Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, University of Oslo, Oslo, Norway.
J Infect Dis. 2024 Oct 16;230(4):e847-e859. doi: 10.1093/infdis/jiae291.
Bivalent messenger RNA (mRNA) vaccines, designed to combat emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, incorporate ancestral strains and a new variant. Our study assessed the immune response in previously vaccinated individuals of the Swiss HIV Cohort Study (SHCS) and the Swiss Transplant Cohort Study (STCS) following bivalent mRNA vaccination.
Eligible SHCS and STCS participants received approved bivalent mRNA SARS-CoV-2 vaccines (mRNA-1273.214 or BA.1-adapted BNT162b2) within clinical routine. Blood samples were collected at baseline, 4 weeks, 8 weeks, and 6 months postvaccination. We analyzed the proportion of participants with anti-spike protein antibody response ≥1642 units/mL (indicating protection against SARS-CoV-2 infection), and in a subsample T-cell response (including mean concentrations), stratifying results by cohorts and population characteristics.
In SHCS participants, baseline anti-spike antibody concentrations ≥1642 units/mL were observed in 87% (96/112), reaching nearly 100% at follow-ups. Among STCS participants, 58% (35/60) had baseline antibodies ≥1642 units/mL, increasing to 80% at 6 months. Except for lung transplant recipients, all participants showed a 5-fold increase in geometric mean antibody concentrations at 4 weeks and a reduction by half at 6 months. At baseline, T-cell responses were positive in 96% (26/27) of SHCS participants and 36% (16/45) of STCS participants (moderate increase to 53% at 6 months). Few participants reported SARS-CoV-2 infections, side-effects, or serious adverse events.
Bivalent mRNA vaccination elicited a robust humoral response in individuals with human immunodeficiency virus (HIV) or solid organ transplants, with delayed responses in lung transplant recipients. Despite a waning effect, antibody levels remained high at 6 months and adverse events were rare. Clinical Trials Registration . NCT04805125.
双价信使 RNA（mRNA）疫苗旨在针对新兴的严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）变体，结合了原始株和一种新变体。我们的研究评估了瑞士艾滋病毒队列研究（SHCS）和瑞士移植队列研究（STCS）中先前接种过疫苗的个体在接种双价 mRNA 疫苗后的免疫反应。
符合条件的 SHCS 和 STCS 参与者在临床常规范围内接种了批准的双价 SARS-CoV-2 mRNA 疫苗（mRNA-1273.214 或 BA.1 适应型 BNT162b2）。在接种疫苗前、接种后 4 周、8 周和 6 个月采集血样。我们分析了抗刺突蛋白抗体反应≥1642 单位/毫升（表明对 SARS-CoV-2 感染有保护作用）的参与者比例，并在亚组中分析了 T 细胞反应（包括平均浓度），按队列和人群特征进行分层。
在 SHCS 参与者中，基线时≥1642 单位/毫升的抗刺突抗体浓度在 87%（96/112）中观察到，在随访中几乎达到 100%。在 STCS 参与者中，基线时有 58%（35/60）的人抗体≥1642 单位/毫升，在 6 个月时增加到 80%。除了肺移植受者外，所有参与者在 4 周时抗体几何平均浓度增加了 5 倍，在 6 个月时减少了一半。在基线时，SHCS 参与者中有 96%（26/27）和 STCS 参与者中有 36%（16/45）的 T 细胞反应呈阳性（6 个月时适度增加至 53%）。少数参与者报告了 SARS-CoV-2 感染、副作用或严重不良事件。
双价 mRNA 疫苗在 HIV 或实体器官移植的个体中引起了强烈的体液反应，肺移植受者的反应延迟。尽管效果减弱，但 6 个月时抗体水平仍然较高，不良事件罕见。临床试验注册。NCT04805125。
Zotero 插件