TY - JOUR
T1 - Immunogenicity of the mRNA-1273 COVID-19 vaccine in adult patients with inborn errors of immunity
AU - van Leeuwen, Leanne P M
AU - GeurtsvanKessel, Corine H
AU - Ellerbroek, Pauline M
AU - de Bree, Godelieve J
AU - Potjewijd, Judith
AU - Rutgers, Abraham
AU - Jolink, Hetty
AU - van de Veerdonk, Frank
AU - van Gorp, Eric C M
AU - de Wilt, Faye
AU - Bogers, Susanne
AU - Gommers, Lennert
AU - Geers, Daryl
AU - Bruns, Anke H W
AU - Leavis, Helen L
AU - van Haga, Jelle W
AU - Lemkes, Bregtje A
AU - van der Veen, Annelou
AU - de Kruijf-Bazen, S F J
AU - van Paassen, Pieter
AU - de Leeuw, Karina
AU - van de Ven, Annick A J M
AU - Verbeek-Menken, Petra H
AU - van Wengen, Annelies
AU - Arend, Sandra M
AU - Ruten-Budde, Anja J
AU - van der Ent, Marianne W
AU - Martin van Hagen, P
AU - Sanders, Rogier W
AU - Grobben, Marloes
AU - van der Straten, Karlijn
AU - Burger, Judith A
AU - Poniman, Meliawati
AU - Nierkens, Stefan
AU - van Gils, Marit J
AU - de Vries, Rory D
AU - Dalm, Virgil A S H
N1 - Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - BACKGROUND: Patients with inborn errors of immunity (IEI) are at increased risk of severe coronavirus disease-2019 (COVID-19). Effective vaccination against COVID-19 is therefore of great importance in this group, but little is known about the immunogenicity of COVID-19 vaccines in these patients.OBJECTIVES: We studied humoral and cellular immune responses after mRNA-1273 COVID-19 vaccination in adult IEI patients.METHODS: In a prospective, controlled, multicenter study 505 IEI patients (common variable immunodeficiency (CVID), isolated or undefined antibody deficiencies, X-linked agammaglobulinemia (XLA), combined immunodeficiency (CID), phagocyte defects) and 192 controls were included. All participants received two doses of the mRNA-1273 COVID-19 vaccine. Levels of SARS-CoV-2-specific binding antibodies, neutralizing antibodies, and T-cell responses were assessed at baseline, 28 days after first and 28 days after second vaccination.RESULTS: Seroconversion rates in patients with clinically mild antibody deficiencies and phagocyte defects were similar to healthy controls, but seroconversion rates in patients with more severe IEI, like CVID and CID, were lower. Binding antibody titers correlated well to the presence of neutralizing antibodies. T-cell responses were comparable to controls in all IEI cohorts, with the exception of CVID patients. The presence of non-infectious complications and the use of immunosuppressive drugs in CVID patients were negatively correlated with the antibody response.CONCLUSION: COVID-19 vaccination with mRNA-1273 was immunogenic in mild antibody deficiencies and phagocyte defects and in most patients with CID and CVID. Lowest response was detected in XLA and in CVID patients with non-infectious complications. The assessment of longevity of immune responses in these vulnerable patient groups will guide decision-making for additional vaccinations.
AB - BACKGROUND: Patients with inborn errors of immunity (IEI) are at increased risk of severe coronavirus disease-2019 (COVID-19). Effective vaccination against COVID-19 is therefore of great importance in this group, but little is known about the immunogenicity of COVID-19 vaccines in these patients.OBJECTIVES: We studied humoral and cellular immune responses after mRNA-1273 COVID-19 vaccination in adult IEI patients.METHODS: In a prospective, controlled, multicenter study 505 IEI patients (common variable immunodeficiency (CVID), isolated or undefined antibody deficiencies, X-linked agammaglobulinemia (XLA), combined immunodeficiency (CID), phagocyte defects) and 192 controls were included. All participants received two doses of the mRNA-1273 COVID-19 vaccine. Levels of SARS-CoV-2-specific binding antibodies, neutralizing antibodies, and T-cell responses were assessed at baseline, 28 days after first and 28 days after second vaccination.RESULTS: Seroconversion rates in patients with clinically mild antibody deficiencies and phagocyte defects were similar to healthy controls, but seroconversion rates in patients with more severe IEI, like CVID and CID, were lower. Binding antibody titers correlated well to the presence of neutralizing antibodies. T-cell responses were comparable to controls in all IEI cohorts, with the exception of CVID patients. The presence of non-infectious complications and the use of immunosuppressive drugs in CVID patients were negatively correlated with the antibody response.CONCLUSION: COVID-19 vaccination with mRNA-1273 was immunogenic in mild antibody deficiencies and phagocyte defects and in most patients with CID and CVID. Lowest response was detected in XLA and in CVID patients with non-infectious complications. The assessment of longevity of immune responses in these vulnerable patient groups will guide decision-making for additional vaccinations.
KW - CID
KW - CVID
KW - Inborn errors of immunity
KW - PRIMARY IMMUNODEFICIENCY
KW - SARS-CoV-2
KW - T-cell response
KW - XLA
KW - antibody response
KW - immuno-genicity
KW - mRNA-1273 COVID-19 vaccine
KW - primary immunodeficiency disorders
U2 - 10.1016/j.jaci.2022.04.002
DO - 10.1016/j.jaci.2022.04.002
M3 - Article
C2 - 35421449
SN - 0091-6749
VL - 149
SP - 1949
EP - 1957
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 6
ER -