在一个多中心纵向队列中评估≥5岁接种和未接种疫苗儿童的SARS-CoV-2感染的免疫和疾病结局。

Evaluating Immunologic and Illness Outcomes of SARS-CoV-2 Infection in Vaccinated and Unvaccinated Children Aged ≥ 5 Years, in a Multisite Longitudinal Cohort.

作者信息

Porter Cynthia, Lyski Zoe L, Uhrlaub Jennifer L, Ellingson Katherine D, Jeddy Zuha, Gwynn Lisa, Rivers Patrick, Sprissler Ryan, Hegmann Kurt T, Coughlin Melissa M, Fowlkes Ashley L, Hollister James, LeClair Lindsay, Mak Josephine, Beitel Shawn C, Fuller Sammantha, Zheng Pearl Q, Vaughan Molly, Rai Ramona P, Grant Lauren, Newes-Adeyi Gabriella, Yoo Young M, Olsho Lauren, Burgess Jefferey L, Caban-Martinez Alberto J, Yoon Sarang K, Britton Amadea, Gaglani Manjusha, Phillips Andrew L, Thiese Matthew S, Hagen Melissa Briggs, Jones Jefferson M, Lutrick Karen

机构信息

Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.

Immunobiology, College of Medicine-Tucson, University of Arizona, Health Sciences, Tucson, AZ 85724, USA.

出版信息

Diseases. 2024 Aug 1;12(8):171. doi: 10.3390/diseases12080171.

DOI:10.3390/diseases12080171

PMID:39195170

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11354143/

Abstract

UNLABELLED

Hybrid immunity, as a result of infection and vaccination to SARS-CoV-2, has been well studied in adults but limited evidence is available in children. We evaluated the antibody responses to primary SARS-CoV-2 infection among vaccinated and unvaccinated children aged ≥ 5 years.

METHODS

A longitudinal cohort study of children aged ≥ 5 was conducted during August 2021-August 2022, at sites in Arizona, Texas, Utah, and Florida. Children submitted weekly nasal swabs for PCR testing and provided sera 14-59 days after PCR-confirmed SARS-CoV-2 infection. Antibodies were measured by ELISA against the receptor-binding domain (RBD) and S2 domain of ancestral Spike (WA1), in addition to Omicron (BA.2) RBD, following infection in children, with and without prior monovalent ancestral mRNA COVID-19 vaccination.

RESULTS

Among the 257 participants aged 5 to 18 years, 166 (65%) had received at least two mRNA COVID-19 vaccine doses ≥ 14 days prior to infection. Of these, 53 occurred during Delta predominance, with 37 (70%) unvaccinated at the time of infection. The remaining 204 infections occurred during Omicron predominance, with 53 (26%) participants unvaccinated. After adjusting for weight, age, symptomatic infection, and gender, significantly higher mean RBD AUC values were observed among the vaccinated group compared to the unvaccinated group for both WA1 and Omicron ( < 0.0001). A smaller percentage of vaccinated children reported fever during illness, with 55 (33%) reporting fever compared to 44 (48%) unvaccinated children reporting fever ( = 0.021).

CONCLUSIONS

Children with vaccine-induced immunity at the time of SARS-CoV-2 infection had higher antibody levels during convalescence and experienced less fever compared to unvaccinated children during infection.

摘要

未标注

由于感染和接种针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的疫苗而产生的混合免疫，在成年人中已有充分研究，但在儿童中的证据有限。我们评估了5岁及以上接种疫苗和未接种疫苗儿童对SARS-CoV-2初次感染的抗体反应。

方法

2021年8月至2022年8月期间，在亚利桑那州、得克萨斯州、犹他州和佛罗里达州的地点对5岁及以上儿童进行了一项纵向队列研究。儿童每周提交鼻拭子进行PCR检测，并在PCR确诊SARS-CoV-2感染后14至59天提供血清。在儿童感染后，无论之前是否接种过单价原始mRNA新冠病毒疫苗，均通过酶联免疫吸附测定（ELISA）检测针对原始刺突蛋白（WA1）的受体结合域（RBD）和S2结构域以及奥密克戎（BA.2）RBD的抗体。

结果

在257名5至18岁的参与者中，166名（65%）在感染前至少14天接种了两剂mRNA新冠病毒疫苗。其中，53例感染发生在德尔塔毒株占主导期间，37例（70%）在感染时未接种疫苗。其余204例感染发生在奥密克戎毒株占主导期间，53例（26%）参与者未接种疫苗。在调整体重、年龄、有症状感染和性别后，接种疫苗组针对WA1和奥密克戎的平均RBD曲线下面积（AUC）值均显著高于未接种疫苗组（<0.0001）。接种疫苗的儿童在患病期间报告发烧的比例较小，55例（33%）报告发烧，而未接种疫苗的儿童有44例（48%）报告发烧（P=0.021）。