Antibody responses to the SARS-CoV-2 vaccine in individuals with various inborn errors of immunity

SARS-CoV-2 vaccination is recommended in patients with inborn errors of immunity (IEIs); however, little is known about immunogenicity and safety in these patients. We sought to evaluate the impact of genetic diagnosis, age, and treatment on antibody response to COVID-19 vaccine and related adverse...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2021-11, Vol.148 (5), p.1192-1197
Main Authors: Delmonte, Ottavia M., Bergerson, Jenna R.E., Burbelo, Peter D., Durkee-Shock, Jessica R., Dobbs, Kerry, Bosticardo, Marita, Keller, Michael D., McDermott, David H., Rao, V. Koneti, Dimitrova, Dimana, Quiros-Roldan, Eugenia, Imberti, Luisa, Ferrè, Elise M.N., Schmitt, Monica, Lafeer, Christine, Pfister, Justina, Shaw, Dawn, Draper, Deborah, Truong, Meng, Ulrick, Jean, DiMaggio, Tom, Urban, Amanda, Holland, Steven M., Lionakis, Michail S., Cohen, Jeffrey I., Ricotta, Emily E., Notarangelo, Luigi D., Freeman, Alexandra F.
Format: Article
Language:English
Subjects:
Adolescent
Adult
adverse events
Age Factors
Aged
Antibodies, Viral - blood
Antibody Formation
antibody response
B-Lymphocytes - immunology
Cohort Studies
Coronavirus Nucleocapsid Proteins - immunology
COVID-19
COVID-19 - genetics
COVID-19 - immunology
COVID-19 Drug Treatment
COVID-19 Vaccines - immunology
Female
Humans
immune suppressants
Immunization, Secondary
Immunogenicity, Vaccine
Immunoglobulin G - blood
immunomodulators
Immunosuppressive Agents - therapeutic use
inborn errors of immunity
JAK inhibitors
Lymphocyte Count
Male
Middle Aged
Phosphoproteins - immunology
Polyendocrinopathies, Autoimmune - drug therapy
Polyendocrinopathies, Autoimmune - genetics
Polyendocrinopathies, Autoimmune - immunology
Rituximab - therapeutic use
SARS-CoV-2
SARS-CoV-2 - physiology
Seroconversion
Spike Glycoprotein, Coronavirus - immunology
T-Lymphocytes - immunology
Young Adult
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Summary:SARS-CoV-2 vaccination is recommended in patients with inborn errors of immunity (IEIs); however, little is known about immunogenicity and safety in these patients. We sought to evaluate the impact of genetic diagnosis, age, and treatment on antibody response to COVID-19 vaccine and related adverse events in a cohort of patients with IEIs. Plasma was collected from 22 health care worker controls, 81 patients with IEIs, and 2 patients with thymoma; the plasma was collected before immunization, 1 to 6 days before the second dose of mRNA vaccine, and at a median of 30 days after completion of the immunization schedule with either mRNA vaccine or a single dose of Johnson & Johnson’s Janssen vaccine. Anti-spike (anti-S) and anti-nucleocapsid antibody titers were measured by using a luciferase immunoprecipitation systems method. Information on T- and B-cell counts and use of immunosuppressive drugs was extracted from medical records, and information on vaccine-associated adverse events was collected after each dose. Anti-S antibodies were detected in 27 of 46 patients (58.7%) after 1 dose of mRNA vaccine and in 63 of 74 fully immunized patients (85.1%). A lower rate of seroconversion (7 of 11 [63.6%]) was observed in patients with autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy. Previous use of rituximab and baseline counts of less than 1000 CD3+ T cells/mL and less than 100 CD19+ B cells/mL were associated with lower anti-S IgG levels. No significant adverse events were reported. Vaccinating patients with IEIs is safe, but immunogenicity is affected by certain therapies and gene defects. These data may guide the counseling of patients with IEIs regarding prevention of SARS-CoV-2 infection and the need for subsequent boosts.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2021.08.016