Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections: A prospective cohort study in non-hospitalized adults

IF 4 3区医学 Q2 VIROLOGY Journal of Clinical Virology Pub Date : 2023-11-28 DOI:10.1016/j.jcv.2023.105622

Martina Prelog , Samuel D. Jeske , Claudia Asam , Andre Fuchs , Andreas Wieser , Christine Gall , Monika Wytopil , Sandra M. Mueller-Schmucker , Stephanie Beileke , Mehmet Goekkaya , Elisabeth Kling , Christof Geldmacher , Raquel Rubio-Acero , Michael Plank , Catharina Christa , Annika Willmann , Martin Vu , Sebastian Einhauser , Manuela Weps , Benedikt M.J. Lampl , Philipp Steininger

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Abstract

Background

SARS-CoV-2 variants of concern (VOC) may result in breakthrough infections (BTIs) in vaccinated individuals. The aim of this study was to investigate the effects of full primary (two-dose) COVID-19 vaccination with wild-type-based SARS-CoV-2 vaccines on symptoms and immunogenicity of SARS-CoV-2 VOC BTIs.

Methods

In a longitudinal multicenter controlled cohort study in Bavaria, Germany, COVID-19 vaccinated and unvaccinated non-hospitalized individuals were prospectively enrolled within 14 days of a PCR-confirmed SARS-CoV-2 infection. Individuals were visited weekly up to 4 times, performing a structured record of medical data and viral load assessment. SARS-CoV-2-specific antibody response was characterized by anti-spike-(S)- and anti-nucleocapsid-(N)-antibody concentrations, anti-S-IgG avidity and neutralization capacity.

Results

A total of 300 individuals (212 BTIs, 88 non-BTIs) were included with VOC Alpha or Delta SARS-CoV-2 infections. Full primary COVID-19 vaccination provided a significant effectiveness against five symptoms (relative risk reduction): fever (33 %), cough (21 %), dysgeusia (22 %), dizziness (52 %) and nausea/vomiting (48 %). Full primary vaccinated individuals showed significantly higher 50 % inhibitory concentration (IC₅₀) values against the infecting VOC compared to unvaccinated individuals at week 1 (269 vs. 56, respectively), and weeks 5–7 (1,917 vs. 932, respectively) with significantly higher relative anti-S-IgG avidity (78% vs. 27 % at week 4, respectively).

Conclusions

Full primary COVID-19 vaccination reduced symptom frequencies in non-hospitalized individuals with BTIs and elicited a more rapid and longer lasting neutralization capacity against the infecting VOC compared to unvaccinated individuals. These results support the recommendation to offer at least full primary vaccination to all adults to reduce disease severity caused by immune escape-variants.

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在SARS-CoV-2突破性感染个体中完全接种COVID-19初级疫苗的临床和免疫学益处:一项针对非住院成人的前瞻性队列研究

背景:sars - cov -2关注变异体(VOC)可能导致接种疫苗个体出现突破性感染(BTIs)。本研究的目的是探讨用野生型SARS-CoV-2疫苗接种全初级(双剂量)COVID-19疫苗对SARS-CoV-2 VOC BTIs的症状和免疫原性的影响。方法在德国巴伐利亚州的一项纵向多中心对照队列研究中，前瞻性地纳入了pcr确诊的SARS-CoV-2感染后14天内接种COVID-19疫苗和未接种疫苗的非住院个体。每个人每周最多访问4次，进行结构化的医疗数据记录和病毒载量评估。sars - cov -2特异性抗体反应的特征是抗spike-(S)-和抗核衣壳-(N)-抗体浓度、抗S- igg的亲和力和中和能力。结果共有300例患者(bti 212例，非bti 88例)出现VOC α或δ型SARS-CoV-2感染。完整的COVID-19初级疫苗接种对五种症状(相对风险降低)有显著效果:发烧(33%)、咳嗽(21%)、语言障碍(22%)、头晕(52%)和恶心/呕吐(48%)。与未接种疫苗的个体相比，在第1周(分别为269对56)和第5-7周(分别为1,917对932)，完全一次接种疫苗的个体对感染VOC的50%抑制浓度(IC50)值显著高于未接种疫苗的个体，抗s - igg的相对亲和力显著高于第4周(分别为78%对27%)。结论与未接种疫苗的人群相比，初次接种完整的COVID-19疫苗可降低未住院bti患者的症状频率，并对感染VOC产生更快速、更持久的中和能力。这些结果支持向所有成年人提供至少完整的初级疫苗接种以降低由免疫逃逸变异引起的疾病严重程度的建议。

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

Journal of Clinical Virology 医学-病毒学

CiteScore

22.70

自引率

1.10%

发文量

149

审稿时长

24 days

期刊介绍： The Journal of Clinical Virology, an esteemed international publication, serves as the official journal for both the Pan American Society for Clinical Virology and The European Society for Clinical Virology. Dedicated to advancing the understanding of human virology in clinical settings, the Journal of Clinical Virology focuses on disseminating research papers and reviews pertaining to the clinical aspects of virology. Its scope encompasses articles discussing diagnostic methodologies and virus-induced clinical conditions, with an emphasis on practicality and relevance to clinical practice. The journal publishes on topics that include: • new diagnostic technologies • nucleic acid amplification and serologic testing • targeted and metagenomic next-generation sequencing • emerging pandemic viral threats • respiratory viruses • transplant viruses • chronic viral infections • cancer-associated viruses • gastrointestinal viruses • central nervous system viruses • one health (excludes animal health)