State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China.
Front Immunol. 2023 Apr 19;14:1167214. doi: 10.3389/fimmu.2023.1167214. eCollection 2023.
Vaccines are known to function as the most effective interventional therapeutics for controlling infectious diseases, including polio, smallpox, rabies, tuberculosis, influenza and SARS-CoV-2. Smallpox has been eliminated completely and polio is almost extinct because of vaccines. Rabies vaccines and Bacille Calmette-Guérin (BCG) vaccines could effectively protect humans against respective infections. However, both influenza vaccines and COVID-19 vaccines are unable to eliminate these two infectious diseases of their highly variable antigenic sites in viral proteins. Vaccine effectiveness (VE) could be negatively influenced (i.e., interfered with) by immune imprinting of previous infections or vaccinations, and repeated vaccinations could interfere with VE against infections due to mismatch between vaccine strains and endemic viral strains. Moreover, VE could also be interfered with when more than one kind of vaccine is administrated concomitantly (i.e., co-administrated), suggesting that the VE could be modulated by the vaccine-induced immunity. In this review, we revisit the evidence that support the interfered VE result from immune imprinting or repeated vaccinations in influenza and COVID-19 vaccine, and the interference in co-administration of these two types of vaccines is also discussed. Regarding the development of next-generation COVID-19 vaccines, the researchers should focus on the induction of cross-reactive T-cell responses and naive B-cell responses to overcome negative effects from the immune system itself. The strategy of co-administrating influenza and COVID-19 vaccine needs to be considered more carefully and more clinical data is needed to verify this strategy to be safe and immunogenic.
疫苗是控制传染病（包括脊髓灰质炎、天花、狂犬病、结核病、流感和 SARS-CoV-2）最有效的干预治疗方法。由于疫苗的作用，天花已被彻底消灭，脊髓灰质炎也几乎绝迹。狂犬病疫苗和卡介苗（BCG）疫苗可以有效保护人类免受相应感染。然而，流感疫苗和 COVID-19 疫苗都无法消除这两种传染病在病毒蛋白中高度可变的抗原部位。疫苗效果（VE）可能会受到先前感染或疫苗接种的免疫印记的负面影响，并且由于疫苗株与地方性病毒株之间不匹配，重复接种可能会干扰针对感染的 VE。此外，当同时接种（即共同接种）超过一种疫苗时，VE 也会受到干扰，这表明 VE 可以通过疫苗诱导的免疫来调节。在这篇综述中，我们重新审视了支持流感和 COVID-19 疫苗中免疫印记或重复接种导致 VE 受到干扰的证据，还讨论了这两种疫苗同时接种的干扰。关于下一代 COVID-19 疫苗的开发，研究人员应专注于诱导交叉反应性 T 细胞反应和幼稚 B 细胞反应，以克服免疫系统自身的负面影响。同时接种流感和 COVID-19 疫苗的策略需要更仔细地考虑，并且需要更多的临床数据来验证该策略的安全性和免疫原性。
