Dynamic IgG seropositivity after rollout of CoronaVac and BNT162b2 COVID-19 vaccines in Chile: a sentinel surveillance study.
Dynamic IgG seropositivity after rollout of CoronaVac and BNT162b2 COVID-19 vaccines in Chile: a sentinel surveillance study.
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DOI：
10.1016/s1473-3099(21)00479-5
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发表时间：
2022-01
期刊：
影响因子：
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通讯作者：
Basso LJ
中科院分区：
文献类型：
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作者：
Sauré D;O'Ryan M;Torres JP;Zuniga M;Santelices E;Basso LJ
截至2021年7月14日，智利81.3%的成年人（年龄≥18岁）接种了第一次SARS-CoV-2疫苗，72.3%的人接种了第二次SARS-CoV-2疫苗，其中大多数人接种了科兴公司的灭活CoronaVac疫苗（占所分配疫苗的75.3%）或辉瑞BioNTech的mRNA BNT 162 b2疫苗（占所分配疫苗的20.9%）。由于缺乏这些疫苗的同步真实世界数据，我们的目的是使用动态国家监测策略比较疫苗之间的SARS-CoV-2 IgG阳性。从2021年3月12日起，在智利人口最多的城市内，基于手机移动跟踪的热点地区安装了28个SARS-CoV-2 IgG检测站。自愿接近检测站的个人被邀请通过手指针刺进行侧流检测，并回答关于社会人口学特征、疫苗接种状况（包括疫苗类型，如果接受了疫苗）、与SARS-CoV-2暴露相关的变量和合并症的问卷。我们比较了接种CoronaVac和BNT 162 b2疫苗后各研究中心每周抗SARS-CoV-2 IgG检测阳性的个体比例。未接种疫苗的参与者作为对照人群，并根据向检测站提交的日期、性别和年龄组与接种疫苗的个体进行匹配。如果个人年龄小于18岁，没有声明性别，IgG检测结果无效，先前PCR检测SARS-CoV-2感染呈阳性，无法回忆其疫苗接种状态，或已使用CoronaVac或BNT 162 b2以外的疫苗接种COVID-19，则将其从分析中排除。在这里，我们报告了截至2021年7月2日收集的数据。在入组的64813名受试者中，56261人被纳入最终分析，其中33533人（59.6%）至少接种了一剂CoronaVac疫苗，8947人（15.9%）至少接种了一剂BNT 162 b2疫苗，13781人（24.5%）未接种疫苗。首次接种CoronaVac后第4周的SARS-CoV-2 IgG阳性率为28.1%（95% CI 25.0 - 31.2; 220/783人），第2次接种后第3周达到峰值77.4%（75.5 - 79.3; 1473/1902人）。首次接种BNT 162 b2疫苗后第4周，SARS-CoV-2 IgG阳性率为79.4%（75.7 - 83.1; 367/462人），第2次接种后第3周增加至96.5%（94.9 - 98.1; 497/515人），并保持在92%以上，直至研究结束。对于未接种疫苗的个体，5个月期间IgG血清阳性率范围为6.0%（4.4 - 7.6; 49/810个体）至18.7%（12.5 - 24.9; 28/150个体）。回归分析显示，在第二次接种后3-16周，CoronaVac疫苗接种者的IgG血清阳性率在男性中显著低于女性，在糖尿病或慢性病患者中显著低于女性（p <0.0001），在两种疫苗接种者中，60岁及以上的个体与18-39岁的个体相比显著低于女性（p<0.0001）。CoronaVac接种后IgG血清阳性率低于BNT 162 b2接种后，并且自CoronaVac接种者而非BNT 162 b2接种者接种后随时间推移而下降。长期IgG监测将允许进一步评价血清阳性随时间的变化，结合有效性研究提供数据，用于未来可能的疫苗接种策略重新评估。智利工程系统和卫生部。摘要的西班牙语翻译见补充材料部分。
By July 14, 2021, 81·3 % of adults (aged ≥18 years) in Chile had received a first SARS-CoV-2 vaccine and 72·3% had received a second SARS-CoV-2 vaccine, with the majority of people given Sinovac's inactivated CoronaVac vaccine (75·3% of vaccines dispensed) or Pfizer–BioNTech's mRNA BNT162b2 vaccine (20·9% of vaccines dispensed). Due to the absence of simultaneous real-world data for these vaccines, we aimed to compare SARS-CoV-2 IgG positivity between vaccines using a dynamic national monitoring strategy. From March 12, 2021, 28 testing stations for SARS-CoV-2 IgG detection were installed in hotspots based on cellular-phone mobility tracking within the most populated cities in Chile. Individuals voluntarily approaching the testing stations were invited to do a lateral flow test by finger prick and respond to a questionnaire on sociodemographic characteristics, vaccination status (including type of vaccine if one was received), variables associated with SARS-CoV-2 exposure, and comorbidities. We compared the proportion of individuals testing positive for anti-SARS-CoV-2 IgG across sites by week since vaccination between recipients of CoronaVac and BNT162b2. Unvaccinated participants served as a control population and were matched to vaccinated individuals on the basis of date of presentation to the testing station, gender, and age group. Individuals were excluded from the analysis if they were younger than 18 years, had no declared gender, had an invalid IgG test result, had previously tested positive for SARS-CoV-2 infection on PCR, could not recall their vaccination status, or had been immunised against COVID-19 with vaccines other than CoronaVac or BNT162b2. Here, we report data collected up to July 2, 2021. Of 64 813 individuals enrolled, 56 261 were included in the final analysis, of whom 33 533 (59·6%) had received at least one dose of the CoronaVac vaccine, 8947 (15·9%) had received at least one dose of the BNT162b2 vaccine, and 13 781 (24·5%) had not received a vaccine. SARS-CoV-2 IgG positivity during week 4 after the first dose of CoronaVac was 28·1% (95% CI 25·0–31·2; 220 of 783 individuals), reaching a peak of 77·4% (75·5–79·3; 1473 of 1902 individuals) during week 3 after the second dose. SARS-CoV-2 IgG positivity during week 4 after the first dose of the BNT162b2 vaccine was 79·4% (75·7–83·1; 367 of 462 individuals), increasing to 96·5% (94·9–98·1; 497 of 515 individuals) during week 3 after the second dose and remaining above 92% until the end of the study. For unvaccinated individuals, IgG seropositivity ranged from 6·0% (4·4–7·6; 49 of 810 individuals) to 18·7% (12·5–24·9; 28 of 150 individuals) during the 5 month period. Regression analyses showed that IgG seropositivity was significantly lower in men than women and in people with diabetes or chronic diseases for CoronaVac vaccine recipients (p<0·0001), and for individuals aged 60 years and older compared with people aged 18–39 years for both vaccines (p<0·0001), 3–16 weeks after the second dose. IgG seropositivity was lower after CoronaVac than after BNT162b2 and declined over time since vaccination for CoronaVac recipients but not BNT162b2 recipients. Prolonged IgG monitoring will allow further evaluation of seropositivity overtime, providing data, in conjunction with effectiveness studies, for possible future re-assessment of vaccination strategies. Instituto Sistemas Complejos de Ingeniería and Ministerio de Salud Chile. For the Spanish translation of the abstract see Supplementary Materials section.