Asamoah-Boaheng Michael, Goldfarb David M, Kayda Iryna, Yap Justin, Kirkham Tracy, Karim Mohammad Ehsanul, Demers Paul, Copp Jeffrey M, Grunau Brian
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Centre for Advancing Health Outcomes, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Access Microbiol. 2025 Jan 13;7(1). doi: 10.1099/acmi.0.000791.v3. eCollection 2025.
Comparative immunogenicity from different mRNA booster vaccines (directed at WT, BA.1 or BA.4/5 antigens) remains unclear. We included blood samples from adult paramedics who received three mRNA WT-directed vaccines plus a fourth dose of the following: (1) WT monovalent, (2) Moderna BA.1-WT bivalent or (3) Pfizer BA.4/5 WT bivalent vaccine. The primary outcome was angiotensin-converting enzyme 2 (ACE2) inhibition to BA.4/5 antigen. We used optimal pair matching (using age, sex-at-birth, preceding SARS-CoV-2 infection and fourth vaccine-to-blood collection interval) to create balanced groups to individually compare each vaccine type to each other vaccine (overall, within subgroups defined by SARS-CoV-2 infection and after combining BA.1 and BA.4/5 cases). We compared outcomes with the Wilcoxon matched-pairs signed rank test. Overall, 158 paramedics (mean age 45 years) were included. ACE2 inhibition was higher for BA.1 compared to WT (=0.002); however, no difference was detected between BA.4/5 vs. WT or BA.1 vs. BA.4/5. Among cases with preceding SARS-CoV-2, there were no detected between-group differences. Among cases without preceding SARS-CoV-2, the only detected difference was BA.1>WT (=0.003). BA.1 and BA.4/5 cases combined had higher ACE2 inhibition than WT (=0.003). Omicron-directed vaccines appear to improve Omicron-specific immunogenicity; however, this appears limited to SARS-CoV-2-naive individuals.
不同mRNA加强疫苗（针对野生型、BA.1或BA.4/5抗原）的相对免疫原性尚不清楚。我们纳入了成年护理人员的血样，这些人员接种了三剂针对野生型的mRNA疫苗，并接种了第四剂以下疫苗：（1）野生型单价疫苗，（2）莫德纳BA.1-野生型二价疫苗或（3）辉瑞BA.4/5-野生型二价疫苗。主要结局是血管紧张素转换酶2（ACE2）对BA.4/5抗原的抑制作用。我们采用最佳配对匹配（根据年龄、出生时性别、既往SARS-CoV-感染情况以及第四剂疫苗接种至采血间隔时间）来创建平衡组，以便将每种疫苗类型与其他每种疫苗进行单独比较（总体上，在由SARS-CoV-感染定义的亚组内以及合并BA.1和BA.4/5病例后）。我们使用Wilcoxon配对符号秩检验比较结局。总体而言，纳入了158名护理人员（平均年龄45岁）。与野生型相比，BA.1的ACE2抑制作用更高（=0.002）；然而在BA.4/5与野生型之间或BA.1与BA.4/5之间未检测到差异。在既往感染过SARS-CoV-的病例中，未检测到组间差异。在既往未感染过SARS-CoV-的病例中，唯一检测到的差异是BA.1>野生型（=0.003）。合并BA.1和BA.4/5病例的ACE2抑制作用高于野生型（=0.003）。针对奥密克戎的疫苗似乎可提高奥密克戎特异性免疫原性；然而，这似乎仅限于未感染过SARS-CoV-的个体。
