Increased vaccine sensitivity of an emerging SARS-CoV-2 variant.

Increased vaccine sensitivity of an emerging SARS-CoV-2 variant.
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DOI:
10.1038/s41467-023-39567-2
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发表时间:
2023-06-29
影响因子:
16.6
通讯作者:
Tartof, Sara Y.
Tartof, Sara Y.
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Lewnard, Joseph A.;Hong, Vennis;Kim, Jeniffer S.;Shaw, Sally F.;Lewin, Bruno;Takhar, Harpreet;Lipsitch, Marc;Tartof, Sara Y.

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宿主免疫反应是驱动病原体进化的选择压力的关键来源。许多 SARS-CoV-2 谱系的出现与其逃避因疫苗接种和感染而产生的群体免疫力的能力增强有关。在这里,我们展示了新兴的 XBB/XBB.1.5 Omicron 谱系逃避疫苗衍生免疫和感染衍生免疫的不同趋势。 2022 年 12 月至 2023 年 2 月期间,在南加州进行了 31,739 名门诊测试的患者中,之前接受 2、3、4 和 ≥5 剂 COVID-19 疫苗的调整后几率分别为 10%(95% 置信区间:1–18%)、11%(3–19%)、13%(3–21%)和 25% XBB/XBB.1.5 感染病例比其他共循环谱系感染病例分别低 (15-34%)。同样,与非 XBB/XBB.1.5 病例相比,先前接种疫苗与 XBB/XBB.1.5 病例中防止进展住院的保护点估计值相关(对于 ≥ 4 剂接种者,分别为 70% [30–87%] 和 48% [7–71%])。相比之下,感染 XBB/XBB.1.5 的病例此前经历过 1 次和 ≥2 次感染(包括 Omicron 之前的变种)的调整后几率分别高出 17% (11–24%) 和 40% (19–65%)。随着从 SARS-CoV-2 感染中获得的免疫力变得越来越普遍,XBB/XBB.1.5 中与疫苗敏感性增强相关的适应成本可能会被逃避感染引起的宿主反应的能力增强所抵消。 SARS-CoV-2 Omicron 谱系 XBB/XBB.1.5 于 2023 年 1 月成为美国新感染的主要原因。在这里,作者使用测试和住院数据表明,这种变体增强了逃避感染源性免疫的能力,但增强了疫苗敏感性。
Host immune responses are a key source of selective pressure driving pathogen evolution. Emergence of many SARS-CoV-2 lineages has been associated with enhancements in their ability to evade population immunity resulting from both vaccination and infection. Here we show diverging trends of escape from vaccine-derived and infection-derived immunity for the emerging XBB/XBB.1.5 Omicron lineage. Among 31,739 patients tested in ambulatory settings in Southern California from December, 2022 to February, 2023, adjusted odds of prior receipt of 2, 3, 4, and ≥5 COVID-19 vaccine doses were 10% (95% confidence interval: 1–18%), 11% (3–19%), 13% (3–21%), and 25% (15–34%) lower, respectively, among cases infected with XBB/XBB.1.5 than among cases infected with other co-circulating lineages. Similarly, prior vaccination was associated with greater point estimates of protection against progression to hospitalization among cases with XBB/XBB.1.5 than among non-XBB/XBB.1.5 cases (70% [30–87%] and 48% [7–71%], respectively, for recipients of ≥4 doses). In contrast, cases infected with XBB/XBB.1.5 had 17% (11–24%) and 40% (19–65%) higher adjusted odds of having experienced 1 and ≥2 prior documented infections, respectively, including with pre-Omicron variants. As immunity acquired from SARS-CoV-2 infection becomes increasingly widespread, fitness costs associated with enhanced vaccine sensitivity in XBB/XBB.1.5 may be offset by increased ability to evade infection-derived host responses. The SARS-CoV-2 Omicron lineage XBB/XBB.1.5 became the leading cause of new infections in the US in January 2023. Here, the authors use testing and hospitalisation data and show that this variant has increased ability to evade infection-derived immunity but enhanced vaccine sensitivity.
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