Lin Chun-Yuan, Song Ying-Chyi, Yang Chin-Chou, Yeh Po-Shou, Yu Ya-Yen, Huang Chih-Chia
Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan; Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan; National Changhua University of Education, Changhua, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung, Taiwan; Research Center of Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
Brain Behav Immun. 2025 Jun 9;129:434-441. doi: 10.1016/j.bbi.2025.06.015.
Research has shown that patients with psychiatric disorders are more susceptible to contracting SARS-CoV-2 and tend to experience worse outcomes from COVID-19. Therefore, vaccination is strongly suggested for these patients to enhance protection. However, there is limited research on how COVID-19 vaccines induce antibody responses, specifically in individuals with psychiatric conditions. Furthermore, the situation has become more complex with the emergence of variants of concern (VOCs), and the effectiveness of antibody responses against these variants is still poorly understood. To determine whether patients with severe mental illness (SMI) mount an adequate immune reaction to COVID-19 vaccination, we studied the immunization effect of two widely used vaccines, ChAdOx1-S (AstraZeneca) and mRNA-1273 (Moderna), in patients with SMI compared to healthy controls. We enrolled 163 patients with SMI (mainly schizophrenia) and 66 healthy controls, all of whom were negative for previous SARS-CoV-2 infection. We analyzed anti-SARS-CoV-2 spike antibody titers against wild-type (WT), Delta, and Omicron variants after full (two-dose) vaccination with either the ChAdOx1-S or mRNA-1273 COVID-19 vaccines. Patients with SMI exhibited significantly lower mean anti-SARS-CoV-2 spike antibody titers. These results were consistent across different vaccine types and VOCs. Vaccination with ChAdOx1-S consistently induced lower spike-binding antibodies against WT, Delta, and Omicron variants compared to the mRNA-1273 vaccine. While the antibody activities against Omicron are well preserved, they are weaker than those against the WT and Delta variants. Our findings explain why patients with SMI are particularly susceptible to SARS-CoV-2 infection, breakthrough infections, and poorer COVID-19 outcomes.
研究表明，患有精神疾病的患者更容易感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2），并且感染新冠病毒病（COVID-19）后往往预后更差。因此，强烈建议这些患者接种疫苗以增强保护。然而，关于COVID-19疫苗如何诱导抗体反应的研究有限，特别是在患有精神疾病的个体中。此外，随着值得关注的变异株（VOC）的出现，情况变得更加复杂，针对这些变异株的抗体反应有效性仍知之甚少。为了确定重度精神疾病（SMI）患者对COVID-19疫苗是否产生足够的免疫反应，我们研究了两种广泛使用的疫苗，即腺病毒载体疫苗ChAdOx1-S（阿斯利康）和信使核糖核酸疫苗mRNA-1273（莫德纳），在SMI患者与健康对照中的免疫效果。我们招募了163名SMI患者（主要为精神分裂症患者）和66名健康对照，他们既往SARS-CoV-2感染均为阴性。在用ChAdOx1-S或mRNA-1273 COVID-19疫苗进行全程（两剂）接种后，我们分析了针对野生型（WT）、德尔塔和奥密克戎变异株的抗SARS-CoV-2刺突抗体滴度。SMI患者的平均抗SARS-CoV-2刺突抗体滴度显著较低。这些结果在不同疫苗类型和VOC中都是一致的。与mRNA-1273疫苗相比，接种ChAdOx1-S疫苗始终诱导产生较低的针对WT、德尔塔和奥密克戎变异株的刺突结合抗体。虽然针对奥密克戎的抗体活性得到了很好的保留，但它们比针对WT和德尔塔变异株的抗体活性弱。我们的研究结果解释了为什么SMI患者特别容易感染SARS-CoV-2、发生突破性感染以及COVID-19预后较差。
