Comparison of neutralizing antibody responses against <scp>SARS‐CoV</scp>‐2 in healthy volunteers who received the <scp>BNT162b2 mRNA</scp> or the <scp>AZD1222</scp> vaccine: Should the second <scp>AZD1222</scp> vaccine dose be given earlier?

Terpos, Evangelos; Trougakos, Ioannis P.; Karalis, Vangelis; Ntanasis‐Stathopoulos, Ioannis; Sklirou, Aimilia D.; Bagratuni, Tina; Papanagnou, Eleni‐Dimitra; Patseas, Dimitrios; Gumeni, Sentiljana; Malandrakis, Panagiotis; Korompoki, Eleni; Dimopoulos, Meletios A.

doi:10.1002/ajh.26248

Cited by 18 publications

(19 citation statements)

References 7 publications

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“…Our results also suggest that a second timely vaccine dose is necessary for patients with hematological malignancies that deregulate the immune homeostasis, and especially for the elderly [21]. A shorter time interval between the two doses of the AZD1222 would be relevant, as well [22]. Similarly, patients with solid cancer present a suboptimal humoral response following the first dose of the BNT162b2 and they should receive an early second dose (21 days after the first shot) [23][24][25].…”

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confidence: 74%

Low neutralizing antibody responses in WM, CLL and NHL patients after the first dose of the BNT162b2 and AZD1222 vaccine

et al. 2021

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Vaccination against SARS-CoV-2 is considered as the most important preventive strategy against COVID-19, but its efficacy in patients with hematological malignancies is largely unknown. We investigated the development of neutralizing antibodies (NAbs) against SARS-CoV-2 in patients with Waldenstrom Macroglobulinemia (WM), Chronic Lymphocytic Leukemia (CLL) and Non-Hodgkin Lymphoma (NHL). After the first dose of the vaccine, on D22, WM/CLL/NHL patients had lower NAb titers compared to controls: the median NAb inhibition titer was 17% (range 0-91%, IQR 8-27%) for WM/CLL/NHL patients versus 32% (range 2-98%, IQR 19-48%) for controls (P < 0.001). Only 8 (14%) patients versus 114 (54%) controls developed NAb titers ≥ 30% on D22 (p < 0.001). Our data indicate that the first dose of both BNT162b2 and AZD1222 leads to lower production of NAbs against SARS-CoV-2 in patients with WM/CLL/NHL compared to controls of similar age and gender and without malignant disease. Even though the response rates were not optimal, vaccination is still considered essential and if possible should be performed before treatment initiation. These patients with suboptimal responses should be considered to be prioritized for booster doses.

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confidence: 74%

Low neutralizing antibody responses in WM, CLL and NHL patients after the first dose of the BNT162b2 and AZD1222 vaccine

et al. 2021

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“…Several reports have suggested higher immunogenicity of mRNA-1273 than BNT162b vaccine [and lower immunogenicity of Ad26.COV2.S than BNT162b vaccine (51)] among healthy subjects (52)(53)(54). A possible explanation is the higher dose of mRNA in the mRNA-1273 (100 mg) than in the BNT162b (30 mg) vaccine.…”

Section: Immune Response To Sars-cov-2 Mrna Vaccination In Healthy Ad...mentioning

confidence: 99%

Insights From Early Clinical Trials Assessing Response to mRNA SARS-CoV-2 Vaccination in Immunocompromised Patients

et al. 2022

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It is critical to protect immunocompromised patients against COVID-19 with effective SARS-CoV-2 vaccination as they have an increased risk of developing severe disease. This is challenging, however, since effective mRNA vaccination requires the successful cooperation of several components of the innate and adaptive immune systems, both of which can be severely affected/deficient in immunocompromised people. In this article, we first review current knowledge on the immunobiology of SARS-COV-2 mRNA vaccination in animal models and in healthy humans. Next, we summarize data from early trials of SARS-COV-2 mRNA vaccination in patients with secondary or primary immunodeficiency. These early clinical trials identified common predictors of lower response to the vaccine such as anti-CD19, anti-CD20 or anti-CD38 therapies, low (naive) CD4+ T-cell counts, genetic or therapeutic Bruton tyrosine kinase deficiency, treatment with antimetabolites, CTLA4 agonists or JAK inhibitors, and vaccination with BNT162b2 versus mRNA1273 vaccine. Finally, we review the first data on third dose mRNA vaccine administration in immunocompromised patients and discuss recent strategies of temporarily holding/pausing immunosuppressive medication during vaccination.

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“…Serum was separated within 4 h from blood collection and stored at −80 • C until the day of measurement. NAbs against SARS-CoV-2 were measured using an FDA-approved methodology (ELISA, cPass™ SARS-CoV-2 NAbs Detection Kit; GenScript, Piscataway, NJ, USA) [49] on the abovementioned timepoints, as previously described [33,50]. An NAb titer of at least 30% is considered positive, whereas an NAb titer of at least 50% has been associated with clinically relevant viral inhibition [45,[51][52][53].…”

Section: Nabs Measurementmentioning

confidence: 99%

Poor Neutralizing Antibody Responses in 132 Patients with CLL, NHL and HL after Vaccination against SARS-CoV-2: A Prospective Study

Terpos

Gavriatopoulou

Fotiou

et al. 2021

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Emerging data suggest suboptimal antibody responses to COVID-19 vaccination in patients with hematological malignancies. We evaluated the humoral response following the BNT162b2 vaccine in patients with chronic lymphocytic leukemia (CLL), non-Hodgkin’s lymphoma (NHL), and Hodgkin’s lymphoma (HL). An FDA-approved, ELISA-based methodology was implemented to evaluate the titers of neutralizing antibodies (NAbs) against SARS-CoV-2 on day 1 of the first vaccine, and afterwards on day 22 and 50. One hundred and thirty-two patients with CLL/lymphomas and 214 healthy matched controls vaccinated during the same period, at the same center were enrolled in the study (NCT04743388). Vaccination with two doses of the BNT162b2 vaccine led to lower production of NAbs against SARS-CoV-2 in patients with CLL/lymphomas compared with controls both on day 22 and on day 50 (p < 0.001 for all comparisons). Disease-related immune dysregulation and therapy-related immunosuppression are involved in the low humoral response. Importantly, active treatment with Rituximab, Bruton’s tyrosine kinase inhibitors, or chemotherapy was an independent prognostic factor for suboptimal antibody response. Patients with HL showed superior humoral responses to the NHL/CLL subgroups. In conclusion, patients with CLL/lymphomas have low humoral response following COVID-19 vaccination, underlining the need for timely vaccination ideally during a treatment-free period and for continuous vigilance on infection control measures.

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Comparison of neutralizing antibody responses against SARS‐CoV‐2 in healthy volunteers who received the BNT162b2 mRNA or the AZD1222 vaccine: Should the second AZD1222 vaccine dose be given earlier?

Abstract: Vaccination programs against SARS-CoV-2 are in full progress across the globe. The BNT162b2 mRNA (Pfizer) and the AZD1222CORRESPONDENCE E321 CORRESPONDENCE E323

Cited by 18 publications

References 7 publications

Low neutralizing antibody responses in WM, CLL and NHL patients after the first dose of the BNT162b2 and AZD1222 vaccine

Low neutralizing antibody responses in WM, CLL and NHL patients after the first dose of the BNT162b2 and AZD1222 vaccine

Insights From Early Clinical Trials Assessing Response to mRNA SARS-CoV-2 Vaccination in Immunocompromised Patients

Poor Neutralizing Antibody Responses in 132 Patients with CLL, NHL and HL after Vaccination against SARS-CoV-2: A Prospective Study

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