The Sheba Pandemic Preparedness Research Institute, Sheba Medical Center, Ramat Gan, Israel.
The Infection Prevention & Control Unit, Sheba Medical Center, Ramat Gan, Israel.
JAMA Netw Open. 2023 May 1;6(5):e2314757. doi: 10.1001/jamanetworkopen.2023.14757.
A correlation between antibody levels and risk of infection has been demonstrated for the wild-type, Alpha, and Delta SARS-COV-2 variants. High rates of breakthrough infections by the Omicron variant emphasized the need to investigate whether the humoral response elicited by mRNA vaccines is also associated with reduced risk of Omicron infection and disease.
To investigate whether the high antibody levels in individuals who have received at least 3 doses of an mRNA vaccine are associated with reduced risk of Omicron infection and disease.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study used serial real time-polymerase chain reaction (RT-PCR) and serological test data from January and May 2022 to assess the association of preinfection immunoglobin G (IgG) and neutralizing antibody titers with incidence of Omicron variant infection, incidence of symptomatic disease, and infectivity. Participants included health care workers who had received 3 or 4 doses of an mRNA COVID-19 vaccine. Data were analyzed from May to August 2022.
Levels of SARS-CoV-2 anti-receptor binding domain IgG and neutralizing antibodies.
The main outcomes were incidence of Omicron infection, incidence of symptomatic disease, and infectivity. Outcomes were measured using SARS-COV-2 PCR and antigen testing and daily online surveys regarding symptomatic disease.
This study included 3 cohorts for 3 different analyses: 2310 participants were included in the protection from infection analysis (4689 exposure events; median [IQR] age, 50 [40-60] years; 3590 [76.6%] among female health care workers), 667 participants (median [IQR] age, 46.28 (37.44,54.8); 516 [77.4%] female) in the symptomatic disease analysis, and 532 participants (median [IQR] age, 48 [39-56] years; 403 [75.8%] female) in the infectivity analysis. Lower odds of infection were observed for each 10-fold increase in preinfection IgG (odds ratio [OR], 0.71; 95% CI, 0.56-0.90) and for each 2-fold increase in neutralizing antibody titers (OR, 0.89; 95% CI, 0.83-0.95). The odds of substantial symptomatic disease were reduced for each 10-fold increase in IgG levels (OR, 0.48; 95% CI, 0.29-0.78) and for each 2-fold increase in neutralizing antibodies levels (OR, 0.86; 95% CI, 0.76-0.96). Infectivity, assessed by mean cycle threshold value, was not significantly decreased with increasing IgG or neutralizing antibodies titers.
In this cohort study of vaccinated health care workers, IgG and neutralizing antibody titer levels were associated with protection against infection with the Omicron variant and against symptomatic disease.
已经证明，野生型、Alpha 和 Delta SARS-COV-2 变体的抗体水平与感染风险之间存在相关性。Omicron 变体突破性感染的高比率强调了需要调查 mRNA 疫苗引起的体液反应是否也与降低 Omicron 感染和疾病的风险有关。
研究至少接受 3 剂 mRNA 疫苗的个体中高抗体水平是否与降低 Omicron 感染和疾病的风险相关。
设计、地点和参与者：本前瞻性队列研究使用 2022 年 1 月和 5 月的实时聚合酶链反应（RT-PCR）和血清学检测数据，评估感染前免疫球蛋白 G（IgG）和中和抗体滴度与 Omicron 变体感染、症状性疾病发病率和传染性的相关性。参与者包括接受过 3 或 4 剂 mRNA COVID-19 疫苗的医护人员。数据于 2022 年 5 月至 8 月进行分析。
SARS-CoV-2 受体结合域 IgG 和中和抗体水平。
主要结局是 Omicron 感染、症状性疾病和传染性的发生率。使用 SARS-COV-2 PCR 和抗原检测以及关于症状性疾病的每日在线调查来衡量结果。
本研究包括 3 个队列进行 3 项不同的分析：2310 名参与者纳入感染保护分析（4689 个暴露事件；中位[IQR]年龄为 50 [40-60] 岁；3590 [76.6%] 为女性医护人员），667 名参与者（中位[IQR]年龄，46.28（37.44，54.8）；516 [77.4%] 为女性）纳入症状性疾病分析，532 名参与者（中位[IQR]年龄，48 [39-56] 岁；403 [75.8%] 为女性）纳入传染性分析。感染前 IgG 每增加 10 倍，感染的可能性降低（优势比[OR]，0.71；95%CI，0.56-0.90），中和抗体滴度每增加 2 倍，感染的可能性降低（OR，0.89；95%CI，0.83-0.95）。与 IgG 水平每增加 10 倍（OR，0.48；95%CI，0.29-0.78）和中和抗体水平每增加 2 倍（OR，0.86；95%CI，0.76-0.96）相比，出现严重症状性疾病的可能性降低。
在这项针对接种疫苗的医护人员的队列研究中，IgG 和中和抗体滴度与预防感染 Omicron 变体和预防症状性疾病有关。
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