Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai Institute of Infectious Disease and Biosecurity, State Key Laboratory of Genetic Engineering, MOE Engineering Research Center of Gene Technology, School of Life Sciences, Fudan University, Shanghai, Shanghai, China.
Emerg Microbes Infect. 2023 Dec;12(2):2249121. doi: 10.1080/22221751.2023.2249121. Epub 2023 Sep 5.
BACKGROUND: Omicron had swept the mainland China between December 2022 and January 2023, while SARS-CoV-2 still continued to evolve. To fully prepare for the next wave, it's urgent to evaluate the humoral immune response post BA.5/BF.7 breakthrough infection against predominant sub-lineages among existing vaccination strategies and the elders. METHOD: This study enrolled a longitudinal young-adult cohort from 2/3-dose vaccination to 1 month after breakthrough infection, and an elder cohort at 1 month after breakthrough infection. Seral samples were collected and tested for humoral immune response to SARS-CoV-2 subvariants including WT, BA.2, BA.5, BF.7, BQ.1.1, CH.1.1, XBB.1.5. RESULTS: BA.5/BF.7 breakthrough infection induced higher neutralization activity than solely vaccination in all SARS-CoV-2 strains, while the latest Omicron subvariants, BQ.1.1, CH.1.1, XBB.1.5, exhibited the strongest neutralization evasion ability. There was a negative correlation between age and humoral immune response in WT, BA.5, BQ.1.1, and XBB.1.5. Compared to non-vaccination groups, breakthrough infection in two-dose vaccination groups had significantly higher neutralizing antibody against WT, BA.2, BA.5, BF.7 but not to BQ.1.1, CH.1.1, XBB.1.5 while booster dose against the prototype prior-breakthrough would not further significantly enhance individual's humoral responses against the latest Omicron subvariants. CONCLUSIONS: Newer variants manifest increasing immune evasion from neutralization and repeated prototype-based booster vaccines may not further enhance neutralizing antibody against emerging new variants. Older adults have lower levels of neutralizing antibody. Future vaccination strategies should aim to enhance effective neutralization to contemporary variants.
背景:2022 年 12 月至 2023 年 1 月,奥密克戎席卷中国大陆,而 SARS-CoV-2 仍在继续进化。为充分准备下一波疫情,迫切需要评估 BA.5/BF.7 突破感染后针对现有疫苗接种策略和老年人中主要亚谱系的体液免疫反应。
方法:本研究纳入了从 2/3 剂疫苗接种到突破感染后 1 个月的纵向青年队列,以及突破感染后 1 个月的老年队列。采集血清样本,检测针对 SARS-CoV-2 亚变体的体液免疫反应,包括 WT、BA.2、BA.5、BF.7、BQ.1.1、CH.1.1、XBB.1.5。
结果:BA.5/BF.7 突破感染诱导的中和活性高于单纯疫苗接种所有 SARS-CoV-2 株,而最新的奥密克戎亚变体 BQ.1.1、CH.1.1、XBB.1.5 表现出最强的中和逃逸能力。WT、BA.5、BQ.1.1 和 XBB.1.5 中,年龄与体液免疫反应呈负相关。与未接种组相比,两剂疫苗接种组突破感染对 WT、BA.2、BA.5、BF.7 的中和抗体显著升高,但对 BQ.1.1、CH.1.1、XBB.1.5 则不然,而对原型突破前的加强针不会进一步显著增强个体对最新奥密克戎亚变体的体液反应。
结论:新型变体表现出对中和的免疫逃逸能力增强,且重复基于原型的加强疫苗接种可能不会进一步增强对新兴新变体的中和抗体。老年人的中和抗体水平较低。未来的疫苗接种策略应旨在增强对当代变体的有效中和。
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