在乌干达高危地区的医护人员中，使用 rVSVΔG-ZEBOV-GP 埃博拉疫苗后的知识、态度、行为和长期免疫反应。
Knowledge, attitudes, and practices and long-term immune response after rVSVΔG-ZEBOV-GP Ebola vaccination in healthcare workers in high-risk districts in Uganda.
机构信息
Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States.
出版信息
Vaccine. 2024 Sep 17;42(22):126031. doi: 10.1016/j.vaccine.2024.05.079. Epub 2024 Jun 15.
BACKGROUND
The rVSVΔG-ZEBOV-GP Ebola vaccine (rVSV-ZEBOV) has been used in response to Ebola disease outbreaks caused by Ebola virus (EBOV). Understanding Ebola knowledge, attitudes, and practices (KAP) and the long-term immune response following rVSV-ZEBOV are critical to inform recommendations on future use.
METHODS
We administered surveys and collected blood samples from healthcare workers (HCWs) from seven Ugandan healthcare facilities. Questionnaires collected information on demographic characteristics and KAP related to Ebola and vaccination. IgG ELISA, virus neutralization, and interferon gamma ELISpot measured immunological responses against EBOV glycoprotein (GP).
RESULTS
Overall, 37 % (210/565) of HCWs reported receiving any Ebola vaccination. Knowledge that rVSV-ZEBOV only protects against EBOV was low among vaccinated (32 %; 62/192) and unvaccinated (7 %; 14/200) HCWs. Most vaccinated (91 %; 192/210) and unvaccinated (92 %; 326/355) HCWs wanted to receive a booster or initial dose of rVSV-ZEBOV, respectively. Median time from rVSV-ZEBOV vaccination to sample collection was 37.7 months (IQR: 30.5, 38.3). IgG antibodies against EBOV GP were detected in 95 % (61/64) of HCWs with vaccination cards and in 84 % (162/194) of HCWs who reported receiving a vaccination. Geometric mean titer among seropositive vaccinees was 0.066 IU/mL (95 % CI: 0.058-0.076).
CONCLUSION
As Uganda has experienced outbreaks of Sudan virus and Bundibugyo virus, for which rVSV-ZEBOV does not protect against, our findings underscore the importance of continued education and risk communication to HCWs on Ebola and other viral hemorrhagic fevers. IgG antibodies against EBOV GP were detected in most vaccinated HCWs in Uganda 2─4 years after vaccination; however, the duration and correlates of protection warrant further investigation.
背景
rVSVΔG-ZEBOV-GP 埃博拉疫苗（rVSV-ZEBOV）已被用于应对由埃博拉病毒（EBOV）引起的埃博拉病疫情。了解埃博拉病毒知识、态度和实践（KAP）以及接种 rVSV-ZEBOV 后的长期免疫反应，对于为未来的使用提供建议至关重要。
方法
我们对来自乌干达七家医疗机构的医护人员（HCWs）进行了调查并采集了血液样本。问卷收集了与埃博拉病毒和疫苗接种相关的人口统计学特征和 KAP 信息。酶联免疫吸附试验（ELISA）、病毒中和试验和干扰素γ酶联免疫斑点试验（ELISpot）测量了针对 EBOV 糖蛋白（GP）的免疫反应。
结果
总体而言，565 名 HCWs 中有 37%（210/565）报告接受了任何埃博拉疫苗接种。在接种疫苗的 HCWs（32%；62/192）和未接种疫苗的 HCWs（7%；14/200）中，rVSV-ZEBOV 仅能预防 EBOV 的知识水平较低。大多数接种疫苗的 HCWs（91%；192/210）和未接种疫苗的 HCWs（92%；326/355）分别希望接受 rVSV-ZEBOV 的加强针或初始剂量。从 rVSV-ZEBOV 接种到样本采集的中位时间为 37.7 个月（IQR：30.5，38.3）。在有接种卡的 HCWs 中，有 95%（61/64）检测到针对 EBOV GP 的 IgG 抗体，在报告接受接种的 HCWs 中，有 84%（162/194）检测到针对 EBOV GP 的 IgG 抗体。血清阳性疫苗接种者的几何平均滴度为 0.066 IU/mL（95%CI：0.058-0.076）。
结论
由于乌干达曾爆发过苏丹病毒和布迪Bugyo 病毒疫情，而 rVSV-ZEBOV 并不能预防这两种病毒，因此我们的研究结果强调了继续向 HCWs 进行关于埃博拉病毒和其他病毒性出血热的教育和风险沟通的重要性。在乌干达，接种 rVSV-ZEBOV 疫苗 2-4 年后，大多数接种疫苗的 HCWs 中都检测到针对 EBOV GP 的 IgG 抗体；然而，保护的持续时间和相关性仍需要进一步研究。
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