Инфекция и иммунитет. 2021; 11: 887-904
Коллективный иммунитет к SARS-CoV-2 населения Республики Беларусь в условиях пандемии COVID-19
https://doi.org/10.15789/2220-7619-HIT-1798Аннотация
Задача — изучить коллективный иммунный статус населения Беларуси против SARS-CoV-2 в контекс те пандемии COVID-19. Материалы и методы. Работа проводилась по методике оценки иммунитета населения SARS-CoV-2, разработанной Роспотребнадзором России и Минздравом Беларуси при участии Санкт-Петербургского института Пастера с учетом рекомендаций ВОЗ. Комитет по биоэтике Беларуси и локальный этический комитет Санкт-Петербургского института Пастера одобрили исследование. Отбор участников проводился анкетным методом и онлайн-технологиями (Интернет, облачный сервер). Добровольцы были рандомизированы на семь возрастных групп (лет): 1–17 лет, 18–29, 30–39, 40–49, 50–59, 60–69 и 70+. Региональная рандомизация обеспечила пропорциональное представительство волонтеров от каждого региона, и от одного предприятия было включено не более 30 человек. В соответствии с инструкциями производителя образцы плазмы крови были проанализированы на IgG-антитела (Abs) к нуклеокапсиду SARS-CoV-2 (Nc) с использованием количественной тест-системы ELISA и на IgGантитела к рецептор-связывающему домену (RBD) поверхностного гликопротеина SARS-CoV-2 S (шип) с использованием качественной тест-системы ELISA. Статистическая обработка проводилась в программе Excel 2010 и в ряде других. Статистические различия считались значимыми при р < 0,05, если не указано иное. Результаты. Уровень распространенности серотипов по отношению Abs к Nc среди населения Беларуси составил 38,4% (95% ДИ 37,6–45,4), самые высокие уровни Ab были зарегистрированы среди лиц в старших возрастных группах (50–70+ лет), самые низкие – у детей 1–17 лет и у молодежи 18–39 лет. Распределение серопревалентности по регионам Беларуси было относительно однородным, за исключением Минской области, где было отмечено статистически значимое снижение показателя. В профессиональном отношении наибольшая доля серопозитивных лиц была обнаружена среди транспортных работников, наименьшая — в сфере предпринимательства. Умеренная заболеваемость COVID-19 не привела к резкому увеличению числа контактов. Базовый номер репродукции (R0) равнялся 1,3. В Республике Беларусь среди серопозитивных лиц отмечен средний уровень бессимптомного COVID-19 (45,3% [95% ДИ 44,0–46,7]). Эта форма заражения чаще всего наблюдалась у детей в возрасте от 1 до 17 лет (65,0% [95% ДИ 61,3–68,6]). Параллельно с оценкой серологической распространенности проводилась вакцинация против SARS-CoV-2. Мы использовали две вакцины: Gam-COVID-Vac (также известный как «Спутник V», разработанный Национальным исследовательским центром эпидемиологии и микробиологии им. Н.Ф. Гамалеи, Россия) и BBIBP-CorV (Sinopharm, КНР). Вакцинация против SARS-CoV-2 сопровождалась повышением уровня антител к RBD (95% [95% ДИ 94,7–96,7]). Принимая во внимание вакцинацию подгруппы населения BBIBP-CorV, общий коллективный иммунитет, выведенный из анализируемых показателей (наличие антител против Nc или против RBD), составил 47,1% (95% ДИ 46,3–48,0). Заключение. COVID-19 в Беларуси характеризовался умеренно выраженным течением эпидемического процесса. Пороговый уровень коллективного иммунитета к SARS-CoV-2 еще не достигнут, вследствие чего сохраняются условия для развития эпидемии.
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Russian Journal of Infection and Immunity. 2021; 11: 887-904
Herd immunity to SARS-CoV-2 among the population of the Republic of Belarus amid the COVID-19 pandemic
https://doi.org/10.15789/2220-7619-HIT-1798Abstract
Objective was to investigate the SARS-CoV-2 collective immunity status of the population of Belarus within the context of the COVID-19 pandemic. Materials and methods. The work was carried out according to the methodology for assessing SARS-CoV-2 population immunity, developed by Rospotrebnadzor Russia and the Ministry of Health of Belarus with the participation of the St. Petersburg Pasteur Institute, taking into account WHO recommendations. The Bioethics Committee of Belarus and the local ethics committee of the St. Petersburg Pasteur Institute approved the study. Selection of participants was carried out using a questionnaire method and online technology (internet, cloud server). Volunteers were randomized into seven age groups (years of age): 1–17; 18–29; 30–39; 40–49; 50–59; 60–69; and 70+. Regional randomization ensured proportional representation of volunteers from each region, and no more than 30 people were included from one enterprise. In accordance with manufacturer instructions, blood plasma samples were analyzed for: IgG antibodies (Abs) to the SARS-CoV-2 nucleocapsid (Nc) using a quantitative ELISA test system; and IgG Abs to the receptor binding domain (RBD) of the SARS-CoV-2 S (spike) surface glycoprotein using a qualitative ELISA test system. Statistical processing was carried out using Excel 2010 and other software. Statistical differences were designated as significant when p < 0.05, unless otherwise indicated. Results. The level of seroprevalence, in terms of Abs to Nc among the Belarusian population, was 38.4% (95% CI 37.6–45.4). The highest Ab levels were found among individuals in older age groups (50-70+ years old). The lowest were found in children 1–17 years old and in young people 18–39 years old The distribution of seroprevalence across Belarusian regions was relatively homogeneous, with the exception of the Minsk Region, where a statistically significant decrease in the indicator was noted. In terms of profession, the largest share of seropositive individuals was found among transportation workers; the smallest was found in business. The moderate COVID-19 incidence has not led to a dramatic increase in the number of contacts. The base reproduction number (R0) was 1.3. In the Republic of Belarus, there was a moderate level of asymptomatic COVID-19 among seropositive individuals (45.3% [95% CI 44.0–46.7]). This form of infection was observed most often among children aged 1–17 years old (65.0% [95% CI 61.3–68.6]). In parallel with seroprevalence assessment, SARS-CoV-2 vaccination was carried out. We used two vaccines: Gam-COVID-Vac (also known as Sputnik V, developed by Gamaleya National Center for Epidemiology and Microbiology, Russia); and BBIBP-CorV (Sinopharm, PRC). Vaccination against SARS-CoV-2 was accompanied by an increase in the level of anti-RBD Abs (95% [95% CI 94.7–96.7]). Taking into account the vaccination of a subset of the population with BBIBP-CorV, the overall herd immunity, inferred from the analyzed indicators (presence of anti-Nc or anti-RBD Abs), was 47.1% (95% CI 46.3–48.0). Conclusion. COVID-19 in Belarus was characterized by a moderately pronounced course of the epidemic process. The threshold level of herd immunity to SARS-CoV-2 has not yet been reached, as a result of which the conditions for progression of the epidemic remain.
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