학술논문
An Observational Cohort Study on the Incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and B.1.1.7 Variant Infection in Healthcare Workers by Antibody and Vaccination Status.
Document Type
Academic Journal
Author
Lumley SF; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Rodger G; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Constantinides B; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Sanderson N; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; Chau KK; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Street TL; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; O'Donnell D; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Howarth A; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Hatch SB; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Marsden BD; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Kennedy Institute of Rheumatology Research, University of Oxford, United Kingdom.; Cox S; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; James T; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Warren F; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Peck LJ; Medical School, University of Oxford, Oxford, United Kingdom.; Ritter TG; Medical School, University of Oxford, Oxford, United Kingdom.; de Toledo Z; Medical School, University of Oxford, Oxford, United Kingdom.; Warren L; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Axten D; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Cornall RJ; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Jones EY; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Stuart DI; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Screaton G; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Ebner D; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Target Discovery Institute, University of Oxford, Oxford, United Kingdom.; Hoosdally S; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Chand M; National Infection Service, Public Health England Colindale, United Kingdom.; Crook DW; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; O'Donnell AM; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Conlon CP; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Pouwels KB; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Walker AS; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Peto TEA; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Hopkins S; National Infection Service, Public Health England Colindale, United Kingdom.; Walker TM; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.; Stoesser NE; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Matthews PC; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Jeffery K; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.; Eyre DW; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, United Kingdom.; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.; Big Data Institute, University of Oxford, Oxford, United Kingdom.
Source
Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Natural and vaccine-induced immunity will play a key role in controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. SARS-CoV-2 variants have the potential to evade natural and vaccine-induced immunity.
Methods: In a longitudinal cohort study of healthcare workers (HCWs) in Oxfordshire, United Kingdom, we investigated the protection from symptomatic and asymptomatic polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection conferred by vaccination (Pfizer-BioNTech BNT162b2, Oxford-AstraZeneca ChAdOx1 nCOV-19) and prior infection (determined using anti-spike antibody status), using Poisson regression adjusted for age, sex, temporal changes in incidence and role. We estimated protection conferred after 1 versus 2 vaccinations and from infections with the B.1.1.7 variant identified using whole genome sequencing.
Results: In total, 13 109 HCWs participated; 8285 received the Pfizer-BioNTech vaccine (1407 two doses), and 2738 the Oxford-AstraZeneca vaccine (49 two doses). Compared to unvaccinated seronegative HCWs, natural immunity and 2 vaccination doses provided similar protection against symptomatic infection: no HCW vaccinated twice had symptomatic infection, and incidence was 98% lower in seropositive HCWs (adjusted incidence rate ratio 0.02 [95% confidence interval {CI} < .01-.18]). Two vaccine doses or seropositivity reduced the incidence of any PCR-positive result with or without symptoms by 90% (0.10 [95% CI .02-.38]) and 85% (0.15 [95% CI .08-.26]), respectively. Single-dose vaccination reduced the incidence of symptomatic infection by 67% (0.33 [95% CI .21-.52]) and any PCR-positive result by 64% (0.36 [95% CI .26-.50]). There was no evidence of differences in immunity induced by natural infection and vaccination for infections with S-gene target failure and B.1.1.7.
Conclusions: Natural infection resulting in detectable anti-spike antibodies and 2 vaccine doses both provide robust protection against SARS-CoV-2 infection, including against the B.1.1.7 variant.
(© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)
Methods: In a longitudinal cohort study of healthcare workers (HCWs) in Oxfordshire, United Kingdom, we investigated the protection from symptomatic and asymptomatic polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection conferred by vaccination (Pfizer-BioNTech BNT162b2, Oxford-AstraZeneca ChAdOx1 nCOV-19) and prior infection (determined using anti-spike antibody status), using Poisson regression adjusted for age, sex, temporal changes in incidence and role. We estimated protection conferred after 1 versus 2 vaccinations and from infections with the B.1.1.7 variant identified using whole genome sequencing.
Results: In total, 13 109 HCWs participated; 8285 received the Pfizer-BioNTech vaccine (1407 two doses), and 2738 the Oxford-AstraZeneca vaccine (49 two doses). Compared to unvaccinated seronegative HCWs, natural immunity and 2 vaccination doses provided similar protection against symptomatic infection: no HCW vaccinated twice had symptomatic infection, and incidence was 98% lower in seropositive HCWs (adjusted incidence rate ratio 0.02 [95% confidence interval {CI} < .01-.18]). Two vaccine doses or seropositivity reduced the incidence of any PCR-positive result with or without symptoms by 90% (0.10 [95% CI .02-.38]) and 85% (0.15 [95% CI .08-.26]), respectively. Single-dose vaccination reduced the incidence of symptomatic infection by 67% (0.33 [95% CI .21-.52]) and any PCR-positive result by 64% (0.36 [95% CI .26-.50]). There was no evidence of differences in immunity induced by natural infection and vaccination for infections with S-gene target failure and B.1.1.7.
Conclusions: Natural infection resulting in detectable anti-spike antibodies and 2 vaccine doses both provide robust protection against SARS-CoV-2 infection, including against the B.1.1.7 variant.
(© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)