要严格评估疫苗接种后体液记忆的长效性,需要适当的取样和更长时间的随访。

Q3 Medicine ImmunoHorizons Pub Date : 2024-06-01 DOI:10.4049/immunohorizons.2300057
Vitaly V Ganusov
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引用次数: 0

摘要

接种疫苗的目的之一是诱导针对感染和/或疾病的长期免疫力。许多研究跟踪了接种疫苗后对 SARS-CoV-2 产生体液免疫的情况;但是,这些研究通常因跟踪时间的长短和测量免疫反应的时间点的多少而有所不同。这些参数(时间点的数量和随访的总体持续时间)如何影响免疫寿命的估计值在很大程度上仍是未知数。包括 Arunachalam 等人的研究(2023 年,J. Clin. Invest. 133: e167955)在内的几项研究评估了接种第三剂或第四剂 mRNA COVID-19 疫苗的个体的体液免疫反应;通过在三个时间点(接种疫苗前、1 个月和 6 个月)测量抗体水平,Arunachalam 等人发现两组血清抗体的半衰期相似,因此认为没有必要额外加强免疫以延长对 SARS-CoV-2 的免疫力。我的研究表明,仅在这三个时间点测量 6 个月的抗体水平并不能准确评估疫苗诱导抗体的长期半衰期。通过使用对献血者队列进行多年跟踪的数据,我证明了在再次接种疫苗后,疫苗病毒特异性抗体的衰减是双相的,甚至晚期衰减率也超过了增强前数年观察到的体液记忆的真实缓慢损失率。应使用初步数据参数化的抗体反应动力学数学模型进行功率分析,以确定最合适的采样时间和持续时间,从而严格确定疫苗接种后体液免疫的持续时间。
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Appropriate Sampling and Longer Follow-Up Are Required to Rigorously Evaluate Longevity of Humoral Memory After Vaccination.

One of the goals of vaccination is to induce long-lived immunity against the infection and/or disease. Many studies have followed the generation of humoral immunity to SARS-CoV-2 after vaccination; however, such studies typically varied by the duration of the follow-up and the number of time points at which immune response measurements were done. How these parameters (the number of time points and the overall duration of the follow-up) impact estimates of immunity longevity remain largely unknown. Several studies, including one by Arunachalam et al. (2023. J. Clin. Invest. 133: e167955), evaluated the humoral immune response in individuals receiving either a third or fourth dose of mRNA COVID-19 vaccine; by measuring Ab levels at three time points (prior to vaccination and at 1 and 6 mo), Arunachalam et al. found similar half-life times for serum Abs in the two groups and thus suggested that additional boosting is unnecessary to prolong immunity to SARS-CoV-2. I demonstrate that measuring Ab levels at these three time points and only for 6 mo does not allow one to accurately evaluate the long-term half-life of vaccine-induced Abs. By using the data from a cohort of blood donors followed for several years, I show that after revaccination with vaccinia virus, vaccinia virus-specific Abs decay biphasically, and even the late decay rate exceeds the true slow loss rate of humoral memory observed years prior to the boosting. Mathematical models of Ab response kinetics, parameterized using preliminary data, should be used for power analysis to determine the most appropriate timing and duration of sampling to rigorously determine the duration of humoral immunity after vaccination.

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