PDF(Pubmed)
Abstract：
BACKGROUND: To inform future response planning we aimed to assess SARS-CoV-2 trends in infection- and/or vaccine-induced immunity, including breakthrough infections, among (sub)groups, professions and regions in the Dutch population during the Variant of Concern (VOC)-era.
METHODS: In this prospective population-based cohort, randomly selected participants (n = 9985) aged 1-92 years (recruited early-2020) donated home-collected fingerstick-blood samples at six timepoints in 2021/2022, covering waves dominated by Alpha, Delta, and multiple Omicron (sub-)variants. IgG antibody assessment against Spike-S1 and Nucleoprotein was combined with vaccination- and testing data to estimate infection-induced (inf) and total (infection- and vaccination-induced) seroprevalence.
RESULTS: Nationwide inf-seroprevalence rose modestly from 12% (95% CI 11-13) since Alpha to 26% (95% CI 24-28) amidst Delta, while total seroprevalence increased rapidly to 87% (95% CI 85-88), particularly in elderly and those with comorbidities (i.e., vulnerable groups). Interestingly, highest infection rates were noticeable among low/middle educated elderly, non-Western, those in contact professions, adolescents and young adults, and in low-vaccination coverage regions. Following Omicron emergence, inf-seroprevalence elevated sharply to 62% (95% CI 59-65) and further to 86% (95% CI 83-90) in late-2022, with frequent breakthrough infections and decreasing seroprevalence dissimilarities between most groups. Whereas > 90% of < 60-year-olds had been infected at least once, 30% of vaccinated vulnerable individuals had still not acquired hybrid immunity.
CONCLUSIONS: Groups identified to have been infected disproportionally during the acute phase of the pandemic require specific attention in evaluation of control measures and future response planning worldwide. Furthermore, ongoing tailored vaccination efforts and (sero-)monitoring of vulnerable groups may remain important.
METHODS: In this prospective population-based cohort, randomly selected participants (n = 9985) aged 1-92 years (recruited early-2020) donated home-collected fingerstick-blood samples at six timepoints in 2021/2022, covering waves dominated by Alpha, Delta, and multiple Omicron (sub-)variants. IgG antibody assessment against Spike-S1 and Nucleoprotein was combined with vaccination- and testing data to estimate infection-induced (inf) and total (infection- and vaccination-induced) seroprevalence.
RESULTS: Nationwide inf-seroprevalence rose modestly from 12% (95% CI 11-13) since Alpha to 26% (95% CI 24-28) amidst Delta, while total seroprevalence increased rapidly to 87% (95% CI 85-88), particularly in elderly and those with comorbidities (i.e., vulnerable groups). Interestingly, highest infection rates were noticeable among low/middle educated elderly, non-Western, those in contact professions, adolescents and young adults, and in low-vaccination coverage regions. Following Omicron emergence, inf-seroprevalence elevated sharply to 62% (95% CI 59-65) and further to 86% (95% CI 83-90) in late-2022, with frequent breakthrough infections and decreasing seroprevalence dissimilarities between most groups. Whereas > 90% of < 60-year-olds had been infected at least once, 30% of vaccinated vulnerable individuals had still not acquired hybrid immunity.
CONCLUSIONS: Groups identified to have been infected disproportionally during the acute phase of the pandemic require specific attention in evaluation of control measures and future response planning worldwide. Furthermore, ongoing tailored vaccination efforts and (sero-)monitoring of vulnerable groups may remain important.
摘要：
背景：为了告知未来的应对计划，我们旨在评估SARS-CoV-2感染和/或疫苗诱导的免疫趋势，包括突破性感染，在(子)群体中，关注变化(VOC)时代荷兰人口的职业和地区。
方法：在这个基于人群的前瞻性队列中，随机选择的1-92岁（2020年初招募）的参与者（n=9985）在2021/2022年的六个时间点捐赠了家庭收集的手指血液样本，覆盖了以Alpha为主的波浪，Delta,和多个Omicron（子）变体。针对Spike-S1和核蛋白的IgG抗体评估与疫苗接种和测试数据相结合，以评估感染诱导的（inf）和总（感染和疫苗接种诱导的）血清阳性率。
结果：全国血清阳性率从自Alpha以来的12％（95％CI11-13）适度上升至Delta中的26％（95％CI24-28），而总血清阳性率迅速上升至87%（95%CI85-88），特别是在老年人和有合并症的人群中(即，弱势群体)。有趣的是,感染率最高的是受教育程度低/中等的老年人，非西方,接触职业的人，青少年和年轻人，在疫苗接种覆盖率低的地区。在Omicron出现之后，在2022年后期，血清阳性率急剧上升至62％（95％CI59-65），并进一步上升至86％（95％CI83-90），大多数组之间频繁的突破性感染和血清阳性率差异降低。而>90%<60岁的人至少感染过一次，30%的接种疫苗的脆弱个体仍未获得杂种免疫。
结论：在全球范围内评估控制措施和未来应对计划时，需要特别注意在大流行急性期被不成比例地感染的人群。此外，正在进行的有针对性的疫苗接种工作和对弱势群体的(血清)监测可能仍然很重要。
方法：在这个基于人群的前瞻性队列中，随机选择的1-92岁（2020年初招募）的参与者（n=9985）在2021/2022年的六个时间点捐赠了家庭收集的手指血液样本，覆盖了以Alpha为主的波浪，Delta,和多个Omicron（子）变体。针对Spike-S1和核蛋白的IgG抗体评估与疫苗接种和测试数据相结合，以评估感染诱导的（inf）和总（感染和疫苗接种诱导的）血清阳性率。
结果：全国血清阳性率从自Alpha以来的12％（95％CI11-13）适度上升至Delta中的26％（95％CI24-28），而总血清阳性率迅速上升至87%（95%CI85-88），特别是在老年人和有合并症的人群中(即，弱势群体)。有趣的是,感染率最高的是受教育程度低/中等的老年人，非西方,接触职业的人，青少年和年轻人，在疫苗接种覆盖率低的地区。在Omicron出现之后，在2022年后期，血清阳性率急剧上升至62％（95％CI59-65），并进一步上升至86％（95％CI83-90），大多数组之间频繁的突破性感染和血清阳性率差异降低。而>90%<60岁的人至少感染过一次，30%的接种疫苗的脆弱个体仍未获得杂种免疫。
结论：在全球范围内评估控制措施和未来应对计划时，需要特别注意在大流行急性期被不成比例地感染的人群。此外，正在进行的有针对性的疫苗接种工作和对弱势群体的(血清)监测可能仍然很重要。
