Lavell A H A, Schramade A E, Sikkens J J, van der Straten K, van Dort K A, Slim M A, Appelman B, van Vught L A, Vlaar A P J, Kootstra N A, van Gils M J, Smulders Y M, de Jongh R T, Bomers M K
Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Internal Medicine, Department of Infectious Diseases and Department of Endocrinology and Metabolism, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; Amsterdam Institute for Infection & Immunity, Amsterdam, the Netherlands.
Amsterdam Institute for Infection & Immunity, Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Amsterdam UMC Location University of Amsterdam, Department of Internal Medicine, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
Vaccine. 2024 Mar 7;42(7):1478-1486. doi: 10.1016/j.vaccine.2023.08.025. Epub 2023 Sep 27.
To improve effectiveness of vaccination against SARS-CoV-2, it is important to identify factors that influence the immune response induced by vaccination. Evidence for the role of vitamin D in immune response against SARS-CoV-2 is contradictory. It is therefore of interest whether 25-hydroxyvitamin D (25[OH]D) concentrations affect the humoral and/or cellular response following SARS-CoV-2 vaccination.
In this prospective cohort study, blood samples were collected from 98 SARS-CoV-2 naive health care workers (HCW) receiving the first two doses of either BNT162b2 or mRNA-1273 in 2021. Wild-type spike (S) protein binding and neutralizing antibodies were determined approximately three weeks after the first dose and four to five weeks after the second dose. Antigen specific T-cells and functionality (proliferative response and interferon gamma [IFN-γ] release) were determined in 18 participants four weeks after the second dose of BNT162b2. We studied the association between 25(OH)D concentrations, which were determined prior to vaccination, and humoral and cellular immune responses following vaccination.
We found no association between 25(OH)D concentrations (median 55.9 nmol/L [IQR 40.5-69.8]) and binding or neutralizing antibody titers after complete vaccination (fold change of antibody titers per 10 nmol/L 25(OH)D increase: 0.98 [95% CI 0.93-1.04] and 1.03 [95% CI: 0.96-1.11], respectively), adjusted for age, sex and type of mRNA vaccine. Subsequently, continuous 25(OH)D concentrations were divided into commonly used clinical categories (<25 nmol/L [n = 6, 6%], 25-49 nmol/L [n = 33, 34%], 50-75 nmol/L [n = 37, 38%] and ≥75 nmol/L [n = 22, 22%]), but no association with the humoral immune response following vaccination was found. Also, 25(OH)D concentrations were not associated with the SARS-CoV-2 specific T cell response.
No association was found between 25(OH)D concentrations and the humoral or cellular immune response following mRNA vaccination against SARS-CoV-2. Based on our findings there is no rationale to advise vitamin D optimization preceding SARS-CoV-2 vaccination in HCW with moderate vitamin D status.
为提高针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的疫苗接种效果，识别影响疫苗接种诱导的免疫反应的因素很重要。维生素D在针对SARS-CoV-2的免疫反应中的作用证据相互矛盾。因此，25-羟基维生素D（25[OH]D）浓度是否会影响SARS-CoV-2疫苗接种后的体液和/或细胞反应备受关注。
在这项前瞻性队列研究中，于2021年从98名未感染过SARS-CoV-2的医护人员（HCW）中采集血样，这些人员接受了两剂BNT162b2或mRNA-1273疫苗中的一种。在第一剂接种后约三周以及第二剂接种后四至五周测定野生型刺突（S）蛋白结合抗体和中和抗体。在18名接受第二剂BNT162b2疫苗四周后的参与者中测定抗原特异性T细胞及其功能（增殖反应和干扰素γ[IFN-γ]释放）。我们研究了接种疫苗前测定的25(OH)D浓度与接种疫苗后的体液和细胞免疫反应之间的关联。
我们发现，在根据年龄、性别和mRNA疫苗类型进行调整后，25(OH)D浓度（中位数55.9 nmol/L[四分位间距40.5 - 69.8]）与全程接种后的结合抗体或中和抗体滴度之间无关联（25(OH)D浓度每增加10 nmol/L时抗体滴度的变化倍数：分别为0.98[95%置信区间0.93 - 1.04]和1.03[95%置信区间：0.96 - 1.11]）。随后，将连续的25(OH)D浓度分为常用的临床类别（<25 nmol/L[n = 6, 6%]、25 - 49 nmol/L[n = 33, 34%]、50 - 75 nmol/L[n = 37, 38%]和≥75 nmol/L[n = 22, 22%]），但未发现与接种疫苗后的体液免疫反应有关联。此外，25(OH)D浓度与SARS-CoV-2特异性T细胞反应也无关联。
未发现25(OH)D浓度与接种针对SARS-CoV-2的mRNA疫苗后的体液或细胞免疫反应之间存在关联。基于我们的研究结果，对于维生素D水平中等的医护人员，没有理由建议在接种SARS-CoV-2疫苗前优化维生素D水平。
