Durability of immunity and clinical protection in nursing home residents following bivalent SARS-CoV-2 vaccination.

IF 9.7 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
EBioMedicine Pub Date : 2024-07-01 Epub Date: 2024-06-10 DOI:10.1016/j.ebiom.2024.105180
Stefan Gravenstein, Frank DeVone, Oladayo A Oyebanji, Yasin Abul, Yi Cao, Philip A Chan, Christopher W Halladay, James L Rudolph, Clare Nugent, Jürgen Bosch, Christopher L King, Brigid M Wilson, Alejandro B Balazs, Elizabeth M White, David H Canaday, Kevin W McConeghy
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引用次数: 0

Abstract

Background: Bivalent SARS-CoV-2 vaccines were developed to counter increasing susceptibility to emerging SARS-CoV-2 variants. We evaluated the durability of immunity and protection following first bivalent vaccination among nursing home residents.

Methods: We evaluated anti-spike and neutralization titers from blood in 653 community nursing home residents before and after each monovalent booster, and a bivalent vaccine. Concurrent clinical outcomes were evaluated using electronic health record data from a separate cohort of 3783 residents of Veterans Affairs (VA) nursing homes who had received at least the primary series monovalent vaccination. Using target trial emulation, we compared VA residents who did and did not receive the bivalent vaccine to measure vaccine effectiveness against infection, hospitalization, and death.

Findings: In the community cohort, Omicron BA.5 neutralization activity rose after each monovalent and bivalent booster vaccination regardless of prior infection history. Titers declined over time but six months post-bivalent vaccination, BA.5 neutralization persisted at detectable levels in 75% of infection-naive and 98% of prior-infected individuals. In the VA nursing home cohort, bivalent vaccine added effectiveness to monovalent booster vaccination by 18.5% for infection (95% confidence interval (CI) -5.6, 34.0%), and 29.2% for hospitalization or death (95% CI -14.2, 56.2%) over five months.

Interpretation: The level of protection declined after bivalent vaccination over a 6 month period and may open a window of added vulnerability before the next updated vaccine becomes available, suggesting a subset of nursing home residents may benefit from an additional vaccination booster.

Funding: CDC, NIH, VHA.

养老院居民接种二价 SARS-CoV-2 疫苗后的免疫持久性和临床保护。
背景:开发二价 SARS-CoV-2 疫苗是为了应对对新出现的 SARS-CoV-2 变体日益增加的易感性。我们评估了养老院居民首次接种二价疫苗后免疫力和保护力的持久性:我们评估了 653 名社区养老院居民在接种单价疫苗和二价疫苗前后血液中的抗穗抗体和中和滴度。我们使用退伍军人事务局 (VA) 养老院中至少接种过初级系列单价疫苗的 3783 名居民的电子健康记录数据,对他们的同期临床结果进行了评估。通过目标试验仿真,我们对接种和未接种二价疫苗的退伍军人事务养老院居民进行了比较,以衡量疫苗在预防感染、住院和死亡方面的效果:在社区队列中,无论之前是否有感染史,在每次接种单价和二价强化疫苗后,Omicron BA.5 中和活性都会上升。随着时间的推移,滴度有所下降,但在二价疫苗接种后六个月,75% 的非感染者和 98% 的既往感染者体内的 BA.5 中和活性仍保持在可检测到的水平。在退伍军人养老院队列中,接种二价疫苗五个月后,感染率增加了18.5%(95% 置信区间 (CI) -5.6%,34.0%),住院或死亡率增加了29.2%(95% CI -14.2%,56.2%):二价疫苗接种后的保护水平在6个月内有所下降,可能会在下一次更新疫苗上市前增加易感性,这表明一部分养老院居民可能会从额外的疫苗加强接种中受益:资助机构:美国疾病预防控制中心、美国国立卫生研究院、美国退伍军人协会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
EBioMedicine
EBioMedicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
17.70
自引率
0.90%
发文量
579
审稿时长
5 weeks
期刊介绍: eBioMedicine is a comprehensive biomedical research journal that covers a wide range of studies that are relevant to human health. Our focus is on original research that explores the fundamental factors influencing human health and disease, including the discovery of new therapeutic targets and treatments, the identification of biomarkers and diagnostic tools, and the investigation and modification of disease pathways and mechanisms. We welcome studies from any biomedical discipline that contribute to our understanding of disease and aim to improve human health.
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