SARS-CoV-2 Vaccine Responses in Individuals with Antibody Deficiency : Findings from the COV-AD Study
© 2022. The Author(s)..
BACKGROUND: Vaccination prevents severe morbidity and mortality from COVID-19 in the general population. The immunogenicity and efficacy of SARS-CoV-2 vaccines in patients with antibody deficiency is poorly understood.
OBJECTIVES: COVID-19 in patients with antibody deficiency (COV-AD) is a multi-site UK study that aims to determine the immune response to SARS-CoV-2 infection and vaccination in patients with primary or secondary antibody deficiency, a population that suffers from severe and recurrent infection and does not respond well to vaccination.
METHODS: Individuals on immunoglobulin replacement therapy or with an IgG less than 4 g/L receiving antibiotic prophylaxis were recruited from April 2021. Serological and cellular responses were determined using ELISA, live-virus neutralisation and interferon gamma release assays. SARS-CoV-2 infection and clearance were determined by PCR from serial nasopharyngeal swabs.
RESULTS: A total of 5.6% (n = 320) of the cohort reported prior SARS-CoV-2 infection, but only 0.3% remained PCR positive on study entry. Seropositivity, following two doses of SARS-CoV-2 vaccination, was 54.8% (n = 168) compared with 100% of healthy controls (n = 205). The magnitude of the antibody response and its neutralising capacity were both significantly reduced compared to controls. Participants vaccinated with the Pfizer/BioNTech vaccine were more likely to be seropositive (65.7% vs. 48.0%, p = 0.03) and have higher antibody levels compared with the AstraZeneca vaccine (IgGAM ratio 3.73 vs. 2.39, p = 0.0003). T cell responses post vaccination was demonstrable in 46.2% of participants and were associated with better antibody responses but there was no difference between the two vaccines. Eleven vaccine-breakthrough infections have occurred to date, 10 of them in recipients of the AstraZeneca vaccine.
CONCLUSION: SARS-CoV-2 vaccines demonstrate reduced immunogenicity in patients with antibody deficiency with evidence of vaccine breakthrough infection.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Journal of clinical immunology - 42(2022), 5 vom: 01. Juli, Seite 923-934 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Shields, Adrian M [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 26.08.2022 Date Revised 20.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10875-022-01231-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a SARS-CoV-2 Vaccine Responses in Individuals with Antibody Deficiency |b Findings from the COV-AD Study |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 26.08.2022 | ||
| 500 | |a Date Revised 20.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a BACKGROUND: Vaccination prevents severe morbidity and mortality from COVID-19 in the general population. The immunogenicity and efficacy of SARS-CoV-2 vaccines in patients with antibody deficiency is poorly understood | ||
| 520 | |a OBJECTIVES: COVID-19 in patients with antibody deficiency (COV-AD) is a multi-site UK study that aims to determine the immune response to SARS-CoV-2 infection and vaccination in patients with primary or secondary antibody deficiency, a population that suffers from severe and recurrent infection and does not respond well to vaccination | ||
| 520 | |a METHODS: Individuals on immunoglobulin replacement therapy or with an IgG less than 4 g/L receiving antibiotic prophylaxis were recruited from April 2021. Serological and cellular responses were determined using ELISA, live-virus neutralisation and interferon gamma release assays. SARS-CoV-2 infection and clearance were determined by PCR from serial nasopharyngeal swabs | ||
| 520 | |a RESULTS: A total of 5.6% (n = 320) of the cohort reported prior SARS-CoV-2 infection, but only 0.3% remained PCR positive on study entry. Seropositivity, following two doses of SARS-CoV-2 vaccination, was 54.8% (n = 168) compared with 100% of healthy controls (n = 205). The magnitude of the antibody response and its neutralising capacity were both significantly reduced compared to controls. Participants vaccinated with the Pfizer/BioNTech vaccine were more likely to be seropositive (65.7% vs. 48.0%, p = 0.03) and have higher antibody levels compared with the AstraZeneca vaccine (IgGAM ratio 3.73 vs. 2.39, p = 0.0003). T cell responses post vaccination was demonstrable in 46.2% of participants and were associated with better antibody responses but there was no difference between the two vaccines. Eleven vaccine-breakthrough infections have occurred to date, 10 of them in recipients of the AstraZeneca vaccine | ||
| 520 | |a CONCLUSION: SARS-CoV-2 vaccines demonstrate reduced immunogenicity in patients with antibody deficiency with evidence of vaccine breakthrough infection | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a CVID | |
| 650 | 4 | |a Inborn errors of immunity | |
| 650 | 4 | |a Primary immunodeficiency | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a Secondary immunodeficiency | |
| 650 | 4 | |a Vaccination | |
| 650 | 7 | |a Antibodies, Viral |2 NLM | |
| 650 | 7 | |a COVID-19 Vaccines |2 NLM | |
| 650 | 7 | |a Viral Vaccines |2 NLM | |
| 700 | 1 | |a Faustini, Sian E |e verfasserin |4 aut | |
| 700 | 1 | |a Hill, Harriet J |e verfasserin |4 aut | |
| 700 | 1 | |a Al-Taei, Saly |e verfasserin |4 aut | |
| 700 | 1 | |a Tanner, Chloe |e verfasserin |4 aut | |
| 700 | 1 | |a Ashford, Fiona |e verfasserin |4 aut | |
| 700 | 1 | |a Workman, Sarita |e verfasserin |4 aut | |
| 700 | 1 | |a Moreira, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Verma, Nisha |e verfasserin |4 aut | |
| 700 | 1 | |a Wagg, Hollie |e verfasserin |4 aut | |
| 700 | 1 | |a Heritage, Gail |e verfasserin |4 aut | |
| 700 | 1 | |a Campton, Naomi |e verfasserin |4 aut | |
| 700 | 1 | |a Stamataki, Zania |e verfasserin |4 aut | |
| 700 | 1 | |a Klenerman, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Thaventhiran, James E D |e verfasserin |4 aut | |
| 700 | 1 | |a Goddard, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Johnston, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Huissoon, Aarnoud |e verfasserin |4 aut | |
| 700 | 1 | |a Bethune, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Elcombe, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a Lowe, David M |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Smita Y |e verfasserin |4 aut | |
| 700 | 1 | |a Savic, Sinisa |e verfasserin |4 aut | |
| 700 | 1 | |a Burns, Siobhan O |e verfasserin |4 aut | |
| 700 | 1 | |a Richter, Alex G |e verfasserin |4 aut | |
| 700 | 0 | |a COV-AD consortium |e verfasserin |4 aut | |
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| 700 | 1 | |a Bancroft, Hollie |e investigator |4 oth | |
| 700 | 1 | |a Bates, Michelle |e investigator |4 oth | |
| 700 | 1 | |a Clifford, Hayley |e investigator |4 oth | |
| 700 | 1 | |a Davis, Georgina |e investigator |4 oth | |
| 700 | 1 | |a Dasgin, Joanne |e investigator |4 oth | |
| 700 | 1 | |a Dinally, Mohammad |e investigator |4 oth | |
| 700 | 1 | |a Dhalla, Fatima |e investigator |4 oth | |
| 700 | 1 | |a Efstathiou, Elena |e investigator |4 oth | |
| 700 | 1 | |a Elkhalifa, Shuayb |e investigator |4 oth | |
| 700 | 1 | |a Gompels, Mark |e investigator |4 oth | |
| 700 | 1 | |a Hartland, Dan |e investigator |4 oth | |
| 700 | 1 | |a Hoque, Madeeha |e investigator |4 oth | |
| 700 | 1 | |a Heritage, Emily |e investigator |4 oth | |
| 700 | 1 | |a Hughes, Deborah |e investigator |4 oth | |
| 700 | 1 | |a Ivory, Ann |e investigator |4 oth | |
| 700 | 1 | |a Jain, Rashmi |e investigator |4 oth | |
| 700 | 1 | |a Kelly, Sinead |e investigator |4 oth | |
| 700 | 1 | |a McCarthy, Theresa |e investigator |4 oth | |
| 700 | 1 | |a McGee, Christopher |e investigator |4 oth | |
| 700 | 1 | |a Mullan, Daniel |e investigator |4 oth | |
| 700 | 1 | |a Morsi, Hadeil |e investigator |4 oth | |
| 700 | 1 | |a O'Grady, Eileen |e investigator |4 oth | |
| 700 | 1 | |a Page, Shannon |e investigator |4 oth | |
| 700 | 1 | |a Peters, Nicholas |e investigator |4 oth | |
| 700 | 1 | |a Plant, Timothy |e investigator |4 oth | |
| 700 | 1 | |a Shajidevadas, Archana |e investigator |4 oth | |
| 700 | 1 | |a Slowinsksa, Malgorzata |e investigator |4 oth | |
| 700 | 1 | |a Suleiman, Zehra |e investigator |4 oth | |
| 700 | 1 | |a Townsend, Neil |e investigator |4 oth | |
| 700 | 1 | |a Trinham, Charlotte |e investigator |4 oth | |
| 700 | 1 | |a Wareham, Stuart |e investigator |4 oth | |
| 700 | 1 | |a Walder, Sinead |e investigator |4 oth | |
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