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Asimakopoulos JV, Lalou E, Seferlis G, Malliarou M, Konstantinou E, Drandakis I, Vasilopoulos I, Georgopoulou AN, Kopsaftopoulou A, Machairas A, Piperidou A, Karapaschalidis A, Lefaki ME, Galopoulos D, Arapaki MP, Petsa P, Benekou E, Siakantaris MP, Papavassiliou AG, Tsaftaridis P, Panayiotidis P, Vassilakopoulos TP, Papapanagiotou A, Angelopoulou MK. Monitoring Humoral Response Following BNT162b2 mRNA Vaccination against SARS-CoV-2 in Hematopoietic Stem-Cell Transplantation Patients: A Single-Center Prospective Study along with a Brief Review of Current Literature. Hematol Rep 2024; 16:220-233. [PMID: 38651451 PMCID: PMC11036264 DOI: 10.3390/hematolrep16020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Data on antibody response (AR) after vaccination against SARS-CoV2 in hematopoietic stem-cell transplantation setting (HSCT) were initially scarce, mainly due to the exclusion of such patients from approval studies. Shortly after the worldwide application of vaccination against SARS-CoV-2 in vulnerable populations such as patients with hematologic malignancies, limited single-center trials, including HSCT patients, were published. However, there was a great heterogeneity between them regarding the type of underlying malignancy, co-current treatment, type of vaccine, method of AR measurement, and time point of AR measurement. Herein, we present the results of a prospective study on AR after vaccination for SARS-CoV-2 using the BNT162b2 vaccine in a cohort of 54 HSCT recipients-mostly autologous from a single Unit-along with a broad review of the current literature. In our cohort, the AR positivity rate at 1 month was 80.8% and remained positive in 85.7% of patients at 3 months after vaccination. There were only nine non-responders, who were more heavily pretreated and more frequently hypogammaglobulinemic compared to responders. High antibody titers (AT), [AT ≥ 1000 U/mL], were detected in 38.5% and 30.6% of the patients at m1 and m3, respectively. A significant decline in AT between m1 and m3 was demonstrated-p < 0.0001; median AT1 and AT3 were 480.5 and 293 U/mL, respectively. A novel finding of our study was the negative impact of IgA hypogammaglobulinemia on response to vaccination. Other negative significant factors were treatment with anti-CD20 antibody at vaccination and vaccination within 18 months from HSCT. Our data indicate that HSCT recipients elicit a positive response to the BNT162b2 vaccine against SARS-CoV-2 when vaccinated at 6 months post-transplant, and vaccination should be offered to this patient population even within the post-pandemic COVID-19 era.
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Affiliation(s)
- John V. Asimakopoulos
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Eleni Lalou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - George Seferlis
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Maria Malliarou
- Department of Biological Chemistry, National and Kapodistrian University of Athens, Biochemistry Laboratory, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (M.M.); (A.G.P.); (A.P.)
| | - Eliana Konstantinou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Ioannis Drandakis
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Ioannis Vasilopoulos
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Angeliki N. Georgopoulou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Anastasia Kopsaftopoulou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Alexandros Machairas
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Alexia Piperidou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Anestis Karapaschalidis
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Maria-Ekaterini Lefaki
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Dimitrios Galopoulos
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Maria-Panagiota Arapaki
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Panagiota Petsa
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Ekaterini Benekou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Marina P. Siakantaris
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Athanasios G. Papavassiliou
- Department of Biological Chemistry, National and Kapodistrian University of Athens, Biochemistry Laboratory, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (M.M.); (A.G.P.); (A.P.)
| | - Panagiotis Tsaftaridis
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Panayiotis Panayiotidis
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Theodoros P. Vassilakopoulos
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
| | - Angeliki Papapanagiotou
- Department of Biological Chemistry, National and Kapodistrian University of Athens, Biochemistry Laboratory, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (M.M.); (A.G.P.); (A.P.)
| | - Maria K. Angelopoulou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece; (E.L.); (G.S.); (E.K.); (I.D.); (I.V.); (A.N.G.); (A.K.); (A.M.); (A.P.); (A.K.); (M.-E.L.); (M.-P.A.); (P.P.); (E.B.); (M.P.S.); (P.T.); (P.P.); (T.P.V.)
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Ben Khlil AA, Zamali I, Belloumi D, Gdoura M, Kharroubi G, Marzouki S, Dachraoui R, Ben Yaiche I, Bchiri S, Hamdi W, Gharbi M, Ben Hmid A, Samoud S, Galai Y, Torjmane L, Ladeb S, Bettaieb J, Triki H, Ben Abdeljelil N, Ben Othman T, Ben Ahmed M. Immunogenicity and Tolerance of BNT162b2 mRNA Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Patients. Vaccines (Basel) 2024; 12:174. [PMID: 38400157 PMCID: PMC10892348 DOI: 10.3390/vaccines12020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/22/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (ASCT) induces acquired immunodeficiency, potentially altering vaccine response. Herein, we aimed to explore the clinical tolerance and the humoral and cellular immune responses following anti-SARS-CoV-2 vaccination in ASCT recipients. METHODS A prospective, non-randomized, controlled study that involved 43 ASCT subjects and 31 healthy controls. Humoral response was investigated using the Elecsys® test anti-SARS-CoV-2. Cellular response was assessed using the QFN® SARS-CoV-2 test. The lymphocyte cytokine profile was tested using the LEGENDplex™ HU Th Cytokine Panel Kit (12-plex). RESULTS Adverse effects (AE) were observed in 69% of patients, encompassing pain at the injection site, fever, asthenia, or headaches. Controls presented more side effects like pain in the injection site and asthenia with no difference in the overall AE frequency. Both groups exhibited robust humoral and cellular responses. Only the vaccine transplant delay impacted the humoral response alongside a previous SARS-CoV-2 infection. Noteworthily, controls displayed a Th1 cytokine profile, while patients showed a mixed Th1/Th2 profile. CONCLUSIONS Pfizer-BioNTech® anti-SARS-CoV-2 vaccination is well tolerated in ASCT patients, inducing robust humoral and cellular responses. Further exploration is warranted to understand the impact of a mixed cytokine profile in ASCT patients.
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Affiliation(s)
- Ahmed Amine Ben Khlil
- Department of Clinical Immunology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (A.A.B.K.); (I.Z.); (W.H.); (A.B.H.); (S.S.); (Y.G.)
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
| | - Imen Zamali
- Department of Clinical Immunology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (A.A.B.K.); (I.Z.); (W.H.); (A.B.H.); (S.S.); (Y.G.)
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
| | - Dorra Belloumi
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Department of Hematology and Transplant, Centre National de Greffe de Moelle Osseuse, Tunis 1006, Tunisia
| | - Mariem Gdoura
- Laboratory of Virology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (M.G.); (M.G.)
- Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Ghassen Kharroubi
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
- Department of Medical Epidemiology, Institut Pasteur de Tunis, Tunis 1002, Tunisia
| | - Soumaya Marzouki
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
| | - Rym Dachraoui
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Department of Hematology and Transplant, Centre National de Greffe de Moelle Osseuse, Tunis 1006, Tunisia
| | - Insaf Ben Yaiche
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Department of Hematology and Transplant, Centre National de Greffe de Moelle Osseuse, Tunis 1006, Tunisia
| | - Soumaya Bchiri
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
| | - Walid Hamdi
- Department of Clinical Immunology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (A.A.B.K.); (I.Z.); (W.H.); (A.B.H.); (S.S.); (Y.G.)
| | - Manel Gharbi
- Laboratory of Virology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (M.G.); (M.G.)
| | - Ahlem Ben Hmid
- Department of Clinical Immunology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (A.A.B.K.); (I.Z.); (W.H.); (A.B.H.); (S.S.); (Y.G.)
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
| | - Samar Samoud
- Department of Clinical Immunology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (A.A.B.K.); (I.Z.); (W.H.); (A.B.H.); (S.S.); (Y.G.)
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
| | - Yousr Galai
- Department of Clinical Immunology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (A.A.B.K.); (I.Z.); (W.H.); (A.B.H.); (S.S.); (Y.G.)
- Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Lamia Torjmane
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Department of Hematology and Transplant, Centre National de Greffe de Moelle Osseuse, Tunis 1006, Tunisia
| | - Saloua Ladeb
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Department of Hematology and Transplant, Centre National de Greffe de Moelle Osseuse, Tunis 1006, Tunisia
| | - Jihene Bettaieb
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
- Department of Medical Epidemiology, Institut Pasteur de Tunis, Tunis 1002, Tunisia
| | - Henda Triki
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Laboratory of Virology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (M.G.); (M.G.)
| | - Nour Ben Abdeljelil
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Department of Hematology and Transplant, Centre National de Greffe de Moelle Osseuse, Tunis 1006, Tunisia
| | - Tarek Ben Othman
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Department of Hematology and Transplant, Centre National de Greffe de Moelle Osseuse, Tunis 1006, Tunisia
| | - Melika Ben Ahmed
- Department of Clinical Immunology, Institut Pasteur de Tunis, Tunis 1002, Tunisia; (A.A.B.K.); (I.Z.); (W.H.); (A.B.H.); (S.S.); (Y.G.)
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis 1068, Tunisia; (D.B.); (G.K.); (R.D.); (I.B.Y.); (L.T.); (S.L.); (J.B.); (H.T.); (N.B.A.); (T.B.O.)
- Laboratory of Transmission, Control and Immunobiology of Infections (LR16IPT02), Institut Pasteur de Tunis, Tunis 1002, Tunisia; (S.M.); (S.B.)
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Reynolds G, Hall VG, Teh BW. Vaccine schedule recommendations and updates for patients with hematologic malignancy post-hematopoietic cell transplant or CAR T-cell therapy. Transpl Infect Dis 2023; 25 Suppl 1:e14109. [PMID: 37515788 PMCID: PMC10909447 DOI: 10.1111/tid.14109] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 07/31/2023]
Abstract
Revaccination after receipt of a hematopoietic cell transplant (HCT) or cellular therapies is a pillar of patient supportive care, with the potential to reduce morbidity and mortality linked to vaccine-preventable infections. This review synthesizes national, international, and expert consensus vaccination schedules post-HCT and presents evidence regarding the efficacy of newer vaccine formulations for pneumococcus, recombinant zoster vaccine, and coronavirus disease 2019 in patients with hematological malignancy. Revaccination post-cellular therapies are less well defined. This review highlights important considerations around poor vaccine response, seroprevalence preservation after cellular therapies, and the optimal timing of revaccination. Future research should assess the immunogenicity and real-world effectiveness of new vaccine formulations and/or vaccine schedules in patients post-HCT and cellular therapy, including analysis of vaccine response that relates to the target of cellular therapies.
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Affiliation(s)
- Gemma Reynolds
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneParkvilleVictoriaAustralia
- Department of Infectious DiseasesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Department of Infectious DiseasesAustin HealthHeidelbergVictoriaAustralia
| | - Victoria G. Hall
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneParkvilleVictoriaAustralia
- Department of Infectious DiseasesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Benjamin W. Teh
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneParkvilleVictoriaAustralia
- Department of Infectious DiseasesPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
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4
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Bordat J, Maury S, Leclerc M. Allogeneic hematopoietic stem cell transplantation in the COVID-19 era. Front Immunol 2023; 14:1100468. [PMID: 36911678 PMCID: PMC9993088 DOI: 10.3389/fimmu.2023.1100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/01/2023] [Indexed: 02/24/2023] Open
Abstract
Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) recipients are especially vulnerable to coronavirus disease 19 (COVID-19), because of their profound immunodeficiency. Indeed, the first pandemic wave was marked by a high mortality rate in this population. Factors increasing immunodepression such as older age, immunosuppressive treatments or a short delay between transplant and infection appear to worsen the prognosis. Many changes in clinical practice had to be implemented in order to limit this risk, including postponing of transplant for non-malignant diseases, preference for local rather than international donations and for peripheral blood as stem cell source, and the widespread use of cryopreservation. The great revolution in the COVID-19 pandemic came from the development of mRNA vaccines that have shown to be able to prevent severe forms of the disease. More than 75% of allo-HSCT recipients develop seroconversion after 2 doses of vaccine. Multiple studies have identified lymphopenia, exposure to immunosuppressive or anti-CD20 therapies, and a short post-transplant period as factors associated with a poor response to vaccination. The use of repeated injections of the vaccine, including a third dose, not only improves the seroconversion rate but also intensifies the immune response, both in B cells and T cells. Vaccines are an effective and well-tolerated method in this high-risk population. Some studies investigated the possibility of immune protection being transferred from a vaccinated donor to a recipient, with encouraging initial results. However, dynamic mutations and immune escape of the virus can lead to breakthrough infections with new variants in vaccinated individuals and still represent a threat of severe disease in allo-HSCT recipients. New challenges include the need to adapt vaccine protection to emerging variants.
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Affiliation(s)
- Jonathan Bordat
- Hematology Department, Henri Mondor Hospital, Assistance Publique/Hôpitaux de Paris, Créteil, France
| | - Sébastien Maury
- Hematology Department, Henri Mondor Hospital, Assistance Publique/Hôpitaux de Paris, Créteil, France.,Institut Mondor de Recherche Biomédicale, équipe Immunorégulation et Biothérapies, INSERM U955, Créteil, France.,Faculté de Médecine, Paris-Est Créteil University, Créteil, France
| | - Mathieu Leclerc
- Hematology Department, Henri Mondor Hospital, Assistance Publique/Hôpitaux de Paris, Créteil, France.,Institut Mondor de Recherche Biomédicale, équipe Immunorégulation et Biothérapies, INSERM U955, Créteil, France.,Faculté de Médecine, Paris-Est Créteil University, Créteil, France
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5
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Toya T, Atsuta Y, Sanada T, Honda T, Sadato D, Sekiya N, Kogure H, Takakuwa S, Onai D, Shingai N, Shimizu H, Najima Y, Kobayashi T, Ohashi K, Harada Y, Kohara M, Doki N. Attenuated humoral response against SARS-CoV-2 mRNA vaccination in allogeneic stem cell transplantation recipients. Cancer Sci 2022; 114:586-595. [PMID: 36161681 PMCID: PMC9538567 DOI: 10.1111/cas.15603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 02/07/2023] Open
Abstract
Antibody persistence several months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccination in allogeneic stem cell transplantation recipients remains largely unknown. We sequentially evaluated the humoral response to two doses of mRNA vaccines in 128 adult recipients and identified the risk factors involved in a poor response. The median interval between stem cell transplantation and vaccination was 2.7 years. The SARS-CoV-2 S1 Ab became positive after the second vaccination dose in 87.6% of the recipients, and the median titer was 1235.4 arbitrary units (AU)/ml. In patients on corticosteroid treatment, the corticosteroid dose inversely correlated with Ab titer. Multivariate analysis identified risk factors for poor peak response such as an interval from stem cell transplantation ≤1 year, history of clinically significant CMV infection, and use of >5 mg/day prednisolone at vaccination. Six months after vaccination, the median titer decreased to 185.15 AU/ml, and use of >5 mg/day prednisolone at vaccination was significantly associated with a poor response. These results indicate that early vaccination after stem cell transplantation (<12 months) and CMV infection are risk factors for poor peak response, while steroid use is important for a peak as well as a persistent response. In conclusion, although humoral response is observed in many stem cell transplantation recipients after two doses of vaccination, Ab titers diminish with time, and factors associated with persistence and a peak immunity should be considered separately.
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Affiliation(s)
- Takashi Toya
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Yuya Atsuta
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Takahiro Sanada
- Department of Microbiology and Cell BiologyTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Tomoko Honda
- Department of Microbiology and Cell BiologyTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Daichi Sadato
- Clinical Research Support Center, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Noritaka Sekiya
- Department of Infection Prevention and Control, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan,Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Hiroko Kogure
- Clinical Research Support Center, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Sonomi Takakuwa
- Clinical Research Support Center, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Daishi Onai
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Naoki Shingai
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Hiroaki Shimizu
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Yuho Najima
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Takeshi Kobayashi
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Kazuteru Ohashi
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Yuka Harada
- Clinical Research Support Center, Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Michinori Kohara
- Department of Microbiology and Cell BiologyTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Noriko Doki
- Hematology Division,Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
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6
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Shao Y, Zhou Y. Antibody response after vaccination against SARS-CoV-2 in adults with hematological malignancies: a systematic review and meta-analysis. Haematologica 2022; 108:653-654. [PMID: 36172816 PMCID: PMC9892848 DOI: 10.3324/haematol.2022.281902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Indexed: 02/03/2023] Open
Affiliation(s)
| | - Yongming Zhou
- Department of Hematology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437.
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7
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Albiol N, Barata A, Aso O, Gómez-Pérez L, Triquell M, Roch N, Lázaro E, Esquirol A, González I, López-Contreras J, Sierra J, Martino R, García-Cadenas I. mRNA-1273 SARS-CoV-2 vaccine safety and COVID-19 risk perception in recently transplanted allogeneic hematopoietic stem cell transplant recipients. Support Care Cancer 2022; 30:9687-9690. [PMID: 36169731 PMCID: PMC9517991 DOI: 10.1007/s00520-022-07376-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/21/2022] [Indexed: 12/01/2022]
Abstract
Purpose This study aims to describe the incidence and severity of adverse events (AEs) following the mRNA-1273 SARS-CoV-2 vaccine and explore the risk perception of COVID-19 in allogeneic hematopoietic stem cell transplant (HCT) recipients. Methods We performed a single-center prospective study including recently transplanted (< 2 years post-infusion) allogeneic HCT recipients. AEs were assessed through phone calls and graded from 0 to 4, while COVID-19 risk perception was measured using the Brief Illness Perception Questionnaire (BIP-Q5). Results Fifty-four HCT recipients were evaluated. Incidence and grades of AE (94.4% and 85.2% after the first and second dose, respectively) were similar to those described in the general population. The most common AE was pain at the site of injection. Three patients (5.6%) developed a grade ≥ 3 AE. Vaccine-related cytopenias and graft-versus-host disease flares were not observed. Female sex (OR 3.94, 95% CI 1.14–13.58, p = 0.03) and time since HCT (per month since HCT: OR 1.09, 95% CI 1.01–1.18, p = 0.04) were associated with the occurrence of any AE. The patients’ risk perception level of COVID-19 decreased over time (p < 0.05). Conclusion Our study confirms that the mRNA-1273 SARS-CoV-2 vaccine is safe in recent HCT recipients and suggests that the perceived risk of COVID-19 decreases over time.
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Affiliation(s)
- Nil Albiol
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain. .,Institut d'Investigació Biomèdica (IIB) Sant Pau, Barcelona, Spain. .,Autonomous University of Barcelona, Barcelona, Spain. .,Josep Carreras Leukaemia Research Institute, Barcelona, Spain.
| | - Anna Barata
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Olga Aso
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Lucía Gómez-Pérez
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Mercè Triquell
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Nerea Roch
- Infectious Diseases Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Elisabeth Lázaro
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Albert Esquirol
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB) Sant Pau, Barcelona, Spain.,Autonomous University of Barcelona, Barcelona, Spain.,Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | - Iria González
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Joaquín López-Contreras
- Autonomous University of Barcelona, Barcelona, Spain.,Infectious Diseases Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB) Sant Pau, Barcelona, Spain.,Autonomous University of Barcelona, Barcelona, Spain.,Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | - Rodrigo Martino
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB) Sant Pau, Barcelona, Spain.,Autonomous University of Barcelona, Barcelona, Spain.,Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | - Irene García-Cadenas
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain. .,Institut d'Investigació Biomèdica (IIB) Sant Pau, Barcelona, Spain. .,Autonomous University of Barcelona, Barcelona, Spain. .,Josep Carreras Leukaemia Research Institute, Barcelona, Spain.
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8
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Noori M, Azizi S, Abbasi Varaki F, Nejadghaderi SA, Bashash D. A systematic review and meta-analysis of immune response against first and second doses of SARS-CoV-2 vaccines in adult patients with hematological malignancies. Int Immunopharmacol 2022; 110:109046. [PMID: 35843148 PMCID: PMC9273573 DOI: 10.1016/j.intimp.2022.109046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cancer patients particularly those with hematological malignancies are at higher risk of affecting by severe coronavirus disease 2019 (COVID-19). Due to the immunocompromised nature of the disease and the immunosuppressive treatments, they are more likely to develop less antibody protection; therefore, we aimed to evaluate the immunogenicity of COVID-19 vaccines in patients with hematological malignancies. METHODS A comprehensive systematic search was conducted in PubMed, Scopus, and Web of Science databases, as well as Google scholar search engine as of December 10, 2021. Our primary outcomes of interest comprised of estimating the antibody seropositive rate following COVID-19 vaccination in patients with hematological malignancies and to compare it with those who were affected by solid tumors or healthy subjects. The secondary outcomes were to assess the vaccine's immunogenicity based on different treatments, status of the disease, and type of vaccine. After the two-step screening, the data were extracted and the summary measures were calculated using a random-effect model. RESULTS A total of 82 articles recording 13,804 patients with a diagnosis of malignancy were included in the present review. The seropositive rates in patients with hematological malignancies after first and second vaccine doses were 30.0% (95% confidence interval (95%CI): 11.9-52.0) and 62.3% (95%CI 56.0-68.5), respectively. These patients were less likely to develop antibody response as compared to cases with solid tumors (RR 0.73, 95%CI 0.67-0.79) and healthy subjects (RR 0.62, 95%CI 0.54-0.71) following complete immunization. Chronic lymphocytic leukemia (CLL) patients had the lowest response rate among all subtypes of hematological malignancies (first dose: 22.0%, 95%CI 13.5-31.8 and second dose: 47.8%, 95%CI 41.2-54.4). Besides, anti-CD20 therapies (5.7%, 95%CI 2.0-10.6) and bruton's tyrosine kinase inhibitors (26.8%, 95%CI 16.9-37.8) represented the lowest seropositiveness post first and second doses, respectively. Notably, patients who were in active status of disease showed lower antibody detection rate compared to those on remission status (RR 0.87, 95%CI 0.76-0.99). Furthermore, lower rate of seropositivity was found in patients received BNT162.b2 compared to ones who received mRNA-1273 (RR 0.89, 95%CI 0.79-0.99). CONCLUSION Our findings highlight the substantially low rate of seroprotection in patients with hematological malignancies with a wide range of rates among disease subgroups and different treatments; further highlighting the fact that booster doses might be acquired for these patients to improve immunity against SARS-CoV-2.
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Affiliation(s)
- Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Azizi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farhan Abbasi Varaki
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Davood Bashash
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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9
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Predictors of Covid-19 Vaccination Response After In-Vivo T-Cell–Depleted Stem Cell Transplantation. Transplant Cell Ther 2022; 28:618.e1-618.e10. [PMID: 35724850 PMCID: PMC9213029 DOI: 10.1016/j.jtct.2022.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/26/2022] [Accepted: 06/13/2022] [Indexed: 01/06/2023]
Abstract
Covid-19 vaccination is recommended in allogeneic transplant recipients, but many questions remain regarding its efficacy. Here we studied serologic responses in 145 patients who had undergone allogeneic transplantation using in vivo T-cell depletion. Median age was 57 (range 21-79) at transplantation and 61 (range 24-80) at vaccination. Sixty-nine percent were Caucasian. One third each received transplants from HLA-identical related (MRD), adult unrelated (MUD), or haploidentical-cord blood donors. Graft-versus-host disease (GVHD) prophylaxis involved in-vivo T-cell depletion using alemtuzumab for MRD or MUD transplants and anti-thymocyte globulin for haplo-cord transplants. Patients were vaccinated between January 2021 and January 2022, an average of 31 months (range 3-111 months) after transplantation. Sixty-one percent received the BNT162b2 (bioNtech/Pfizer) vaccine, 34% received mRNA-1273 (Moderna), and 5% received JNJ-78436735 (Johnson & Johnson). After the initial vaccinations (2 doses for BNT162b2 and mRNA-1273, 1 dose for JNJ-7843673), 124 of the 145 (85%) patients had a detectable SARS-CoV-2 spike protein (S) antibody, and 21 (15%) did not respond. Ninety-nine (68%) had high-level responses (≥100 binding antibody units [BAU]/mL)m and 25 (17%) had a low-level response (<100 BAU/mL). In multivariable analysis, lymphocyte count less than 1 × 109/ mL, having chronic GVHD, and being vaccinated in the first year after transplantation emerged as independent predictors for poor response. Neither donor source nor prior exposure to rituximab was predictive of antibody response. SARS-CoV-2 vaccination induced generally high response rates in recipients of allogeneic transplants including recipients of umbilical cord blood transplants and after in-vivo T cell depletion. Responses are less robust in those vaccinated in the first year after transplantation, those with low lymphocyte counts, and those with chronic GVHD.
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10
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Ge C, Du K, Luo M, Shen K, Zhou Y, Guo K, Liu Y, Yin C, Li Y, Li G, Chen X. Serologic response and safety of COVID-19 vaccination in HSCT or CAR T-cell recipients: a systematic review and meta-analysis. Exp Hematol Oncol 2022; 11:46. [PMID: 35974381 PMCID: PMC9380660 DOI: 10.1186/s40164-022-00299-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/08/2022] [Indexed: 12/21/2022] Open
Abstract
Background Patients receiving hematopoietic stem cell transplantation (HSCT) or chimeric antigen receptor T cell (CAR T-cell) therapy are immunocompromised and at high risk of viral infection, including SAR2-CoV-2 infection. However, the effectiveness and safety of COVID-19 vaccines in these recipients is not well characterized. The present meta-analysis evaluated the serologic response and safety of COVID-19 vaccines in these population. Methods Literature databases (MEDLINE, EMBASE, Web of Science, MedRvix and BioRvix) were searched for original studies with serologic response post COVID-19 vaccination in HSCT or CAR T-cell recipients published until July 14, 2022. The analysis included 27 observational studies with a total of 2899 patients receiving allogeneic HSCT (2506), autologous HSCT (286) or CAR T-cell therapy (107), and 683 healthy participants with serologic response data. Random effects models were used to pool the rate of serologic response to COVID-19 vaccination in HSCT or CAR T-cell recipients and odds ratio comparing with healthy controls. Results The pooled seropositivity rates in HSCT and CAR T-cell recipients were 0.624 [0.506–0.729] for one dose, 0.745 [0.712–0.776] for two doses. The rates were significantly lower than those in healthy controls (nearly 100%). In subgroup analysis, CAR T-cell recipients exhibited an even lower seroconversion rate (one dose: 0.204 [0.094–0.386]; two doses: 0.277 [0.190–0.386]) than HSCT counterparts (one dose: 0.779 [0.666–0.862]; two doses: 0.793 [0.762–0.821]). The rates were comparable between autologous and allogeneic HSCT recipients. Other possible impact factors related to seropositivity were time interval between therapy and vaccination, use of immunosuppressive drugs and immune cell counts. Most vaccine-related adverse effects were mild and resolvable, comparable to general population. Conclusions This analysis revealed a diminished response to COVID-19 vaccines in HSCT or CAR T-cell recipients. Our findings may inform regular COVID-19 vaccination at appropriate intervals after HSCT or CAR T-cell therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s40164-022-00299-6.
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Affiliation(s)
- Chenghao Ge
- Tsinghua Clinical Research Institute, School of Medicine, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Kelei Du
- School of Medicine, Tsinghua University, Beijing, China
| | - Mingjie Luo
- School of Medicine, Tsinghua University, Beijing, China
| | - Kaini Shen
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yangzhong Zhou
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kaiyuan Guo
- School of Medicine, Tsinghua University, Beijing, China
| | - Yang Liu
- Tsinghua Clinical Research Institute, School of Medicine, Tsinghua University, Beijing, China
| | - Chen Yin
- Tsinghua Clinical Research Institute, School of Medicine, Tsinghua University, Beijing, China
| | - Yi Li
- Tsinghua Clinical Research Institute, School of Medicine, Tsinghua University, Beijing, China
| | - Guanqiao Li
- Vanke School of Public Health, Tsinghua University, Beijing, China.
| | - Xiaoyuan Chen
- Tsinghua Clinical Research Institute, School of Medicine, Tsinghua University, Beijing, China. .,Office of Clinical Trial Institute, Beijing Tsinghua Changgung Hospital, Beijing, China.
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11
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Mehrabi Nejad MM, Shobeiri P, Dehghanbanadaki H, Tabary M, Aryannejad A, Haji Ghadery A, Shabani M, Moosaie F, SeyedAlinaghi S, Rezaei N. Seroconversion following the first, second, and third dose of SARS-CoV-2 vaccines in immunocompromised population: a systematic review and meta-analysis. Virol J 2022; 19:132. [PMID: 35941646 PMCID: PMC9358061 DOI: 10.1186/s12985-022-01858-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 07/18/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Immunocompromised (IC) patients are at higher risk of more severe COVID-19 infections than the general population. Special considerations should be dedicated to such patients. We aimed to investigate the efficacy of COVID-19 vaccines based on the vaccine type and etiology as well as the necessity of booster dose in this high-risk population. MATERIALS AND METHODS We searched PubMed, Web of Science, and Scopus databases for observational studies published between June 1st, 2020, and September 1st, 2021, which investigated the seroconversion after COVID-19 vaccine administration in adult patients with IC conditions. For investigation of sources of heterogeneity, subgroup analysis and sensitivity analysis were conducted. Statistical analysis was performed using R software. RESULTS According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 81 articles in the meta-analysis. The overall crude prevalence of seroconversion after the first (n: 7460), second (n: 13,181), and third (n: 909, all population were transplant patients with mRNA vaccine administration) dose administration was 26.17% (95% CI 19.01%, 33.99%, I2 = 97.1%), 57.11% (95% CI: 49.22%, 64.83%, I2 = 98.4%), and 48.65% (95% CI: 34.63%, 62.79%, I2 = 94.4%). Despite the relatively same immunogenicity of mRNA and vector-based vaccines after the first dose, the mRNA vaccines induced higher immunity after the second dose. Regarding the etiologic factor, transplant patients were less likely to develop immunity after both first and second dose rather than patients with malignancy (17.0% vs 37.0% after first dose, P = 0.02; 38.3% vs 72.1% after second dose, P < 0.001) or autoimmune disease (17.0% vs 36.4%, P = 0.04; 38.3% vs 80.2%, P < 0.001). To evaluate the efficacy of the third dose, we observed an increasing trend in transplant patients after the first (17.0%), second (38.3%), and third (48.6%) dose. CONCLUSION The rising pattern of seroconversion after boosting tends to be promising. In this case, more attention should be devoted to transplant patients who possess the lowest response rate.
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Affiliation(s)
- Mohammad-Mehdi Mehrabi Nejad
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Immunology, Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Hojat Dehghanbanadaki
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Tabary
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Armin Aryannejad
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolkarim Haji Ghadery
- Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahya Shabani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Moosaie
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419733141, Iran.
| | - Nima Rezaei
- Department of Immunology, Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran. .,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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12
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SeyedAlinaghi S, Karimi A, Pashaei Z, Afzalian A, Mirzapour P, Ghorbanzadeh K, Ghasemzadeh A, Dashti M, Nazarian N, Vahedi F, Tantuoyir MM, Shamsabadi A, Dadras O, Mehraeen E. Safety and Adverse Events Related to COVID-19 mRNA Vaccines; a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e41. [PMID: 35765616 PMCID: PMC9206826 DOI: 10.22037/aaem.v10i1.1597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Knowledge of vaccine-related adverse events is crucial as they are among the most important factors that cause hesitation in receiving vaccines. Therefore, we aimed to systematically review the adverse events related to the mRNA vaccines reported in the literature. Method: A systematic literature search was carried out in the databases of Scopus, PubMed, Cochrane, and Web of Science. We selected original studies that explored the side effects of mRNA COVID-19 vaccines using a two-phase (title/abstract and full-text) screening process. Results: Cardiac complications were the most commonly reported severe adverse events. It appeared that systemic adverse reactions are more common after the second dose of vaccines. The number of adverse effects reported after the Pfizer vaccine was higher than other vaccines, mostly due to its earlier approval and more widespread use throughout the world. Cardiac adverse events had a higher prevalence but no significant association has been found between COVID-19 mRNA vaccines and cardiac adverse events except for myopericarditis. Conclusion: Vaccines play a crucial role in controlling the COVID-19 pandemic and decreasing mortalities and the results of the present review acknowledge the fact that the benefits outweigh the adverse events of these vaccines.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Afzalian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Kobra Ghorbanzadeh
- Department of Nursing, Khalkhal University of Medical Sciences; Khalkhal, Iran
| | - Afsaneh Ghasemzadeh
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohsen Dashti
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Farzin Vahedi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Marcarious M Tantuoyir
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Biomedical Engineering Unit, University of Ghana Medical Center (UGMC), Accra, Ghana
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
| | - Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.,School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
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13
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SARS-CoV-2 vaccine safety and immunogenicity in patients with hematologic malignancies, transplantation, and cellular therapies. Blood Rev 2022; 56:100984. [PMID: 35752546 PMCID: PMC9188822 DOI: 10.1016/j.blre.2022.100984] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022]
Abstract
Individuals with hematological malignancies and hematopoietic stem cell transplant (HCT) recipients are immunologically heterogenous groups with varying degrees of immunosuppression at increased risk of severe disease and mortality from SARS-CoV-2 infection. SARS-CoV-2 vaccines are key interventions to preventing severe COVID-19 and its complications. While these individuals were excluded from initial vaccine trials, there is now a growing body of acceptable safety and immunogenicity data among these individuals. A consistent signal for new or worsening graft versus host disease in allogeneic HCT recipients has not been demonstrated post-vaccination. Immunogenicity in these populations is variable depending on disease and treatment factors. However, serological responses may not accurately reflect vaccine protection as correlates of protection within these populations are not yet established. Large-scale studies powered to identify rare serious events, resolve differences in vaccine responses between different vaccination strategies, and identify immune correlates of protection within these populations are needed.
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14
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Sadeghalvad M, Mansourabadi AH, Noori M, Nejadghaderi SA, Masoomikarimi M, Alimohammadi M, Rezaei N. Recent developments in SARS-CoV-2 vaccines: A systematic review of the current studies. Rev Med Virol 2022; 33:e2359. [PMID: 35491495 PMCID: PMC9348268 DOI: 10.1002/rmv.2359] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 01/28/2023]
Abstract
Designing and manufacturing efficient vaccines against coronavirus disease 2019 (COVID-19) is a major objective. In this systematic review, we aimed to evaluate the most important vaccines under construction worldwide, their efficiencies and clinical results in healthy individuals and in those with specific underlying diseases. We conducted a comprehensive search in PubMed, Scopus, EMBASE, and Web of Sciences by 1 December 2021 to identify published research studies. The inclusion criteria were publications that evaluated the immune responses and safety of COVID-19 vaccines in healthy individuals and in those with pre-existing diseases. We also searched the VAERS database to estimate the incidence of adverse events of special interest (AESI) post COVID-19 vaccination. Almost all investigated vaccines were well tolerated and developed good levels of both humoural and cellular responses. A protective and efficient humoural immune response develops after the second or third dose of vaccine and a longer interval (about 28 days) between the first and second injections of vaccine could induce higher antibody responses. The vaccines were less immunogenic in immunocompromised patients, particularly those with haematological malignancies. In addition, we found that venous and arterial thrombotic events, Bell's palsy, and myocarditis/pericarditis were the most common AESI. The results showed the potency of the SARS-CoV-2 vaccines to protect subjects against disease. The provision of further effective and safe vaccines is necessary in order to reach a high coverage of immunisation programs across the globe and to provide protection against infection itself.
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Affiliation(s)
- Mona Sadeghalvad
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran
| | | | - Maryam Noori
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran,Urology Research CenterTehran University of Medical SciencesTehranIran
| | - Seyed Aria Nejadghaderi
- Systematic Review and Meta‐Analysis Expert Group (SRMEG)Universal Scientific Education and Research Network (USERN)TehranIran,School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Masoomeh Masoomikarimi
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran
| | - Masoumeh Alimohammadi
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA)Universal Scientific Education and Research Network (USERN)TehranIran,Research Center for ImmunodeficienciesChildren's Medical CenterTehran University of Medical SciencesTehranIran
| | - Nima Rezaei
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA)Universal Scientific Education and Research Network (USERN)TehranIran,Research Center for ImmunodeficienciesChildren's Medical CenterTehran University of Medical SciencesTehranIran
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15
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Jullien M, Coste‐Burel M, Clemenceau B, Letailleur V, Guillaume T, Peterlin P, Garnier A, Bourgeois AL, Imbert B, Ollier J, Grain A, Touzeau C, Moreau P, Béné MC, Vié H, Chevallier P. Anti‐SARS‐CoV‐2 vaccines in recipient and/or donor before allotransplant. EJHAEM 2022; 3:484-487. [PMID: 35313664 PMCID: PMC8924852 DOI: 10.1002/jha2.398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 01/03/2023]
Abstract
The impact of pre‐transplant anti‐severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) vaccine in 20 recipients of allogeneic hematopoietic stem cell transplantation (Allo‐HSCT) and/or their donors is reported here, showing that the persistence of anti‐SARS‐CoV‐2 antibodies can be detected in almost all patients, whatever the type of vaccine used, and up to 9 months post transplant. Also, an anti‐SARS‐CoV‐2 spike glycoprotein CD3+ T‐cell response could be detected in six (35%) of 17 evaluable patients. This study provides a rationale to consider anti‐SARS‐CoV‐2 vaccination of both recipients and donors before Allo‐HSCT.
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Affiliation(s)
- Maxime Jullien
- Hematology Clinic Nantes University Hospital Nantes France
| | | | | | | | - Thierry Guillaume
- Hematology Clinic Nantes University Hospital Nantes France
- Inserm 1232, CRCINA Nantes University Nantes France
| | | | - Alice Garnier
- Hematology Clinic Nantes University Hospital Nantes France
| | | | | | | | - Audrey Grain
- Inserm 1232, CRCINA Nantes University Nantes France
| | | | | | - Marie C Béné
- Inserm 1232, CRCINA Nantes University Nantes France
- Hematology Biology Nantes University Hospital Nantes France
| | - Henri Vié
- Inserm 1232, CRCINA Nantes University Nantes France
| | - Patrice Chevallier
- Hematology Clinic Nantes University Hospital Nantes France
- Inserm 1232, CRCINA Nantes University Nantes France
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16
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Jullien M, Le Bourgeois A, Coste-Burel M, Peterlin P, Garnier A, Rimbert M, Imbert BM, Le Gouill S, Moreau P, Mahe B, Dubruille V, Blin N, Lok A, Touzeau C, Gastinne T, Tessoulin B, Vantyghem S, Béné MC, Guillaume T, Chevallier P. B Cell Aplasia Is the Most Powerful Predictive Marker for Poor Humoral Response after BNT162b2 mRNA SARS-CoV-2 Vaccination in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation. Transplant Cell Ther 2022; 28:279.e1-279.e4. [PMID: 35218998 PMCID: PMC8865956 DOI: 10.1016/j.jtct.2022.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/14/2022] [Accepted: 02/17/2022] [Indexed: 12/14/2022]
Abstract
Little is known about the immune response to SARS-CoV-2 vaccination in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, several studies have reported that adequate protection could be provided to this population. The purpose of this study was to evaluate which factors can predict the efficacy of SARS-CoV-2 vaccination in these specifically immunosuppressed patients. Specific anti-Spike (S) antibody responses were assessed in a cohort of 117 allo-HSCT recipients after 2 injections of BNT162b2 mRNA SARS-CoV-2 vaccine (V1 and V2). Factors considered liable to influence the antibody response and analyzed in this series were the interval between allo-HSCT and V1, donor source, recipient and donor age, current immunosuppressive/chemotherapy (I/C) treatment, and levels of CD4+and CD8+ T cells, B cells, and natural killer cells at the time of V1. Overall, the S-antibody response rate, evaluated at a median of 35 days after V2, was 82.9% for the entire cohort, with 71 patients (61%) reaching the highest titer. In univariate analysis, a lower pre-V1 median total lymphocyte count, lower CD4+ T cell and B cell counts, ongoing I/C treatment, and a haploidentical donor were characteristic of nonhumoral responders. However, multiparameter analysis showed that B cell aplasia was the sole factor predicting the absence of a specific immune response (odds ratio, 0.01; 95% confidence interval, 0.00 to 0.10; P < 10-3). Indeed, the rate of humoral response was 9.1% in patients with B cell aplasia versus 95.9% in patients with a B cell count >0 (P < 10-9). These results advocate for the administration of anti-SARS-CoV-2 vaccination in allo-HSCT recipients as early as peripheral B cell levels can be detected, and also suggest the need for close monitoring of B-cell reconstitution after Allo-HSCT.
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Affiliation(s)
- Maxime Jullien
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | | | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Alice Garnier
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Marie Rimbert
- Immunology Department, Nantes University Hospital, Nantes, France
| | | | - Steven Le Gouill
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Philippe Moreau
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Beatrice Mahe
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Nicolas Blin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Anne Lok
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Cyrille Touzeau
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Thomas Gastinne
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Benoit Tessoulin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Sophie Vantyghem
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Marie C. Béné
- INSERM UMR1232, CRCINA IRS-UN, University of Nantes, University Hospital, Nantes, France,Hematology Biology Department, Nantes University Hospital, Nantes, France
| | - Thierry Guillaume
- Hematology Department, Nantes University Hospital, Nantes, France,INSERM UMR1232, CRCINA IRS-UN, University of Nantes, University Hospital, Nantes, France
| | - Patrice Chevallier
- Hematology Department, Nantes University Hospital, Nantes, France,INSERM UMR1232, CRCINA IRS-UN, University of Nantes, University Hospital, Nantes, France,Correspondence and reprint requests: Patrice Chevallier, Service d'Hématologie Clinique, CHU Hotel-Dieu, Place A. Ricordeau, 44093 Nantes Cedex, France
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17
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Chen L, Cai X, Zhao T, Han B, Xie M, Cui J, Zhang J, Wang C, Liu B, Lu Q, Cui F. Safety of Global SARS-CoV-2 Vaccines, a Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10040596. [PMID: 35455344 PMCID: PMC9030038 DOI: 10.3390/vaccines10040596] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines were developed in only a short amount of time and were widely distributed. We conducted this meta-analysis to understand the safety of SARS-CoV-2 vaccines. (2) Methods: We searched the corresponding literature published from 1 January 2020 to 20 October 2021. Information of adverse events (AEs) of each selected work was collected. The quality and bias of studies was evaluated, and meta-analysis was carried out by using Stata 17.0. (3) Results: Totally, 11,451 articles were retrieved, and 53 of them were included for analysis. The incidence rate of AEs was 20.05–94.48%. The incidence rate of vascular events increased after viral vector vaccination, while the incidence rate of vascular events decreased after mRNA vaccination. Viral vector vaccine had a higher AE rate compared to mRNA vaccines and inactivated vaccines. In most circumstances, the incidence of AEs was higher in older people, female and after the second dose. The sensitivity of meta-analysis was acceptable; however, the literature was subject to a certain publication bias. (4) Conclusions: The safety of SARS-CoV-2 vaccines was acceptable. The incidence of allergic symptoms and cardiovascular and cerebrovascular symptoms was low. Viral vector vaccine had a higher risk of leading to thrombosis events. The understanding of SARS-CoV-2 vaccine AEs should be enhanced, so as to promote the vaccination.
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Affiliation(s)
- Linyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Xianming Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Bingfeng Han
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Mingzhu Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Jiahao Cui
- Faculty of Medicine, Imperial College London, London SW7 2AZ, UK;
| | - Jiayu Zhang
- Bioinformatics Program, School of Science, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China;
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
- Correspondence: ; Tel./Fax: +86-10-8280-1518
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18
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Lupo-Stanghellini MT, Di Cosimo S, Costantini M, Monti S, Mantegazza R, Mantovani A, Salvarani C, Zinzani PL, Inglese M, Ciceri F, Apolone G, Ciliberto G, Baldanti F, Morrone A, Sinno V, Locatelli F, Notari S, Turola E, Giannarelli D, Silvestris N. mRNA-COVID19 Vaccination Can Be Considered Safe and Tolerable for Frail Patients. Front Oncol 2022; 12:855723. [PMID: 35371993 PMCID: PMC8969577 DOI: 10.3389/fonc.2022.855723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/21/2022] [Indexed: 01/04/2023] Open
Abstract
Background Frail patients are considered at relevant risk of complications due to coronavirus disease 2019 (COVID-19) infection and, for this reason, are prioritized candidates for vaccination. As these patients were originally not included in the registration trials, fear related to vaccine adverse events and disease worsening was one of the reasons for vaccine hesitancy. Herein, we report the safety profile of the prospective, multicenter, national VAX4FRAIL study (NCT04848493) to evaluate vaccines in a large trans-disease cohort of patients with solid or hematological malignancies and neurological and rheumatological diseases. Methods Between March 3 and September 2, 2021, 566 patients were evaluable for safety endpoint: 105 received the mRNA-1273 vaccine and 461 the BNT162b2 vaccine. Frail patients were defined per protocol as patients under treatment with hematological malignancies (n = 131), solid tumors (n = 191), immune-rheumatological diseases (n = 86), and neurological diseases (n = 158), including multiple sclerosis and generalized myasthenia. The impact of the vaccination on the health status of patients was assessed through a questionnaire focused on the first week after each vaccine dose. Results The most frequently reported moderate–severe adverse events were pain at the injection site (60.3% after the first dose, 55.4% after the second), fatigue (30.1%–41.7%), bone pain (27.4%–27.2%), and headache (11.8%–18.9%). Risk factors associated with the occurrence of severe symptoms after vaccine administration were identified through a multivariate logistic regression analysis: age was associated with severe fever presentation (younger patients vs. middle-aged vs. older ones), female individuals presented a higher probability of severe pain at the injection site, fatigue, headache, and bone pain; and the mRNA-1237 vaccine was associated with a higher probability of severe pain at the injection site and fever. After the first dose, patients presenting a severe symptom were at a relevant risk of recurrence of the same severe symptom after the second one. Overall, 11 patients (1.9%) after the first dose and 7 (1.2%) after the second one required postponement or suspension of the disease-specific treatment. Finally, two fatal events occurred among our 566 patients. These two events were considered unrelated to the vaccine. Conclusions Our study reports that mRNA-COVID-19 vaccination is safe also in frail patients; as expected, side effects were manageable and had a minimum impact on patient care path.
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Affiliation(s)
| | - Serena Di Cosimo
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Sara Monti
- Department of Rheumatology, Policlinico San Matteo IRCCS Fondazione, University of Pavia, Pavia, Italy
| | - Renato Mantegazza
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Isitituto Neurologico Carlo Besta, Milano, Italy
| | - Alberto Mantovani
- Humanitas Scientific Directorate, IRCCS Humanitas, Clinical and Research Center, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
- William Harvey Research Institute, Queen Mary University, London, United Kingdom
| | - Carlo Salvarani
- Unità di Reumatologia, Azienda unità sanitaria locale-IRCCS, Reggio Emilia, Italy
- Unità di Reumatologia, Università degli Studi di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Pier Luigi Zinzani
- Istituto di Ematologia “Seràgnoli” Azienda Ospedaliero-Universitaria di Bologna, IRCCS, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy
| | - Matilde Inglese
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Gennaro Ciliberto
- Scientific Directorate, IRCCS Regina Elena, National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostics and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Aldo Morrone
- Scientific Directorate, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Valentina Sinno
- Department of Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology and Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
- Department of Gynecology-Obstetrics and Pediatrics, University “La Sapienza”, Roma, Italy
| | - Stefania Notari
- Cellular Immunology Laboratory, National Institute for Infectious Diseases L Spallanzani–IRCCS, Rome, Italy
| | - Elena Turola
- Infrastruttura Ricerca e Statistica, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Diana Giannarelli
- Biostatistical Unit, Istituto Nazionale Tumori Regina Elena IRCCS-IFO, Rome, Italy
| | - Nicola Silvestris
- Medical Oncology Department, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, Bari, Italy
- *Correspondence: Nicola Silvestris,
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19
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Piñana JL, López‐Corral L, Martino R, Montoro J, Vazquez L, Pérez A, Martin‐Martin G, Facal‐Malvar A, Ferrer E, Pascual M, Sanz‐Linares G, Gago B, Sanchez‐Salinas A, Villalon L, Conesa‐Garcia V, Olave MT, López‐Jimenez J, Marcos‐Corrales S, García‐Blázquez M, Garcia‐Gutiérrez V, Hernández‐Rivas JÁ, Saus A, Espigado I, Alonso C, Hernani R, Solano C, Ferrer‐Lores B, Guerreiro M, Ruiz‐García M, Muñoz‐Bellido JL, Navarro D, Cedillo A, Sureda A. SARS-CoV-2-reactive antibody detection after SARS-CoV-2 vaccination in hematopoietic stem cell transplant recipients: Prospective survey from the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group. Am J Hematol 2022; 97:30-42. [PMID: 34695229 PMCID: PMC8646900 DOI: 10.1002/ajh.26385] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/17/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023]
Abstract
This is a multicenter prospective observational study that included a large cohort (n = 397) of allogeneic (allo‐HSCT; (n = 311) and autologous (ASCT) hematopoietic stem cell transplant (n = 86) recipients who were monitored for antibody detection within 3–6 weeks after complete severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccination from February 1, 2021, to July 20, 2021. Most patients (n = 387, 97.4%) received mRNA‐based vaccines. Most of the recipients (93%) were vaccinated more than 1 year after transplant. Detectable SARS‐CoV‐2‐reactive antibodies were observed in 242 (78%) of allo‐HSCT and in 73 (85%) of ASCT recipients. Multivariate analysis in allo‐HSCT recipients identified lymphopenia < 1 × 109/ml (odds ratio [OR] 0.33, 95% confidence interval [95% CI] 0.16–0.69, p = .003), active graft versus host disease (GvHD; OR 0.51, 95% CI 0.27–0.98, p = .04) and vaccination within the first year of transplant (OR 0.3, 95% CI 0.15–0.9, p = .04) associated with lower antibody detection whereas. In ASCT, non‐Hodgkin's lymphoma (NHL; OR 0.09, 95% CI 0.02–0.44, p = .003) and active corticosteroid therapy (OR 0.2, 95% CI 0.02–0.87, p = .03) were associated with lower detection rate. We report an encouraging rate of SARS‐CoV‐2‐reactive antibodies detection in these severe immunocompromised patients. Lymphopenia, GvHD, the timing of vaccine, and NHL and corticosteroids therapy should be considered in allo‐HSCT and ASCT, respectively, to identify candidates for SARS‐CoV‐2 antibodies monitoring.
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Affiliation(s)
- José Luis Piñana
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | | | - Rodrigo Martino
- Hematology Division Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Juan Montoro
- Hematology Division Hospital universitario y politécnico La Fe Valencia Spain
| | - Lourdes Vazquez
- Hematology Division Hospital Universitario de Salamanca Salamanca Spain
| | - Ariadna Pérez
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | | | - Ana Facal‐Malvar
- Hematology Division Hospital universitario y politécnico La Fe Valencia Spain
| | - Elena Ferrer
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
| | - María‐Jesús Pascual
- Hematology Division Hospital Regional Universitario Carlos Haya Malaga Spain
| | - Gabriela Sanz‐Linares
- Hematology Division Institut Català Oncologia‐Hospital Duran i reynals Barcelona Spain
| | - Beatriz Gago
- Hematology Division Hospital Regional Universitario Carlos Haya Malaga Spain
| | | | - Lucia Villalon
- Hematology Division Hospital Universitario Fundación Alcorcón Madrid Spain
| | | | - Maria T. Olave
- Hematology Division Hospital Clínico Universitario Lozano Blesa IIS Aragon, Zaragoza Spain
| | | | | | | | | | | | - Ana Saus
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | - Ildefonso Espigado
- Hematology Division Universidad de Sevilla, Hospital Universitario Virgen Macarena‐Hospital Universitario Virgen del Rocío, IBiS/CSIC Sevilla Spain
| | - Carmen Alonso
- Hematology Division Hospital Arnau de Vilanova Valencia Spain
| | - Rafael Hernani
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | - Carlos Solano
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
- Department of Medicine, School of Medicine University of Valencia Valencia Spain
| | - Blanca Ferrer‐Lores
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | - Manuel Guerreiro
- Hematology Division Hospital universitario y politécnico La Fe Valencia Spain
| | | | | | - David Navarro
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
- Microbiology department Hospital Clinico Universitario de Valencia Valencia Spain
| | - Angel Cedillo
- Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH) Madrid Spain
| | - Anna Sureda
- Hematology Division Institut Català Oncologia‐Hospital Duran i reynals Barcelona Spain
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20
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Liu Q, Qin C, Liu M, Liu J. Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis. Infect Dis Poverty 2021; 10:132. [PMID: 34776011 PMCID: PMC8590867 DOI: 10.1186/s40249-021-00915-3] [Citation(s) in RCA: 193] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/01/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND To date, coronavirus disease 2019 (COVID-19) becomes increasingly fierce due to the emergence of variants. Rapid herd immunity through vaccination is needed to block the mutation and prevent the emergence of variants that can completely escape the immune surveillance. We aimed to systematically evaluate the effectiveness and safety of COVID-19 vaccines in the real world and to establish a reliable evidence-based basis for the actual protective effect of the COVID-19 vaccines, especially in the ensuing waves of infections dominated by variants. METHODS We searched PubMed, Embase and Web of Science from inception to July 22, 2021. Observational studies that examined the effectiveness and safety of SARS-CoV-2 vaccines among people vaccinated were included. Random-effects or fixed-effects models were used to estimate the pooled vaccine effectiveness (VE) and incidence rate of adverse events after vaccination, and their 95% confidence intervals (CI). RESULTS A total of 58 studies (32 studies for vaccine effectiveness and 26 studies for vaccine safety) were included. A single dose of vaccines was 41% (95% CI: 28-54%) effective at preventing SARS-CoV-2 infections, 52% (31-73%) for symptomatic COVID-19, 66% (50-81%) for hospitalization, 45% (42-49%) for Intensive Care Unit (ICU) admissions, and 53% (15-91%) for COVID-19-related death; and two doses were 85% (81-89%) effective at preventing SARS-CoV-2 infections, 97% (97-98%) for symptomatic COVID-19, 93% (89-96%) for hospitalization, 96% (93-98%) for ICU admissions, and 95% (92-98%) effective for COVID-19-related death, respectively. The pooled VE was 85% (80-91%) for the prevention of Alpha variant of SARS-CoV-2 infections, 75% (71-79%) for the Beta variant, 54% (35-74%) for the Gamma variant, and 74% (62-85%) for the Delta variant. The overall pooled incidence rate was 1.5% (1.4-1.6%) for adverse events, 0.4 (0.2-0.5) per 10 000 for severe adverse events, and 0.1 (0.1-0.2) per 10 000 for death after vaccination. CONCLUSIONS SARS-CoV-2 vaccines have reassuring safety and could effectively reduce the death, severe cases, symptomatic cases, and infections resulting from SARS-CoV-2 across the world. In the context of global pandemic and the continuous emergence of SARS-CoV-2 variants, accelerating vaccination and improving vaccination coverage is still the most important and urgent matter, and it is also the final means to end the pandemic.
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Affiliation(s)
- Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, 100871, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.
- Institute for Global Health and Development, Peking University, Beijing, 100871, China.
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21
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Shem-Tov N, Yerushalmi R, Danylesko I, Litachevsky V, Levy I, Olmer L, Lusitg Y, Avigdor A, Nagler A, Shimoni A, Rahav G. Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in haematopoietic stem cell transplantation recipients. Br J Haematol 2021; 196:884-891. [PMID: 34713441 PMCID: PMC8652777 DOI: 10.1111/bjh.17918] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/26/2022]
Abstract
The immunogenicity and safety of Pfizer‐BioNTech BNT162b2 mRNA vaccine in allogeneic haematopoietic stem cell transplantation (HSCT) recipients are unknown. We prospectively followed 152 HSCT recipients who were at least six months following transplantation and with no active acute graft‐versus‐host disease (GVHD). Blood samples were taken 2–4 weeks after the second vaccination and analyzed for receptor‐binding domain (RBD) antibodies and neutralizing antibodies (NA). 272 immunocompetent healthcare workers served as controls. At a median of 28 days after the second vaccination, 118 patients (77·6%) developed RBD immunoglobulin G (IgG) with a geometric mean titre (GMT) of 2·61 [95% CI (confidence interval), 2·16–3·16]. In the control group 269/272 (98·9%) developed RBD IgG, with a GMT of 5·98 (95% CI 5·70–6·28), P < 0·0001. The GMT of NA in HSCT recipients and controls was 116·0 (95% CI 76·5–175·9), and 427·9 (95% CI 354·3–516·7) respectively (P < 0001). Multivariate logistic regression analysis revealed that HSCT recipients with no chronic GVHD and no immunosuppressive therapy at the time of vaccination had significantly higher levels of NA following the second vaccination. Adverse events were minimal and were less common than in healthy controls. In conclusion; the BNT162b2 mRNA vaccination is safe and effective in HSCT recipients, especially those who are immunosuppression‐free. A significant fraction developed protecting NA.
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Affiliation(s)
- Noga Shem-Tov
- Division of Hematology and Bone-Marrow Transplantation, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ronit Yerushalmi
- Division of Hematology and Bone-Marrow Transplantation, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ivetta Danylesko
- Division of Hematology and Bone-Marrow Transplantation, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | | | - Itzchak Levy
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,The Infectious Diseases Unit, Sheba Medical Center, Tel-Hashomer, Israel
| | - Liraz Olmer
- Bio-statistical and Bio-mathematical Unit, The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yaniv Lusitg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Central Virology Laboratory, Ministry of Health and Sheba Medical Center, Tel-Hashomer, Israel
| | - Abraham Avigdor
- Division of Hematology and Bone-Marrow Transplantation, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Arnon Nagler
- Division of Hematology and Bone-Marrow Transplantation, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Avichai Shimoni
- Division of Hematology and Bone-Marrow Transplantation, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Galia Rahav
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,The Infectious Diseases Unit, Sheba Medical Center, Tel-Hashomer, Israel
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22
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Matkowska-Kocjan A, Owoc-Lempach J, Chruszcz J, Kuźnik E, Szenborn F, Jurczenko L, Wójcik M, Banyś D, Szenborn L, Ussowicz M. The COVID-19 mRNA BNT163b2 Vaccine Was Well Tolerated and Highly Immunogenic in Young Adults in Long Follow-Up after Haematopoietic Stem Cell Transplantation. Vaccines (Basel) 2021; 9:vaccines9101209. [PMID: 34696317 PMCID: PMC8539173 DOI: 10.3390/vaccines9101209] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/07/2021] [Accepted: 10/15/2021] [Indexed: 01/14/2023] Open
Abstract
Sixty five patients (18–31 years) who had received allogeneic haematopoietic stem cell transplantation (3–27 years from HSCT) were evaluated for the tolerance and immunogenicity of the COVID-19 mRNA BNT163b2 vaccine. Methods: Patients were vaccinated with two doses at 5 weeks interval. After each dose, patients completed a survey concerning adverse events (AE) and anti-SARS-CoV-2 IgG antibodies were measured before the first vaccine dose (1stVD) and 14–21 days after the second dose (2ndVD). AE reported after 1stVD and 2ndVD, respectively were: fever 0%, 1.7%; fatigue 15.4%, 25.8%; headache 15.4%, 24.1%; chills 6.1%, 12.0%; muscle pain 15.4%, 24.1%; joint pain 3.0%, 6.9%; nausea 6.1%, 6.9%; pain at injection site 30.7%, 34.4%; swelling 3.0%, 10.3%; redness 0, 3.4%; pruritus 0, 5.2%; and axillary lymphadenopathy 3.0%, 1.7%. After 2ndVD, 96.5% patients were positive for anti-SARS-CoV-2 (GMC 3290.94 BAU/mL). No correlation presented between the antibody titer and symptoms of chronic Graft-versus-Host disease, total IgG, lymphocyte CD4+, or AE. Significantly higher titers were observed in COVID-19 convalescents, and inverse correlation (R2 = −0.0925, p = 0.02) between the time from HSCT and titers after 2ndVD was present. Conclusions: The young adults after HSCT tolerate the COVID-19 mRNA vaccine well and show immunologic response.
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Affiliation(s)
- Agnieszka Matkowska-Kocjan
- Department and Clinic of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wrocław, Poland; (J.C.); (M.W.); (D.B.); (L.S.)
- Correspondence:
| | - Joanna Owoc-Lempach
- Department and Clinic of Paediatric Oncology, Haematology and Bone Marrow Transplantation, Wroclaw Medical University, 50-556 Wrocław, Poland; (J.O.-L.); (L.J.); (M.U.)
| | - Joanna Chruszcz
- Department and Clinic of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wrocław, Poland; (J.C.); (M.W.); (D.B.); (L.S.)
| | - Edwin Kuźnik
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, 50-529 Wrocław, Poland;
| | - Filip Szenborn
- Faculty of Electronics, Wroclaw University of Science and Technology, 50-370 Wrocław, Poland;
| | - Lidia Jurczenko
- Department and Clinic of Paediatric Oncology, Haematology and Bone Marrow Transplantation, Wroclaw Medical University, 50-556 Wrocław, Poland; (J.O.-L.); (L.J.); (M.U.)
| | - Marta Wójcik
- Department and Clinic of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wrocław, Poland; (J.C.); (M.W.); (D.B.); (L.S.)
| | - Dorota Banyś
- Department and Clinic of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wrocław, Poland; (J.C.); (M.W.); (D.B.); (L.S.)
| | - Leszek Szenborn
- Department and Clinic of Pediatric Infectious Diseases, Wroclaw Medical University, 50-368 Wrocław, Poland; (J.C.); (M.W.); (D.B.); (L.S.)
| | - Marek Ussowicz
- Department and Clinic of Paediatric Oncology, Haematology and Bone Marrow Transplantation, Wroclaw Medical University, 50-556 Wrocław, Poland; (J.O.-L.); (L.J.); (M.U.)
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23
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Lindemann M, Klisanin V, Thümmler L, Fisenkci N, Tsachakis-Mück N, Ditschkowski M, Schwarzkopf S, Klump H, Reinhardt HC, Horn PA, Koldehoff M. Humoral and Cellular Vaccination Responses against SARS-CoV-2 in Hematopoietic Stem Cell Transplant Recipients. Vaccines (Basel) 2021; 9:1075. [PMID: 34696183 PMCID: PMC8537291 DOI: 10.3390/vaccines9101075] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 01/14/2023] Open
Abstract
The cellular response to SARS-CoV-2 vaccination and infection in allogeneic hematopoietic stem cell transplant (HSCT) recipients is not yet clear. In the current study, HSCT recipients prior to and post vaccination were tested for SARS-CoV-2-specific humoral and cellular immunity. Antibodies against spike (S) 1 were assessed by Anti-SARS-CoV-2 IgG ELISA (Euroimmun). Cellular immunity was analyzed by an in house interferon-gamma ELISpot and T-SPOT.COVID (Oxford Immunotec), using altogether seven SARS-CoV-2-specific antigens. In 117 HSCT patients vaccinated twice, SARS-CoV-2 IgG antibodies were significantly higher than in HSCT controls pre vaccination (p < 0.0001). After the second vaccination, we observed a median antibody ratio of 4.7 and 68% positive results, whereas 35 healthy controls reached a median ratio of 9.0 and 100% positivity. ELISpot responses in patients were significantly (p < 0.001) reduced to ≤33% of the controls. After the second vaccination, female HSCT patients and female healthy controls showed significantly higher antibody responses than males (6.0 vs. 2.1 and 9.2 vs. 8.2, respectively; p < 0.05). Cellular immunity was diminished in patients irrespective of sex. In conclusion, especially male HSCT recipients showed impaired antibody responses after SARS-CoV-2 vaccination. Changing the vaccine schedule or composition could help increase vaccine responses.
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Affiliation(s)
- Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Vesna Klisanin
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Laura Thümmler
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Neslinur Fisenkci
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Nikolaos Tsachakis-Mück
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Markus Ditschkowski
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Sina Schwarzkopf
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Hannes Klump
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Hans Christian Reinhardt
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
| | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (L.T.); (N.F.); (S.S.); (H.K.); (P.A.H.)
| | - Michael Koldehoff
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (V.K.); (N.T.-M.); (M.D.); (H.C.R.); (M.K.)
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24
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Le Bourgeois A, Coste-Burel M, Guillaume T, Peterlin P, Garnier A, Béné MC, Chevallier P. Safety and Antibody Response After 1 and 2 Doses of BNT162b2 mRNA Vaccine in Recipients of Allogeneic Hematopoietic Stem Cell Transplant. JAMA Netw Open 2021; 4:e2126344. [PMID: 34519770 PMCID: PMC8441592 DOI: 10.1001/jamanetworkopen.2021.26344] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This cohort study examines safety and antibody responses after 1 and 2 doses of BNT162b2 mRNA vaccine in recipients of allogeneic hematopoietic stem cell transplant (HSCT).
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Affiliation(s)
| | | | - Thierry Guillaume
- Hematology Department, Nantes University Hospital, Nantes, France
- Institut National de al Santé et de la Recherche Médicale, Unité Mixte Recherche 1232, Centre de Recherche en Cancérologie et Immunologie Nantes Angers Institut de Recherche en Santé de l’Université de Nantes, University of Nantes, France
| | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Alice Garnier
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Marie C. Béné
- Institut National de al Santé et de la Recherche Médicale, Unité Mixte Recherche 1232, Centre de Recherche en Cancérologie et Immunologie Nantes Angers Institut de Recherche en Santé de l’Université de Nantes, University of Nantes, France
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Patrice Chevallier
- Hematology Department, Nantes University Hospital, Nantes, France
- Institut National de al Santé et de la Recherche Médicale, Unité Mixte Recherche 1232, Centre de Recherche en Cancérologie et Immunologie Nantes Angers Institut de Recherche en Santé de l’Université de Nantes, University of Nantes, France
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25
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Béné MC, Bittencourt MDC, Chevallier P. Post-SARS-CoV-2 vaccination specific antibody decrease : Let's get the half-full glass perspective. J Infect 2021; 84:94-118. [PMID: 34332018 PMCID: PMC8318667 DOI: 10.1016/j.jinf.2021.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 01/17/2023]
Affiliation(s)
- Marie C Béné
- Hematology Biology, Nantes University Hospital, Nantes, France; CRCINA, Inserm, Nantes, France.
| | - Marcelo de Carvalho Bittencourt
- Immunology Laboratory, Nancy University Hospital, Nancy, France; CNRS UMR 7365, IMoPA, Université de Lorraine, Nancy, France
| | - Patrice Chevallier
- CRCINA, Inserm, Nantes, France; Hematology Clinic, Nantes University Hospital, Nantes, France
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26
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Zajac-Spychala O, Kampmeier S, Lehrnbecher T, Groll AH. Infectious Complications in Paediatric Haematopoetic Cell Transplantation for Acute Lymphoblastic Leukemia: Current Status. Front Pediatr 2021; 9:782530. [PMID: 35223707 PMCID: PMC8866305 DOI: 10.3389/fped.2021.782530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/15/2021] [Indexed: 12/02/2022] Open
Abstract
Haematopoietic stem cell transplantation (HSCT) in paediatric patients with acute lymphoblastic leukaemia (ALL) is associated with a variety of infectious complications which result in significant morbidity and mortality. These patients are profoundly immunocompromised, and immune reconstitution after HSCT generally occurs in astrictly defined order. During the early phase after HSCT until engraftment, patients are at risk of infections due to presence of neutropenia and mucosal damage, with Gramme-positive and Gramme-negative bacteria and fungi being the predominant pathogens. After neutrophil recovery, the profound impairment of cell-mediated immunity and use of glucocorticosteroids for control of graft-vs.-host disease (GvHD) increases the risk of invasive mould infection and infection or reactivation of various viruses, such as cytomegalovirus, varicella zoster virus, Epstein-Barr virus and human adenovirus. In the late phase, characterised by impaired cellular and humoral immunity, particularly in conjunction with chronic GvHD, invasive infections with encapsulated bacterial infections are observed in addition to fungal and viral infections. HSCT also causes a loss of pretransplant naturally acquired and vaccine-acquired immunity; therefore, complete reimmunization is necessary to maintain long-term health in these patients. During the last two decades, major advances have been made in our understanding of and in the control of infectious complications associated with HSCT. In this article, we review current recommendations for the diagnosis, prophylaxis and treatment of infectious complications following HSCT for ALL in childhood.
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Affiliation(s)
- Olga Zajac-Spychala
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Thomas Lehrnbecher
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Andreas H Groll
- Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology, University Children's Hospital Münster, Münster, Germany
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