Priyambodo Seto, Kuo Kuang-Che, Weng Ken-Pen, Liu Shih-Feng, Syu Guan-Da, Kuo Ho-Chang
Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, Taiwan.
Department of Biochemistry, Faculty of Medicine, University of Mataram, Mataram, Indonesia.
Ann Med. 2025 Dec;57(1):2442533. doi: 10.1080/07853890.2024.2442533. Epub 2024 Dec 23.
Vaccination is one of the best ways to control the SARS-CoV-2 outbreak. In Taiwan, healthcare workers were prioritized for vaccination, but the effectiveness of these vaccines for them remains unclear. Thus, it's essential to examine their neutralizing antibodies after prime-boost vaccinations.
In this prospective observational study, 514 healthcare workers from Chang Gung Memorial hospitals in Taiwan were included between 19 March 2021 and 21 August 2021. The two doses of COVID-19 vaccines were either a match or a mixing of AZD1222 and mRNA-1273, e.g. AZD1222 + AZD1222 ( = 406), mRNA-1273 + mRNA-1273 ( = 62), and AZD1222 + mRNA-1273 ( = 46). Blood specimens were drawn after two doses of vaccines, defined as post-vaccine days [median 34.00 days and interquartile range (IQR) 29.00-42.00 days], and examined for the neutralizing antibodies SARS-CoV-2 neutralization kits. The results were analyzed as a percentage of inhibition based on the negative control.
After 2 vaccination doses, subjects with AZD1222 + mRNA-1273 (median 97.15%, IQR 96.06-98.06%) and mRNA-1273 + mRNA-1273 (median 97.47%, IQR 96.75-97.89%) exhibited higher neutralizing antibodies than those receiving AZD1222 + AZD1222 vaccines (median 71.28%, IQR 49.39-89.70%) (the percentage was referred to inhibition of surrogate virus). The post-vaccination days negatively impacted the neutralizing antibodies, except for the mRNA-1273 + mRNA-1273 group. The presence of fever, headache, and myalgia after the second dosage was reflected in the higher neutralizing antibodies (median of no fever 76.00% fever 97.00%, < 0.0001; median of no headache 76.00% headache 95.00%, < 0.0001; median of no myalgia 75.50% myalgia 96.00%, < 0.0001). The subjects with underlying diseases, including hypertension and cancer showed lower neutralizing antibodies (median of no hypertension 81.00% hypertension 56.00%, = 0.0029; median of no cancer 81.00% cancer 56.00%, = 0.0143).
Heterologous prime-boost vaccines (AZD1222 + mRNA-1273) and two doses of mRNA vaccines are recommended. For future directions, we need to investigate the effectiveness of the vaccination against new SARS-CoV-2 variants.
接种疫苗是控制严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫情的最佳方法之一。在台湾，医护人员被优先接种疫苗，但这些疫苗对他们的有效性仍不明确。因此，在进行加强免疫接种后检测他们的中和抗体至关重要。
在这项前瞻性观察研究中，纳入了2021年3月19日至2021年8月21日期间来自台湾长庚纪念医院的514名医护人员。两剂新冠疫苗为阿斯利康新冠疫苗（AZD1222）和信使核糖核酸-1273（mRNA-1273）的匹配或混合接种，例如AZD1222+AZD1222（=406人）、mRNA-1273+mRNA-1273（=62人）以及AZD1222+mRNA-1273（=46人）。在接种两剂疫苗后采集血样，接种后天数定义为[中位数34.00天，四分位间距（IQR）29.00 - 42.00天]，并使用SARS-CoV-2中和试剂盒检测中和抗体。结果以基于阴性对照的抑制百分比进行分析。
接种两剂疫苗后，接种AZD1222+mRNA-1273（中位数97.15%，IQR 96.06 - 98.06%）和mRNA-1273+mRNA-1273（中位数97.47%，IQR 96.75 - 97.89%）的受试者比接种AZD1222+AZD1222疫苗的受试者（中位数71.28%，IQR 49.39 - 89.70%）表现出更高的中和抗体（该百分比指对替代病毒的抑制）。接种后天数对中和抗体有负面影响，但mRNA-1273+mRNA-1273组除外。第二次接种后出现发热、头痛和肌痛的受试者中和抗体水平较高（无发热者中位数76.00%，发热者97.00%，P<0.0001；无头痛者中位数76.00%，头痛者95.00%，P<0.0001；无肌痛者中位数75.50%，肌痛者96.00%，P<0.0001）。患有包括高血压和癌症在内基础疾病的受试者中和抗体水平较低（无高血压者中位数81.00%，高血压者56.00%，P = 0.00(2)9；无癌症者中位数81.00%，癌症者56.00%，P = 0.0143）。
推荐采用异源加强免疫接种（AZD1222+mRNA-1273）和两剂mRNA疫苗。对于未来的研究方向，我们需要调查接种疫苗对新型SARS-CoV-2变体的有效性。
