Effectiveness and Durability of mRNA Vaccine-Induced SARS-CoV-2-Specific Humoral and Cellular Immunity in Severe Asthma Patients on Biological Therapy

Abstract

Coronavirus disease 2019 (COVID-19) vaccines effectively elicit humoral and cellular immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthy populations. This immunity decreases several months after vaccination. However, the efficacy of vaccine-induced immunity and its durability in patients with severe asthma on biological therapy are unknown. In this study, we evaluated the effectiveness and durability of mRNA vaccine-induced SARS-CoV-2-specific humoral and cellular immunity in severe asthma patients on biological therapy. The study included 34 patients with severe asthma treated with anti-IgE (omalizumab, n=17), anti-IL5 (mepolizumab, n=13; reslizumab, n=3), or anti-IL5R (benralizumab, n=1) biological therapy. All patients were vaccinated with two doses of the BNT162b2 mRNA vaccine with a 6-week interval between the doses. We found that this COVID-19 vaccination regimen elicited SARS-CoV-2-specific humoral and cellular immunity, which had significantly declined 6 months after receipt of the second dose of the vaccine. The type of biological treatment did not affect vaccine-elicited immunity. However, patient age negatively impacted the vaccine-induced humoral response. On the other hand, no such age-related impact on vaccine-elicited cellular immunity was observed. Our findings show that treatment of patients with severe asthma with biological therapy does not compromise the effectiveness or durability of COVID-19 vaccine-induced immunity.

Results of the Stop the Spread Ottawa (SSO) cohort study: a Canadian urban-based prospective evaluation of antibody responses and neutralisation efficiency to SARS-CoV-2 infection and vaccination

“… 6 14 There is evidence that humoral responses decline at the 4–6 months point after vaccination, especially in immune compromised individuals. 16 17 Podrazil et al observed a sharp decline in humoral and cellular immune responses 6 months after vaccination with the mRNA Pfizer vaccine in asthma patients receiving biological therapy. 16 Breakthrough COVID-19 infections further raise concerns regarding the durability of protection following two doses.…”

“…16 17 Podrazil et al observed a sharp decline in humoral and cellular immune responses 6 months after vaccination with the mRNA Pfizer vaccine in asthma patients receiving biological therapy. 16 Breakthrough COVID-19 infections further raise concerns regarding the durability of protection following two doses. 18 Vaccine immunogenicity was robust in young and middle age participants; many of which worked in publicfacing occupations including as healthcare providers, teachers, daycare and in the transport sector.…”

Viral Infection and Airway Epithelial Immunity in Asthma

“…It is also advised that patients who are on biologics for asthma receive a COVID-19 vaccine. Recent reports have revealed that severe asthma patients on biologic treatment showed optimal safety and tolerability profiles of mRNA SARS-CoV-2/COVID-19 vaccines and that the biological treatment did not compromise the effectiveness and durability of the COVID-19-vaccine-induced immunity [ 168 , 169 ]. However, the long-term effects of COVID-19 vaccines on asthmatics are still unclear and warrant further investigation.…”

The BNT162b2 mRNA COVID-19 Vaccine Increases the Contractile Sensitivity to Histamine and Parasympathetic Activation in a Human Ex Vivo Model of Severe Eosinophilic Asthma

“…In severe asthmatic patients treated with biologic therapies such as benralizumab, mepolizumab, and dupilumab, conflicting findings resulted from real-world settings concerning the response to the COVID-19 vaccine: some studies reported significantly lower antibody levels compared with healthy subjects after vaccination, whereas other studies reported no significant difference in antibody response to the vaccine compared to other patient groups after either two or three vaccine doses [ 10 , 11 ]. In any case, it seems that the type of biological treatment does not affect vaccine-elicited humoral and cellular immunity in severe asthmatic patients [ 12 ].…”