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Kim E, Shin J, Ferrari A, Huang S, An E, Han D, Khan MS, Kenniston TW, Cassaniti I, Baldanti F, Jeong D, Gambotto A. Fourth dose of microneedle array patch of SARS-CoV-2 S1 protein subunit vaccine elicits robust long-lasting humoral responses in mice. Int Immunopharmacol 2024; 129:111569. [PMID: 38340419 DOI: 10.1016/j.intimp.2024.111569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024]
Abstract
The COVID-19 pandemic has underscored the pressing need for safe and effective booster vaccines, particularly in considering the emergence of new SARS-CoV-2 variants and addressing vaccine distribution inequalities. Dissolving microneedle array patches (MAP) offer a promising delivery method, enhancing immunogenicity and improving accessibility through the skin's immune potential. In this study, we evaluated a microneedle array patch-based S1 subunit protein COVID-19 vaccine candidate, which comprised a bivalent formulation targeting the Wuhan and Beta variant alongside a monovalent Delta variant spike proteins in a murine model. Notably, the second boost of homologous bivalent MAP-S1(WU + Beta) induced a 15.7-fold increase in IgG endpoint titer, while the third boost of heterologous MAP-S1RS09Delta yielded a more modest 1.6-fold increase. Importantly, this study demonstrated that the administration of four doses of the MAP vaccine induced robust and long-lasting immune responses, persisting for at least 80 weeks. These immune responses encompassed various IgG isotypes and remained statistically significant for one year. Furthermore, neutralizing antibodies against multiple SARS-CoV-2 variants were generated, with comparable responses observed against the Omicron variant. Overall, these findings emphasize the potential of MAP-based vaccines as a promising strategy to combat the evolving landscape of COVID-19 and to deliver a safe and effective booster vaccine worldwide.
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Affiliation(s)
- Eun Kim
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Juyeop Shin
- Medical Business Division, Raphas Co., Ltd., Seoul, Republic of Korea
| | - Alessandro Ferrari
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Shaohua Huang
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Eunjin An
- Medical Business Division, Raphas Co., Ltd., Seoul, Republic of Korea
| | - Donghoon Han
- Medical Business Division, Raphas Co., Ltd., Seoul, Republic of Korea
| | - Muhammad S Khan
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Thomas W Kenniston
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Irene Cassaniti
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Dohyeon Jeong
- Medical Business Division, Raphas Co., Ltd., Seoul, Republic of Korea
| | - Andrea Gambotto
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA; Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
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Nelli F, Fabbri A, Virtuoso A, Giannarelli D, Marrucci E, Fiore C, Giron Berrios JR, Schirripa M, Signorelli C, Chilelli MG, Primi F, Panichi V, Caterini L, Farinelli S, Silvestri MA, Ruggeri EM. Herpes zoster after the third dose of SARS-CoV-2 mRNA-BNT162b2 vaccine in actively treated cancer patients: a prospective study. Clin Exp Med 2024; 24:13. [PMID: 38244147 PMCID: PMC10799787 DOI: 10.1007/s10238-023-01263-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/07/2023] [Indexed: 01/22/2024]
Abstract
Several concerns have been raised about a causal relationship between COVID-19 mRNA-based vaccines and the development of herpes zoster (HZ). We performed a prospective analysis of the Vax-On-Third-Profile study to investigate the incidence of HZ after the third dose of mRNA-BNT162b2 (tozinameran) and its correlation with immune responses. Patients who had received a booster dose and had been actively treated for at least 8 weeks were eligible. Serologic assessment was performed before the third dose of tozinameran (timepoint-1) and 4 weeks later (timepoint-2). We also assessed the incidence of SARS-CoV-2 breakthrough infections at predefined time points. The current analysis included 310 patients, of whom 109 (35.2%) and 111 (35.8%) were being treated with targeted therapies and cytotoxic chemotherapy, respectively. All participants received a third dose of tozinameran between September 26 and October 30, 2021. After a mean follow-up of 17.3 (IQR 15.1-18.4) months, HZ occurred in 8 recipients, for a cumulative incidence of 2.6%, and an incidence rate of 0.310 per person-year (95% CI 0.267-0.333). All HZ cases occurred within 30 days of booster dosing (range 5-29 days), with a median time to onset of 15 (IQR 9-22) days. Among the 7 patients (2.2%) who also contracted a SARS-CoV-2 infection, all cases preceded COVID-19 outbreaks. No instances of complicated HZ were reported. In multivariate analysis, impaired T helper and T cytotoxic cell counts independently correlated with HZ occurrence. These findings provide the first evidence that cancer patients on active treatment have a not negligible risk of developing HZ within 30 days after the third dose of tozinameran. The favorable clinical outcome of all observed cases confirms that protective effects of boosters in reducing the risk of severe COVID-19 outweigh the potential risk of HZ occurrence.
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Affiliation(s)
- Fabrizio Nelli
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy.
| | - Agnese Fabbri
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Antonella Virtuoso
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Diana Giannarelli
- Biostatistics Unit, Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Eleonora Marrucci
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Cristina Fiore
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Julio Rodrigo Giron Berrios
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Marta Schirripa
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Carlo Signorelli
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Mario Giovanni Chilelli
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Francesca Primi
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
| | - Valentina Panichi
- Citofluorimetry Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Viterbo, Italy
| | - Luciano Caterini
- Infectious Disease Unit, Department of Medicine, Central Hospital of Belcolle, Viterbo, Italy
| | - Stefania Farinelli
- Infectious Disease Unit, Department of Medicine, Central Hospital of Belcolle, Viterbo, Italy
| | - Maria Assunta Silvestri
- Microbiology and Virology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Viterbo, Italy
| | - Enzo Maria Ruggeri
- Medical Oncology Unit, Department of Oncology and Hematology, Central Hospital of Belcolle, Strada Sammartinese Snc, 01100, Viterbo, Italy
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Neuhann JM, Stemler J, Carcas AJ, Frías-Iniesta J, Akova M, Bethe U, Heringer S, Salmanton-García J, Tischmann L, Zarrouk M, Cüppers A, Grothe J, Leon AG, Mallon P, Negi R, Gaillard C, Saini G, Lammens C, Hotterbeekx A, Loens K, Malhotra-Kumar S, Goossens H, Kumar-Singh S, König F, Yeghiazaryan L, Posch M, Koehler P, Cornely OA. Immunogenicity and reactogenicity of a first booster with BNT162b2 or full-dose mRNA-1273: A randomised VACCELERATE trial in adults ≥75 years (EU-COVAT-1). Vaccine 2023; 41:7166-7175. [PMID: 37919141 DOI: 10.1016/j.vaccine.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/19/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Vaccination remains crucial for protection against severe SARS-CoV-2 infection, especially for people of advanced age, however, optimal dosing regimens are as yet lacking. METHODS EU-COVAT-1-AGED Part A is a randomised controlled, adaptive, multicentre phase II trial evaluating safety and immunogenicity of a 3rd vaccination (1st booster) in individuals ≥75 years. Fifty-three participants were randomised to full-doses of either mRNA-1273 (Spikevax®, 100 µg) or BNT162b2 (Comirnaty®, 30 µg). The primary endpoint was the rate of 2-fold circulating antibody titre increase 14 days post-vaccination measured by quantitative electrochemiluminescence (ECL) immunoassay, targeting RBD region of Wuhan wild-type SARS-CoV-2. Secondary endpoints included the changes in neutralising capacity against wild-type and 25 variants of concern at 14 days and up to 12 months. Safety was assessed by monitoring of solicited adverse events (AEs) for seven days after on-study vaccination. Unsolicited AEs were collected until the end of follow-up at 12 months, SAEs were pursued for a further 30 days. RESULTS Between 08th of November 2021 and 04th of January 2022, 53 participants ≥75 years received a COVID-19 vaccine as 1st booster. Fifty subjects (BNT162b2 n = 25/mRNA-1273 n = 25) were included in the analyses for immunogenicity at day 14. The primary endpoint of a 2-fold anti-RBD IgG titre increase 14 days after vaccination was reached for all subjects. A 3rd vaccination of full-dose mRNA-1273 provided higher anti-RBD IgG titres (Geometric mean titre) D14 mRNA-127310711 IU/mL (95 %-CI: 8003;14336) vs. BNT162b2: 7090 IU/mL (95 %-CI: 5688;8837). We detected a pattern showing higher neutralising capacity of full-dose mRNA-1273 against wild-type as well as for 23 out of 25 tested variants. INTERPRETATION Third doses of either BNT162b2 or mRNA-1273 provide substantial circulating antibody increase 14 days after vaccination. Full-dose mRNA-1273 provides higher antibody levels with an overall similar safety profile for people ≥75 years. FUNDING This trial was funded by the European Commission (Framework Program HORIZON 2020).
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Affiliation(s)
- Julia M Neuhann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany
| | - Jannik Stemler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany
| | - Antonio J Carcas
- Hospital La Paz, Clinical Pharmacology Service, Institute for Health Research (IdiPAZ), Universidad Autónoma de Madrid, Faculty of Medicine, Madrid, Spain
| | - Jesús Frías-Iniesta
- Hospital La Paz, Clinical Pharmacology Service, Institute for Health Research (IdiPAZ), Universidad Autónoma de Madrid, Faculty of Medicine, Madrid, Spain
| | - Murat Akova
- Hacettepe University School of Medicine, Department of Infectious Diseases, Ankara, Turkey
| | - Ullrich Bethe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany
| | - Sarah Heringer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany
| | - Lea Tischmann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany
| | - Marouan Zarrouk
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany
| | - Arnd Cüppers
- University of Cologne, Faculty of Medicine, Clinical Trials Centre Cologne (CTCC Cologne), Gleueler Str. 269, 50935 Cologne, Germany
| | - Jan Grothe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany
| | - Alejandro Garcia Leon
- Centre for Experimental Pathogen Host Research (CEPHR), School of Medicine, University College Dublin (UCD), Ireland
| | - Patrick Mallon
- Centre for Experimental Pathogen Host Research (CEPHR), School of Medicine, University College Dublin (UCD), Ireland
| | - Riya Negi
- Centre for Experimental Pathogen Host Research (CEPHR), School of Medicine, University College Dublin (UCD), Ireland
| | - Colette Gaillard
- Centre for Experimental Pathogen Host Research (CEPHR), School of Medicine, University College Dublin (UCD), Ireland
| | - Gurvin Saini
- Centre for Experimental Pathogen Host Research (CEPHR), School of Medicine, University College Dublin (UCD), Ireland
| | - Christine Lammens
- Laboratory of Medical Microbiology (LMM), Vaccine & Infectious Disease Institute and Biobank Antwerp, University of Antwerp, Belgium
| | - An Hotterbeekx
- Molecular Pathology Group, Laboratory of Cell Biology & Histology and Vaccine & Infectious Disease Institute (CBH), Faculty of Medicine, University of Antwerp, Belgium
| | - Katherine Loens
- Laboratory of Medical Microbiology (LMM), Vaccine & Infectious Disease Institute and Biobank Antwerp, University of Antwerp, Belgium
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology (LMM), Vaccine & Infectious Disease Institute and Biobank Antwerp, University of Antwerp, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology (LMM), Vaccine & Infectious Disease Institute and Biobank Antwerp, University of Antwerp, Belgium
| | - Samir Kumar-Singh
- Molecular Pathology Group, Laboratory of Cell Biology & Histology and Vaccine & Infectious Disease Institute (CBH), Faculty of Medicine, University of Antwerp, Belgium
| | - Franz König
- Medical University of Vienna, Center for Medical Data Science, Spitalgasse 23, 1090 Vienna, Austria
| | - Lusine Yeghiazaryan
- Medical University of Vienna, Center for Medical Data Science, Spitalgasse 23, 1090 Vienna, Austria
| | - Martin Posch
- Medical University of Vienna, Center for Medical Data Science, Spitalgasse 23, 1090 Vienna, Austria
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Kerpener Str. 62, 50937 Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department, Herderstr. 52, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, Clinical Trials Centre Cologne (CTCC Cologne), Gleueler Str. 269, 50935 Cologne, Germany.
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Suteja RC, Salim A, Suryanov IPD, Tirtayasa PMW, Duarsa GWK. Immunologic response and seroconversion following third-dose COVID-19 vaccination in solid organ transplant recipients: A meta-analysis. Transpl Immunol 2023; 80:101902. [PMID: 37494981 DOI: 10.1016/j.trim.2023.101902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/11/2023] [Accepted: 07/22/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION The immunogenicity and efficacy of COVID-19 vaccination varied by demographic, including solid organ transplant recipients on immunosuppressive therapy. AIM This purpose of this study is to assess seropositivity and seroconversion in solid-organ transplant recipients before and after third-dose COVID-19 vaccination. METHODS This study is a systematic review and meta-analysis performed using PRISMA guidelines. To analyze clinical and cohort studies reporting immunologic response and seroconversion third-dose vaccination, a systematic search was performed using electronic databases (PubMed, Scopus, Cochrane, Directory of Open Access Journal (DOAJ), and Clinicaltrials.gov). RESULT There were 18 full-text papers that could be analyzed qualitatively and quantitatively. After the third vaccination, the pooled rate seropositivity was 67.00% (95% CI 59.511; 74.047, I2 = 93.82%), and the pooled rate seroconversion was 52.51% (95% CI 44.03; 60.91, I2 = 92.15%). The pooled rate of seroconversion after the mRNA-based booster was 52.380% (95% CI 40.988; 63.649, I2 = 94.35%), and after the viral-vector-based booster was 42.478% (95% CI 35.222; 49.900, I2 = 0.00%). CONCLUSION Based on the analysis of immunologic responses and seroconversion findings, the third-dose vaccination of solid organ transplant recipients is an effective method in establishing better immunity against COVID-19.
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Affiliation(s)
| | - Albert Salim
- Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | | | - Pande Made Wisnu Tirtayasa
- Department of Urology, Faculty of Medicine, Universitas Udayana, Universitas Udayana Teaching Hospital, Bali, Indonesia.
| | - Gede Wirya Kusuma Duarsa
- Department of Urology, Faculty of Medicine, Universitas Udayana, Prof. Dr. I.G.N.G Ngoerah General Hospital, Bali, Indonesia
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Yamamoto S, Matsuda K, Maeda K, Horii K, Okudera K, Oshiro Y, Inamura N, Takeuchi JS, Konishi M, Ozeki M, Mizoue T, Sugiyama H, Aoyanagi N, Mitsuya H, Sugiura W, Ohmagari N. Neutralizing antibodies after three doses of the BNT162b2 vaccine, breakthrough infection, and symptoms during the Omicron-predominant wave. Int J Infect Dis 2023; 128:347-354. [PMID: 36693493 PMCID: PMC9867771 DOI: 10.1016/j.ijid.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To investigate the role of immunogenicity after the third vaccine dose against Omicron infection and COVID-19-compatible symptoms of infection. METHODS First, we examined vaccine effectiveness (VE) of the third dose against the second dose during the Omicron wave among the staff at a tertiary hospital in Tokyo. In a case-control study of third vaccine recipients, we compared the preinfection live-virus neutralizing antibodies (NAb) against Omicron between breakthrough cases and their controls who had close contact with patients with COVID-19. Among these cases, we examined the association between NAb levels and the number of COVID-19-compatible symptoms. RESULTS Among the 1456 participants for VE analysis, 60 breakthrough infections occurred during the Omicron wave. The third dose VE for infection was 54.6%. Among the third dose recipients, NAb levels against Omicron did not differ between the cases (n = 22) and controls (n = 21). Among the cases, those who experienced COVID-19-compatible symptoms had lower NAb levels against Omicron than those who did not. CONCLUSION The third vaccine dose was effective in decreasing the risk of SARS-CoV-2 infection during Omicron wave compared with the second dose. Among third dose recipients, higher preinfection NAb levels may not be associated with a lower risk of Omicron infection. Contrarily, they may be associated with fewer symptoms of infection.
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Affiliation(s)
- Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Kouki Matsuda
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Kumi Horii
- Infection Control Office, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Kaori Okudera
- Infection Control Office, Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Yusuke Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Natsumi Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Junko S Takeuchi
- Department of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuru Ozeki
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Haruhito Sugiyama
- Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Nobuyoshi Aoyanagi
- Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Gressens SB, Wiedemann A, Déchenaud M, Dupuis J, Gallien S, Melica G, Haioun C, Lemonnier F, Levy Y. Anti-SARS-CoV-2 cellular response after 2 and 3 doses of BNT162b2 mRNA vaccine in lymphoma patients receiving anti-CD20 antibodies. Vaccine 2023; 41:1550-1553. [PMID: 36737320 PMCID: PMC9884622 DOI: 10.1016/j.vaccine.2023.01.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/28/2022] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
Patients receiving anti-CD20 antibodies showed limited efficacy of a booster dose of BNT162b2. Patients with lymphomas combine such immunotherapies with cytotoxic chemotherapies that could result in an even greater alteration of the immune response to vaccination. We report here the impact of a third vaccine dose on T cell specific responses in a small cohort of patients treated in our center by anti-CD20 therapies and cytotoxic chemotherapies for lymphoid malignancies. Our results showed that a third dose in these severely immune suppressed patients could improve the expansion on CD4+Th1+T cell responses while the effect CD8 + T cell responses was marginal.
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Affiliation(s)
- Simon B Gressens
- Infectious Diseases and Immunology Department, Hôpital Universitaire Henri Mondor, Assistance Publique Hôpitaux de Paris - Université Paris Est Créteil, France.
| | - Aurélie Wiedemann
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France
| | - Marie Déchenaud
- Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - Jehan Dupuis
- IAP-HP, Groupe hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, F-94010 Créteil, France
| | - Sébastien Gallien
- Infectious Diseases and Immunology Department, Hôpital Universitaire Henri Mondor, Assistance Publique Hôpitaux de Paris - Université Paris Est Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France
| | - Giovanna Melica
- Infectious Diseases and Immunology Department, Hôpital Universitaire Henri Mondor, Assistance Publique Hôpitaux de Paris - Université Paris Est Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France.
| | - Corinne Haioun
- IAP-HP, Groupe hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, F-94010 Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France
| | - François Lemonnier
- IAP-HP, Groupe hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, F-94010 Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France
| | - Yves Levy
- Infectious Diseases and Immunology Department, Hôpital Universitaire Henri Mondor, Assistance Publique Hôpitaux de Paris - Université Paris Est Créteil, France; Vaccine Research Institute, Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France.
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7
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Uwamino Y, Yokoyama T, Sato Y, Shibata A, Kurafuji T, Tanabe A, Noguchi M, Arai T, Ohno A, Yokota H, Namkoong H, Nishimura T, Kosaki K, Hasegawa N, Wakui M, Murata M, Matsushita H. Humoral and cellular immune response dynamics in Japanese healthcare workers up to six months after receiving a third dose of BNT162b2 monovalent vaccine. Vaccine 2023; 41:1545-1549. [PMID: 36732167 PMCID: PMC9887493 DOI: 10.1016/j.vaccine.2023.01.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/15/2023] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
Longitudinal data on the immune response from the first dose to several months after the third dose of COVID-19 vaccine are limited. We analyzed the immune response in 406 Japanese healthcare workers who received at least three doses of vaccine. The geometric mean anti-receptor binding domain IgG antibody titers and antigen-stimulated T-cell interferon-gamma levels after 6 months after receiving a third dose were similar to those 8 weeks after receiving a second dose. Humoral and cellular immunity induced by the third dose was more durable than that induced by the second dose. UMIN Clinical Trials Registry ID: UMIN000043340.
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Affiliation(s)
- Yoshifumi Uwamino
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Takashi Yokoyama
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yasunori Sato
- Department of Public Health and Preventive Medicine, Keio University School of Medicine, Japan
| | - Ayako Shibata
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toshinobu Kurafuji
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akiko Tanabe
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masayo Noguchi
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tomoko Arai
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akemi Ohno
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hiromitsu Yokota
- Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tomoyasu Nishimura
- Keio University Health Center, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kenjiro Kosaki
- Center for Clinical Genetics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masatoshi Wakui
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Clinical Research Center for Medicine, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo 107-8402, Japan
| | - Hiromichi Matsushita
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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8
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Chuang CH, Huang CG, Huang CT, Chen YC, Kung YA, Chen CJ, Chuang TC, Liu CC, Huang PW, Yang SL, Gu PW, Shih SR, Chiu CH. Titers and breadth of neutralizing antibodies against SARS-CoV-2 variants after heterologous booster vaccination in health care workers primed with two doses of ChAdOx1 nCov-19: A single-blinded, randomized clinical trial. J Clin Virol 2022; 157:105328. [PMID: 36399969 PMCID: PMC9651991 DOI: 10.1016/j.jcv.2022.105328] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/27/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES We conducted a single-blinded, randomized trial to evaluate the safety, reactogenicity, and immunogenicity of heterologous booster vaccination in health care workers (HCW) who had received two doses of ChAdOx1 nCov-19. METHODS HCW who had at least 90 days after the second dose were enrolled to receive one of the four vaccines: BNT162b2 (30 μg), half-dose mRNA-1273 (50 μg), mRNA-1273 (100 μg), and MVC-COV1901 (15 μg). The primary outcomes were humoral and cellular immunogenicity and secondary outcomes assessed safety and reactogenicity at 28 days post-booster. RESULTS MVC-COV1901 Three hundred and forty HCW were enrolled: 83 received BNT162b2 (2 excluded), 85 half-dose mRNA-1273, 85 mRNA-1273, and 85 MVC-COV1901. mRNA vaccines had more reactogenicity than protein vaccine. The fold-rise of anti-spike IgG geometric mean titer was 8.4 (95% CI 6.8-10.4) for MVC-COV1901, 32.2 (27.2-38.1) for BNT162b2, 47.6 (40.8-55.6) for half-dose mRNA-1273 and 63.2 (53.6-74.6) for mRNA-1273. The live virus microneutralization assays (LVMNA) against the wild type, alpha and delta variants were consistent with anti-spike IgG for all booster vaccines. The LVMNA in the four groups against omicron BA.1 variant were 6.4 to 13.5 times lower than those against the wild type. All booster vaccines induced a comparable T cell response. CONCLUSIONS Third dose booster not only increases neutralizing antibody titer but also enhances antibody breadth against SARS-CoV-2 variants. mRNA vaccines are preferred booster vaccines for those who received primary series of ChAdOx1 nCov-19.
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Affiliation(s)
- Chih-Hsien Chuang
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Department of Pediatrics, St. Paul's Hospital, Taoyuan, Taiwan,School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Chung-Guei Huang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Tai Huang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ching Chen
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-An Kung
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Jung Chen
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzu-Chun Chuang
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Chi Liu
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Po-Wei Huang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Li Yang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Po-Wen Gu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shin-Ru Shih
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan,Corresponding author at: Department of Pediatrics, Chang Gung Memorial Hospital, No.5, Fu-Hsin Street, Kweishan 333, Taoyuan, Taiwan
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9
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Lee LYW, Ionescu MC, Starkey T, Little M, Tilby M, Tripathy AR, Mckenzie HS, Al-Hajji Y, Appanna N, Barnard M, Benny L, Burnett A, Cattell EL, Clark JJ, Khan S, Ghafoor Q, Panneerselvam H, Illsley G, Harper-Wynne C, Hattersley RJ, Lee AJ, Lomas O, Liu JK, McCauley A, Pang M, Pascoe JS, Platt JR, Patel G, Patel V, Potter VA, Randle A, Rigg AS, Robinson TM, Roques TW, Roux RL, Rozmanowski S, Taylor H, Tuthill MH, Watts I, Williams S, Beggs A, Iveson T, Lee SM, Middleton G, Middleton M, Protheroe A, Fittall MW, Fowler T, Johnson P. COVID-19: Third dose booster vaccine effectiveness against breakthrough coronavirus infection, hospitalisations and death in patients with cancer: A population-based study. Eur J Cancer 2022; 175:1-10. [PMID: 36084618 PMCID: PMC9276646 DOI: 10.1016/j.ejca.2022.06.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE People living with cancer and haematological malignancies are at an increased risk of hospitalisation and death following infection with acute respiratory syndrome coronavirus 2. Coronavirus third dose vaccine boosters are proposed to boost waning immune responses in immunocompromised individuals and increase coronavirus protection; however, their effectiveness has not yet been systematically evaluated. METHODS This study is a population-scale real-world evaluation of the United Kingdom's third dose vaccine booster programme for cancer patients from 8th December 2020 to 7th December 2021. The cancer cohort comprises individuals from Public Health England's national cancer dataset, excluding individuals less than 18 years. A test-negative case-control design was used to assess the third dose booster vaccine effectiveness. Multivariable logistic regression models were fitted to compare risk in the cancer cohort relative to the general population. RESULTS The cancer cohort comprised of 2,258,553 tests from 361,098 individuals. Third dose boosters were evaluated by reference to 87,039,743 polymerase chain reaction coronavirus tests. Vaccine effectiveness against breakthrough infections, symptomatic infections, coronavirus hospitalisation and death in cancer patients were 59.1%, 62.8%, 80.5% and 94.5%, respectively. Lower vaccine effectiveness was associated with a cancer diagnosis within 12 months, lymphoma, recent systemic anti-cancer therapy (SACT) or radiotherapy. Patients with lymphoma had low levels of protection from symptomatic disease. In spite of third dose boosters, following multivariable adjustment, individuals with cancer remain at an increased risk of coronavirus hospitalisation and death compared to the population control (OR 3.38, 3.01, respectively. p < 0.001 for both). CONCLUSIONS Third dose boosters are effective for most individuals with cancer, increasing protection from coronavirus. However, their effectiveness is heterogenous and lower than the general population. Many patients with cancer will remain at the increased risk of coronavirus infections even after 3 doses. In the case of patients with lymphoma, there is a particularly strong disparity of vaccine effectiveness against breakthrough infection and severe disease. Breakthrough infections will disrupt cancer care and treatment with potentially adverse consequences on survival outcomes. The data support the role of vaccine boosters in preventing severe disease, and further pharmacological intervention to prevent transmission and aid viral clearance to limit the disruption of cancer care as the delivery of care continues to evolve during the coronavirus pandemic.
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Affiliation(s)
- Lennard Y W Lee
- Department of Oncology, University of Oxford; Institute of Cancer and Genomic Sciences, University of Birmingham; Institute of Immunology and Immunotherapy, University of Birmingham.
| | | | - Thomas Starkey
- Institute of Cancer and Genomic Sciences, University of Birmingham
| | - Martin Little
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust
| | - Michael Tilby
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust
| | - Arvind R Tripathy
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust
| | - Hayley S Mckenzie
- Oncology Department, University Hospitals Southampton NHS Foundation Trust
| | | | | | | | | | | | - Emma L Cattell
- Department of Cancer, Taunton and Somerset NHS Foundation Trust
| | - James J Clark
- Department of Surgery and Cancer, Imperial College London
| | - Sam Khan
- Leicester Cancer Research Centre, University of Leicester
| | - Qamar Ghafoor
- University Hospitals Birmingham NHS Foundation Trust
| | | | | | | | | | - Alvin Jx Lee
- UCL Cancer Institute, University College London; University College London Hospitals NHS Trust
| | - Oliver Lomas
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust
| | - Justin Kh Liu
- Leeds Institute of Medical Research at St James's, University of Leeds
| | | | | | - Jennifer S Pascoe
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust
| | - James R Platt
- Leeds Institute of Medical Research at St James's, University of Leeds
| | - Grisma Patel
- Cancer Division, UCL Cancer Institute, University College London
| | | | - Vanessa A Potter
- Department of Oncology, University Hospital Coventry and Warwickshire
| | | | - Anne S Rigg
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust
| | | | - Tom W Roques
- Cancer Services, Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - René L Roux
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust
| | | | | | - Mark H Tuthill
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust
| | | | - Sarah Williams
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust
| | - Andrew Beggs
- Institute of Cancer and Genomic Sciences, University of Birmingham
| | - Tim Iveson
- Cancer Sciences, University of Southampton
| | - Siow M Lee
- UCL Cancer Institute, University College London; University College London Hospitals NHS Trust; CRUK Lung Cancer Centre of Excellence, University College London
| | - Gary Middleton
- Institute of Immunology and Immunotherapy, University of Birmingham; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust
| | | | - Andrew Protheroe
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust
| | | | | | - Peter Johnson
- Department of Oncology, University Hospital Coventry and Warwickshire; Cancer Sciences, University of Southampton
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10
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Perrier Q, Lupo J, Gerster T, Augier C, Falque L, Rostaing L, Pelletier L, Bedouch P, Blanc M, Saint-Raymond C, Boignard A, Bonadona A, Noble J, Epaulard O. SARS-CoV-2 anti-spike antibodies after a fourth dose of COVID-19 vaccine in adult solid-organ transplant recipients. Vaccine 2022; 40:6404-6411. [PMID: 36184404 PMCID: PMC9444490 DOI: 10.1016/j.vaccine.2022.08.065] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/16/2022] [Accepted: 08/28/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND A fourth dose of SARS-CoV-2 vaccine is recommended in solid-organ transplant (SOT) recipients, but the immunogenicity is poorly known. METHODS We conducted a retrospective, observational, monocentric study between the 1st January 2021 and 31st March 2022 of the anti-Spike antibody titers after one to four doses of vaccine in SOT. RESULTS 825 SOT were included. Median age at first vaccine injection was 61.2 (IQR 50.9-69.3) years; 66.7 % were male; 63.4 % had received four vaccine doses. The proportion of participants with a strong humoral response (>260 BAU/mL) increased with the number of vaccine doses: 10.6 % after the 1st dose (D1), 35.1 % after the 2nd (D2), 48.5 % after the 3rd (D3), and 65.1 % after the 4th (D4) (p < 0.001). Among the tested patients, the proportion with a detectable humoral response was significantly higher after D4 than after D3 (47 % vs 22 %, p = 0.01). Liver transplant recipients had more frequently a strong humoral response after D2, D3 and D4 (OR = 5.3, 3.7 and 6.6 respectively when compared with other organ transplant recipients, p < 0.001). In kidney transplant recipients, belatacept-containing regimen was associated with a lower rate of detectable humoral (9 % vs 40 %, p = 0.025) after D3, but there was no statistical difference after D4. CONCLUSION A fourth dose should be proposed to SOT recipients who did not developed an immune response after 3 doses. Kidney transplant recipients receiving belatacept have a poorer, although frequently detectable response.
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Affiliation(s)
- Quentin Perrier
- Pharmacy Department, Grenoble Alpes University Hospital and Univ. Grenoble Alpes, Laboratory of Fundamental and Applied Bioenergetic (LBFA), INSERM U1055, Grenoble, France
| | - Julien Lupo
- Virology Laboratory, Grenoble Alpes University Hospital and Univ. Grenoble Alpes, Institut de Biologie Structurale (IBS), CEA, CNRS, Grenoble, France
| | - Théophile Gerster
- Hepatogastroenterology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Caroline Augier
- Cardiology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Loïc Falque
- Pneumology and Physiology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Lionel Rostaing
- Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, Grenoble Alpes University Hospital and Univ. Grenoble Alpes, Grenoble, France
| | - Laurent Pelletier
- Virology Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Pierrick Bedouch
- Pharmacy Department, Grenoble Alpes University Hospital and Univ. Grenoble Alpes, CNRS, TIMC-IMAG, Grenoble, France
| | - Myriam Blanc
- Infectious Diseases Department, Grenoble Alpes University Hospital and Univ. Grenoble Alpes, Groupe de Recherche en Infectiologie Clinique, CIC-1406, INSERM, Grenoble, France
| | - Christel Saint-Raymond
- Pneumology and Physiology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Aude Boignard
- Cardiology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Agnès Bonadona
- Hepatogastroenterology Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Johan Noble
- Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, Grenoble Alpes University Hospital and Univ. Grenoble Alpes, Grenoble, France
| | - Olivier Epaulard
- Infectious Diseases Department, Grenoble Alpes University Hospital and Univ. Grenoble Alpes, Groupe de Recherche en Infectiologie Clinique, CIC-1406, INSERM, Grenoble, France,Corresponding author at: Service des maladie infectieuses, CHU Grenoble Alpes, France
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11
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Moussaoui ME, Desmecht S, Tashkeev A, Lambert N, Maes N, Braghini J, Marechal N, Quintana C, Briquet K, Gofflot S, Toussaint F, Hayette MP, Vermeersch P, Lutteri L, Grégoire C, Beguin Y, Rahmouni S, Moutschen M, Desmecht D, Darcis G. Reduced T-cell response following a third dose of SARS-CoV-2 vaccine in infection-naïve people living with HIV. J Infect 2022; 85:702-769. [PMID: 36096313 PMCID: PMC9458764 DOI: 10.1016/j.jinf.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium.
| | - Salomé Desmecht
- Laboratory of Animal Genomics, GIGA-Medical Genomics. GIGA-Institute, University of Liege, Belgium
| | - Aleksandr Tashkeev
- Laboratory of Animal Genomics, GIGA-Medical Genomics. GIGA-Institute, University of Liege, Belgium
| | - Nicolas Lambert
- Department of Neurology, University Hospital of Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Belgium
| | - Joachim Braghini
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Nicole Marechal
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Céline Quintana
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Karine Briquet
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Stéphanie Gofflot
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, Belgium
| | | | | | - Pieter Vermeersch
- Department of Laboratory Medicine, University Hospital of Leuven, Leuven, Belgium
| | - Laurence Lutteri
- Department of Clinical Chemistry, University Hospital of Liège, Belgium
| | - Céline Grégoire
- Department of Haematology, University Hospital of Liège, University of Liège, Belgium
| | - Yves Beguin
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, Belgium; Department of Haematology, University Hospital of Liège, University of Liège, Belgium
| | - Souad Rahmouni
- Laboratory of Animal Genomics, GIGA-Medical Genomics. GIGA-Institute, University of Liege, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Daniel Desmecht
- Department of Animal Pathology, Fundamental and Applied Research for Animals and Health, University of Liège, Liège 4000, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
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12
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Shaul AA, Itzhaki Ben Zadok O, Ben-Avraham B, Yaari V, Barsheshet A, Levi A, Ben Zvi H, Eliakim Raz N, Abed G, Abuhazira M, Abu Akel M, Mats I, Barac YD, Aravot D, Kornowski R, Ben-Gal T. Improved immunogenicity following the third dose of BNT162b2 mRNA vaccine in heart transplant recipients. Eur J Cardiothorac Surg 2022; 62:ezac145. [PMID: 35244690 PMCID: PMC9383557 DOI: 10.1093/ejcts/ezac145] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/06/2022] [Accepted: 02/21/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The immunogenicity of two-dose severe acute respiratory syndrome coronavirus 2 vaccine is lower among heart transplant (HTx) recipients, compared with the general population. Our aim was to assess the immunogenicity of a third-dose vaccine in HTx recipients. METHODS This is a prospective cohort study of HTx recipients who received a third dose of the BNT162b2 vaccine. Immunogenicity was assessed by serum levels of anti-spike immunoglobulin G (S-IgG), taken at baseline and 14-28 days after the third dose. Titres above 50 U/ml were interpreted positive. RESULTS We Included 42 HTx recipients at a median age of 65 years [interquartile range (IQR) 58-70]. At baseline, the median of 27 days (IQR 13-42) before the third dose and the median titre of the whole group was 18 U/ml (IQR 4-130). Only 14 patients (33%) were S-IgG seropositive. After the third dose, the proportion of seropositive patients increased significantly to 57% (P = 0.05) and the median titre increased significantly to 633 U/ml (IQR 7-6104, P < 0.0001). Younger age at HTx (OR per 1-year decrease 1.07, P = 0.05), low tacrolimus serum level (OR per 1-unit decrease 2.28, P = 0.02), mammalian target of rapamycin use (OR 13.3, P = 0.003), lack of oral steroids use (OR 4.17, P = 0.04) and lack of calcineurin inhibitor use (71% of responders vs 100% non-responders received calcineurin inhibitors, P = 0.01) were predictors of seropositive result after the third dose. However, no significant association was detected following adjustment for baseline S-IgG titre. CONCLUSIONS Third-dose booster of BNT162b2 vaccine significantly increased immunogenicity among HTx recipients who previously received a two-dose vaccine.
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Affiliation(s)
- Aviv Avraham Shaul
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Osnat Itzhaki Ben Zadok
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Binyamin Ben-Avraham
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Vicky Yaari
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Barsheshet
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amos Levi
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Ben Zvi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Microbiology Laboratory, Rabin Medical Center, Petach Tikva, Israel
| | - Noa Eliakim Raz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases, Rabin Medical Center, Petach Tikva, Israel
| | - Galia Abed
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
| | - Miriam Abuhazira
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Cardio-Thoracic Surgery, Rabin Medical Center, Petach Tikva, Israel
| | - Mahmood Abu Akel
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Israel Mats
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaron D Barac
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Cardio-Thoracic Surgery, Rabin Medical Center, Petach Tikva, Israel
| | - Dan Aravot
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Cardio-Thoracic Surgery, Rabin Medical Center, Petach Tikva, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tuvia Ben-Gal
- Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Margioris AN. Immunosuppressed non-responders to two doses of mRNA SARS-CoV-2 vaccines achieve an immune response comparable to those of immunocompetent individuals after a third dose. Hormones (Athens) 2022; 21:369-373. [PMID: 35750960 PMCID: PMC9244320 DOI: 10.1007/s42000-022-00365-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/05/2022] [Indexed: 01/06/2023]
Abstract
The SARS-CoV-2 vaccines trigger the production of neutralizing antibodies to the SARS-CoV-2 spike (S) protein and induce a T cell-mediated immune response. However, the antibody titers that confer protection against the SARS-CoV-2 virus are currently not well-established. While immunocompetent individuals achieve a high level of immune response after SARS-CoV-2 vaccination, it now appears that a high proportion of immunosuppressed or immunocompromised, patients exhibit low or no response to two doses of the vaccines. Most non-responders are on treatment with either glucocorticoids, mycophenolate-mofetil (MMF), the anti-CD20 monoclonal antibody rituximab, calcineurin inhibitors like cyclosporine and tacrolimus, rapamycin (mTOR) signaling cascade inhibitors (i.e., sirolimus and everolimus), azathioprine, or methotrexate given for a variety of diseases including autoimmune disorders, hematological malignancies, and solid cancers, while recipients of solid organ transplants also fall within this category. Recently, several published reports have suggested that a third dose of these vaccines induces an elevated antibody response against the SARS-CoV-2 S protein.
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14
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Kanokudom S, Assawakosri S, Suntronwong N, Chansaenroj J, Auphimai C, Nilyanimit P, Vichaiwattana P, Thongmee T, Yorsaeng R, Duangchinda T, Chantima W, Pakchotanon P, Srimuan D, Thatsanatorn T, Klinfueng S, Mongkolsapaya J, Sudhinaraset N, Wanlapakorn N, Honsawek S, Poovorawan Y. Comparison of the reactogenicity and immunogenicity of a reduced and standard booster dose of the mRNA COVID-19 vaccine in healthy adults after two doses of inactivated vaccine. Vaccine 2022; 40:5657-5663. [PMID: 36031500 PMCID: PMC9393164 DOI: 10.1016/j.vaccine.2022.08.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/07/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has been a serious healthcare problem worldwide since December 2019. The third dose of heterologous vaccine was recently approved by World Health Organization. The present study compared the reactogenicity and immunogenicity of the reduced and standard third booster dose of the BNT162b2 and mRNA-1273 vaccine in adults who previously received the two-dose CoronaVac vaccine. Results showed that headache, joint pain, and diarrhea were more frequent in the 15 μg- than the 30 μg-BNT162b2 groups, whereas joint pain and chilling were more frequent in the 100 μg- than the 50 μg-mRNA-1273 groups. No significant differences in immunogenicity were detected. These findings demonstrate that the reduced dose of the mRNA vaccines elicited antibody responses against the SARS-CoV-2 delta and omicron variants that were comparable to the standard dose. The reduced dose could be used to increase vaccine coverage in situations of limited global vaccine supply.
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Affiliation(s)
- Sitthichai Kanokudom
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Center of Excellence in Osteoarthritis and Musculoskeleton, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Suvichada Assawakosri
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Center of Excellence in Osteoarthritis and Musculoskeleton, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Nungruthai Suntronwong
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Jira Chansaenroj
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chompoonut Auphimai
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Pornjarim Nilyanimit
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Preeyaporn Vichaiwattana
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Thanunrat Thongmee
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Ritthideach Yorsaeng
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Thaneeya Duangchinda
- Molecular Biology of Dengue and Flaviviruses Research Team, National Center for Genetic Engineering and Biotechnology, National Science and Development Agency, NSTDA, Pathum Thani 12120, Thailand
| | - Warangkana Chantima
- Division of Dengue Hemorrhagic Fever Research, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Siriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pattarakul Pakchotanon
- Molecular Biology of Dengue and Flaviviruses Research Team, National Center for Genetic Engineering and Biotechnology, National Science and Development Agency, NSTDA, Pathum Thani 12120, Thailand
| | - Donchida Srimuan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Thaksaporn Thatsanatorn
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Sirapa Klinfueng
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Juthathip Mongkolsapaya
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK; Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
| | - Natthinee Sudhinaraset
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Sittisak Honsawek
- Center of Excellence in Osteoarthritis and Musculoskeleton, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; The Royal Society of Thailand (FRS(T)), Sanam Sueapa, Dusit, Bangkok 10330, Thailand.
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15
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Agur T, Zingerman B, Ben-Dor N, Alkeesh W, Steinmetz T, Rachamimov R, Korzets A, Rozen-Zvi B, Herman-Edelstein M. Humoral Response to the Third Dose of BNT162b2 COVID-19 Vaccine among Hemodialysis Patients. Nephron Clin Pract 2022; 147:185-192. [PMID: 35896080 PMCID: PMC9747736 DOI: 10.1159/000525519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hemodialysis patients are at high risk for severe COVID-19 disease. Despite a high early seropositivity rate, dialysis patients mount a dampened immune response following two doses of an mRNA vaccine. This study aimed to evaluate the serologic response to a booster dose of BNT162b2 vaccine, 6 months after the second dose, among hemodialysis patients. METHODS This prospective study included 80 hemodialysis patients and 56 healthcare workers serving as controls. Serologic samples were evaluated before and ∼3 weeks after the third vaccine dose. The primary outcomes were the seropositivity rate and the log-transformed anti-SARS-COV-2 S1 (RBD) IgG as a continuous variable after the third dose. Secondary outcomes were the proportion of participants with "high response," defined as antibody levels >1,000 AU/mL, and "robust response," defined as antibody levels >4,160 AU/mL, according to prespecified cutoff values associated with neutralizing antibodies. Univariate and multivariate analyses were conducted to identify predictors of antibody response. RESULTS Among 80 hemodialysis patients, seropositivity rates improved from 78% (62/80) before the third dose, up to 96% (77/80) after the booster dose. The S1-RBD log-transformed antibody level increased significantly following the third dose from 2.15 ± 0.75 to 3.99 ± 0.83 compared with 2.65 ± 0.4 to 4.31 ± 0.42 in the control group. Among the hemodialysis patients, 88% (70/80) became "high responders" (>1,000 AU/mL), and of these, 79% (63/80) mounted a "robust response" (>4,160 AU/mL). Baseline antibody level, dialysis therapy, and hypoalbuminemia were independent predictors of impaired antibody response. CONCLUSIONS A third dose of BNT162b2 COVID-19 vaccine, 6 months after the standard two-dose vaccination regimen, substantially improved humoral response in hemodialysis patients.
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Affiliation(s)
- Timna Agur
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Boris Zingerman
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Ben-Dor
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Weaam Alkeesh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Internal Medicine B, Rabin Medical Center, Hasharon Hospital, Petah-Tikva, Israel
| | - Tali Steinmetz
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ruth Rachamimov
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asher Korzets
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Benaya Rozen-Zvi
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Herman-Edelstein
- Department of Nephrology and Hypertension, Rabin Medical Center, Petah-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Gressens SB, Fourati S, Le Bouter A, Le Bras F, Dupuis J, Hammoud M, El Gnaoui T, Gounot R, Roulin L, Belhadj K, Haioun C, Gallien S, Melica G, Lemonnier F. Anti-SARS-CoV-2 antibody response after 2 and 3 doses of BNT162b2 mRNA vaccine in patients with lymphoid malignancies. Clin Microbiol Infect 2022; 28:885.e7-885.e11. [PMID: 35259530 PMCID: PMC8897197 DOI: 10.1016/j.cmi.2022.02.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/10/2022] [Accepted: 02/19/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES COVID-19 patients affected by haematological malignancies have a more severe course of the disease and higher mortality, prompting for effective prophylaxis. The present study aims to evaluate the humoral response after mRNA vaccination as well as the impact of a third vaccine dose in patients with lymphoid malignancies. METHODS We conducted a single-centre study, evaluating the serological responses of mRNA vaccination amongst a cohort of 200 patients affected by lymphoid malignancies after two or three doses using an industrial SARS-CoV-2 serology assay for anti-receptor binding domain (RBD) Spike IgG detection and quantification. RESULTS Among patients with plasma cell disorders, 59 of 96 (61%) had seroconversion (anti-RBD >50 AU/mL), and recent anti-CD38 therapies were associated with lower serological anti-RBD IgG concentrations (median IgG concentration 137 (IQR 0-512) AU/mL vs. 543 (IQR 35-3496) AU/mL; p < 0.001). Patients with B-cell malignancies had a lower seroconversion rate (20/84, 24%) mainly due to the broad usage of anti-CD20 monoclonal antibodies; only 2 of 53 (4%) patients treated by anti-CD20 antibodies during the last 12 months experienced a seroconversion. A total of 78 patients (44 with plasma cell disorders, 27 with B-cell malignancies, and 7 with other lymphomas) received a third dose of vaccine. The seroconversion rate and antibody concentrations increased significantly, especially in patients with plasma cell disorders, where an increment of anti-RBD IgG concentrations was observed in 31 of 44 (70%) patients, with an anti-RBD concentration median-fold increase of 10.6 (IQR 2.4-25.5). Its benefit in B-cell malignancies is uncertain, with only 2 of 25 (8%) patients having seroconverted after the vaccine booster, without increased median antibody concentration. DISCUSSION A third mRNA vaccine dose significantly improved humoral responses among patients with plasma cell disorders, whereas the effect was limited among patients with B-cell malignancies.
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Affiliation(s)
- Simon B Gressens
- Infectious Diseases and Immunology Department, Hôpital Universitaire Henri Mondor, Assistance Publique Hôpitaux de Paris - Université Paris Est Créteil, Créteil, France.
| | - Slim Fourati
- Virology Unit, Department of Prevention, Diagnosis and Treatment of Infections, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France
| | - Anne Le Bouter
- Virology Unit, Department of Prevention, Diagnosis and Treatment of Infections, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France
| | - Fabien Le Bras
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Jehan Dupuis
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Mohammad Hammoud
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Taoufik El Gnaoui
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Romain Gounot
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Louise Roulin
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Karim Belhadj
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Corinne Haioun
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France
| | - Sébastien Gallien
- Infectious Diseases and Immunology Department, Hôpital Universitaire Henri Mondor, Assistance Publique Hôpitaux de Paris - Université Paris Est Créteil, Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, Créteil, France
| | - Giovanna Melica
- Infectious Diseases and Immunology Department, Hôpital Universitaire Henri Mondor, Assistance Publique Hôpitaux de Paris - Université Paris Est Créteil, Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, Créteil, France.
| | - François Lemonnier
- AP-HP, Groupe Hospitalo-universitaire Chenevier Mondor, Service Unité Hémopathies Lymphoides, Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, Créteil, France.
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17
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Liu X, Munro APS, Feng S, Janani L, Aley PK, Babbage G, Baxter D, Bula M, Cathie K, Chatterjee K, Dejnirattisai W, Dodd K, Enever Y, Qureshi E, Goodman AL, Green CA, Harndahl L, Haughney J, Hicks A, van der Klaauw AA, Kwok J, Libri V, Llewelyn MJ, McGregor AC, Minassian AM, Moore P, Mughal M, Mujadidi YF, Holliday K, Osanlou O, Osanlou R, Owens DR, Pacurar M, Palfreeman A, Pan D, Rampling T, Regan K, Saich S, Serafimova T, Saralaya D, Screaton GR, Sharma S, Sheridan R, Sturdy A, Supasa P, Thomson EC, Todd S, Twelves C, Read RC, Charlton S, Hallis B, Ramsay M, Andrews N, Lambe T, Nguyen-Van-Tam JS, Cornelius V, Snape MD, Faust SN. Persistence of immunogenicity after seven COVID-19 vaccines given as third dose boosters following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK: Three month analyses of the COV-BOOST trial. J Infect 2022; 84:795-813. [PMID: 35405168 PMCID: PMC8993491 DOI: 10.1016/j.jinf.2022.04.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To evaluate the persistence of immunogenicity three months after third dose boosters. METHODS COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of seven COVID-19 vaccines used as a third booster dose. The analysis was conducted using all randomised participants who were SARS-CoV-2 naïve during the study. RESULTS Amongst the 2883 participants randomised, there were 2422 SARS-CoV-2 naïve participants until D84 visit included in the analysis with median age of 70 (IQR: 30-94) years. In the participants who had two initial doses of ChAdOx1 nCov-19 (Oxford-AstraZeneca; hereafter referred to as ChAd), schedules using mRNA vaccines as third dose have the highest anti-spike IgG at D84 (e.g. geometric mean concentration of 8674 ELU/ml (95% CI: 7461-10,085) following ChAd/ChAd/BNT162b2 (Pfizer-BioNtech, hearafter referred to as BNT)). However, in people who had two initial doses of BNT there was no significant difference at D84 in people given ChAd versus BNT (geometric mean ratio (GMR) of 0.95 (95%CI: 0.78, 1.15). Also, people given Ad26.COV2.S (Janssen; hereafter referred to as Ad26) as a third dose had significantly higher anti-spike IgG at D84 than BNT (GMR of 1.20, 95%CI: 1.01,1.43). Responses at D84 between people who received BNT (15 μg) or BNT (30 μg) after ChAd/ChAd or BNT/BNT were similar, with anti-spike IgG GMRs of half-BNT (15 μg) versus BNT (30 μg) ranging between 0.74-0.86. The decay rate of cellular responses were similar between all the vaccine schedules and doses. CONCLUSIONS 84 days after a third dose of COVID-19 vaccine the decay rates of humoral response were different between vaccines. Adenoviral vector vaccine anti-spike IgG concentrations at D84 following BNT/BNT initial doses were similar to or even higher than for a three dose (BNT/BNT/BNT) schedule. Half dose BNT immune responses were similar to full dose responses. While high antibody tires are desirable in situations of high transmission of new variants of concern, the maintenance of immune responses that confer long-lasting protection against severe disease or death is also of critical importance. Policymakers may also consider adenoviral vector, fractional dose of mRNA, or other non-mRNA vaccines as third doses.
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Affiliation(s)
- Xinxue Liu
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
| | - Alasdair P S Munro
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Shuo Feng
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - Leila Janani
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Parvinder K Aley
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Gavin Babbage
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Marcin Bula
- NIHR Liverpool and Broadgreen Clinical Research Facility, Liverpool, UK
| | - Katrina Cathie
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Krishna Chatterjee
- NIHR Cambridge Clinical Research Facility, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Wanwisa Dejnirattisai
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Kate Dodd
- NIHR Liverpool and Broadgreen Clinical Research Facility, Liverpool, UK
| | | | - Ehsaan Qureshi
- NIHR/Wellcome Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Anna L Goodman
- Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK; MRC Clinical Trials Unit, University College London, London, UK
| | - Christopher A Green
- NIHR/Wellcome Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Linda Harndahl
- Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - John Haughney
- Queen Elizabeth University Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK
| | | | - Agatha A van der Klaauw
- Wellcome-MRC Institute of Metabolic Science, Department of Clinical Biochemistry, University of Cambridge, Cambridge, UK
| | - Jonathan Kwok
- Cancer Research UK Oxford Centre, University of Oxford, Oxford, UK
| | - Vincenzo Libri
- NIHR UCLH Clinical Research Facility and NIHR UCLH Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Alastair C McGregor
- Department of Infectious Diseases and Tropical Medicine, London Northwest University Healthcare, London, UK
| | - Angela M Minassian
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | | | | | - Kyra Holliday
- NIHR Leeds Clinical Research Facility, Leeds Teaching Hospitals Trust and University of Leeds, Leeds, UK
| | - Orod Osanlou
- Public Health Wales, Betsi Cadwaladr University Health Board, Bangor University, Bangor, UK
| | | | - Daniel R Owens
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Mihaela Pacurar
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Adrian Palfreeman
- University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, UK
| | - Daniel Pan
- University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, UK
| | - Tommy Rampling
- NIHR UCLH Clinical Research Facility and NIHR UCLH Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Karen Regan
- Bradford Institute for Health Research and Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Stephen Saich
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Teona Serafimova
- Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Dinesh Saralaya
- Bradford Institute for Health Research and Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Gavin R Screaton
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sunil Sharma
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Ray Sheridan
- Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - Ann Sturdy
- Department of Infectious Diseases and Tropical Medicine, London Northwest University Healthcare, London, UK
| | - Piyada Supasa
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Emma C Thomson
- Queen Elizabeth University Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK; MRC University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Shirley Todd
- Royal Devon and Exeter Hospital NHS Foundation Trust, Exeter, UK
| | - Chris Twelves
- NIHR Leeds Clinical Research Facility, Leeds Teaching Hospitals Trust and University of Leeds, Leeds, UK
| | - Robert C Read
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | | | | | - Mary Ramsay
- UK Health Security Agency, Colindale, London, UK
| | - Nick Andrews
- UK Health Security Agency, Colindale, London, UK
| | - Teresa Lambe
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | | | | | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Saul N Faust
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
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18
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Oster Y, Benenson S, Nir-Paz R, Buda I, Cohen MJ. The effect of a third BNT162b2 vaccine on breakthrough infections in health care workers: a cohort analysis. Clin Microbiol Infect 2022; 28:735.e1-735.e3. [PMID: 35143997 PMCID: PMC8820100 DOI: 10.1016/j.cmi.2022.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES In August 2021, 6 months after mass vaccination of the Israeli population with the two-dose BNT162b2 mRNA vaccine, a surge of coronavirus disease 2019 infections, mostly from the delta variant, appeared also among the vaccinated. In response, the Israeli Ministry of Health initiated a booster (third dose) vaccination program. We assessed the protective effect of the third dose among health care workers (HCWs). METHODS Infections with severe acute respiratory syndrome coronavirus 2 are monitored systematically among HCWs at the Hadassah tertiary care medical centre in Jerusalem, Israel. In this cohort, we included breakthrough infections, defined as those occurring >180 days since the second vaccine dose. The follow-up period lasted 120 days. We compared infection rates between HCWs who received the booster dose and those who received only the two-dose regimen. RESULTS The rate of breakthrough infections among HCWs who received only the two-dose regimen was 21.4% (85 of 398). The rate in the boosted group was 0.7% (35/4973; relative risk 30, 95% CI 20-50). Those results were seen in all age groups. DISCUSSION The significantly lower rate of breakthrough infections in boosted HCWs indicates substantial protection by a third vaccine dose.
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Affiliation(s)
- Yonatan Oster
- The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Shmuel Benenson
- The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ran Nir-Paz
- The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Inon Buda
- General Management, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
| | - Matan J Cohen
- Clalit Health Services, Jerusalem District, Affiliated with the Hebrew University, Jerusalem, Israel
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19
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Tartof SY, Slezak JM, Puzniak L, Hong V, Frankland TB, Ackerson BK, Takhar HS, Ogun OA, Simmons SR, Zamparo JM, Gray S, Valluri SR, Pan K, Jodar L, McLaughlin JM. Effectiveness of a third dose of BNT162b2 mRNA COVID-19 vaccine in a large US health system: A retrospective cohort study. Lancet Reg Health Am 2022; 9:100198. [PMID: 35187521 PMCID: PMC8841530 DOI: 10.1016/j.lana.2022.100198] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Globally, recommendations are expanding for third (booster) doses of BNT162b2 (Pfizer-BioNTech). In the United States, as of November 19, 2021, boosters were recommended for all adults aged 18 years and older. We evaluated the effectiveness of a third dose of BNT162b2 among adults in a large US integrated health system. Methods In this retrospective cohort study, we analyzed electronic health records from Kaiser Permanente Southern California between Dec 14, 2020 and Dec 5, 2021 to assess vaccine effectiveness (VE) of two and three doses of BNT162b2 against SARS-CoV-2 infections (without hospital admission) andCOVID-19-related hospital admission. VE was calculated using hazards ratios from adjusted Cox models. Findings After only two doses, VE against infection declined from 85% (95% CI 83-86) during the first month to 49% (46-51) ≥ 7 months following vaccination. Overall VE against hospitalization was 90% (95% CI 86-92) within one month and did not wane, however, effectiveness against hospitalization appeared to wane among immunocompromised individuals but was not statistically significant (93% [72-98] at 1 month to 74% [45-88] after ≥ 7 months; p=0·490). Three-dose VE (median follow-up 1·3 months [SD 0·6]) was 88% (95% CI 86-89) against infection and 97% (95-98) against hospitalization. Effectiveness after three doses was higher than that seen one month after receiving only two doses for both outcomes. Relative VE of three doses compared to two (with at least six months after the second dose) was 75% (95% CI 71-78) against infections and 70% (48-83) against hospital admissions. Interpretation These data support the benefit of broad BNT162b2 booster recommendations, as three doses confers comparable, if not better, protection against SARS-CoV-2 infections and hospital admission as was seen soon after receiving two doses. Funding Pfizer Inc.
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Affiliation(s)
- Sara Y. Tartof
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
- Corresponding author at: Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA.
| | - Jeff M. Slezak
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | | | - Vennis Hong
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | | | | | - Harpreet S. Takhar
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | - Oluwaseye A. Ogun
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
| | - Sarah R. Simmons
- Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA
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20
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Ripabelli G, Sammarco ML, Rezza G, D'Amico A, De Dona R, Iafigliola M, Parente A, Samprati N, Santagata A, Adesso C, Natale A, Di Palma MA, Cannizzaro F, Dentizzi C, Stefanelli P, Tamburro M. A SARS-CoV-2 Outbreak Among Nursing Home Residents Vaccinated with a Booster Dose of mRNA COVID-19 Vaccine. J Community Health 2022. [PMID: 35334031 DOI: 10.1007/s10900-022-01082-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 10/26/2022]
Abstract
This study describes a SARS-CoV-2 outbreak caused by the Delta (B.1.617.2) variant in a nursing home in Central Italy during October-November 2021. Trained interviewers collected data from residents, staff, and administration officers with an agreed informed consent procedure. Thirty-two (44.5%) out of 72 residents (median age 89 years) and six (26.1%) of 23 healthcare workers were found to be infected with SARS-CoV-2. Infections occurred more often among residents with a higher index of independence in daily living activities, suggesting an increased risk for those with more interactions. Twenty-five infected residents (78.1%) received the booster dose of mRNA anti-COVID-19 vaccine > 7 days before SARS-CoV-2 onset. Half of the infected residents had mild symptoms, and only three required hospitalisation, one of whom died from COVID-19 complications. The study underlines the effectiveness of a booster dose in providing a high protection against severe disease and hospitalisation even among vulnerable individuals infected with the Delta variant of concern.
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21
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Assawakosri S, Kanokudom S, Suntronwong N, Auphimai C, Nilyanimit P, Vichaiwattana P, Thongmee T, Duangchinda T, Chantima W, Pakchotanon P, Srimuan D, Thatsanatorn T, Klinfueng S, Yorsang R, Sudhinaraset N, Wanlapakorn N, Mongkolsapaya J, Honsawek S, Poovorawan Y. Neutralizing Activities against the Omicron Variant after a Heterologous Booster in Healthy Adults Receiving Two Doses of CoronaVac Vaccination. J Infect Dis 2022; 226:1372-1381. [PMID: 35267040 DOI: 10.1093/infdis/jiac092] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/08/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac) against SARS-CoV-2 is implemented worldwide. However, waning immunity and breakthrough infections have been observed. Therefore, we hypothesized that the heterologous booster might improve the protection against the delta and omicron variants. METHODS A total of 224 individuals who completed the two-dose CoronaVac for six months were included. We studied reactogenicity and immunogenicity following a heterologous booster with the inactivated vaccine (BBIBP), the viral vector vaccine (AZD1222), and the mRNA vaccine (both BNT162B2 and mRNA-1273). We also determined immunogenicity at 3- and 6-months boosting intervals. RESULTS The solicited adverse events (AEs) were mild to moderate and well-tolerated. Total RBD immunoglobulin (Ig), anti-RBD IgG, focus reduction neutralization test (FRNT50) against delta and omicron variants, and T-cell response were highest in the mRNA-1273 group followed by the BNT162b2, AZD1222 and BBIBP groups, respectively. We also witnessed a higher total Ig anti-RBD in the long-interval than in the short-interval groups. CONCLUSIONS All four booster vaccines significantly increased binding and neutralizing antibody (NAbs) in individuals immunized with two doses of CoronaVac. The present evidence may benefit vaccine strategies to thwart variants of concern, including the omicron variant.
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Affiliation(s)
- Suvichada Assawakosri
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.,Osteoarthritis and Musculoskeleton Research Unit, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Sitthichai Kanokudom
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.,Osteoarthritis and Musculoskeleton Research Unit, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Nungruthai Suntronwong
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chompoonut Auphimai
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Pornjarim Nilyanimit
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Preeyaporn Vichaiwattana
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thanunrat Thongmee
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thaneeya Duangchinda
- Molecular Biology of Dengue and Flaviviruses Research Team, National Center for Genetic Engineering and Biotechnology, National Science and Development Agency, NSTDA, Pathum Thani 12120, Thailand
| | - Warangkana Chantima
- Division of Dengue Hemorrhagic Fever Research, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.,Siriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pattarakul Pakchotanon
- Molecular Biology of Dengue and Flaviviruses Research Team, National Center for Genetic Engineering and Biotechnology, National Science and Development Agency, NSTDA, Pathum Thani 12120, Thailand
| | - Donchida Srimuan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thaksaporn Thatsanatorn
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Sirapa Klinfueng
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Ritthideach Yorsang
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Natthinee Sudhinaraset
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Juthathip Mongkolsapaya
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK.,Chinese Academy of Medical Science(CAMS) Oxford Institute (COI), University of Oxford, Oxford, U.K
| | - Sittisak Honsawek
- Osteoarthritis and Musculoskeleton Research Unit, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.,FRS, the Royal Society of Thailand, Sanam Sueapa, Dusit, Bangkok 10330, Thailand
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22
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Barrière J, Carles M, Audigier-Valette C, Re D, Adjtoutah Z, Seitz-Polski B, Gounant V, Descamps D, Zalcman G. Third dose of anti-SARS-CoV-2 vaccine for patients with cancer: Should humoral responses be monitored? A position article. Eur J Cancer 2022; 162:182-193. [PMID: 35016032 PMCID: PMC8674546 DOI: 10.1016/j.ejca.2021.12.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022]
Abstract
Taking into account higher risk of severe coronavirus disease 2019 or death among patients with cancer, as well as impaired immunogenicity after anti-SARS-CoV-2 vaccines, in addition to waning immunity, booster dosing appears mandatory in this patient population. This review sought to provide reasonable evidence so as to assist oncologists in their daily practice, helping them decide when an anti-SARS-Cov2 antibody (Ab) dosage should be scheduled after a full two-dose vaccination and, if necessary, propose an early third dose (D3). Such D3 could apply to non-responder patients with anti-Spike (S) Abs titres <40 binding Ab unit (BAU)/mL. For lowresponder patients with anti-S Ab titres between 40 BAU/mL and 100/260 BAU/mL (suggested area of uncertainty), an early D3 may similarly be proposed. Nevertheless, this D3 could be administered in a less urgent manner, taking into account associated comorbidities and regional epidemic incidence rates. This latter strategy may comprise a monthly dosage of anti-S titres so as to better assess the kinetics of waning immunity. For responder patients with anti-S titres above 260 BAU/mL, we suggest to follow the recommendations outlined for the general population. Given this context, patients with anti-S titres above 1000 BAU/mL should be given the possibility to undergo anti-S titre control after three months, designed to assess rapid humoral waning immunity. We strongly recommend that patients with cancer be included into observational serological monitoring studies or clinical trials that are dedicated to severe immunocompromised patients without any humoral seroconversion after D3.
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Affiliation(s)
- Jérôme Barrière
- Medical Oncology Department, Polyclinique Saint-Jean, 92 Avenue Dr Donat, FR-06800, Cagnes-sur-Mer, France.
| | - Michel Carles
- Infectious Diseases Department, Côte D'Azur University, CHU de Nice, Hôpital Archet 1, FR-06000, Nice, France.
| | - Clarisse Audigier-Valette
- Pulmonology and Oncology Department, Centre Hospitalier Toulon Sainte-Musse, 54 rue Henri-Sainte-Claire-Deville, FR-83056 Toulon, France.
| | - Daniel Re
- Department of Hematology and Medical Oncology, Centre Hospitalier Antibes Juan-les-Pins, 107 Route de Nice, FR-06600 Antibes, France.
| | - Zoubir Adjtoutah
- Medical Biology Laboratory, Cerballiance Côte D'Azur, 52 Avenue des Alpes FR-06800, Cagnes-sur-Mer, France.
| | - Barbara Seitz-Polski
- Department of Immunology & UR2CA, Côte D'Azur University, CHU Nice, 151 Route Saint-Antoine de Ginestière FR-06200 Nice, France.
| | - Valérie Gounant
- Thoracic Oncology Department & INSERM Centre D'Investigation Clinique 1425, Université de Paris, University Institute of Cancer AP-HP North, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), 46 Rue Henri Huchard, Paris, France.
| | - Diane Descamps
- Department of Virology and INSERM UMR 1137, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), 46 Rue Henri Huchard, Paris, France.
| | - Gérard Zalcman
- Thoracic Oncology Department & INSERM Centre D'Investigation Clinique 1425, Université de Paris, University Institute of Cancer AP-HP North, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), 46 Rue Henri Huchard, Paris, France.
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23
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Barrière J, Re D, Peyrade F, Carles M. Current perspectives for SARS-CoV-2 vaccination efficacy improvement in patients with active treatment against cancer. Eur J Cancer 2021; 154:66-72. [PMID: 34243079 PMCID: PMC8260097 DOI: 10.1016/j.ejca.2021.06.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 01/20/2023]
Abstract
A higher risk of death from coronavirus disease 19 has been shown for patients with solid cancers or haematological malignancies (HM). Thanks to the accelerated development of anti–SARS-SoV-2 vaccines in less than a year since the start of the global pandemic, patients with cancer were quickly prioritised in early 2021 for vaccination, however dependent on the very unequal availability at the global level. Impaired immunogenicity of SARS-CoV-2 mRNA vaccines in immunocompromised patients was rapidly reported as early as April 2021, although the vaccination fortunately appears to be generally effective without increasing the spacing. Worryingly, the humoral response of the SARS-CoV-2 vaccination is, however, considered insufficient in patients followed for HM, in particular when they are on anti-CD20 treatment. Thus, improving vaccination coverage by strengthening immune stimulation should be evaluated in patients under active treatment against cancer. Here, we discuss three different approaches: a third dose of early vaccine (repeated immune stimulation), heterologous prime-boost vaccination (multimodal immune stimulation) and a double-dose strategy (maximisation of immune response). Dedicated therapeutic trials, currently almost non-existent, seem rapidly necessary.
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Affiliation(s)
- Jérôme Barrière
- Department of Medical Oncology, Polyclinique Saint Jean, Cagnes-sur-Mer, France.
| | - Daniel Re
- Department of Medical Oncology, Centre Hospitalier La Fontonne, Antibes, France.
| | - Frédéric Peyrade
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France.
| | - Michel Carles
- Department of Infectious Disease, Centre Hospitalo-Universitaire, Nice, France.
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