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Erra L, Uriarte I, Colado A, Paolini MV, Seminario G, Fernández JB, Tau L, Bernatowiez J, Moreira I, Vishnopolska S, Rumbo M, Cassarino C, Vijoditz G, López AL, Curciarello R, Rodríguez D, Rizzo G, Ferreyra M, Ferreyra Mufarregue LR, Badano MN, Pérez Millán MI, Quiroga MF, Baré P, Ibañez I, Pozner R, Borge M, Docena G, Bezrodnik L, Almejun MB. COVID-19 Vaccination Responses with Different Vaccine Platforms in Patients with Inborn Errors of Immunity. J Clin Immunol 2023; 43:271-285. [PMID: 36251205 PMCID: PMC9574808 DOI: 10.1007/s10875-022-01382-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/05/2022] [Indexed: 02/07/2023]
Abstract
Patients with inborn errors of immunity (IEI) in Argentina were encouraged to receive licensed Sputnik, AstraZeneca, Sinopharm, Moderna, and Pfizer vaccines, even though most of the data of humoral and cellular responses combination on available vaccines comes from trials conducted in healthy individuals. We aimed to evaluate the safety and immunogenicity of the different vaccines in IEI patients in Argentina. The study cohort included adults and pediatric IEI patients (n = 118) and age-matched healthy controls (HC) (n = 37). B cell response was evaluated by measuring IgG anti-spike/receptor binding domain (S/RBD) and anti-nucleocapsid(N) antibodies by ELISA. Neutralization antibodies were also assessed with an alpha-S protein-expressing pseudo-virus assay. The T cell response was analyzed by IFN-γ secretion on S- or N-stimulated PBMC by ELISPOT and the frequency of S-specific circulating T follicular-helper cells (TFH) was evaluated by flow cytometry.No moderate/severe vaccine-associated adverse events were observed. Anti-S/RBD titers showed significant differences in both pediatric and adult IEI patients versus the age-matched HC cohort (p < 0.05). Neutralizing antibodies were also significantly lower in the patient cohort than in age-matched HC (p < 0.01). Positive S-specific IFN-γ response was observed in 84.5% of IEI patients and 82.1% presented S-specific TFH cells. Moderna vaccines, which were mainly administered in the pediatric population, elicited a stronger humoral response in IEI patients, both in antibody titer and neutralization capacity, but the cellular immune response was similar between vaccine platforms. No difference in humoral response was observed between vaccinated patients with and without previous SARS-CoV-2 infection.In conclusion, COVID-19 vaccines showed safety in IEI patients and, although immunogenicity was lower than HC, they showed specific anti-S/RBD IgG, neutralizing antibody titers, and T cell-dependent cellular immunity with IFN-γ secreting cells. These findings may guide the recommendation for a vaccination with all the available vaccines in IEI patients to prevent COVID-19 disease.
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Affiliation(s)
- Lorenzo Erra
- Departamento de Fisiología, Biología Molecular y Celular, Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3) e Instituto de Química Biológica (IQUIBICEN), FCEN, UBA, CONICET, Buenos Aires, CABA, Argentina
| | - Ignacio Uriarte
- Escuela Superior de Medicina, Universidad Nacional Mar del Plata-Hospital Interzonal Especializado Materno Infantil Don Vitorio Tetamanti, Mar del Plata, Buenos Aires, Argentina
| | - Ana Colado
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, CABA, Argentina
| | | | | | - Julieta Belén Fernández
- Departamento de Fisiología, Biología Molecular y Celular, Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3) e Instituto de Química Biológica (IQUIBICEN), FCEN, UBA, CONICET, Buenos Aires, CABA, Argentina
| | - Lorena Tau
- Laboratorio de Salud Pública de La Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, Asociado a CIC PBA, UNLP, La Plata, Argentina
| | - Juliana Bernatowiez
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, CABA, Argentina
| | - Ileana Moreira
- Centro de Inmunología Clínica, Buenos Aires, CABA, Argentina
| | - Sebastián Vishnopolska
- Departamento de Fisiología, Biología Molecular y Celular, Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3) e Instituto de Química Biológica (IQUIBICEN), FCEN, UBA, CONICET, Buenos Aires, CABA, Argentina
| | - Martín Rumbo
- Laboratorio de Salud Pública de La Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, Asociado a CIC PBA, UNLP, La Plata, Argentina
| | - Chiara Cassarino
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, CABA, Argentina
| | - Gustavo Vijoditz
- Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Ana Laura López
- Hospital General de Agudos C. G. Durand, Buenos Aires, CABA, Argentina
| | - Renata Curciarello
- Laboratorio de Salud Pública de La Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, Asociado a CIC PBA, UNLP, La Plata, Argentina
| | - Diego Rodríguez
- Escuela Superior de Medicina, Universidad Nacional Mar del Plata-Hospital Interzonal Especializado Materno Infantil Don Vitorio Tetamanti, Mar del Plata, Buenos Aires, Argentina
| | - Gastón Rizzo
- Laboratorio de Salud Pública de La Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, Asociado a CIC PBA, UNLP, La Plata, Argentina
| | - Malena Ferreyra
- Laboratorio de Salud Pública de La Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, Asociado a CIC PBA, UNLP, La Plata, Argentina
| | | | - María Noel Badano
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, CABA, Argentina
| | - María Inés Pérez Millán
- Departamento de Fisiología, Biología Molecular y Celular, Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3) e Instituto de Química Biológica (IQUIBICEN), FCEN, UBA, CONICET, Buenos Aires, CABA, Argentina
| | - María Florencia Quiroga
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), CONICET, Buenos Aires, CABA, Argentina
| | - Patricia Baré
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, CABA, Argentina
| | - Itatí Ibañez
- Instituto de Química Física de los Materiales, Medio Ambiente y Energía (INQUIMAE), CONICET, FCEN, UBA, Buenos Aires, CABA, Argentina
| | - Roberto Pozner
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, CABA, Argentina
| | - Mercedes Borge
- Instituto de Medicina Experimental (IMEX), CONICET-Academia Nacional de Medicina, Buenos Aires, CABA, Argentina
| | - Guillermo Docena
- Laboratorio de Salud Pública de La Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, Asociado a CIC PBA, UNLP, La Plata, Argentina
| | | | - María Belén Almejun
- Departamento de Fisiología, Biología Molecular y Celular, Instituto de Biociencias, Biotecnología y Biología Traslacional (IB3) e Instituto de Química Biológica (IQUIBICEN), FCEN, UBA, CONICET, Buenos Aires, CABA, Argentina.
- Pabellón II, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160-Ciudad Universitaria-CABA C1428EG, Buenos Aires, Argentina.
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Leung D, Mu X, Duque JSR, Cheng SMS, Wang M, Zhang W, Zhang Y, Tam IYS, Lee TSS, Lam JHY, Chan SM, Cheang CH, Chung Y, Wong HHW, Lee AMT, Li WY, Chaothai S, Tsang LCH, Chua GT, Cheong KN, Au EYL, Kwok JSY, Chan KW, Chong PCY, Lee PPW, Ho MHK, Lee TL, Tu W, Peiris M, Lau YL. Safety and immunogenicity of 3 doses of BNT162b2 and CoronaVac in children and adults with inborn errors of immunity. Front Immunol 2022; 13:982155. [PMID: 36203563 PMCID: PMC9530261 DOI: 10.3389/fimmu.2022.982155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Our study (NCT04800133) aimed to determine the safety and immunogenicity in patients with IEIs receiving a 3-dose primary series of mRNA vaccine BNT162b2 (age 12+) or inactivated whole-virion vaccine CoronaVac (age 3+) in Hong Kong, including Omicron BA.1 neutralization, in a nonrandomized manner. Intradermal vaccination was also studied. Thirty-nine patients were vaccinated, including 16 with homologous intramuscular 0.3ml BNT162b2 and 17 with homologous intramuscular 0.5ml CoronaVac. Two patients received 3 doses of intradermal 0.5ml CoronaVac, and 4 patients received 2 doses of intramuscular BNT162b2 and the third dose with intradermal BNT162b2. No safety concerns were identified. Inadequate S-RBD IgG and surrogate virus neutralization responses were found after 2 doses in patients with humoral immunodeficiencies and especially so against BA.1. Dose 3 of either vaccine increased S-RBD IgG response. T cell responses against SARS-CoV-2 antigens were detected in vaccinated IEI patients by intracellular cytokine staining on flow cytometry. Intradermal third dose vaccine led to high antibody response in 4 patients. The primary vaccination series of BNT162b2 and CoronaVac in adults and children with IEIs should include 3 doses for optimal immunogenicity.
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Affiliation(s)
- Daniel Leung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xiaofeng Mu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jaime S. Rosa Duque
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Samuel M. S. Cheng
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Manni Wang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wenyue Zhang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yanmei Zhang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Issan Y. S. Tam
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Toby S. S. Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jennifer H. Y. Lam
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sau Man Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Cheuk Hei Cheang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuet Chung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Howard H. W. Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Amos M. T. Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wing Yan Li
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sara Chaothai
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Leo C. H. Tsang
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Gilbert T. Chua
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kai-Ning Cheong
- Hong Kong Children’s Hospital, Hong Kong, Hong Kong SAR, China
| | - Elaine Y. L. Au
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Janette S. Y. Kwok
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Koon Wing Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Pamela P. W. Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Tsz Leung Lee
- Hong Kong Children’s Hospital, Hong Kong, Hong Kong SAR, China
| | - Wenwei Tu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Wenwei Tu, ; Malik Peiris, ; Yu Lung Lau,
| | - Malik Peiris
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Centre for Immunology and Infection C2i, Hong Kong, Hong Kong SAR, China
- *Correspondence: Wenwei Tu, ; Malik Peiris, ; Yu Lung Lau,
| | - Yu Lung Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Wenwei Tu, ; Malik Peiris, ; Yu Lung Lau,
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Durkee-Shock JR, Keller MD. Immunizing the Imperfect Immune System: COVID-19 Vaccination in Patients with Inborn Errors of Immunity. Ann Allergy Asthma Immunol 2022; 129:562-571.e1. [PMID: 35718282 PMCID: PMC9212748 DOI: 10.1016/j.anai.2022.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
Abstract
Objective To update clinicians on current evidence regarding the immunogenicity and safety of coronavirus disease 2019 (COVID-19) vaccines in patients with inborn errors of immunity (IEI). Data Sources Peer-reviewed, published studies in PubMed, clinical trials listed on ClinicalTrials.gov, and professional organization and governmental guidelines. Study Selections Literature searches on PubMed and ClinicalTrials.gov were performed using a combination of the following keywords: primary immunodeficiency, COVID-19, SARS-CoV-2, and vaccination. Results A total of 26 studies met the criteria and were included in this review. Overall, antibody responses to COVID-19 vaccination were found in 72% of study subjects, with stronger responses observed after messenger RNA vaccination. Neutralizing antibodies were detected in patients with IEI, though consistently at lower levels than healthy controls. Risk factors for poor antibody responses included diagnosis of common variable immunodeficiency, presence of autoimmune comorbidities, and use of rituximab. T cell responses were detectable in most patients with IEI, with poorer responses often found in patients with common variable immunodeficiency. Safety of COVID-19 vaccines in patients with IEI was acceptable with high rates of reactogenicity but very few serious adverse events, including in patients with immune dysregulation. Conclusion COVID-19 vaccines are safe in patients with IEI and seem to be immunogenic in most individuals, with stronger responses found after messenger RNA vaccinations.
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Affiliation(s)
- Jessica R Durkee-Shock
- Laboratory of Infectious Diseases, National Institute for Allergy and Infectious Diseases, Bethesda, Maryland
| | - Michael D Keller
- Division of Allergy & Immunology and Center for Cancer and Immunology Research, Children's National Hospital, Washington, District of Columbia; Department of Pediatrics and GW Cancer Center, George Washington University, Washington, District of Columbia.
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