Correlates of protection against SARS-CoV-2 Omicron variant and anti-spike antibody responses after a third/booster vaccination or breakthrough infection in the UK general population
Correlates of protection against SARS-CoV-2 Omicron variant and anti-spike antibody responses after a third/booster vaccination or breakthrough infection in the UK general population
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英国普通人群第三次/加强疫苗接种或突破性感染后针对 SARS-CoV-2 Omicron 变体的保护与抗尖峰抗体反应的相关性
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
D. Eyre
中科院分区：
文献类型：
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作者：
J. Wei;P. Matthews;N. Stoesser;J. Newton;I. Diamond;R. Studley;N. Taylor;J. Bell;J. Farrar;B. Marsden;J. Kolenchery;S. Hoosdally;Y. Jones;D. Stuart;D. Crook;T. Peto;A. Walker;K. Pouwels;D. Eyre
在初次接种SARS-CoV-2疫苗后，了解预防增强剂感染或突破性感染（即以前接种过疫苗的感染）的相对保护程度对疫苗政策具有重要意义。在这项研究中，我们调查了来自英国普通人群的154,149名[≥]18岁的成年人在第三次/加强接种或第二次接种后突破感染后对Omicron BA.4/5感染和抗刺突IgG抗体轨迹的相关保护。我们发现，较高的抗刺突IgG抗体水平与对Omicron BA.4/5感染的保护增强有关，并且在任何给定的抗体水平下，突破性感染的保护水平都高于加强疫苗接种。突破性感染产生的抗体水平与第三次/加强疫苗接种相似，随后抗体水平的下降与第三次/加强疫苗接种相似或略慢。综上所述，我们的研究结果表明，突破性感染比加强疫苗接种能提供更持久的保护，防止进一步感染。例如，考虑到抗体水平与67%的感染保护相关，第三次/加强疫苗接种不能提供持久的保护，而Delta/Omicron BA.1突破感染可以提供5-10个月的保护，防止Omicron BA.4/5再次感染。到2022年底，英国接种疫苗的突破性感染人群中，仍有50-60%的人受到保护，而未感染的三次接种疫苗的英国人群中，这一比例不到15%。尽管与持续传播相关的某些个体存在社会影响和风险，但突破性感染可能是一种有效的免疫增强机制，适用于人群的亚群体，包括年轻健康成年人，他们感染不良后果的风险较低。
Following primary SARS-CoV-2 vaccination, understanding the relative extent of protection against SARS-CoV-2 infection from boosters or from breakthrough infections (i.e. infection in the context of previous vaccination) has important implications for vaccine policy. In this study, we investigated correlates of protection against Omicron BA.4/5 infections and anti-spike IgG antibody trajectories after a third/booster vaccination or breakthrough infection following second vaccination in 154,149 adults [≥]18y from the United Kingdom general population. We found that higher anti-spike IgG antibody levels were associated with increased protection against Omicron BA.4/5 infection and that breakthrough infections were associated with higher levels of protection at any given antibody level than booster vaccinations. Breakthrough infections generated similar antibody levels to third/booster vaccinations, and the subsequent declines in antibody levels were similar to or slightly slower than those after third/booster vaccinations. Taken together our findings show that breakthrough infection provides longer lasting protection against further infections than booster vaccinations. For example, considering antibody levels associated with 67% protection against infection, a third/booster vaccination did not provide long-lasting protection, while a Delta/Omicron BA.1 breakthrough infection could provide 5-10 months of protection against Omicron BA.4/5 reinfection. 50-60% of the vaccinated UK population with a breakthrough infection would still be protected by the end of 2022, compared to <15% of the triple-vaccinated UK population without previous infection. Although there are societal impacts and risks to some individuals associated with ongoing transmission, breakthrough infection could be an efficient immune-boosting mechanism for subgroups of the population, including younger healthy adults, who have low risks of adverse consequences from infection.