. doi: 10.7774/cevr.2023.12.1.60. Epub 2023 Jan 31.
Although the fast development of safe and effective messenger RNA (mRNA) vaccines against severe acute respiratory syndrome coronavirus 2 has been a success, waning humoral immunity has led to the recommendation of booster immunization. However, knowledge of the humoral immune response to different booster strategies and the association with adverse reactions is limited.
We investigated adverse reactions and anti-spike protein immunoglobulin G (IgG) concentrations among health care workers who received primary immunization with mRNA-1273 and booster immunization with mRNA-1273 or BNT162b2.
Adverse reactions were reported by 85.1% after the first dose, 94.7% after the second dose, 87.5% after a third dose of BNT162b2, and 86.0% after a third dose of mRNA-1273. They lasted for a median of 1.8, 2.0, 2.5, and 1.8 days, respectively; 6.4%, 43.6%, and 21.0% of the participants were unable to work after the first, second, and third vaccination, respectively, which should be considered when scheduling vaccinations among essential workers. Booster immunization induced a 13.75-fold (interquartile range, 9.30-24.47) increase of anti-spike protein IgG concentrations with significantly higher concentrations after homologous compared to heterologous vaccination. We found an association between fever, chills, and arthralgia after the second vaccination and anti-spike protein IgG concentrations indicating a linkage between adverse reactions, inflammation, and humoral immune response.
Further investigations should focus on the possible advantages of homologous and heterologous booster vaccinations and their capability of stimulating memory B-cells. Additionally, understanding inflammatory processes induced by mRNA vaccines might help to improve reactogenicity while maintaining immunogenicity and efficacy.
尽管针对严重急性呼吸综合征冠状病毒2的安全有效信使核糖核酸（mRNA）疫苗的快速发展已取得成功，但体液免疫的减弱导致了加强免疫的建议。然而，关于对不同加强免疫策略的体液免疫反应以及与不良反应的关联的了解有限。
我们调查了接受mRNA-1273初次免疫并使用mRNA-1273或BNT162b2进行加强免疫的医护人员的不良反应和抗刺突蛋白免疫球蛋白G（IgG）浓度。
首次接种后85.1%的人报告有不良反应，第二次接种后为94.7%，第三次接种BNT162b2后为87.5%，第三次接种mRNA-1273后为86.0%。不良反应持续的中位数分别为1.8、2.0、2.5和1.8天；分别有6.4%、43.6%和21.0%的参与者在第一次、第二次和第三次接种后无法工作，在安排必要工作人员的疫苗接种时应考虑这一点。加强免疫使抗刺突蛋白IgG浓度增加了13.75倍（四分位间距，9.30 - 24.47），同源接种后的浓度明显高于异源接种。我们发现第二次接种后发热、寒战和关节痛与抗刺突蛋白IgG浓度之间存在关联，表明不良反应、炎症和体液免疫反应之间存在联系。
进一步的研究应侧重于同源和异源加强接种的可能优势及其刺激记忆B细胞的能力。此外，了解mRNA疫苗诱导的炎症过程可能有助于在保持免疫原性和效力的同时改善反应原性。
