Department of Pediatric Infectious Diseases, Wroclaw Medical University, Ludwika Pasteura 1, 50-367 Wrocław, Poland.
Department of Pediatric Infectious Diseases, Wroclaw Medical University, Ludwika Pasteura 1, 50-367 Wrocław, Poland; Department of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Ludwika Pasteura 1, 50-367 Wrocław, Poland.
Vaccine. 2023 May 16;41(21):3317-3327. doi: 10.1016/j.vaccine.2023.04.035. Epub 2023 Apr 14.
We conducted a prospective cohort study of 20 patients with a history of paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS group, median age seven years, 70% male) and 34 healthy controls without such a history (CONTROL group, median age eight years, 38% male) aged 5-12 years, to assess the immunogenicity of Pfizer-BioNTech COVID-19 mRNA BNT162b2 vaccine (Comirnaty®). Patients received two doses of COVID-19 mRNA BNT162b2 vaccine (10 ug/dose) 21 days apart. Pre-vaccine anti-S SARS-CoV-2 IgG antibodies were measured on the day of the first dose and at the median of 23 days after the second dose. The study was conducted during the COVID-19 wave dominated by the Omicron variant of the virus. Anti-NCP SARS-CoV-2 IgG antibodies were measured twice to evaluate incidents of infection during the study period. Pre-vaccine quantification of both types of antibodies allowed us to differentiate patients into COVID-19 naive and previously infected in order to compare hybrid immunity with vaccine-induced immunity. Before vaccination, anti-S IgG serum geometric mean concentration (GMC) was 61.17 BAU/ml in the PIMS group and 24.97 in the CONTROL group, while post-vaccination GMC was 3879.14 BAU/ml and 3704.87 BAU/ml, respectively, and did not significantly differ between the groups. Hybrid immunity (regardless of PIMS history) resulted in a higher concentration of SARS-CoV-2 anti-S antibodies after vaccination. Four (20%) of the children in the PIMS group and 11 (32%) in the CONTROL group got infected with SARS-CoV-2 during the study period, yet all of them asymptomatically, and this event has not significantly altered post-vaccination anti-S titers. In conclusion, COVID-19 vaccination was highly immunogenic in children, including those with a history of PIMS-TS; hybrid immunity overperforms vaccine-induced immunity in terms of serological response in children. However, vaccination effectiveness in preventing SARS-CoV-2 infections in children should be further evaluated.
我们进行了一项前瞻性队列研究，纳入了 20 例有儿科多系统炎症综合征伴 COVID-19 病史的患儿（PIMS 组，中位年龄 7 岁，70%为男性）和 34 例无此类病史的健康对照者（对照组，中位年龄 8 岁，38%为男性），年龄 5-12 岁，以评估辉瑞-生物科技 COVID-19 mRNA BNT162b2 疫苗（Comirnaty®）的免疫原性。患儿接受两剂 COVID-19 mRNA BNT162b2 疫苗（10 μg/剂），间隔 21 天。在第一剂疫苗接种当天和第二剂疫苗接种后中位数 23 天，检测预疫苗抗 SARS-CoV-2 IgG 抗体。该研究在 COVID-19 疫情期间进行，当时病毒以奥密克戎变异株为主。两次检测抗 NCP SARS-CoV-2 IgG 抗体以评估研究期间的感染事件。预疫苗定量检测这两种类型的抗体可使我们将患儿分为 COVID-19 初免者和既往感染者，以比较混合免疫与疫苗诱导免疫。接种疫苗前，PIMS 组的抗 S IgG 血清几何平均浓度（GMC）为 61.17 BAU/ml，对照组为 24.97 BAU/ml，而接种疫苗后的 GMC 分别为 3879.14 BAU/ml 和 3704.87 BAU/ml，两组间无显著差异。（无论是否有 PIMS 病史）的混合免疫在接种疫苗后可使 SARS-CoV-2 抗 S 抗体浓度更高。在研究期间，PIMS 组有 4 例（20%）和对照组有 11 例（32%）儿童感染了 SARS-CoV-2，但均为无症状感染，且这一事件并未显著改变接种疫苗后的抗 S 滴度。总之，COVID-19 疫苗接种在儿童中具有高度免疫原性，包括有 PIMS-TS 病史的儿童；混合免疫在儿童的血清学反应方面优于疫苗诱导免疫。然而，疫苗在预防儿童 SARS-CoV-2 感染方面的有效性还需要进一步评估。
