Institute of Global Health, University of Geneva, Geneva, Switzerland.
The GRAPH Network, Geneva, Switzerland.
Swiss Med Wkly. 2024 May 6;154:3732. doi: 10.57187/s.3732.
With the emergence of newer SARS-CoV-2 variants and their substantial effects on the levels and duration of protection against infection, an understanding of these characteristics of the protection conferred by humoral and cellular immunity can aid in the proper development and implementation of vaccine and safety guidelines.
We conducted a rapid literature review and searched five electronic databases weekly from 1 November 2021 to 30 September 2022. Studies that assessed the humoral or cellular immunity conferred by infection, vaccination or a hybrid (combination of both) in adults and risk groups (immunocompromised and older populations) were identified. Studies were eligible when they reported data on immunological assays of COVID-19 (related to vaccination and/or infection) or the effectiveness of protection (related to the effectiveness of vaccination and/or infection).
We screened 5103 studies and included 205 studies, of which 70 provided data on the duration of protection against SARS-CoV-2 infection. The duration of protection of adaptive immunity was greatly impacted by Omicron and its subvariants: levels of protection were low by 3-6 months from exposure to infection/vaccination. Although more durable, cellular immunity also showed signs of waning by 6 months. First and second mRNA vaccine booster doses increased the levels of protection against infection and severe disease from Omicron and its subvariants but continued to demonstrate a high degree of waning over time.
All humoral immunities (infection-acquired, vaccine-acquired and hybrid) waned by 3-6 months. Cellular immunity was more durable but showed signs of waning by 6 months. Hybrid immunity had the highest magnitude of protection against SARS-CoV-2 infection. Boosting may be recommended as early as 3-4 months after the last dose, especially in risk groups.
随着新型 SARS-CoV-2 变异株的出现及其对感染防护水平和持续时间的重大影响，了解体液免疫和细胞免疫所提供的保护的这些特征有助于正确制定和实施疫苗和安全指南。
我们进行了快速文献综述，从 2021 年 11 月 1 日至 2022 年 9 月 30 日每周在五个电子数据库中进行搜索。确定了评估感染、接种疫苗或混合（两者结合）在成年人和风险人群（免疫功能低下者和老年人）中产生的体液或细胞免疫的研究。当研究报告 COVID-19 的免疫测定数据（与疫苗接种和/或感染有关）或保护效力数据（与疫苗接种和/或感染的有效性有关）时，研究即符合入选条件。
我们筛选了 5103 篇研究文章，纳入了 205 项研究，其中 70 项提供了关于 SARS-CoV-2 感染保护持续时间的数据。适应性免疫的保护持续时间受到 Omicron 及其亚变种的极大影响：从感染/接种疫苗后 3-6 个月，保护水平较低。尽管更持久，但细胞免疫在 6 个月时也显示出减弱的迹象。第一剂和第二剂 mRNA 疫苗加强针增加了对 Omicron 及其亚变种的感染和严重疾病的保护水平，但随着时间的推移，持续显示出高度衰减。
所有体液免疫（感染获得、疫苗获得和混合）在 3-6 个月时减弱。细胞免疫更持久，但在 6 个月时显示出减弱的迹象。混合免疫对 SARS-CoV-2 感染的保护效果最强。在最后一剂疫苗接种后 3-4 个月，尤其是在风险人群中，可能建议进行加强接种。
