Reduced Immune Response to Inactivated Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine in a Cohort of Immunocompromised Patients in Chile

Balcells, María Elvira; Corre, Nicole Le; Durán, Josefina; Ceballos, María Elena; Vizcaya, Cecilia; Mondaca, Sebastián; Dib, M.; Rabagliati, Ricardo; Sarmiento, Mauricio; Burgos, Paula I.; Espinoza, Manuel; Ferrés, Marcela; Martínez-Valdebenito, Constanza; Ruiz-Tagle, Cinthya; Ortiz, Catalina; Ross, Patricio; Budnik, Sigall; Solari, Sandra; Vizcaya, María de Los Ángeles; Lembach, Hanns; Berrios, Roslye V; Melo-González, Felipe; Ríos, Mariana; Kalergis, Alexis M.; Bueno, Susan M.; Nervi, Bruno

doi:10.1093/cid/ciac167

Cited by 35 publications

(50 citation statements)

References 34 publications

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“…Similar to our research, a study from Chile showed that immune responses to inactivated COVID-19 vaccines in immunocompromised patients were markedly weaker than those of healthy controls. 21 Further analysis revealed a markedly lower antibody level in patients with CD4 + T-cell counts ≤350 cells per μL, consistent with the finding that CD4 + T-cell count is positively correlated with neutralizing antibody responses to inactivated SARS-CoV-2. 22 , 23 Therefore, a booster dose or dose adjustment might be needed in HIV-infected individuals, especially those with lower CD4 + T-cell counts.…”

Section: Discussionsupporting

confidence: 82%

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

Han¹,

Yu²,

Han³

et al. 2022

IDR

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Purpose Vaccination reduces the incidence of severe COVID-19 and death and effectively limits viral spread. Concerns have been raised about COVID-19 vaccine responses in the large population of HIV-infected patients. This study aims to explore the safety and immunogenicity of the inactivated COVID-19 vaccine in people living with HIV (PLWH). Patients and Methods All participants in this study already had their second dose of an inactivated COVID-19 vaccine at least 14 days earlier, without a history of SARS-CoV-2 infection. The primary safety outcomes were the incidence of adverse reactions and changes in CD4 + T-cell counts. SARS-CoV-2 IgG and neutralizing antibody responses to the D614G variant and delta variant were measured for immune response assessment. Results Forty-seven HIV-infected patients and 18 healthy donors (HDs) were enrolled in this study. Adverse reactions were mild or self-limiting and were reported in 19.1% of HIV-infected patients. Most PLWH developed antibody responses against the inactivated COVID-19 vaccine. The longitudinal analysis of antibody responses in PLWH (median interval between detection and complete vaccination, 59 days) showed that antibodies were maintained for at least three months, though their titers were reduced. However, the antibody-positive rates in PLWH were significantly lower than those in HDs. Additionally, compared to HDs (Geomean titers (GMT) of 165 for D614G and GMT of 72 for delta), the neutralizing antibody titers against the two variants in PLWH (GMT of 43 for D614G and GMT 13 for delta) were decreased significantly (p = 0.018 and p < 0.001, respectively). HIV-infected patients with CD4 + T-cell counts ≤350 cells/μL appeared to exhibit a poor antibody response to inactivated vaccination. Conclusion Inactivated COVID-19 vaccines appear to be efficacious in PLWH. However, antibody responses in HIV-infected patients are inferior to those in healthy individuals, especially PLWH with lower CD4 + T-cell counts.

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Section: Discussionsupporting

confidence: 82%

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

Han¹,

Yu²,

Han³

et al. 2022

IDR

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“…persistent HIV-related immunopathology can nevertheless blunt vaccine responses [17][18][19], prompting initial concern that PLWH may respond sub-optimally to COVID-19 immunization. Data from clinical trials [20,21] and real-world studies however [22][23][24][25][26][27], including from our group [28], described strong initial immune responses to two-dose COVID-19 vaccination in PLWH with controlled HIV loads on therapy and preserved CD4+ T-cell counts [20][21][22][23][24]28], though weaker responses have been observed in PLWH who are not receiving therapy or who have CD4+ T-cell counts <200 cells/mm 3 [22,[25][26][27].…”

Section: Introductionmentioning

confidence: 98%

People with HIV receiving suppressive antiretroviral therapy show typical antibody durability after dual COVID-19 vaccination, and strong third dose responses

Lapointe

Mwimanzi

Cheung

et al. 2022

Preprint

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Background: Longer-term humoral responses to two-dose COVID-19 vaccines remain incompletely characterized in people living with HIV (PLWH), as do initial responses to a third dose. Methods: We measured antibodies against the SARS-CoV-2 spike protein receptor-binding domain, ACE2 displacement and viral neutralization against wild-type and Omicron strains up to six months following two-dose vaccination, and one month following the third dose, in 99 PLWH receiving suppressive antiretroviral therapy, and 152 controls. Results: Though humoral responses naturally decline following two-dose vaccination, we found no evidence of lower antibody concentrations nor faster rates of antibody decline in PLWH compared to controls after accounting for sociodemographic, health and vaccine-related factors. We also found no evidence of poorer viral neutralization in PLWH after two doses, nor evidence that a low nadir CD4+ T-cell count compromised responses. Post-third-dose humoral responses substantially exceeded post-second-dose levels, though anti-Omicron responses were consistently weaker than against wild-type. Nevertheless, post-third-dose responses in PLWH were comparable to or higher than controls. An mRNA-1273 third dose was the strongest consistent correlate of higher post-third-dose responses. Conclusion: PLWH receiving suppressive antiretroviral therapy mount strong antibody responses after two- and three-dose COVID-19 vaccination. Results underscore the immune benefits of third doses in light of Omicron.

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“…Studies in adult patients with secondary immunodeficiencies or immune dysregulation disorders showed reduced antibody responses to 2 doses of CoronaVac. [31][32][33] S-RBD IgG and sVNT results in our study showed 3 doses of CoronaVac elicited antibody response in IEI patients. Eleven of 17 patients with humoral deficiencies in our study opted for CoronaVac.…”

Section: Discussionmentioning

confidence: 79%

Safety and Immunogenicity of 3 Doses of BNT162b2 and CoronaVac in Children and Adults with Inborn Errors of Immunity

Leung

Duque

et al. 2022

Preprint

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Background Safety and immunogenicity of 3 doses of BNT162b2 and CoronaVac in adult and pediatric patients with inborn errors of immunity (IEIs) remain unknown. Intradermal vaccination may improve immunogenicity in immunocompromised patients. Our study (NCT04800133) aimed to determine the safety and immunogenicity in patients with IEIs receiving a 3-dose primary series of mRNA vaccine BNT162b2 (age 12+) or inactivated whole-virion vaccine CoronaVac (age 3+) in Hong Kong, including Omicron BA.1 neutralization, in a nonrandomized manner. Intradermal vaccination was also studied. Methods Thirty-nine patients were vaccinated, including 16 with homologous intramuscular 0.3ml BNT162b2 and 17 with homologous intramuscular 0.5ml CoronaVac. Two patients received 3 doses of intradermal 0.5ml CoronaVac, and 4 patients received 2 doses of intramuscular BNT162b2 and the third dose with intradermal BNT162b2. Adverse reactions and adverse events were tracked for 7 and 28 days after each dose. Antibody responses assessed included binding IgG antibody to wild-type (WT) spike receptor-binding domain (S-RBD IgG) and surrogate neutralization activity to WT and BA.1 viruses. T cell responses were examined by intracellular cytokine staining following stimulation with SARS-CoV-2 peptide pool(s). Results No safety concerns were identified. Inadequate antibody responses were found after 2 doses in patients with humoral immunodeficiencies and especially so against BA.1. Dose 3 of either vaccine increased S-RBD IgG response. T cell responses against SARS-CoV-2 antigens were detected in vaccinated IEI patients. Intradermal third dose vaccine led to high antibody response in 4 patients. Conclusions The primary vaccination series of BNT162b2 and CoronaVac in adults and children with IEIs should include 3 doses for optimal immunogenicity.

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Reduced Immune Response to Inactivated Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine in a Cohort of Immunocompromised Patients in Chile

Cited by 35 publications

References 34 publications

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

Safety and Immunogenicity of Inactivated COVID-19 Vaccines Among People Living with HIV in China

People with HIV receiving suppressive antiretroviral therapy show typical antibody durability after dual COVID-19 vaccination, and strong third dose responses

Safety and Immunogenicity of 3 Doses of BNT162b2 and CoronaVac in Children and Adults with Inborn Errors of Immunity

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