背景:先前的研究表明,第四次SARS-CoV-2疫苗剂量具有预防感染的作用,以及对抗严重的疾病和死亡。这项研究旨在检查第三剂量后高水平抗体的知识是否会降低医护人员(HCWs)对第四加强剂量的依从性。
方法:我们在RambamHealthcareCampus接种前三剂疫苗的HCWs中进行了前瞻性队列研究,以色列北部的一家三级医院。参与者在向所有人提供第四种加强疫苗之前接受了血清学测试,结果提供给参与者。人口分为两组,即抗体低于955AU/mL的那些和955AU/mL及更高的那些,在先前的研究中发现了一个保护的截止点。采用多因素logistic回归分析比较两组患者对第4次助推器的依从性,根据人口统计学和临床变量进行调整。
结果:调整混杂变量后,抗体水平低于955AU/mL的患者依从性较高(OR=1.41,p=0.05,95%CI1.10-1.96).此外,男性和60岁及以上的年龄也与较高的疫苗接种率相关(OR=2.28,p<0.001,95%CI1.64-3.17),(OR=1.14,p=0.043,95%CI1.06-1.75),分别。
结论:了解抗体状态可能会影响加强剂量的依从性。考虑到免疫力随着时间的推移而下降,依从性降低可能会影响拒绝第四次剂量的HCWs的保护。
BACKGROUND: Previous studies showed that the fourth SARS-CoV-2 vaccine dose has a protective effect against infection, as well as against severe disease and death. This study aimed to examine whether knowledge of a high-level antibody after the third dose may reduce compliance to the fourth
booster dose among healthcare workers (HCWs).
METHODS: We conducted a prospective cohort study among HCWs vaccinated with the first three doses at Rambam Healthcare Campus, a tertiary hospital in northern Israel. Participants underwent a serological test before the fourth
booster vaccine was offered to all of them, with results provided to participants. The population was divided into two groups, namely those with antibodies below 955 AU/mL and those with 955 AU/mL and higher, a cutoff found protective in a previous study. Multiple logistic regression was carried out to compare the compliance to the fourth
booster between the two groups, adjusted for demographic and clinical variables.
RESULTS: After adjusting for the confounding variables, the compliance was higher in those with antibody levels below 955 AU/mL (OR = 1.41, p = 0.05, 95% CI 1.10-1.96). In addition, male sex and age of 60 years and above were also associated with higher vaccination rates (OR = 2.28, p < 0.001, 95% CI 1.64-3.17), (OR = 1.14, p = 0.043, 95% CI 1.06-1.75), respectively.
CONCLUSIONS: Knowledge of the antibody status may affect compliance with the
booster dose. Considering waning immunity over time, reduced compliance may affect the protection of HCWs who declined the fourth dose.