The slower antibody response in myelofibrosis patients after two doses of mRNA SARS-CoV-2 vaccine calls for a third dose

Fiorino, Fabio; Sicuranza, Anna; Ciabattini, Annalisa; Santoni, Alessandro; Pastore, Gabiria; Simoncelli, Martina; Polvere, Jacopo; Galimberti, Sara; Auddino, Stefano; Baratè, Claudia; Montagnani, Francesca; Sammartano, Vincenzo; Bocchia, Monica; Medaglini, Donata

doi:10.1101/2021.09.21.21263627

Cited by 6 publications

(1 citation statement)

References 18 publications

(26 reference statements)

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“…In the setting of hematological patients, we previously studied and reported the risk of vaccine exacerbating an underline coagulative disorder (i.e., hemophilia or thrombotic thrombocytopenic purpura [31,32]). It's known the role of the disrupted immune system and the previous or concomitant therapy in not allowing an adequate antibody response to administering the vaccine [33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Breakthrough infection after SARS-CoV-2 vaccines in patients with hemoglobinopathies and blood-transfusion management: a single Center experience

Duminuco,

Bulla,

Rosso

et al. 2023

Preprint

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Purpose Immune system impairment is frequently reported in patients affected by hemoglobinopathies due to various mechanisms, including iron accumulation, antigenic stimulation due to numerous transfusions, chronic hemolysis, and a hyperinflammatory state. The antigenic immune response after a vaccine could be ineffective. Methods We evaluated the anti-spike IgG production after 2 doses of vaccine for SARS-CoV-2 in patients affected by hemoglobinopathies, reporting the risk of breakthrough infections, monitoring the outcome and the risk of severe disease or complications related to the basal hematological disease. Results All 114 enrolled patients developed adequate antibody production, with a median value of serum anti-S IgG of 2184.4 BAU/mL. The amount of antibody was unrelated to any other clinical characteristics evaluated, including transfusion dependence, age, gender, disease type, ferritin, blood count, spleen status, and therapy with hydroxyurea or iron chelators (p > 0.05). Moreover, 47 (41.2%) patients developed breakthrough SARS-CoV-2 infection during the follow-up, all with a mildly symptomatic course, without requiring hospitalization or experiencing a significative drop in hemoglobin values, allowing for a slight delay in their transfusion regimen. Conclusion Vaccination has been an effective and safe tool in this category of patients, preventing severe complications. Watchful waiting in the transfusion strategy can be safely ensured, guaranteeing better management of transfusion components.

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Section: Discussionmentioning

confidence: 99%

Breakthrough infection after SARS-CoV-2 vaccines in patients with hemoglobinopathies and blood-transfusion management: a single Center experience

Duminuco,

Bulla,

Rosso

et al. 2023

Preprint

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Trajectory of Spike-Specific B Cells Elicited by Two Doses of BNT162b2 mRNA Vaccine

Ciabattini

Pastore

Lucchesi

et al. 2023

Cells

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The mRNA vaccines for SARS-CoV-2 have demonstrated efficacy and immunogenicity in the real-world setting. However, most of the research on vaccine immunogenicity has been centered on characterizing the antibody response, with limited exploration into the persistence of spike-specific memory B cells. Here we monitored the durability of the memory B cell response up to 9 months post-vaccination, and characterized the trajectory of spike-specific B cell phenotypes in healthy individuals who received two doses of the BNT162b2 vaccine. To profile the spike-specific B cell response, we applied the tSNE and Cytotree automated approaches. Spike-specific IgA+ and IgG+ plasmablasts and IgA+ activated cells were observed 7 days after the second dose and disappeared 3 months later, while subsets of spike-specific IgG+ resting memory B cells became predominant 9 months after vaccination, and they were capable of differentiating into spike-specific IgG secreting cells when restimulated in vitro. Other subsets of spike-specific B cells, such as IgM+ or unswitched IgM+IgD+ or IgG+ double negative/atypical cells, were also elicited by the BNT162b2 vaccine and persisted up to month 9. The analysis of circulating spike-specific IgG, IgA, and IgM was in line with the plasmablasts observed. The longitudinal analysis of the antigen-specific B cell response elicited by mRNA-based vaccines provides valuable insights into our understanding of the immunogenicity of this novel vaccine platform destined for future widespread use, and it can help in guiding future decisions and vaccination schedules.

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Monitoring Anti-PEG Antibodies Level upon Repeated Lipid Nanoparticle-Based COVID-19 Vaccine Administration

Guerrini

Gioria

Sauer

et al. 2022

IJMS

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PEGylated lipids are one of the four constituents of lipid nanoparticle mRNA COVID-19 vaccines. Therefore, various concerns have been raised on the generation of anti-PEG antibodies and their potential role in inducing hypersensitivity reactions following vaccination or in reducing vaccine efficacy due to anti-carrier immunity. Here, we assess the prevalence of anti-PEG antibodies, in a cohort of vaccinated individuals, and give an overview of their time evolution after repeated vaccine administrations. Results indicate that, in our cohort, the presence of PEG in the formulation did not influence the level of anti-Spike antibodies generated upon vaccination and was not related to any reported, serious adverse effects. The time-course analysis of anti-PEG IgG showed no significant booster effect after each dose, whereas for IgM a significant increase in antibody levels was detected after the first and third dose. Data suggest that the presence of PEG in the formulation does not affect safety or efficacy of lipid-nanoparticle-based COVID-19 vaccines.

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The slower antibody response in myelofibrosis patients after two doses of mRNA SARS-CoV-2 vaccine calls for a third dose

Cited by 6 publications

References 18 publications

Breakthrough infection after SARS-CoV-2 vaccines in patients with hemoglobinopathies and blood-transfusion management: a single Center experience

Breakthrough infection after SARS-CoV-2 vaccines in patients with hemoglobinopathies and blood-transfusion management: a single Center experience

Trajectory of Spike-Specific B Cells Elicited by Two Doses of BNT162b2 mRNA Vaccine

Monitoring Anti-PEG Antibodies Level upon Repeated Lipid Nanoparticle-Based COVID-19 Vaccine Administration

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