Dept of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
BMJ Open. 2023 Oct 31;13(10):e077714. doi: 10.1136/bmjopen-2023-077714.
Predictors of COVID-19 vaccine immunogenicity and the influence of prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection require elucidation.
Stop the Spread Ottawa is a prospective cohort of individuals at-risk for or who have been infected with SARS-CoV-2, initially enrolled for 10 months beginning October 2020. This cohort was enriched for public-facing workers. This analysis focuses on safety and immunogenicity of the initial two doses of COVID-19 vaccine.
Post-vaccination data with blood specimens were available for 930 participants. 22.8% were SARS-CoV2 infected prior to the first vaccine dose. Cohort characteristics include: median age 44 (IQR: 22-56), 66.6% women, 89.0% white, 83.2% employed. 38.1% reported two or more comorbidities and 30.8% reported immune compromising condition(s). Over 95% had detectable IgG levels against the spike and receptor binding domain (RBD) 3 months post second vaccine dose. By multivariable analysis, increasing age and high-level immune compromise predicted diminishing IgG spike and RBD titres at month 3 post second dose. IgG spike and RBD titres were higher immediately post vaccination in those with SARS-CoV-2 infection prior to first vaccination and spike titres were higher at 6 months in those with wider time intervals between dose 1 and 2. IgG spike and RBD titres and neutralisation were generally similar by sex, weight and whether receiving homogeneous or heterogeneous combinations of vaccines. Common symptoms post dose 1 vaccine included fatigue (64.7%), injection site pain (47.5%), headache (27.2%), fever/chills (26.2%) and body aches (25.3%). These symptoms were similar with subsequent doses.
The initial two COVID-19 vaccine doses are safe, well-tolerated and highly immunogenic across a broad spectrum of vaccine recipients including those working in public facing environments.
需要阐明 COVID-19 疫苗免疫原性的预测因素以及先前严重急性呼吸系统综合症冠状病毒 2（SARS-CoV-2）感染的影响。
Stop the Spread Ottawa 是一个由感染 SARS-CoV-2 风险较高或已感染 SARS-CoV-2 的个体组成的前瞻性队列，于 2020 年 10 月开始首次入组，入组时间为 10 个月。该队列的特点是包含面向公众的工作人员。本分析重点关注 COVID-19 疫苗初始两剂的安全性和免疫原性。
在接种疫苗后，有 930 名参与者提供了血液样本数据。在接种第一剂疫苗之前，有 22.8%的参与者已感染 SARS-CoV2。队列特征包括：中位年龄 44（IQR：22-56），66.6%为女性，89.0%为白人，83.2%为在职人员。38.1%报告有两种或两种以上的合并症，30.8%报告有免疫抑制状况。超过 95%的人在接种第二剂疫苗后 3 个月时，针对刺突和受体结合域（RBD）的 IgG 水平可检测到。通过多变量分析，年龄增加和高水平免疫抑制预测第二剂疫苗接种后 3 个月时 IgG 刺突和 RBD 滴度降低。与首次接种前已感染 SARS-CoV-2 的参与者相比，在接种第一剂疫苗前感染 SARS-CoV-2 的参与者在接种疫苗后立即出现更高的 IgG 刺突和 RBD 滴度，并且在第一剂和第二剂之间间隔时间更长的情况下，6 个月时 IgG 刺突和 RBD 滴度更高。根据性别、体重以及接种同种或不同种疫苗组合，IgG 刺突和 RBD 滴度和中和作用通常相似。接种第一剂疫苗后的常见症状包括疲劳（64.7%）、注射部位疼痛（47.5%）、头痛（27.2%）、发热/发冷（26.2%）和肌肉疼痛（25.3%）。这些症状在随后的剂量中相似。
COVID-19 疫苗的初始两剂安全、耐受良好且高度免疫原性，适用于包括面向公众的环境中工作的人员在内的广泛疫苗接种者。
