mRNA vaccine boosting enhances antibody responses against SARS-CoV-2 Omicron variant in individuals with antibody deficiency syndromes

SARS-CoV-2 booster vaccination rescues attenuated IgG1 memory B cell response in primary antibody deficiency patients

“…Individuals with medical conditions that compromise their ability to mount immune responses, such as primary and secondary immunodeficiencies, are at increased risk for severe illness and death following SARS-CoV-2 infection ( 13, 14 ). Patients with primary and secondary immunodeficiencies also have an impaired SARS-CoV-2-specific antibody response following a primary vaccination series ( 15 – 24 ). Moderately or severely immunosuppressed patients are recommended by the Centers for Disease Control and Prevention (CDC) to receive a third dose as part of their primary series against SARS-CoV-2 and a fourth dose at least 3 months following the completion of the primary vaccination series.…”

“…Moderately or severely immunosuppressed patients are recommended by the Centers for Disease Control and Prevention (CDC) to receive a third dose as part of their primary series against SARS-CoV-2 and a fourth dose at least 3 months following the completion of the primary vaccination series. Administration of booster doses leads to an increased SARS-CoV-2-specific antibody response in immunocompromised individuals ( 17, 24 ).…”

“…Most individuals with PAD syndromes receive intravenous or subcutaneous immunoglobulin replacement therapy every 1 to 4 weeks to reduce the frequency and severity of infections ( 31 ). However, immunoglobulin replacement therapy consists of immunoglobulin donated up to one year earlier and is unlikely to contain high titers of neutralizing antibodies specific for the strain of SARS-CoV-2 that is dominant at the time of administration ( 24, 32, 33 ).…”

“…We previously found that COVID-19-naïve individuals with PAD syndromes had a reduced SARS-CoV-2-specific antibody response following vaccination relative to healthy donors ( 24 ). The administration of a booster vaccine dose increased the antibody response and led to the development of antibodies with an enhanced ability to neutralize the Delta (B.1.617.2) and Omicron variants ( 24 ).…”

“…We previously found that COVID-19-naïve individuals with PAD syndromes had a reduced SARS-CoV-2-specific antibody response following vaccination relative to healthy donors ( 24 ). The administration of a booster vaccine dose increased the antibody response and led to the development of antibodies with an enhanced ability to neutralize the Delta (B.1.617.2) and Omicron variants ( 24 ). However, the total and neutralizing antibody titers markedly declined by day 90 post-boost suggesting that the endogenous antibody response may be insufficient to mediate long-term protective immunity in individuals with PAD syndromes ( 24 ).…”