Immunogenicity and Reactogenicity of mRNA BNT162b2 COVID-19 Vaccine among Thai Adolescents with Chronic Diseases

Abstract

Adolescents with underlying diseases are at risk of severe COVID-19. The immune response of BNT162b2 may be poor among immunocompromised adolescents. We aim to describe immunogenicity of mRNA BNT162b2 among adolescents who are immunocompromised or have chronic diseases. We recruited adolescents 12–18 years of age; group A impaired-immunity (post-transplantation, cancer, on immunosuppressive drugs) and group B chronic diseases. A two-dose regimen of BNT162b2 was given. Immunogenicity was determined by surrogate virus neutralization test (sVNT) and IgG against receptor-binding domain (RBD). From August to October 2021, 312 adolescents, with a median age (IQR) of 15 years (13.7–16.5), were enrolled (group A 100, group B 212). The geometric means (GMs) of sVNT (% inhibition) against Delta strain and anti-RBD IgG (BAU/mL) after the 2nd dose among group A were: post-transplantation recipients 52.9 (95% CI 37.7–74.2) and 233.6 (95% CI 79–690.6); adolescents with cancer 62.3 (95% CI 29.2–133.1) and 214.9(95% CI 34.2–1348.6); and adolescents with other immunosuppressive conditions 66.7 (95% CI 52.4–84.8) and 849.8 (95% CI 393.4–1835.8). In group B were: adolescents living with HIV 98 (95% CI 97.3–98.8) and 3240.3 (95% CI 2699–3890.2), and adolescents with other chronic disease 98.6 (95% CI 98.3–98.9) and 3818.5 (95% CI 3490.4–4177.4). At day 90, immunity declined; among impaired-immunity participants were 43.9 (95% CI 30.8–62.4) and 178.7 (95% CI 91.2–350.1) and adolescents with chronic diseases were 90.6 (95% CI 88.4–92.8) and 1037.1 (95% CI 933.3–1152.5). In conclusion, adolescents with impaired immunity had a poor response to 2-doses of BNT162b2, additional dose should be considered. Adolescents with chronic diseases had excellent response but immunity waned after 3 m, booster dose may be required.

Time course of adverse reactions after BNT162b2 vaccination in healthy and allergic disease individuals aged 5–11 years: an observational and historical cohort study

“…The higher frequency of adverse reactions in those with allergic diseases was consistent with previous reports on adults [39]. It has been suggested that individuals with allergic diseases, such as asthma, who are potentially susceptible to COVID-19 [8; [25][26][27][28][29], may experience more adverse reactions after BNT162b2 vaccination. Therefore, to ensure that children with allergic diseases, receive the vaccine safely, further information regarding adverse reactions and long-term effects of BNT162b2 vaccination needs to be collected.…”

“…Adverse reactions in this population were generally non-serious, more common after second vaccination, and substantially less common than those observed among individuals aged 12-15 years [22][23][24]. Children with underlying comorbidities are at risk of severe COVID-19 [8; [25][26][27][28][29]; however, long-term data on the adverse reactions after BNT162b2 vaccination in these patients are limited. Fukushima Prefecture, Japan began administering BNT162b2 as two doses (10 µg, 0.2 mL each), three weeks apart to individuals aged 5-11 years on March 9, 2022.…”

Time course of adverse reactions following BNT162b2 vaccination in healthy and allergic disease individuals aged 5–11 years and comparison with individuals aged 12–15 years: an observational and historical cohort study

“…The higher frequency of adverse reactions in those with allergic diseases was consistent with previous reports on adults [ 40 ]. It has been suggested that individuals with allergic diseases, such as asthma, who are potentially susceptible to COVID-19 [ 8 , 25 – 29 ], may experience more adverse reactions after BNT162b2 vaccination. Therefore, to ensure that children with allergic diseases receive the vaccine safely, further information regarding adverse reactions and long-term effects of BNT162b2 vaccination needs to be collected.…”

Adaptive immune response to BNT162b2 mRNA vaccine in immunocompromised adolescent patients

“…In contrast, their underlying immune deficiency or immunosuppressive treatment might impair their ability to respond to the vaccine and develop protective immunity, characterized by generating anti-SARS-CoV-2 antibodies and cellular immune responses ( 5 , 13 ). Some evidence exists regarding the effects of vaccination outcomes in adult immunocompromised individuals ( 18 ), while the protective immunity elicited by vaccines in immunocompromised children was mainly focused on the humoral response ( 19 , 20 ). In one study, it was shown that adolescents who are immunocompromised (post-transplantation, cancer, or due to immunosuppressive drugs) displayed impaired in vitro neutralization capacity as measured by competition with ACE2, and total IgG against RBD, in comparison to adolescents who have chronic diseases, such as HIV.…”