Hollister James, Porter Cynthia, Sprissler Ryan, Beitel Shawn C, Romine James K, Uhrlaub Jennifer L, Grant Lauren, Yoo Young M, Fowlkes Ashley, Britton Amadea, Olsho Lauren E W, Newes-Adeyi Gabriella, Fuller Sammantha, Zheng Pearl Q, Gaglani Manjusha, Rose Spencer, Dunnigan Kayan, Naleway Allison L, Gwynn Lisa, Caban-Martinez Alberto, Schaefer Solle Natasha, Tyner Harmony L, Philips Andrew L, Hegmann Kurt T, Yoon Sarang, Lutrick Karen, Burgess Jefferey L, Ellingson Katherine D
Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America.
University of Arizona Genetics Core-Center for Applied Genetics and Genomic Medicine, University of Arizona, Tucson, Arizona, United States of America.
PLoS One. 2024 Dec 31;19(12):e0306953. doi: 10.1371/journal.pone.0306953. eCollection 2024.
The extent to which semi-quantitative antibody levels confer protection against SARS-CoV-2 infection in populations with heterogenous immune histories is unclear. Two nested case-control studies were designed within the multisite HEROES/RECOVER prospective cohort of frontline workers to study the relationship between antibody levels and protection against first-time post-vaccination infection and reinfection with SARS-CoV-2 from December 2021 to January 2023. All participants submitted weekly nasal swabs for rRT-PCR testing and blood samples quarterly and following infection or vaccination. Cases of first-time post-vaccination infection following a third dose of monovalent (origin strain WA-1) mRNA vaccine (n = 613) and reinfection (n = 350) were 1:1 matched to controls based on timing of blood draw and other potential confounders. Conditional logistic regression models were fit to estimate infection risk reductions associated with 3-fold increases in end titers for receptor binding domain (RBD). In first-time post-vaccination and reinfection study samples, most were female (67%, 57%), non-Hispanic (82%, 68%), and without chronic conditions (65%, 65%). The odds of first-time post-vaccination infection were reduced by 21% (aOR = 0.79, 95% CI = [0.66-0.96]) for each 3-fold increase in RBD end titers. The odds of reinfection associated with a 3-fold increase in RBD end titers were reduced by 23% (aOR = 0.77, 95% CI = [0.65-0.92] for unvaccinated individuals and 58% (aOR = 0.42, 95% CI = [0.22-0.84]) for individuals with three mRNA vaccine doses following their first infection. Frontline workers with higher antibody levels following a third dose of mRNA COVID-19 vaccine were at reduced risk of SARS-CoV-2 during Omicron predominance. Among those with previous infections, the point estimates of risk reduction associated with antibody levels was greater for those with three vaccine doses compared to those who were unvaccinated.
在免疫史各异的人群中，半定量抗体水平对预防新冠病毒（SARS-CoV-2）感染的作用程度尚不清楚。在多中心的HEROES/RECOVER一线工作者前瞻性队列研究中设计了两项嵌套病例对照研究，以探讨2021年12月至2023年1月期间抗体水平与预防首次接种疫苗后感染以及再次感染SARS-CoV-2之间的关系。所有参与者每周提交鼻拭子进行逆转录聚合酶链反应（rRT-PCR）检测，并在每季度以及感染或接种疫苗后采集血样。在接种第三剂单价（原始毒株WA-1）mRNA疫苗后首次接种疫苗后感染的病例（n = 613）和再次感染的病例（n = 350），根据采血时间和其他潜在混杂因素与对照进行1:1匹配。采用条件逻辑回归模型来估计与受体结合域（RBD）最终滴度增加3倍相关的感染风险降低情况。在首次接种疫苗后感染和再次感染的研究样本中，大多数为女性（分别为67%、57%）、非西班牙裔（分别为82%、68%）且无慢性病（分别为65%、65%）。RBD最终滴度每增加3倍，首次接种疫苗后感染的几率降低21%（调整后比值比[aOR]=0.79，95%置信区间[CI]=[0.66 - 0.96]）。对于未接种疫苗的个体，RBD最终滴度增加3倍与再次感染相关的几率降低23%（aOR = 0.77，95% CI = [0.65 - 0.92]），而对于首次感染后接种三剂mRNA疫苗的个体，这一几率降低58%（aOR = 0.42，95% CI = [0.22 - 0.84]）。在奥密克戎毒株占主导期间，接种第三剂mRNA新冠疫苗后抗体水平较高的一线工作者感染SARS-CoV-2的风险降低。在既往有感染史的人群中，与抗体水平相关的风险降低点估计值在接种三剂疫苗的人群中比未接种疫苗的人群更大。
