Immune escape and waning immunity of COVID-19 monovalent mRNA vaccines against symptomatic infection with BA.1/BA.2 and BA.5 in Japan

被引：4

作者：

Arashiro, Takeshi ^{[1
,2
,3
,4
]}

Arima, Yuzo ^{[1
]}

Kuramochi, Jin ^{[5
,6
]}

Muraoka, Hirokazu ^{[7
]}

Sato, Akihiro ^{[8
]}

Chubachi, Kumi ^{[9
]}

Oba, Kunihiro ^{[10
]}

Yanai, Atsushi ^{[11
]}

Arioka, Hiroko ^{[11
]}

Uehara, Yuki ^{[12
,13
]}

Ihara, Genei ^{[14
]}

Kato, Yasuyuki ^{[15
]}

Yanagisawa, Naoki ^{[16
]}

Nagura, Yoshito ^{[17
]}

Yanai, Hideki ^{[18
]}

Ueda, Akihiro ^{[19
]}

Numata, Akira ^{[20
]}

Kato, Hideaki ^{[21
]}

Oka, Hideaki ^{[22
]}

Nishida, Yusuke ^{[22
]}

Ishii, Koji ^{[23
]}

Ooki, Takao ^{[23
]}

Nidaira, Yuki ^{[5
]}

Asami, Takahiro ^{[24
]}

Jinta, Torahiko ^{[25
]}

Nakamura, Akira ^{[26
]}

Taniyama, Daisuke ^{[27
]}

Yamamoto, Kei ^{[22
]}

Tanaka, Katsushi ^{[21
]}

Ueshima, Kankuro ^{[28
]}

Fuwa, Tetsuji ^{[1
,28
]}

Stucky, Ashley ^{[1
]}

Suzuki, Tadaki ^{[2
]}

Smith, Chris ^{[3
,4
]}

Hibberd, Martin ^{[3
]}

Ariyoshi, Koya ^{[4
]}

Suzuki, Motoi ^{[1
]}

机构：

[1] Natl Inst Infect Dis, Ctr Surveillance Immunizat & Epidemiol Res, Tokyo, Japan

[2] Natl Inst Infect Dis, Dept Pathol, Tokyo, Japan

[3] London Sch Hyg & Trop Med, Fac Infect & Trop Dis, London, England

[4] Nagasaki Univ, Sch Trop Med & Global Hlth, Nagasaki, Japan

[5] Kuramochi Clin Interpk, Utsunomiya, Tochigi, Japan

[6] Tokyo Med & Dent Univ, Dept Global Hlth Promot, Tokyo, Japan

[7] Clin Tamachi, Tokyo, Japan

[8] KARADA Internal Med Clin, Tokyo, Japan

[9] Chubachi Internal Resp Med Clin, Tokyo, Japan

[10] Showa Gen Hosp, Dept Pediat, Tokyo, Japan

[11] St Lukes Int Hosp, Dept Gen Internal Med, Tokyo, Japan

[12] St Lukes Int Hosp, Dept Clin Lab, Tokyo, Japan

[13] Fujita Hlth Univ, Sch Med, Dept Infect Dis, Toyoake, Aichi, Japan

[14] Machida Ekimae Naika Clin, Tokyo, Japan

[15] Int Univ Hlth & Welf Narita Hosp, Dept Infect Dis, Chiba, Japan

[16] Yanagisawa Clin, Tokyo, Japan

[17] Shinjuku Home Clin, Tokyo, Japan

[18] Japan Anti TB Assoc, Fukujuji Hosp, Kiyose, Japan

[19] Japanese Red Cross Med Ctr, Dept Infect Dis, Tokyo, Japan

[20] Ikebukuro Metropolitan Clin, Tokyo, Japan

[21] Yokohama City Univ Med, Infect Prevent & Control Dept, Yokohama, Kanagawa, Japan

[22] Saitama Med Ctr, Dept Gen Internal Med & Infect Dis, Saitama, Japan

[23] Saitama Sekishinkai Hosp, Saitama, Japan

[24] Sano Kosei Gen Hosp, Dept Internal Med, Sano, Tochigi, Japan

[25] St Lukes Int Hosp, Dept Pulm Med, Tokyo, Japan

[26] Asahi Gen Hosp, Dept Internal Med, Chiba, Japan

[27] Showa Gen Hosp, Dept Infect Dis, Tokyo, Japan

[28] NATURALI Co Ltd, Tokyo, Japan

来源：

VACCINE | 2023年 / 41卷 / 47期

关键词：

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); Coronavirus disease 2019 (COVID-19); Test-negative design; Vaccine effectiveness; SARS-CoV-2; variants; SARS-COV-2; INFECTION; BNT162B2;

D O I：

10.1016/j.vaccine.2023.10.021

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: Repeated emergence of variants with immune escape capacity and waning immunity from vaccination are major concerns for COVID-19. We examined whether the surge in Omicron subvariant BA.5 cases was due to immune escape or waning immunity through vaccine effectiveness (VE) evaluation.Methods: A test-negative case-control study was conducted in 16 clinics/hospitals during the BA.1/BA.2-dominant and BA.5-dominant periods. VE against symptomatic infection was estimated after adjusting for age, sex, comorbidity, occupation, testing frequency, prior infection, close contact history, clinic/hospital, week, and preventive measures. Absolute VE (aVE) was calculated for 2/3/4 doses, compared to the unvaccinated. Relative VE (rVE) was calculated, comparing 3 vs 2 and 4 vs 3 doses.Results: 13,025 individuals were tested during the BA.1/BA.2-dominant and BA.5-dominant periods with similar baseline characteristics. For BA.1/BA.2, aVE was 52 % (95 %CI:34-66) 14 days-3 months post-dose 2, 42 % (29-52) > 6 months post-dose 2, 71 % (64-77) 14 days-3 months post-dose 3, and 68 % (52-79) 3-6 months post-dose 3. rVE was 49 % (38-57) 14 days-3 months post-dose 3 and 45 % (18-63) 3-6 months post-dose 3. For BA.5, aVE was 56 % (27-73) 3-6 months post-dose 2, 32 % (12-47) > 6 months post-dose 2, 70 % (61-78) 14 days-3 months post-dose 3, 59 % (48-68) 3-6 months post-dose 3, 50 % (29-64) > 6 months post-dose 3, and 74 % (61-83) >= 14 days post-dose 4. rVE was 56 % (45-65) 14 days-3 months post-dose 3, 39 % (27-48) 3-6 months post-dose 3, 25 % (-2-45) > 6 months post-dose 3, and 30 % (-6-54) >= 14 days post-dose 4.Conclusions: Booster doses initially provided high protection against BA.5 at a level similar to that against BA.1/BA.2. However, the protection seemed shorter-lasting against BA.5, which likely contributed to the surge. Furthermore, rVE post-dose 4 was low even among recent vaccinees. These results support the introduction of variant-containing vaccines and emphasize the need for vaccines with longer duration of protection.

引用

页码：6969 / 6979

页数：11

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