Seroconversion after coronavirus disease 2019 vaccination in patients with immune deficiency

Abstract

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“…All but the patient with X-linked agammaglobulinemia were able to produce specific anti–SARS-CoV-2 spike protein antibodies, suggesting that patients with antibody deficiency are able to respond to the vaccine. 6 That said, we agree that further data with larger-scale studies and longer duration of follow-up are required.…”

“…Kinoshita et al recently described a robust immune response after COVID-19, with 4 of 5 patients generating a humoral immune response despite their underlying antibody deficiency. 5 Similarly, Squire and Joshi 6 evaluated the humoral immune response to mRNA COVID-19 vaccine in 10 patients with underlying primary immune deficiency. Their cohort included 6 patients with CVID, 1 patient with hypogammaglobulinemia, 1 patient with Wiskott-Aldrich syndrome, 1 patient with 22q11.2 deletion syndrome, and 1 patient with X-linked agammaglobulinemia.…”

Anti-COVID-19 Vaccination in Patients with Autoimmune-Autoinflammatory Disorders and Primary/Secondary Immunodeficiencies: The Position of the Task Force on Behalf of the Italian Immunological Societies

“…Even patients with PIDs and SIDs do not seem to have contraindications to COVID-19 vaccines. In fact, no higher frequency of AEs was observed in two preliminary studies, the first one on 11 immune deficient patients (10 PIDs and 1 SID) [98] and the other on 26 patients with inborn errors of immunity (26 PIDs) [99], where substantial safety of the mRNA Pfizer vaccine and satisfactory immunogenicity was observed, except for the four patients with X-linked agammaglobulinemia, in whom an adaptive cellular response was observed. A recent study confirmed the lack of antibody response in patients with X-linked agammaglobulinemia, compensated by the induction of an adaptive cellular response, whereas the response of patients with Common Variable Immunodeficiency was found to be unsatisfactory and non-protective at both cellular and humoral levels [100].…”

“…* The risk-benefit evaluation of temporary immunosuppressive treatment interruption should be done by the immunology specialist based on the clinical picture. Regarding PIDs, the presence of Ig replacement therapy does not seem to have interfered with the cellular and humoral immune response observed in most patients, except for patients with X-linked agammaglobulinemia, who did not show antibody response, but were protected by the adaptive cellular immunity[98,99]. However, immunoglobulin for intravenous (IVIg) or subcutaneous (SCIg) use should not be administered in the same time period as vaccination, because it is impossible to check the humoral vaccine response, given that IVIg/SCIg may contain different concentrations of anti-SARS-CoV-2 antibodies[115,116].…”

“…Although in the pre-approval studies details on the possible presence of patients with AIAIDs in the study population have not been provided, recent studies have reported substantial safety and immunogenicity of these vaccines in patients with AIAIDs [48][49][50]92,[106][107][108]. Even in PIDs, two preliminary studies [98,99] have shown the substantial safety and immunogenicity of the mRNA vaccines. Finally, COVID-19 vaccines were safe and immunogenic in onco-hematologic pathologies, and mRNA vaccines were more immunogenic than the adenoviral vaccine [101].…”