英国医护人员中同时接种 SARS-CoV-2 疫苗和流感疫苗的免疫原性：一项前瞻性纵向观察研究。
Immunogenicity of concomitant SARS-CoV-2 and influenza vaccination in UK healthcare workers: a prospective longitudinal observational study.
作者信息
Nazareth Joshua, Martin Christopher A, Pan Daniel, Barr Ian G, Sullivan Sheena G, Peck Heidi, Veli Neyme, Das Mrinal, Bryant Luke, George Nisha, Gohar Marjan, Gray Laura J, Teece Lucy, Vail Denny, Renals Val, Karia Aleesha, Renals Paul, Moss Paul, Tattersall Andrea, Otter Ashley D, Haldar Pranab, Cooper Andrea, Stephenson Iain, Wiselka Martin J, Tang Julian W, Nellums Laura, Pareek Manish
机构信息
Department of Respiratory Sciences, University of Leicester, UK.
Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
出版信息
Lancet Reg Health Eur. 2024 Aug 12;44:101022. doi: 10.1016/j.lanepe.2024.101022. eCollection 2024 Sep.
BACKGROUND
Co-administration of inactivated influenza vaccine (IIV) and SARS-CoV-2 vaccine may impact SARS-CoV-2 vaccine induced humoral immune responses. We aimed to compare IIV and SARS-CoV-2 vaccine induced cellular and humoral immune responses in those receiving concomitant vaccination to those receiving these vaccines separately.
METHODS
We conducted a cohort study between 29th September 2021 and 5th August 2022 in healthcare workers who worked at the local NHS trust and in the surrounding area that were vaccinated with a mRNA SARS-CoV-2 booster and cell-based IIV. We measured haemagglutination inhibition assay (HAI) titres, SARS-CoV-2 anti-spike antibody and SARS-CoV-2 ELISpot count pre-vaccination, 1-month and 6-months post-vaccination and evaluated differences by vaccine strategy.
FINDINGS
We recruited 420 participants, 234/420 (56%) were vaccinated concomitantly and 186/420 (44%) separately. The 1-month post-vaccination mean fold rise (MFR) in SARS-CoV-2 anti-spike antibodies was lower in those vaccinated concomitantly compared to separately (MFR [95% confidence interval (CI)] 9.7 [8.3, 11.4] vs 12.8 [10.3, 15.9], = 0.04). After adjustment for age and sex, the adjusted geometric mean ratio (aGMR) remained lower for those vaccinated concomitantly compared to separately (aGMR [95% CI] 0.80 [0.70, 0.92], = 0.001). At 6-months post-vaccination, we found no statistically significant difference in SARS-CoV-2 anti-spike antibody titres (aGMR [95% CI] 1.09 [0.87, 1.35], = 0.45). We found no statistically significant correlation between vaccine strategy with SARS-CoV-2 ELISpot count and influenza HAI titres at 1-month and 6-months post-vaccination.
INTERPRETATION
Our study found that concomitant vaccination with SARS-CoV-2 and IIV has no statistically significant impacts on long-term immunogenicity. Further research is required to understand the underlying mechanisms and assess the clinical significance of reduced anti-spike antibodies in those vaccinated concomitantly.
FUNDING
Research and Innovation (UKRI) through the COVID-19 National Core Studies Immunity (NCSi) programme (MC_PC_20060).
背景
灭活流感疫苗（IIV）与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗同时接种可能会影响SARS-CoV-2疫苗诱导的体液免疫反应。我们旨在比较同时接种IIV和SARS-CoV-2疫苗者与分别接种这两种疫苗者的细胞免疫和体液免疫反应。
方法
2021年9月29日至2022年8月5日，我们在当地国民保健服务（NHS）信托机构及周边地区工作的医护人员中开展了一项队列研究，这些医护人员接种了mRNA SARS-CoV-2加强针和细胞培养的IIV。我们在接种前、接种后1个月和6个月测量了血凝抑制试验（HAI）滴度、SARS-CoV-2抗刺突抗体和SARS-CoV-2酶联免疫斑点试验（ELISpot）计数，并按疫苗接种策略评估差异。
结果
我们招募了420名参与者，其中234/420（56%）为同时接种，186/420（44%）为分别接种。与分别接种相比，同时接种者接种后1个月SARS-CoV-2抗刺突抗体的平均升高倍数（MFR）较低（MFR[95%置信区间（CI）]9.7[8.3, 11.4] vs 12.8[10.3, 15.9]，P = 0.04）。在调整年龄和性别后，同时接种者的调整几何平均比（aGMR）仍低于分别接种者（aGMR[95%CI]0.80[0.70, 0.92]，P = 0.001）。接种后6个月，我们发现SARS-CoV-2抗刺突抗体滴度无统计学显著差异（aGMR[95%CI]1.09[0.87, 1.35]，P = 0.45）。我们发现疫苗接种策略与接种后1个月和6个月的SARS-CoV-2 ELISpot计数及流感HAI滴度之间无统计学显著相关性。
解读
我们的研究发现，同时接种SARS-CoV-2疫苗和IIV对长期免疫原性无统计学显著影响。需要进一步研究以了解其潜在机制，并评估同时接种者抗刺突抗体降低的临床意义。
资助
研究与创新部（英国研究与创新署）通过新冠病毒19国家核心研究免疫（NCSi）项目（MC_PC_20060）提供资金。
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