SARS-CoV-2 Omicron 变种:疾病负担,对疫苗有效性的影响以及对变种适应疫苗的需求
Shanti Pather1, Shabir A Madhi2, Benjamin J Cowling3
1BioNTech, Mainz, Germany.
Frontiers in immunology
|June 8, 2023
概括
尽管SARS-CoV-2的Omicron变种通常不那么严重,但它压倒了医疗保健系统,并显示出免疫逃逸. 需要适应变异的疫苗来改善对Omicron亚系的保护.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 2021年底出现的SARS-CoV-2的Omicron变种 (B.1.1.529),导致由BA.1,BA.2,BA.4和BA.5.5等子系驱动的广泛波浪.
- 尽管由于人口免疫力,Omicron波通常会在健康成年人中引起不太严重的疾病,但Omicron波给医疗保健系统带来了压力,并增加了儿科入院.
- 奥米克朗亚系表现出来自野生型疫苗引起的抗体的免疫逃避,这对疫苗有效性 (VE) 评估构成了挑战.
研究的目的:
- 评估Omicron变异波对医疗保健系统和疾病严重性的影响.
- 评估现有疫苗的有效性,以及针对Omicron亚系的变种适应策略的需要.
- 了解对Omicron感染和疫苗接种的免疫反应,包括T细胞和B细胞免疫力.
主要方法:
- 在Omicron波浪期间分析疾病患病率,医疗保健系统负担和儿科入院情况.
- 对抗Omicron症状和严重疾病的疫苗有效性的评估,考虑疫苗覆盖率和先前感染等因素.
- 通过疫苗引起的T细胞 (CD8+和CD4+) 和中和抗体反应对Omicron亚系的交叉识别的评估.
主要成果:
- 尽管Omicron波的平均严重程度较低,但在全球范围内压倒了医疗保健系统,并导致儿科住院病例增加.
- 原始的mRNA疫苗助推剂改善了针对BA.1/BA.2症状疾病的VE,但在2个月内保护减弱了.
- 疫苗引起的T细胞反应交叉识别了Omicron,提供了对严重结果的保护,但B细胞反应显示范围和持久性减少.
结论:
- 适应变异的疫苗是必要的,以扩大B细胞的反应,并提高对Omicron亚系的保护的持久性.
- 在2022年底推出适应变异的疫苗旨在改善对免疫逃避变异的症状和严重感染的保护.
- 持续监测和适应疫苗对于对抗不断变化的SARS-CoV-2环境至关重要.
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