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免疫抑制人群中新冠病毒疫苗加强针的免疫效果和不良事件:一项系统综述

The immunologic outcomes and adverse events of COVID-19 vaccine booster dose in immunosuppressed people: A systematic review.

作者信息

SeyedAlinaghi SeyedAhmad, Dashti Mohsen, Afzalian Arian, Siami Haleh, Ghasemzadeh Afsaneh, Varshochi Sanaz, Parikhani Sahar Nooralioghli, Amrollah Masoomeh Fathi, Nourian Anahid, Mehraeen Esmaeil, Dadras Omid

机构信息

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.

Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Prev Med Rep. 2024 May 31;44:102778. doi: 10.1016/j.pmedr.2024.102778. eCollection 2024 Aug.

Abstract

INTRODUCTION

This study examines the efficacy and safety of three COVID-19 booster vaccines including mRNA-based vaccines (BNT162b2 (BioNTech/Pfizer) and/or mRNA-1273 (Moderna)), Non-Replicating Viral-Vector vaccines (ChAdOx1 nCoV-19 vaccine (AstraZeneca) and/or Ad26. COV2.S (Johnson & Johnson)), and Protein Subunit vaccine (SpikoGen) in immunosuppressed patients.

METHODS

Relevant articles were systematically searched using medical subject heading (MeSH) and keywords "COVID-19" and "booster dose" or "booster vaccine" or ''fourth dose" in the online databases of PubMed, Embase, Scopus, and Web of Science. To identify eligible studies, a two-phase screening process was implemented. Initially, three researchers evaluated the studies based on the relevancy of the title and abstract.

RESULTS

A total of 58 studies met the inclusion criteria and were included in this review. The findings suggest that booster doses offer greater protection against the disease than the primary dose. The study also compared various vaccine types, revealing that viral vector and nucleic acid vaccines outperformed inactivated vaccines. Results indicated that individuals receiving booster doses experienced superior outcomes compared to those without boosters. Vaccination against COVID-19 emerged as the most effective preventive measure against infection and symptom severity. Elevated antibody levels post-booster dose vaccination in the population signaled robust immune responses, underscoring the benefits of supplementary vaccine doses.

CONCLUSION

This systematic review highlights preliminary evidence supporting the immunologic outcomes and safety of COVID-19 vaccine boosters in enhancing immune responses against SARS-CoV-2. However, further research is needed to determine optimal timing intervals between primary vaccination series and boosters while considering global equity issues and variant-specific considerations.

摘要

引言

本研究考察了三种新冠病毒加强疫苗在免疫抑制患者中的疗效和安全性,这些疫苗包括基于信使核糖核酸的疫苗(BNT162b2(复必泰,由BioNTech和辉瑞合作研发)和/或mRNA-1273(莫德纳))、非复制型病毒载体疫苗(ChAdOx1 nCoV-19疫苗(阿斯利康)和/或Ad26.COV2.S(强生))以及蛋白质亚单位疫苗(斯皮可佐剂)。

方法

在PubMed、Embase、Scopus和Web of Science在线数据库中,使用医学主题词(MeSH)以及关键词“COVID-19”和“加强剂量”或“加强疫苗”或“第四剂”对相关文章进行系统检索。为确定符合条件的研究,实施了两阶段筛选过程。最初,三名研究人员根据标题和摘要的相关性对研究进行评估。

结果

共有58项研究符合纳入标准并被纳入本综述。研究结果表明,加强剂量比初始剂量能提供更强的疾病防护。该研究还比较了各种疫苗类型,发现病毒载体疫苗和核酸疫苗的表现优于灭活疫苗。结果表明,接受加强剂量的个体比未接受加强剂量的个体有更好的结果。接种新冠病毒疫苗是预防感染和减轻症状严重程度最有效的预防措施。人群中加强剂量疫苗接种后抗体水平升高表明免疫反应强烈,突出了补充疫苗剂量的益处。

结论

本系统综述强调了初步证据,支持新冠病毒疫苗加强针在增强针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的免疫反应方面的免疫效果和安全性。然而,在考虑全球公平问题和特定变异株相关因素的同时,还需要进一步研究以确定初始疫苗接种系列和加强针之间的最佳时间间隔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94db/11228787/f0fa0c3197d1/gr1.jpg

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