Academic Journal
Real-world assessment of immunogenicity in immunocompromised individuals following SARS-CoV-2 mRNA vaccination: a two-year follow-up of the prospective clinical trial COVAXIDResearch in context
| Title: | Real-world assessment of immunogenicity in immunocompromised individuals following SARS-CoV-2 mRNA vaccination: a two-year follow-up of the prospective clinical trial COVAXIDResearch in context |
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| Authors: | Puran Chen, Peter Bergman, Ola Blennow, Lotta Hansson, Stephan Mielke, Piotr Nowak, Yu Gao, Gunnar Söderdahl, Anders Österborg, C.I.Edvard Smith, Jan Vesterbacka, David Wullimann, Angelica Cuapio, Mira Akber, Gordana Bogdanovic, Sandra Muschiol, Mikael Åberg, Karin Loré, Margaret Sällberg Chen, Per Ljungman, Marcus Buggert, Soo Aleman, Hans-Gustaf Ljunggren |
| Source: | EBioMedicine, Vol 109, Iss , Pp 105385- (2024) |
| Publisher Information: | Elsevier, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Medicine LCC:Medicine (General) |
| Subject Terms: | SARS-CoV-2, COVID-19, mRNA vaccine, Clinical study, Primary immunodeficiency disease, HIV, Medicine, Medicine (General), R5-920 |
| More Details: | Summary: Background: Immunocompromised patients with primary and secondary immunodeficiencies have shown impaired responses to SARS-CoV-2 mRNA vaccines, necessitating recommendations for additional booster doses. However, longitudinal data reflecting the real-world impact of such recommendations remains limited. Methods: This study represents a two-year follow-up of the COVAXID clinical trial, where 364 of the original 539 subjects consented to participate. 355 individuals provided blood samples for evaluation of binding antibody (Ab) titers and pseudo-neutralisation capacity against both the ancestral SARS-CoV-2 strain and prevalent Omicron variants. T cell responses were assessed in a subset of these individuals. A multivariate analysis determined the correlation between Ab responses and the number of vaccine doses received, documented infection events, immunoglobulin replacement therapy (IGRT), and specific immunosuppressive drugs. The original COVAXID clinical trial was registered in EudraCT (2021-000175-37) and clinicaltrials.gov (NCT04780659). Findings: Several of the patient groups that responded poorly to the initial primary vaccine schedule and early booster doses presented with stronger immunogenicity-related responses including binding Ab titres and pseudo-neutralisation at the 18- and 24-month sampling time point. Responses correlated positively with the number of vaccine doses and infection. The vaccine response was blunted by an immunosuppressive state due to the underlying specific disease and/or to specific immunosuppressive treatment. Interpretation: The study results highlight the importance of continuous SARS-CoV-2 vaccine booster doses in building up and sustaining Ab responses in specific immunocompromised patient populations. Funding: The present studies were supported by the European Research Council, Karolinska Institutet, Knut and Alice Wallenberg Foundation, Nordstjernan AB, Region Stockholm, and the Swedish Research Council. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2352-3964 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2352396424004213; https://doaj.org/toc/2352-3964 |
| DOI: | 10.1016/j.ebiom.2024.105385 |
| Access URL: | https://doaj.org/article/e065b36ec6674ac794485395f839553b |
| Accession Number: | edsdoj.065b36ec6674ac794485395f839553b |
| Database: | Directory of Open Access Journals |
| ISSN: | 23523964 |
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| DOI: | 10.1016/j.ebiom.2024.105385 |
| Published in: | EBioMedicine |
| Language: | English |