Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months.
Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months.
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DOI：
10.1056/nejmoa2114583
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发表时间：
2021-12-09
期刊：
影响因子：
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通讯作者：
Regev-Yochay G
中科院分区：
文献类型：
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作者：
Levin EG;Lustig Y;Cohen C;Fluss R;Indenbaum V;Amit S;Doolman R;Asraf K;Mendelson E;Ziv A;Rubin C;Freedman L;Kreiss Y;Regev-Yochay G
尽管疫苗覆盖率和有效性很高，但以色列严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）症状感染的发生率一直在增加。感染发生率的增加是否是由于接种两剂BNT 162 b2疫苗后免疫力下降所致尚不清楚。我们进行了一项为期6个月的纵向前瞻性研究，研究对象为接种疫苗的医护人员，他们每月接受一次抗刺突IgG和中和抗体检测。使用线性混合模型评估抗体水平的动态，并确定6个月时抗体水平的预测因子。该研究包括4868名参与者，其中3808名被纳入线性混合模型分析。IgG抗体水平以一致的速率下降，而中和抗体水平在前3个月迅速下降，此后下降相对缓慢。尽管IgG抗体水平与中和抗体滴度高度相关（斯皮尔曼秩相关系数为0.68 - 0.75），但IgG和中和抗体水平之间的回归关系取决于接种第二剂疫苗后的时间。在接受第二剂疫苗后6个月，男性的中和抗体滴度明显低于女性（平均值比，0.64; 95%置信区间[CI]，0.55至0.75），65岁或以上人群低于18至45岁以下人群（平均值比，0.58; 95%CI，0.48至0.70），免疫抑制参与者低于无免疫抑制的参与者（平均值比，0.30; 95%CI，0.20至0.46）。在接种第二剂BNT 162 b2疫苗后6个月，体液应答显著降低，尤其是在男性、65岁或以上人群以及免疫抑制人群中。
Despite high vaccine coverage and effectiveness, the incidence of symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been increasing in Israel. Whether the increasing incidence of infection is due to waning immunity after the receipt of two doses of the BNT162b2 vaccine is unclear. We conducted a 6-month longitudinal prospective study involving vaccinated health care workers who were tested monthly for the presence of anti-spike IgG and neutralizing antibodies. Linear mixed models were used to assess the dynamics of antibody levels and to determine predictors of antibody levels at 6 months. The study included 4868 participants, with 3808 being included in the linear mixed-model analyses. The level of IgG antibodies decreased at a consistent rate, whereas the neutralizing antibody level decreased rapidly for the first 3 months with a relatively slow decrease thereafter. Although IgG antibody levels were highly correlated with neutralizing antibody titers (Spearman’s rank correlation between 0.68 and 0.75), the regression relationship between the IgG and neutralizing antibody levels depended on the time since receipt of the second vaccine dose. Six months after receipt of the second dose, neutralizing antibody titers were substantially lower among men than among women (ratio of means, 0.64; 95% confidence interval [CI], 0.55 to 0.75), lower among persons 65 years of age or older than among those 18 to less than 45 years of age (ratio of means, 0.58; 95% CI, 0.48 to 0.70), and lower among participants with immunosuppression than among those without immunosuppression (ratio of means, 0.30; 95% CI, 0.20 to 0.46). Six months after receipt of the second dose of the BNT162b2 vaccine, humoral response was substantially decreased, especially among men, among persons 65 years of age or older, and among persons with immunosuppression.